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...

Danish energy-sector exports. Products and consulting services

International Nuclear Information System (INIS)

Wolter, H.C.

2000-06-01

Danish Energy Agency has previously carried out studies of Danish energy-sector exports. The latest results were published in the report, Energisektorens eksport. Produkter og raadgivning. Danish Energy Agency, September 1998. The present survey is an update of the earlier studies, and includes 1998 exports. As previously, the study, carried out in cooperation with the Confederation of Danish Industries and the Danish Council of Consulting Architects and Engineers, is based on questionnaires sent to relevant companies. In addition, information has been obtained from companies that do not belong to these organisations. On the basis of the answers received, 58 Danish companies exported products to a value of approximately DKK 16,000 million, and 22 consulting firms exported consulting services to a value of approximately DKK 370 million. These exports of approximately DKK 16.5 billion accounted for 5% of all Danish exports in 1998. In comparison with 1996, energy-sector exports have risen by more than 40% in a period in which Danish exports in general have risen by an average of 8%. Energy sector exports provide employment for more than 18,000 persons in Denmark - approximately 17,500 employees in companies that export products, and approximately 600 persons in consulting firms. To this must be added a presumably significantly larger number of persons employed by sub-suppliers to the above companies computed by value, 80% of the exports come from relatively few companies, i.e. 13 companies with products, and five offering consulting services. Energy-sector exports fall within the following product areas: 1) Wind turbines (25%). 2) District heating and combined heat and power (CHP) (21%). 3) Energy savings and control (20%). 4) Oil and natural gas (13%). 5) Electricity plants and power supply (13%). 6) Other (8%). 67% of the exports go to Western Europe, 18% to Asia, 7% to Eastern and Central Europe, and 8% to other parts of the world. (EHS)

Services of strategic consulting: special features and types

OpenAIRE

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...

Implementing Systems Engineering in the Civil Engineering Consulting Firm: An Evaluation

NARCIS (Netherlands)

de Graaf, Robin S.; Voordijk, Johannes T.; van den Heuvel, Len

2016-01-01

This study explores the challenges that civil engineering consulting firms face in their projects when they apply Systems Engineering (SE). It is also explained were these firms should focus when improving the use of SE. To conduct this study, the methodology of Eisenhardt (Building theories from

Sustainability of a Primary Care-Driven eConsult Service.

Science.gov (United States)

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.

Communication strategies for a successful inpatient dermatology consultative service: a narrative review.

Science.gov (United States)

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.

"Systematizing" ethics consultation services.

Science.gov (United States)

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.

Improving access to urologists through an electronic consultation service

Science.gov (United States)

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

The Impact of Ict on Business Models for Delivery Of ConsultancyServices - The Case Of Technical Engineering

DEFF Research Database (Denmark)

Falch, Morten; Nicolajsen, Hanne Westh

2009-01-01

section in a Scandinavian engineering consultancy firm as its point of departure. The discussion identifies three different structural aspects, which all are affected by the use of ICT: Internationalisation vs. Local markets, Outsourcing vs. Structural integration, and Division of work between actors...

Radiology consultation in the era of precision oncology: A review of consultation models and services in the tertiary setting

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.

Radiology Consultation in the Era of Precision Oncology: A Review of Consultation Models and Services in the Tertiary Setting.

Science.gov (United States)

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.

Initiation of a medical toxicology consult service at a tertiary care children's hospital.

Science.gov (United States)

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.

Client/consultant model services agreement

CERN Document Server

International Federation of Consulting Engineers

2006-01-01

The terms of the Client Consultant Model Services agreement (The White Book) have been prepared by the Fédération Internationale des Ingénieurs-Conseils (FIDIC) and are recommended for general use for the purposes of pre-investment and feasibility studies, designs and administration of construction and project management, where proposals for such services are invited on an international basis. They are equally adaptable for domestic agreements. - See more at: http://fidic.org/books/clientconsultant-model-services-agreement-4th-ed-2006-white-book#sthash.3Uxy5qT3.dpuf

Integrating ergonomics knowledge into business-driven design projects: The shaping of resource constraints in engineering consultancy.

Science.gov (United States)

Hall-Andersen, Lene Bjerg; Neumann, Patrick; Broberg, Ole

2016-10-17

The integration of ergonomics knowledge into engineering projects leads to both healthier and more efficient workplaces. There is a lack of knowledge about integrating ergonomic knowledge into the design practice in engineering consultancies. This study explores how organizational resources can pose constraints for the integration of ergonomics knowledge into engineering design projects in a business-driven setting, and how ergonomists cope with these resource constraints. An exploratory case study in an engineering consultancy was conducted. A total of 27 participants were interviewed. Data were collected applying semi-structured interviews, observations, and documentary studies. Interviews were transcribed, coded, and categorized into themes. From the analysis five overall themes emerged as major constituents of resource constraints: 1) maximizing project revenue, 2) payment for ergonomics services, 3) value of ergonomic services, 4) role of the client, and 5) coping strategies to overcome resource constraints. We hypothesize that resource constraints were shaped due to sub-optimization of costs in design projects. The economical contribution of ergonomics measures was not evaluated in the entire life cycle of a designed workplace. Coping strategies included teaming up with engineering designers in the sales process or creating an alliance with ergonomists in the client organization.

Consultancy services and the urban hierarchy in Western Europe

OpenAIRE

P W Daniels; J H J Van Dinteren; M C Monnayer

1992-01-01

A cross-national survey of the relationship between the evolving organisation and structure of consultancy service enterprises and the urban hierarchy in Europe has been undertaken. Primate cities in Europe are still the preeminent foci for business services performing strong national and international control. The relationship between markets for consultancy services and the urban hierarchy is complex, but it is possible to suggest a typology of firms on the basis of client characteristics a...

Determinants of customer satisfaction with professional services: A study of consultants services

DEFF Research Database (Denmark)

Sonne, Anne-Mette

1999-01-01

Although models of service quality and customer satisfaction have been well researched within the consumer goods and services area, much less attention has been paid to high involvement business-to-business service satisfaction. The objective of this study is to contribute to this stream...... of research through a survey of customers of the Norwegian Institute of Fisheries and Aquaculture. Information on which factors are the determinants of customer satisfaction is important to consultants since customer satisfaction is what the service business depends on for repeat business. In this study we...... found that customer satisfaction is mostly influenced by the perceived competence of the consultant and the technical reliability demonstrated in the project. However, the perceived service quality is also influenced by the way the customer is treated during the service production process....

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...

Optimizing education on the inpatient dermatology consultative service.

Science.gov (United States)

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.

Consultancy and innovation the business service revolution in Europe

CERN Document Server

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.

A Home-Based Palliative Care Consult Service for Veterans.

Science.gov (United States)

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.

The negotiation of writer identity in engineering faculty - writing consultant collaborations

Directory of Open Access Journals (Sweden)

Sarah Read

2011-12-01

Full Text Available Negotiating faculty-writing consultant collaborations in engineering contexts can be challenging when the writing consultant originates in the humanities. The author found that one of the sites of negotiation in the formation of working relationships is that of writer identity, and disciplinary writer identity in particular. In order to confirm her experiential knowledge, the author interviewed her faculty collaborators to further investigate their attitudes and experiences about writing. Analysis of two excerpts of these interviews makes visible "clashes" between the faculty engineers' and the writing consultant's autobiographical and disciplinary writer identities. Implications of the role of writer identity in faculty-writing consultant collaborations include considering the value of extending this negotiation explicitly to students and the question of how writing curriculum can explicitly engage students in the formation of positive disciplinary writer identities

Consultation performance of general practitioners when supported by an asthma/COPDC-service

Directory of Open Access Journals (Sweden)

Annelies Lucas EM

2012-07-01

Full Text Available Abstract Background General practitioners (GPs can refer patients to an asthma/COPD service (AC-service for diagnostic assessment of spirometry and medical history and for asthma or COPD monitoring. The AC-service reports diagnostic results and additional information about disease burden (BORG-score for complaints, MRC-dyspnoea score, exacerbation rate, life style, medication and compliance, to the patient’s GP. This study explores how GPs use this additional information when discussing the patient’s disease burden and how this influences GPs’ information and education provision during consultations with asthma/COPD patients. Method Patients with (a suspicion of asthma or COPD were referred to an AC-service and consulted their GPs after they had received a report from the AC-service. Retrospectively patients answered questions about their GPs’ performance during these consultations. Performances were compared with performances of the same GPs during consultations without support of the AC-service (usual care, earlier that year. Results Of consultations not initiated by an AC-service check-up, 91% focussed on complaints, the initial reason for the consultation. In AC-service supported follow-up consultations, GPs explored disease burden when the (BORG-score for complaints was high - as reported by the AC-service - even when patients themselves thought it was irrelevant. GPs put significantly less effort in exploring disease burden when the Borg-score was low (BORG 3–4: 69%; BORG1-2: 51%, p = 0,01. GPs mostly ignored MRC-dyspnoea scores: attention to dyspnoea was 18% for MRC-score p = 0,63. GPs encouraged physical fitness in 13% of patients. Smoking behaviour was discussed with 66% of the actual smokers but only 14% remembered a stop smoking advice. Furthermore, pharmacotherapeutic management education in AC-service supported consultations did not differ from performance in usual care according to patient evaluations. Conclusion

76 FR 30396 - Deloitte Financial Advisory Services LLP, Real Estate Consulting, Houston, TX; Amended...

Science.gov (United States)

2011-05-25

... Advisory Services LLP, Real Estate Consulting, Houston, TX; Amended Certification Regarding Eligibility To... Financial Advisory Services LLP, Real Estate Consulting, Houston, Texas (subject firm). The Department's... Services LLP, Real Estate Consulting, Houston, Texas who were adversely affected by a shift in services to...

Development and Evaluation of a Novel Survey Tool Assessing Inpatient Consult Service Performance.

Science.gov (United States)

Miloslavsky, Eli M; Chang, Yuchiao

2017-12-01

Subspecialty consultation in inpatient medicine is increasing, and enhancing performance of consultation services may have a broad-reaching impact. Multisource feedback is an important tool in assessing competence and improving performance. A mechanism for primary team resident feedback on performance of consult services has not been described. We developed and evaluated an instrument designed to assess internal medicine (IM) subspecialty inpatient consult service performance. We hypothesized that the instrument would be feasible to administer and provide important information to fellowship directors. The instrument was administered in 2015 and 2016 at a single academic center. All IM residents were invited to evaluate 10 IM subspecialty consult services on 4 items and an overall satisfaction rating. The instrument allowed for free-text feedback to fellows. Program directors completed another survey assessing the impact of the consult service evaluation. A total of 113 residents responded (47 in 2015 and 66 in 2016, for a combined response rate of 35%). Each of the 4 items measured (communication, professionalism, teaching, and pushback) correlated significantly with the overall satisfaction rating in univariate and multivariate analyses. There were no differences in ratings across postgraduate year or year of administration. There was considerable variation in ratings among the services evaluated. The 7 program directors who provided feedback found the survey useful and made programmatic changes following evaluation implementation. A primary team resident evaluation of inpatient medicine subspecialty consult services is feasible, provides valuable information, and is associated with changes in consult service structure and curricula.

Why and When do Patients Use e-Consultation Services? The Trust and Resource Supplementary Perspectives.

Science.gov (United States)

Li, Jia; Liu, Minghui; Liu, Xuan; Ma, Ling

2018-01-01

e-Consultation provides a new way to deliver healthcare services online. With the help of e-Consultation services, patients can gain access to nationwide medical expertise that otherwise would not be available to them. As an online delivery approach, e-Consultation also provides a choice for patients to receive medical advice from online doctors immediately, no matter how far away from the hospital they may be or how late in the day it is. However, the adoption and usage of e-Consultation is still far from satisfactory. Therefore, understanding why and when patients use e-Consultation services are important research questions. Considering that the choice of a healthcare provider is a serious decision, this research uses the trust perspective to explain the e-Consultation service adoption phenomenon. Specifically, trust is conceptualized as a second-order construct consisting of two dimensions: competence and integrity. In addition, e-Consultation is viewed as a supplementary resource to traditional off-line consultation services, and disease type as a contextual factor is hypothesized to focus the context where e-Consultation services are more suitable. A scenario-based survey was conducted to test the proposed research model. We obtained a total of 190 valid questionnaires. Our results indicated that trust (p e-Consultation service. Meanwhile, our results also indicated that the higher the disease is in rarity (p e-Consultation service. Trust is the major driving force of an e-Consultation service adoption. When the disease is high in rarity, severity, or urgency, an off-line healthcare provider is less capable of providing meaningful, qualified, and immediate service. Therefore, there is a decreased positive effect of trust on the intention to use an e-Consultation service for those diseases.

CERN's IT Consultancy Team: a new IT project support service

CERN Multimedia

Ignacio Reguero, IT Department

2016-01-01

Newly created IT Consultancy Team provides advice on IT matters to communities at CERN starting new projects or reviewing computing activities of old.   The members of CERN's IT Consultancy Team. The consultants share their knowledge and experience to improve awareness of the IT landscape at CERN and to advise on system architecture and design to ensure best usage of existing IT services and solutions that favour, and are compatible with, the infrastructure already in place. They also help to formalise requirements and assess impact on security, software licenses and cost, especially where contacts among different services are needed and questions go beyond the current computing service offerings. For instance, the IT consultants may help answering questions like the ones below: We are starting with project X – how could we make its computing aspects compatible with the CERN IT infrastructure? E.g. if you need a web content management system favour Drupal instead of Wor...

Telehone consultations: At the emergency service, Copenhagen County: Analysis of doctor-patient communication patterns

DEFF Research Database (Denmark)

Larsen, Jan-Helge; Risør, Ole

1997-01-01

Communications patterns, emergency service, out-of-hours service, telehpone consultations, video-supervision......Communications patterns, emergency service, out-of-hours service, telehpone consultations, video-supervision...

Preferred supplier programs for consulting services: An exploratory study of German client companies

NARCIS (Netherlands)

Sieweke, J.; Birkner, Stephanie; Mohe, Michael

2012-01-01

Research has recently provided evidence that at least some companies have involved purchasing departments in buying professional services such as management consulting services. Some departments have established preferred supplier programs (PSPs) for consulting services, i.e., programs for

A Pharmaceutical Bioethics Consultation Service: Six-Year Descriptive Characteristics and Results of a Feedback Survey.

Science.gov (United States)

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

Hospitalist Perspective of Interactions with Medicine Subspecialty Consult Services.

Science.gov (United States)

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.

Extent and types of management consulting services to SMEs in Vojvodina

Directory of Open Access Journals (Sweden)

Dragan Dukić

2013-11-01

Full Text Available Growth and development of small and medium enterprises depends on many external and internal factors, as well as the volume, type and quality of support available to them. This paper highlights the importance of management knowledge and skills in small business, and the importance of management consulting in their acquisition and development. We have researched and analyzed the extent to management consulting (MC services, separately in the micro, small and medium enterprises. In addition, we learn which types of MC services are most commonly used by companies of different sizes. In that way, we provided qualitative and quantitative data for each group of enterprises, both in the type and volume of services used. It is observed that micro-enterprises use a small amount  MC services, and those of more general type. With the growth of the enterprises, comes an increase in scope, and sophistication of services used. The results may be useful both for small and medium enterprises, as well as for institutional and private providers of management consulting services.

Development and Implementation of an Inpatient Otolaryngology Consultation Service at an Academic Medical Center.

Science.gov (United States)

Huddle, Matthew G; London, Nyall R; Stewart, C Matthew

2018-02-01

To design and implement a formal otolaryngology inpatient consultation service that improves satisfaction of consulting services, increases educational opportunities, improves the quality of patient care, and ensures sustainability after implementation. This was a retrospective cohort study in a large academic medical center encompassing all inpatient otolaryngology service consultations from July 2005 to June 2014. Staged interventions included adding fellow coverage (July 2007 onward), intermittent hospitalist coverage (July 2010 onward), and a physician assistant (October 2011 onward). Billing data were collected for incidences of new patient and subsequent consultation charges. The 2-year preimplementation period (July 2005-June 2007) was compared with the postimplementation periods, divided into 2-year blocks (July 2007-June 2013). Outcome measures of patient encounters and work relative value units were compared between pre- and postimplementation blocks. Total encounters increased from 321 preimplementation to 1211, 1347, and 1073 in postimplementation groups ( P < 0.001). Total work relative value units increased from 515 preimplementation to 2090, 1934, and 1273 in postimplementation groups ( P < 0.001). A formal inpatient consultation service was designed with supervisory oversight by non-Accreditation Council for Graduate Medical Education fellows and then expanded to include intermittent hospitalist management, followed by the addition of a dedicated physician assistant. These additions have led to the formation of a sustainable consultation service that supports the mission of high-quality care and service to consulting teams.

Implementation of a nationwide health economic consultation service to assist substance use researchers: Lessons learned.

Science.gov (United States)

Murphy, Sean M; Leff, Jared A; Linas, Benjamin P; Morgan, Jake R; McCollister, Kathryn; Schackman, Bruce R

2018-03-20

Health economic evaluation findings assist stakeholders in improving the quality, availability, scalability, and sustainability of evidence-based services, and in maximizing the efficiency of service delivery. The Center for Health Economics of Treatment Interventions for Substance Use Disorders, HCV, and HIV (CHERISH) is a NIDA-funded multi-institutional center of excellence whose mission is to develop and disseminate health-economic research on healthcare utilization, health outcomes, and health-related behaviors that informs substance use disorder treatment policy, and HCV and HIV care of people who use substances. We designed a consultation service that is free to researchers whose work aligns with CHERISH's mission. The service includes up to six hours of consulting time. After prospective consultees submit their request online, they receive a screening call from the consultation service director, who connects them with a consultant with relevant expertise. Consultees and consultants complete web-based evaluations following the consultation; consultees also complete a six-month follow-up. We report on the status of the service from its inception in July 2015 through June 2017. We have received 28 consultation requests (54% Early Stage Investigators, 57% MD or equivalent, 28% PhD, 61% women) on projects typically related to planning a study or grant application (93%); 71% were HIV/AIDS-related. Leading topics included cost-effectiveness (43%), statistical-analysis/econometrics (36%), cost (32%), cost-benefit (21%), and quality-of-life (18%). All consultees were satisfied with their overall experience, and felt that consultation expectations and objectives were clearly defined and the consultant's expertise was matched appropriately with their needs. Results were similar for consultants, who spent a median of 3 hours on consultations. There is a need for health-economic methodological guidance among substance use, HCV, and HIV researchers. Lessons learned

Borda application of selection planning scheduling method in dock engineering consultants in Central Sulawesi province Indonesia

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Siti Fatimah

2015-04-01

Full Text Available The aim of this paper to find out the planning scheduling method that used in dock engineering consultants as a project supervisor dock. This research use qualitative approach to find the most preferred method by engineering consultants, this research was explorative that test and find out the most preferred method. This research showed that dock engineering consultants in Palu City, Central Sulawesi most preferred curve-s method than method such as CPM, PERT, PDM, and Bar Chart. This research can help further research to determine differences and similarities the project planning scheduling method and being basic for The New Dock Engineering Consultans. This research looking for the most preferred method with limited respondents dock engineering consultans in Palu City, Central Sulawesi.

Consultation with specialist palliative care services in palliative sedation: considerations of Dutch physicians.

Science.gov (United States)

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.

Development and Preliminary Application of Multi-channel Agricultural Science and Technology Consulting Service U Disk

Science.gov (United States)

Yu, W. S.; Luo, C. S.; Wei, Q. F.; Zheng, Y. M.; Cao, C. Z.

2017-12-01

To deal with the “last kilometer” problem during the agricultural science and technology information service, the USB flash disk “Zixuntong”, which integrated five major consulting channels, i.e., telephone consultation, mutual video, message consultation, online customer service and QQ group was developed on the bases of capital experts and date resources. Since the products have the computer and telephone USB interface and are combined with localized information resources, users can obtain useful information on any terminal without the restriction of network. Meanwhile, the cartoon appearance make it friendly and attractive to people. The USB flash disk was used to provide agricultural expert consulting services and obtained a good preliminary application achievement. Finally, we concluded the creative application of USB flash disk in agricultural consulting services and prospected the future development direction of agricultural mobile consultation.

Industrial Buying Behavior Related to Human Resource Consulting Services

DEFF Research Database (Denmark)

Hollensen, Svend; Grünbaum, Niels Nolsøe; Andresen, Marc

2013-01-01

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 ...

Harvard Catalyst | The Clinical Translational Science Center IND/IDE Consult Service: providing an IND/IDE consult service in a decentralized network of academic healthcare centers.

Science.gov (United States)

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.

Harvard Catalyst | The Clinical Translational Science Center IND/IDE Consult Service: Providing an IND/IDE Consult Service in a Decentralized Network of Academic Healthcare Centers

Science.gov (United States)

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

Attracting Child Psychiatrists to a Televideo Consultation Service: The TeleLink Experience.

Science.gov (United States)

Volpe, Tiziana; Boydell, Katherine M; Pignatiello, Antonio

2013-01-01

Objective. Identify aspects of psychiatry work that are rewarding, as well as those that are challenging, from the perspective of psychiatrists and residents participating in televideo consultation services. Method. A web-based survey was distributed to psychiatrists within the Division of Child Psychiatry at the University of Toronto. Also, semistructured interviews were conducted with six child psychiatrists providing services to a telepsychiatry program. Finally, a focus group interview was held with four psychiatry residents. Results. Child psychiatrists are very comfortable conducting assessments via televideo. Factors identified as being important in the decision to participate in telepsychiatry include assisting underserved communities, supportive administrative staff, enhanced rural provider capacity, financial incentives, and convenience. The study's qualitative phase identified four themes in the decision to participate in telepsychiatry: (1) organizational, (2) shared values, (3) innovation, and (4) the consultation model. Conclusion. The success of televideo consultation programs in attracting child psychiatrists to provide consultation services to underresourced communities makes an important contribution to psychiatric workforce shortages. Understanding what aspects of telepsychiatry are most appreciated by consulting psychiatrists and residents offers useful strategies to telepsychiatry administrators and medical school educators seeking to attract, train, and retain psychiatry practitioners.

Attracting Child Psychiatrists to a Televideo Consultation Service: The TeleLink Experience

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Tiziana Volpe

2013-01-01

Full Text Available Objective. Identify aspects of psychiatry work that are rewarding, as well as those that are challenging, from the perspective of psychiatrists and residents participating in televideo consultation services. Method. A web-based survey was distributed to psychiatrists within the Division of Child Psychiatry at the University of Toronto. Also, semistructured interviews were conducted with six child psychiatrists providing services to a telepsychiatry program. Finally, a focus group interview was held with four psychiatry residents. Results. Child psychiatrists are very comfortable conducting assessments via televideo. Factors identified as being important in the decision to participate in telepsychiatry include assisting underserved communities, supportive administrative staff, enhanced rural provider capacity, financial incentives, and convenience. The study’s qualitative phase identified four themes in the decision to participate in telepsychiatry: (1 organizational, (2 shared values, (3 innovation, and (4 the consultation model. Conclusion. The success of televideo consultation programs in attracting child psychiatrists to provide consultation services to underresourced communities makes an important contribution to psychiatric workforce shortages. Understanding what aspects of telepsychiatry are most appreciated by consulting psychiatrists and residents offers useful strategies to telepsychiatry administrators and medical school educators seeking to attract, train, and retain psychiatry practitioners.

Service Modeling for Service Engineering

Science.gov (United States)

Shimomura, Yoshiki; Tomiyama, Tetsuo

Intensification of service and knowledge contents within product life cycles is considered crucial for dematerialization, in particular, to design optimal product-service systems from the viewpoint of environmentally conscious design and manufacturing in advanced post industrial societies. In addition to the environmental limitations, we are facing social limitations which include limitations of markets to accept increasing numbers of mass-produced artifacts and such environmental and social limitations are restraining economic growth. To attack and remove these problems, we need to reconsider the current mass production paradigm and to make products have more added values largely from knowledge and service contents to compensate volume reduction under the concept of dematerialization. Namely, dematerialization of products needs to enrich service contents. However, service was mainly discussed within marketing and has been mostly neglected within traditional engineering. Therefore, we need new engineering methods to look at services, rather than just functions, called "Service Engineering." To establish service engineering, this paper proposes a modeling technique of service.

The association between question type and the outcomes of a Dermatology eConsult service.

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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.

Clinical and demographic profile of cancer patients in a consultation-liaison psychiatric service

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Vanessa de Albuquerque Citero

Full Text Available ABSTRACT CONTEXT: An almost 50% prevalence of psychiatric disorders among cancer patients has prompted a series of studies on consultation-liaison psychiatry. Nonetheless, there are few reports on the epidemiological factors involving comorbidity between cancer and psychiatric disorders. OBJECTIVE: To evaluate the epidemiological profile of cancer inpatients referred to the consultation-liaison psychiatric service in an oncology hospital during its first year of activity. TYPE OF STUDY: Descriptive study. SETTING: Tertiary-care teaching hospital. PARTICIPANTS: 319 patients referred 412 times to the consultation-liaison psychiatry service. PROCEDURES: From August 97 to July 98, an appraisal was made of data on all admissions registered at the Hospital do Câncer, and also all referrals registered at the consultation-liaison psychiatry service. MAIN MEASUREMENTS: The demographics and patients' clinical data, the type and flow of the request, and the evaluation conducted by the service were analyzed and comparisons with the hospital data were made. The distribution of the number of referrals was used to construct a profile of patients who had repeatedly used the service. RESULTS: Psychiatric diagnoses were found in 59% of the cases. Forty-three percent of these required medication, 18.3% needed psychotherapy, 22.1% family intervention and 20.5% guidance from the staff. Over 22.8% of the consultations were reevaluations, mainly involving younger male patients with worst prognoses. These patients required lengthier and more elaborate intervention, and had higher prevalence of depressive and behavioral disorders. CONCLUSION: A younger and mainly male population of non-surgical oncological cases was referred to the consultation-liaison psychiatric service during its first year of activity. The psychiatric disorder prevalence was higher than expected, and consisted predominantly of mood disorders. We detected a priority group, namely the reevaluated

Revenue Potential for Inpatient IR Consultation Services: A Financial Model.

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Misono, Alexander S; Mueller, Peter R; Hirsch, Joshua A; Sheridan, Robert M; Siddiqi, Assad U; Liu, Raymond W

2016-05-01

Interventional radiology (IR) has historically failed to fully capture the value of evaluation and management services in the inpatient setting. Understanding financial benefits of a formally incorporated billing discipline may yield meaningful insights for interventional practices. A revenue modeling tool was created deploying standard financial modeling techniques, including sensitivity and scenario analyses. Sensitivity analysis calculates revenue fluctuation related to dynamic adjustment of discrete variables. In scenario analysis, possible future scenarios as well as revenue potential of different-size clinical practices are modeled. Assuming a hypothetical inpatient IR consultation service with a daily patient census of 35 patients and two new consults per day, the model estimates annual charges of $2.3 million and collected revenue of $390,000. Revenues are most sensitive to provider billing documentation rates and patient volume. A range of realistic scenarios-from cautious to optimistic-results in a range of annual charges of $1.8 million to $2.7 million and a collected revenue range of $241,000 to $601,000. Even a small practice with a daily patient census of 5 and 0.20 new consults per day may expect annual charges of $320,000 and collected revenue of $55,000. A financial revenue modeling tool is a powerful adjunct in understanding economics of an inpatient IR consultation service. Sensitivity and scenario analyses demonstrate a wide range of revenue potential and uncover levers for financial optimization. Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.

FEATURES OF MARKETING POLICY OF THE COMPANIES IN THE MARKET OF CONSULTING SERVICES

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Timur A. Tultaev

2013-01-01

Full Text Available Dynamic development of the market of consulting services against progressing competitive fight promoted strengthening of a role of marketing in the activity of the consultant companies. The given article is devoted to the analysis of marketing policy and features of its application in consulting business.

Price elasticity of demand for psychiatric consultation in a Nigerian psychiatric service.

Science.gov (United States)

Esan, Oluyomi

2016-12-01

This paper addresses price elasticity of demand (PED) in a region where most patients make payments for consultations out of pocket. PED is a measure of the responsiveness of the quantity demanded of goods or services to changes in price. The study was done in the context of an outpatient psychiatric clinic in a sub -Saharan African country. The study was performed at the University College Hospital (UCH), Ibadan, Nigeria. Aggregate data were collected on weekly clinic attendance over a 24-month period October 2008 - September 2010 representing 12 months before, to 12months after a 67% increase in price of outpatient psychiatric consultation. The average weekly clinic attendance prior to the increase was compared to the average clinic attendance after the price increase. Arc-PED for consultation was also estimated. Clinic attendance dropped immediately and significantly in the weeks following the price increase. There was a 34.4% reduction in average weekly clinic attendance. Arc-PED for psychiatric consultation was -0.85. In comparison to reported PED on health care goods and services, this study finds a relatively high PED in psychiatric consultation following an increase in price of user fees of psychiatric consultation.

Investigating the Effect of New Communication and Information Technologies on Organizational Structure and Firm Performance in Service Industry: a Survey of Consultant Engineering Firms

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ali akbar Farghangi

2013-10-01

Full Text Available This study aims to investigate the current and desired situation of information and communication technologies (ICT, organizational structure and firm performance in Consultant Engineering Firms. To do so, a descriptive-exploratory study was performed among 252 managers and experts of consultant engineering firms in Tehran. A cluster sampling approach was used bya self-administrated questionnaire. Reliability was confirmed by Cronbach’s coefficient. Using one sample t-test, paired sample t-test and regression analysis, results indicated that 1 current and desired situation of ICT, organizational structure and firm performance are acceptable, 2 there is significant difference between current and desired situation of ICT, organizational structure and firm performance, 3 ICT has a positive and significant effect on organizational structure and firm performance

Knowledge Service Engineering Handbook

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Kantola, Jussi

2012-01-01

Covering the emerging field of knowledge service engineering, this groundbreaking handbook outlines how to acquire and utilize knowledge in the 21st century. Drawn on the expertise of the founding faculty member of the world's first university knowledge engineering service department, this book describes what knowledge services engineering means and how it is different from service engineering and service production. Presenting multiple cultural aspects including US, Finnish, and Korean, this handbook provides engineering, systemic, industry, and consumer use viewpoints to knowledge service sy

"When are you seeing my patient?"--an analysis of the cardiology consultation service in a teaching hospital.

LENUS (Irish Health Repository)

Cronin, E

2010-05-01

The provision of an efficient consultation service is essential to the efficient functioning of any hospital. Surprisingly little is known about this activity. We present the first reported evaluation of a cardiology consultation service in an attempt to determine the characteristics, efficiency and workload implications of such a service. We performed an audit of the in-patient cardiology consultation service over a four week period. During this period, 125 consultations were seen, of which 85 (68%) were requested by medical specialties. Consultations were seen in a timely fashion, with 76 (61%) being seen on the same day that the request was received. The most common problem was chest pain, (49 patients; 38%) which was felt to be of cardiac origin in only a minority (20; 40%) of cases. Consultations had significant resource implications for our department, with 35 (28%) procedures being performed, 25 (20%) patients\\' care being taken over, and a further 27 (21.6%) new out-patient referrals generated. Our results indicate that the consultation service considered was efficiently delivered but contributed significantly to the department\\'s workload. The most frequent consultation request was for chest pain that was often non-cardiac in nature.

A Consultation Phone Service for Patients With Total Joint Arthroplasty May Reduce Unnecessary Emergency Department Visits.

Science.gov (United States)

Hällfors, Eerik; Saku, Sami A; Mäkinen, Tatu J; Madanat, Rami

2018-03-01

Different measures for reducing costs after total joint arthroplasty (TJA) have gained attention lately. At our institution, a free-of-charge consultation phone service was initiated that targeted patients with TJA. This service aimed at reducing unnecessary emergency department (ED) visits and, thus, potentially improving the cost-effectiveness of TJAs. To our knowledge, a similar consultation service had not been described previously. We aimed at examining the rates and reasons for early postdischarge phone calls and evaluating the efficacy of this consultation service. During a 2-month period, we gathered information on every call received by the consultation phone service from patients with TJAs within 90 days of the index TJA procedure. Patients were followed for 2 weeks after making a call to detect major complications and self-initiated ED visits. Data were collected from electronic medical charts regarding age, gender, type of surgery, date of discharge, and length of hospital stay. We analyzed 288 phone calls. Calls were mostly related to medication (41%), wound complications (17%), and mobilization issues (15%). Most calls were resolved in the phone consultation. Few patients (13%) required further evaluation in the ED. The consultation service failed to detect the need for an ED visit in 2 cases (0.7%) that required further care. The consultation phone service clearly benefitted patients with TJAs. The service reduced the number of unnecessary ED visits and functioned well in detecting patients who required further care. Most postoperative concerns were related to prescribed medications, wound complications, and mobilization issues. Copyright © 2017 Elsevier Inc. All rights reserved.

Identification of general characteristics, motivation, and satisfaction of internet-based medical consultation service users in Croatia.

Science.gov (United States)

Klinar, Ivana; Balazin, Ana; Barsić, Bruno; Tiljak, Hrvoje

2011-08-15

To identify users' reasons to look for physician consultation on the internet instead of visiting a physician and to explore their general characteristics, motivation, and satisfaction with internet medical consultation service 'Your Questions.' Users of a free internet medical consultation service 'Your Questions' (www.plivazdravlje.hr) were invited to participate in a web-based survey designed to explore their general characteristics (age, sex, etc), reasons for using the service, the nature of their health problem or question, and their satisfaction with the service. Respondents were divided into two groups: users who consulted an internet physician only (Group I) and users who used internet consulting before or after visiting a physician (Group II). The response rate was 38% (1036/2747), with 79% female respondents. A fifth of the respondents (21%) consulted an internet physician only (Group I). Multivariate analysis revealed that the respondents in Group I were younger (median 24 vs 28 years in Group II), more interested into questions about pregnancy (odds ratio [OR], 1.984; 95% confidence interval [CI], 1.203-3.272), more often embarrassed to talk to a physician in person (OR, 1.828; 95% CI, 1.119-2.989), and more motivated to protect their privacy (OR, 1.727; 95% CI, 1.252-2.380). They also had greater satisfaction with the service (77% vs 60%, Pinternet-based medical consultation services were younger age, need for privacy protection, avoidance of embarrassment at the physician's office, and having a question related to pregnancy. This reveals the internet medical consultation service as a useful health promotion supplement that is particularly applicable for the population of young adults.

Consultations of health service providers amongst patients of pulmonary tuberculosis from an urban area

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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.

The Impact of Enterprise Crowdsourcing on Company Innovation Culture : The case of an engineering consultancy

DEFF Research Database (Denmark)

Scupola, Ada; Nicolajsen, Hanne Westh

2014-01-01

In this article we investigate how enterprise crowdsourcing can be used to change the innovation culture in a consultancy company by conducting an empirical investigation in a large engineering consultancy. The analysis shows that enterprise crowdsourcing has created a new and different awareness...

ERP and the changing role of IT in engineering consultancy firms

NARCIS (Netherlands)

Voordijk, Johannes T.; Stegwee, R.A.; Helmus, Rogier

2005-01-01

Purpose – In recent years, large engineering consultancy firms in the Netherlands have implemented enterprise resource planning (ERP) systems. The purpose of this study is to shed light on the changing role of information technology (IT) in these firms after implementing ERP.

Business process re-engineering in service operations

International Nuclear Information System (INIS)

McClintock, J.W.

1995-01-01

The concept of business process re-engineering, and how it was applied to the operations of the Consumers Gas Company were discussed. Business process re-engineering was defined as the improvement of the efficiency of the customer-service process, and the overall improvement of practices and operations. The re-engineering project was said to involve a thorough analysis of information technology, current limitations, and business operational needs, undertaken on an enterprise-wide basis. Viewed generically,a re-engineering project was said to have six major components: (1) business drivers (i.e. the articulation of the Company's strategic issues); (2) benchmark measures; (3) future state process models; (4) cost/benefit analysis; (5) a change management plan; and (6) a development plan. Business improvements expected to result from the project include reduced cost of operation, reduction of waste, and a substantially complete re-design of the business process. Management of the project involved a team approach, and help of a consultant to identify the scope of the re-design, its limitations, and future state. A life expectancy of approximately 10 years was given for the re-engineering plan, with annual benefits (in terms of cost reduction) of $4.6 million by the year 2000

Establishing specialized health services for professional consultation in euthanasia: experiences in the Netherlands and Belgium

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Bilsen Johan

2009-12-01

Full Text Available Abstract Background The Netherlands, Belgium, and Luxembourg have adopted laws decriminalizing euthanasia under strict conditions of prudent practice. These laws stipulate, among other things, that the attending physician should consult an independent colleague to judge whether the substantive criteria of due care have been met. In this context initiatives were taken in the Netherlands and Belgium to establish specialized services providing such consultants: Support and Consultation for Euthanasia in the Netherlands (SCEN and Life End Information Forum (LEIF in Belgium. The aim of this study is to describe and compare these initiatives. Methods We studied and compared relevant documents concerning the Dutch and Belgian consultation service (e.g. articles of bye-laws, inventories of activities, training books, consultation protocols. Results In both countries, the consultation services are delivered by trained physicians who can be consulted in cases of a request for euthanasia and who offer support and information to attending physicians. The context in which the two organisations were founded, as well as the way they are organised and regulated, is different in each country. By providing information on all end-of-life care matters, the Belgian LEIF seems to have a broader consultation role than the Dutch SCEN. SCEN on the other hand has a longer history, is more regulated and organised on a larger scale and receives more government funding than LEIF. The number of training hours for physicians is equal. However, SCEN-training puts more emphasis on the consultation report, whereas LEIF-training primarily emphasizes the ethical framework of end-of-life decisions. Conclusion In case of a request for euthanasia, in the Netherlands as well as in Belgium similar consultation services by independent qualified physicians have been developed. In countries where legalising physician-assisted death is being contemplated, the development of such a

Characterization of Complementary and Alternative Medicine-Related Consultations in an Academic Drug Information Service.

Science.gov (United States)

Gregory, Philip J; Jalloh, Mohamed A; Abe, Andrew M; Hu, James; Hein, Darren J

2016-12-01

To characterize requests received through an academic drug information consultation service related to complementary and alternative medicines. A retrospective review and descriptive analysis of drug information consultations was conducted. A total of 195 consultations related to complementary and alternative medicine were evaluated. All consultation requests involved questions about dietary supplements. The most common request types were related to safety and tolerability (39%), effectiveness (38%), and therapeutic use (34%). Sixty-eight percent of the requests were from pharmacists. The most frequent consultation requests from pharmacists were questions related to drug interactions (37%), therapeutic use (37%), or stability/compatibility/storage (34%). Nearly 60% of complementary and alternative medicine-related consultation requests were able to be completely addressed using available resources. Among review sources, Natural Medicines Comprehensive Database, Clinical Pharmacology, Micromedex, and Pharmacist's Letter were the most common resources used to address consultations. Utilization of a drug information service may be a viable option for health care professionals to help answer a complementary and alternative medicine-related question. Additionally, pharmacists and other health care professionals may consider acquiring resources identified to consistently answering these questions. © The Author(s) 2015.

Empirical research in service engineering based on AHP and fuzzy methods

Science.gov (United States)

Zhang, Yanrui; Cao, Wenfu; Zhang, Lina

2015-12-01

Recent years, management consulting industry has been rapidly developing worldwide. Taking a big management consulting company as research object, this paper established an index system of service quality of consulting, based on customer satisfaction survey, evaluated service quality of the consulting company by AHP and fuzzy comprehensive evaluation methods.

Can Knowledge Management Become Global? - Consulting Engineering Companies in the Knowledge Economy

DEFF Research Database (Denmark)

Koch, Christian

2004-01-01

The paper presents different strategies for consulting engineering companies in the emergent global economy. It is a common assumption that players can obtain market gain through cross border mergers, acquisitions, or strategic alliances in synchronisation with internal organisation. Many big...

Service engineers in change: count your words : A case study into professional discourse and culture within three Dutch organizations

NARCIS (Netherlands)

Drs Jos Pieterse

2014-01-01

This doctoral thesis describes three case studies of service engineers participating in organizational change, interacting with managers and consultants. The study investigates the role of differences in professional discourse and culture when these three professional groups interact in

WTP (willingness to pay) for tele-health consultation service in Hokkaido, Japan.

Science.gov (United States)

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".

Consultation on the Libyan health systems: towards patient-centred services

Science.gov (United States)

El Oakley, Reida M.; Ghrew, Murad H.; Aboutwerat, Ali A.; Alageli, Nabil A.; Neami, Khaldon A.; Kerwat, Rajab M.; Elfituri, Abdulbaset A.; Ziglam, Hisham M.; Saifenasser, Aymen M.; Bahron, Ali M.; Aburawi, Elhadi H.; Sagar, Samir A.; Tajoury, Adel E.; Benamer, Hani T.S.

2013-01-01

The extra demand imposed upon the Libyan health services during and after the Libyan revolution in 2011 led the ailing health systems to collapse. To start the planning process to re-engineer the health sector, the Libyan Ministry of Health in collaboration with the World Health Organisation (WHO) and other international experts in the field sponsored the National Health Systems Conference in Tripoli, Libya, between the 26th and the 30th of August 2012. The aim of this conference was to study how health systems function at the international arena and to facilitate a consultative process between 500 Libyan health experts in order to identify the problems within the Libyan health system and propose potential solutions. The scientific programme adopted the WHO health care system framework and used its six system building blocks: i) Health Governance; ii) Health Care Finance; iii) Health Service Delivery; iv) Human Resources for Health; v) Pharmaceuticals and Health Technology; and vi) Health Information System. The experts used a structured approach starting with clarifying the concepts, evaluating the current status of that health system block in Libya, thereby identifying the strengths, weaknesses, and major deficiencies. This article summarises the 500 health expert recommendations that seized the opportunity to map a modern health systems to take the Libyan health sector into the 21st century. PMID:23359277

Consultant management estimating tool.

Science.gov (United States)

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...

Being an effective nurse consultant in the English National Health Service: what does it take? A study of consultants specializing in safeguarding.

Science.gov (United States)

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.

The role of national consultant services industries to support the first nuclear power plant programme in Indonesia

International Nuclear Information System (INIS)

Dharu Dewi; Sahala Lumbanraja; Sriyana

2007-01-01

Study has been done which concerning the role of Indonesian National Consultant Services Industries to support the First Nuclear Power Plant (NPP) Programme in Indonesia. NPP programme activities will be success if the studies should be started with good planning. To obtain the optimal results, the opportunity and the role of national consultants should be considered to the localization of NPP Programme to be bigger. Utilizing of national consultants services can be expected to become second opinion which is to play important role in socialization of NPP Programme. The Government and NPP Project Owner's candidate should analysis, plan and implement the Nuclear Power Plant Programme activities, started from identification of the available national consultants, considering the national consults procurement process, definition of scope of works of national consultants activities, carry out the selection of national consultants, evaluation, monitoring and supervision so that the utilizing of national consultants will give benefit more effective, efficient, economic appropriate objectives and good quality. This study to assess the structure and type of national consultants, works package which can be done by national consultants, selection methods of national consultants, constraints of national consultants and enhancing of the role of national consultants to involve and support in the nuclear power plant programme in Indonesia. The research methods are literature study, consultation with resource person and exploring of website/internet. (author)

Factors associated with non-reimbursable activity on an inpatient pediatric consultation-liaison service.

Science.gov (United States)

Bierenbaum, Melanie L; Katsikas, Steven; Furr, Allen; Carter, Bryan D

2013-12-01

The aim of this study was to identify factors contributing to clinician time spent in non-reimbursable activity on an inpatient pediatric consultation-liaison (C-L) service. A retrospective study was conducted using inpatient C-L service data on 1,246 consecutive referrals. For this patient population, the strongest predictor of level of non-reimbursable clinical activity was illness chronicity and the number of contacts with C-L service clinicians during their hospital stay. Patients with acute life-threatening illnesses required the highest mean amount of non-reimbursable service activity. On average, 28 % of total clinician time in completing a hospital consultation was spent in non-reimbursable activity. Effective C-L services require a proportion of time spent in non-reimbursable clinical activity, such as liaison and coordinating care with other providers. Identifying referral and systemic factors contributing to non-reimbursable activity can provide insight into budgeting/negotiating for institutional support for essential clinical and non-clinical functions in providing competent quality patient care.

Integrating ergonomics in design processes: a case study within an engineering consultancy firm.

Science.gov (United States)

Sørensen, Lene Bjerg; Broberg, Ole

2012-01-01

This paper reports on a case study within an engineering consultancy firm, where engineering designers and ergonomists were working together on the design of a new hospital sterile processing plant. The objective of the paper is to gain a better understanding of the premises for integrating ergonomics into engineering design processes and how different factors either promote or limit the integration. Based on a grounded theory approach a model illustrating these factors is developed and different hypotheses about how these factors either promote and/or limit the integration of ergonomics into design processes is presented along with the model.

Audit of an inpatient liaison psychiatry consultation service.

Science.gov (United States)

Lyne, John; Hill, Michelle; Burke, Patricia; Ryan, Martina

2009-01-01

The purpose of this paper is to examine an audit that was performed of all patients referred to a liaison psychiatry inpatient consultation service which sought to establish a baseline for demographics, type of referral, and management of referrals, with a view to introducing improved evidence-based treatments. It also aims to examine timeliness of response to referrals benchmarked against published standards. All inpatient referrals to a liaison psychiatry service were recorded over a six-month period, including demographics, diagnosis, management and timeliness of response to referrals. The data were retrospectively analysed and compared against international standards. A total of 172 referrals were received in the six months. Commonest referral reasons included assessments regarding depressive disorders (23.8 per cent), delirium/other cognitive disorders (19.2 per cent), alcohol-related disorders (18.6 per cent), anxiety disorders (14.5 per cent), and risk management (12.2 per cent). Evidence-based practices were not utilised effectively for a number of different types of presentations. A total of 40.1 per cent of referrals were seen on the same day, 75.4 per cent by the end of the next day, and 93.4 per cent by the end of the following day. Use of a hospital protocol for management of delirium may improve outcomes for these patients. Evidence-based techniques, such as brief intervention therapies, may be beneficial for referrals involving alcohol dependence. Referrals were seen reasonably quickly, but there is room for improvement when compared with published standards. This paper provides valuable information for those involved in management of liaison psychiatry consultation services, providing ideas for development and implementation of evidence based practices.

Breast cancer patients' satisfaction with individual therapy goals and treatment in a standardized integrative medicine consultancy service.

Science.gov (United States)

Hack, Carolin C; Antoniadis, Sophia; Hackl, Janina; Langemann, Hanna; Schwitulla, Judith; Fasching, Peter A; Beckmann, Matthias W; Theuser, Anna-Katharin

2018-04-27

Complementary medicine services are nowadays usually quite heterogeneous, and little information is available on standards for running an integrative medicine consultancy service. This study aimed to assess patients' satisfaction with a standardized treatment service on integrative medicine. Using a cross-sectional design, 75 breast cancer patients from the integrative medicine consultancy service at the University Breast Center for Franconia were evaluated between January 2016 and March 2017. At primary consultation, patients answered a standardized questionnaire on their medical history and treatment goals regarding integrative medicine. In a subsequent interview, patients evaluated their satisfaction with the treatment service and individual treatment goals. 72% of the patients (n = 54) reported high satisfaction with the overall approach of the treatment service. 76% of the patients (n = 57) were very satisfied or satisfied with their individual treatment plans. The most frequently reported goals were to slow tumor progression (n = 64, 85.3%), reducing the side effects of conventional cancer treatments (n = 60, 80%), and a desire to participate actively in the treatment of breast cancer (n = 64, 85.3%). Using a standardized procedure in integrative medicine allows a high quality level to be offered to patients. Overall, breast cancer patients report very high satisfaction with the integrative medicine consultancy service and state long-term treatment goals. Hence, long-term treatment with integrative medicine methods should be taken into consideration.

Hidden Costs in Paediatric Psychiatry Consultation Liaison Services

LENUS (Irish Health Repository)

Kehoe, C

2018-03-01

It is recognised that children attending paediatric services have an increased rate of mental health (MH) problems1. Hospital based Mental Health services, interchangeably termed Psychiatric Consultation Liaison Services (PCLS), or Psychological Medicine, exist in the large hospitals, and collaborate with their paediatric colleagues, offering assessment and intervention as required. However, PCLS may also have a role in providing Emergency MH assessments for young people presenting to the Emergency Department (ED), a role independent of their paediatric colleagues. In some cases, these children will need to be admitted to an acute paediatric bed for the management of their mental health illness or psychological distress, awaiting transfer to a child psychiatry specialised bed, or discharge to community services. The profile and costs of these cases are inadequately captured by both HSE CAMHS Annual Reporting System3,4 and the Healthcare Pricing Office (HIPE)2 as they often inadequately record MH referrals. This study explores the costs associated with a cohort of patients presenting to a large paediatric hospital ED, and managed by PCLS, in a one-year period.

Initial development of the recovery-oriented services assessment: A collaboration with peer-provider consultants.

Science.gov (United States)

Lodge, Amy C; Kuhn, Wendy; Earley, Juli; Stevens Manser, Stacey

2018-06-01

The Recovery Self-Assessment (RSA) is a reliable and valid tool used to measure recovery-oriented services. Recent studies, however, suggest that the length and reading level of the RSA makes its routine use in service settings difficult. Recognizing the importance of including people with lived experience of a mental health challenge in research processes and the need to enhance the utility of tools that measure recovery-oriented services, this paper describes an innovative researcher-peer provider consultant multistep process used to revise the provider version of the RSA to create a new instrument-the Recovery-Oriented Services Assessment (ROSA). The authors conducted an exploratory factor analysis (EFA) with principal axis factoring extraction and direct oblimin rotation to evaluate the underlying structure of the provider RSA using data from mental health employees (n = 323). To triangulate the findings of the EFA, quantitative and qualitative data were collected from peer provider consultants (n = 9) on the importance of and language of RSA items. EFA results indicated that a 1-factor solution provided the best fit and explained 48% of the total variance. Consultants triangulated EFA results and recommended the addition of 2 items and language revisions. These results were used to develop the ROSA-a 15-item instrument measuring recovery-oriented services with accessible language. Two versions of the ROSA were developed: a staff version and a people-in-services version. The ROSA may provide organizations with a more accessible way to measure the extent to which their services are recovery oriented. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

The establishment of research ethics consultation services (RECS): an emerging research resource.

Science.gov (United States)

McCormick, Jennifer B; Sharp, Richard R; Ottenberg, Abigale L; Reider, Carson R; Taylor, Holly A; Wilfond, Benjamin S

2013-02-01

Emphasis on translational research to facilitate progression from the laboratory into the community also creates a dynamic in which ethics and social policy questions and solutions are ever pressing. In response, academic institutions are creating Research Ethics Consultation Services (RECS). All Clinical Translational Science Award institutions were surveyed in early 2010 to determine which institutions have a RECS in operation and what is their composition and function. Of the 46 institutions surveyed, 33 (70%) have a RECS. Only 15 RECS have received any consult requests in the last year. Issues that are common among these relatively nascent services include relationships with institutional oversight committees, balancing requestor concerns about confidentiality with research integrity and human subjects protection priorities, tracking consult data and outcomes, and developing systems for internal evaluation. There is variability in how these issues are approached. It will be important to be attentive to the institutional context to develop an appropriate approach. Further data about the issues raised by requestors and the recommendations provided are necessary to build a community of scholars who can navigate and resolve ethical issues encountered along the translational research pathway. © 2012 Wiley Periodicals, Inc.

Research on the development and preliminary application of Beijing agricultural sci-tech service hotline WebApp in agricultural consulting services

Science.gov (United States)

Yu, Weishui; Luo, Changshou; Zheng, Yaming; Wei, Qingfeng; Cao, Chengzhong

2017-09-01

To deal with the “last kilometer” problem during the agricultural science and technology information service, we analyzed the feasibility, necessity and advantages of WebApp applied to agricultural information service and discussed the modes of WebApp used in agricultural information service based on the requirements analysis and the function of WebApp. To overcome the existing App’s defects of difficult installation and weak compatibility between the mobile operating systems, the Beijing Agricultural Sci-tech Service Hotline WebApp was developed based on the HTML and JAVA technology. The WebApp has greater compatibility and simpler operation than the Native App, what’s more, it can be linked to the WeChat public platform making it spread easily and run directly without setup process. The WebApp was used to provide agricultural expert consulting services and agriculture information push, obtained a good preliminary application achievement. Finally, we concluded the creative application of WebApp in agricultural consulting services and prospected the development of WebApp in agricultural information service.

Audit of an inpatient liaison psychiatry consultation service.

LENUS (Irish Health Repository)

Lyne, John

2012-02-01

PURPOSE: The purpose of this paper is to examine an audit that was performed of all patients referred to a liaison psychiatry inpatient consultation service which sought to establish a baseline for demographics, type of referral, and management of referrals, with a view to introducing improved evidence-based treatments. It also aims to examine timeliness of response to referrals benchmarked against published standards. DESIGN\\/METHODOLOGY\\/APPROACH: All inpatient referrals to a liaison psychiatry service were recorded over a six-month period, including demographics, diagnosis, management and timeliness of response to referrals. The data were retrospectively analysed and compared against international standards. FINDINGS: A total of 172 referrals were received in the six months. Commonest referral reasons included assessments regarding depressive disorders (23.8 per cent), delirium\\/other cognitive disorders (19.2 per cent), alcohol-related disorders (18.6 per cent), anxiety disorders (14.5 per cent), and risk management (12.2 per cent). Evidence-based practices were not utilised effectively for a number of different types of presentations. A total of 40.1 per cent of referrals were seen on the same day, 75.4 per cent by the end of the next day, and 93.4 per cent by the end of the following day. PRACTICAL IMPLICATIONS: Use of a hospital protocol for management of delirium may improve outcomes for these patients. Evidence-based techniques, such as brief intervention therapies, may be beneficial for referrals involving alcohol dependence. Referrals were seen reasonably quickly, but there is room for improvement when compared with published standards. ORIGINALITY\\/VALUE: This paper provides valuable information for those involved in management of liaison psychiatry consultation services, providing ideas for development and implementation of evidence based practices.

The influence pattern of key factors affecting the purpose of organizational excellence consulting on the efficiency of businesses consulting services (A case study of small and medium-size food enterprises in Tehran province

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.

Increased demand for E-mail health consultation service: analysis of a Web survey.

Science.gov (United States)

Klinar, Ivana; Balazin, Ana; Basić, Martina; Plantas, Igor; Biskupić, Kresimir

2010-06-01

The aim of the study was to explore characteristics of the users of the Interactive Service "Your Questions" that is based on E-mail health consultations. We wanted to find out what motivated users to use it, were they satisfied with it and what were its impacts on their health behavior. Therefore, we developed a Web survey and invited 2,747 users to take part in it. 919 (33.5%) of users responded. Results showed that the majority of respondents were women (79.1%) and that most hold at least a college degree (52.4%). The Service was mostly used for obtaining information about certain medical symptoms or medical conditions (50.1%), for a second opinion on a diagnosis (18.6%) and for more information about medical treatment (14.4%). In terms of Service features, it was used because of its convenience with regard to time (38.7%) and a sense of privacy (25.7%). Before posting a question to the Service, 93.2% of the respondents searched for health articles on the PLIVAzdravlje portal while 90% of them read the Questions and Answers database. Over half of them (61.8%) posted their question after they already visited their physicians on that particular issue. Nevertheless, 48% of them were encouraged to visit their physicians after they received the answer. The results show an important trend of increased demand for e-mail health consultation and the need for reliable medical information, with one thousand questions submitted to the Service in the observed period of 40 days. If the source of medical information is reliable, as in case of our Service as well as other forms of e-mail health consultations, it can have positive impact on valuable physician-patient communication based on knowledge and mutual understanding.

Experience within the CERN Civil Engineering Group with Outsourced Design Services

CERN Document Server

Watson, T

1998-01-01

In April 1996, CERN awarded three contracts for civil engineering design services associated with the LHC project. The three contracts were awarded to three different joint ventures of firms from five member states. The total bid price for these services was in excess of 35 MCHF and the contracts will run for up to seven years. This paper aims to discuss and analyze the experience gained to date in the management of these contracts. In particular, the paper will address the issues of conditions of contract and specification for this form of contract. Current experience with each of the three consultants will be presented with the areas of difficulty highlighted. Conclusions will be made regarding future use of such contracts and in particular the way in which CERN must change in order to work efficiently with external designers.

Decision Analysis on Survey and SOil Investigation Problem in Power Engineering Consultant

OpenAIRE

Setyaman, Amy Maulany; Sunitiyoso, Yos

2013-01-01

The study aims to gather and organize information for decision making against the problems arising in Power Engineering Consultant's survey and soil investigation product due to new policy in production cost efficiency that is implemented in 2012. The study conducted using Kepner and Tragoe's analytical process that consisted of four stages analytical process such as situation analysis, problem analysis, decision making analysis and potential problem analysis. As for the decision making analy...

Interdependence in decision-making by medical consultants: implications for improving the efficiency of inpatient physician services.

Science.gov (United States)

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.

Effective antimicrobial stewardship in a long-term care facility through an infectious disease consultation service: keeping a LID on antibiotic use.

Science.gov (United States)

Jump, Robin L P; Olds, Danielle M; Seifi, Nasim; Kypriotakis, Georgios; Jury, Lucy A; Peron, Emily P; Hirsch, Amy A; Drawz, Paul E; Watts, Brook; Bonomo, Robert A; Donskey, Curtis J

2012-12-01

We introduced a long-term care facility (LTCF) infectious disease (ID) consultation service (LID service) that provides on-site consultations to residents of a Veterans Affairs (VA) LTCF. We determined the impact of the LID service on antimicrobial use and Clostridium difficile infections at the LTCF. A 160-bed VA LTCF. Systemic antimicrobial use and positive C. difficile tests at the LTCF were compared for the 36 months before and the 18 months after the initiation of the ID consultation service through segmented regression analysis of an interrupted time series. Relative to that in the preintervention period, total systemic antibiotic administration decreased by 30% (Peffective means to achieve antimicrobial stewardship.

Customers as Partners in Radical Service Innovation

DEFF Research Database (Denmark)

Scupola, Ada; Nicolajsen, Hanne Westh

2009-01-01

  Purpose- The main purpose of this paper is to investigate customer involvement and related challenges in radical service innovations in engineering consulting services Design/methodology/approach - The paper uses a case study approach and so called rich descriptions to investigate customer...... involvement, roles and related challenges and conditions in radical service innovations.Findings- One main finding is that customers can engage in radical service innovations in engineering consultancy services and may play a decisive role. In doing this they most likely take on all the three user involvement...... roles defined in the literature of New Service and New Product Development. Also a number of conditions are found to be necessary in order for this collaboration to succeed. The conclusion is that another understanding and handling of the customer/supplier relation is needed along with a need...

Adapting services to the needs of children and families with complex migration experiences: The Toulouse University Hospital's intercultural consultation.

Science.gov (United States)

Sturm, Gesine; Guerraoui, Zohra; Bonnet, Sylvie; Gouzvinski, Françoise; Raynaud, Jean-Philippe

2017-08-01

This article presents the recently created intercultural consultation at the Medical and Psychological Health Care Service (CMP) of the University Hospital la Grave at Toulouse. The approach of the intercultural consultation was elaborated in response to the increasing diversity of children and families using the service in Toulouse. It is also based on local research that indicates the difficulties service providers encounter when trying to establish a solid therapeutic alliance with families with complex migration backgrounds who accumulate different disadvantaging factors. The intercultural consultation adapts existing models of culture-sensitive consultations in child mental health care in France and Canada to the local context in Toulouse. We describe the underlying principles of the intercultural consultation work, the therapeutic and mediation techniques used, and the way the work is integrated into the global service provision of the CMP. The process is illustrated with a case study followed by a discussion of the innovations.

[Differences between patients in consultation psychiatry and psychiatric inpatients].

Science.gov (United States)

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.

Activities of an ethics consultation service in a Tertiary Military Medical Center.

Science.gov (United States)

Waisel, D B; Vanscoy, S E; Tice, L H; Bulger, K L; Schmelz, J O; Perucca, P J

2000-07-01

The Joint Commission on Accreditation of Healthcare Organizations requires hospitals to have a mechanism to address issues of medical ethics. Most hospitals, especially those in the military, have an ethics committee composed solely of members who serve as an additional duty. To enhance the ethics consultation service, the 59th Medical Wing created a position under the chief of the medical staff for a full-time, fellowship-trained, medical ethicist. After establishment of this position, the number of consultations increased, a systematic program for caregiver education was developed and delivered, and an organizational presence was achieved by instituting positions on the institutional review board, the executive committee of the medical staff, and the credentials committee. Issues in medical care are becoming increasingly complicated, due in large part to financial stresses and technological advancements. Ethics consultation can help prevent and resolve many of these problems. This report discusses the activities of the first year of a full-time ethicist in a tertiary military medical center.

Photovoltaics. Section 2: Products and services

International Nuclear Information System (INIS)

Anon.

1991-01-01

This is a directory of companies providing products and services in the area of photovoltaics. The subheadings of the directory include developers and distributors, equipment manufacturers, measuring instruments and controls, consulting services, engineering and construction, operation and maintenance, project management, repair, and financial and legal services

Strangers at the Benchside: Research Ethics Consultation

Science.gov (United States)

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

The contribution of an asthma diagnostic consultation service in obtaining an accurate asthma diagnosis for primary care patients: results of a real-life study.

Science.gov (United States)

Gillis, R M E; van Litsenburg, W; van Balkom, R H; Muris, J W; Smeenk, F W

2017-05-19

Previous studies showed that general practitioners have problems in diagnosing asthma accurately, resulting in both under and overdiagnosis. To support general practitioners in their diagnostic process, an asthma diagnostic consultation service was set up. We evaluated the performance of this asthma diagnostic consultation service by analysing the (dis)concordance between the general practitioners working hypotheses and the asthma diagnostic consultation service diagnoses and possible consequences this had on the patients' pharmacotherapy. In total 659 patients were included in this study. At this service the patients' medical history was taken and a physical examination and a histamine challenge test were carried out. We compared the general practitioners working hypotheses with the asthma diagnostic consultation service diagnoses and the change in medication that was incurred. In 52% (n = 340) an asthma diagnosis was excluded. The diagnosis was confirmed in 42% (n = 275). Furthermore, chronic rhinitis was diagnosed in 40% (n = 261) of the patients whereas this was noted in 25% (n = 163) by their general practitioner. The adjusted diagnosis resulted in a change of medication for more than half of all patients. In 10% (n = 63) medication was started because of a new asthma diagnosis. The 'one-stop-shop' principle was met with 53% of patients and 91% (n = 599) were referred back to their general practitioner, mostly within 6 months. Only 6% (n = 41) remained under control of the asthma diagnostic consultation service because of severe unstable asthma. In conclusion, the asthma diagnostic consultation service helped general practitioners significantly in setting accurate diagnoses for their patients with an asthma hypothesis. This may contribute to diminish the problem of over and underdiagnosis and may result in more appropriate treatment regimens. SERVICE HELPS GENERAL PRACTITIONERS MAKE ACCURATE DIAGNOSES: A consultation service can

Geothermal. Section 2: Products and services

International Nuclear Information System (INIS)

Anon.

1991-01-01

This is a directory of companies providing products and services in the area of geothermal power. The subheadings of the directory include developers and owner operators, equipment manufacturers, measuring instruments and controls, consulting services, engineering and construction, operation and maintenance, project management, repair, and financial and legal services

Hydropower. Section 2: Products and services

International Nuclear Information System (INIS)

Anon.

1991-01-01

This is a directory of companies providing products and services in the area of hydroelectric power. The subheadings of the directory include developers and owner operators, equipment manufacturers, measuring instruments and controls, consulting services, engineering and construction, operation and maintenance, project management, repair, and financial and legal services

Windpower. Section 2: Products and services

International Nuclear Information System (INIS)

Anon.

1991-01-01

This is a directory of companies providing products and services in the area of wind power. The subheadings of the directory include developers and owner operators, equipment manufacturers, measuring instruments and controls, consulting services, engineering and construction, operation and maintenance, project management, repair, and financial and legal services

Service engineering for prospective vehicle service processes

OpenAIRE

Nagel, Alexander; Steinhilper, Rolf; Freiberger, Stefan; Thäter, Stefan

2013-01-01

Garages are - concerning the vehicle service - faced with growing complexity in automotive mechatronics and on-board bus communication technology. Because of the necessity of profound technical knowledge and smart as well as cost efficient diagnostic tools for garages, Bayreuth University and Fraunhofer IPA pick up the challenge and develop innovative service-processes for future requirements by the project "Kfz-Service Engineering 2020". In order to improve established service-processes and ...

Experience of a year of adult hospital dermatology consultations.

Science.gov (United States)

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.

Services in the Community for Adults with Psychosis and Intellectual Disabilities: A Delphi Consultation of Professionals' Views

Science.gov (United States)

Hemmings, C. P.; Underwood, L. A.; Bouras, N.

2009-01-01

Background: There remains a severe lack of evidence on the effectiveness of community services for adults with psychosis and intellectual disabilities (ID). There has been little consensus even of what services should provide for this service user group. Method: A consultation of multidisciplinary professionals was carried out by using a…

The Value of a Brief Thought for the Day Reflection on an Academic Consult Service.

Science.gov (United States)

O'Neil, Thomas; Lyndale, Patricia; Szakatis, Kathryn; Fitzgerald, Tom

2017-11-01

Work in hospice and palliative medicine can be stressful. A variety of methods have been used to mitigate workplace stress including mindfulness mediation, reflective writing, and physical activity. An intervention implemented at our institution is a "Thought for the Day," a short reflection on a piece of poetry, music, or religious writing. Although this practice may be commonplace in the field of hospice and palliative medicine, no literature has been published about its perceived utility by team members with various competing demands on their time. This study's objective was to obtain a better understanding about the perception and utility of a Thought for the Day held by clinicians rounding on an academic palliative medicine consult service. A survey, containing qualitative and quantitative elements was sent to faculty, staff, and learners who participated in a Thought for the Day over the 18 months between March 2013 and October 2014. Twenty-eight responses were returned and analyzed. Most participants (23 of the 28) felt that the Thought for the Day was an important use of their time on the academic consult service. Differences were seen by gender and team role. Additionally, it was reported that the Thought for the Day improved the participants' perception of teamwork. The use of a Thought for the Day reflection may be beneficial and constructive even for a busy academic consult service.

Development of an operational manual for a consultation-liaison psychiatry service.

Science.gov (United States)

Wand, Anne Pf; Sharma, Swapnil; Carpenter, Lindsay J; Gatsi, Mike

2018-02-01

Consultation-liaison psychiatry (CLP) services sit between mental health and the general hospital, and risk being poorly understood by both systems. The aim of this study was to develop an operational manual for a CLP service, which defined functions and governance. The CLP literature was reviewed with a focus on descriptions of CLP roles, organisational processes, quality measures and service development. The CLP team held service planning meetings and met with members of the mental health and hospital executives. Site visits and collaboration with other CLP services occurred in defining the roles of the CLP service and organisational governance. A CLP operational document was developed, including a description of the service, its functions, staff roles and governance. Procedural information such as the CLP timetable, referral process, triage and assessment, documentation, activity recording, quality assurance and relevant policies were outlined. The development of a dedicated operational manual for CLP clarified the roles, functions and governance of CLP within the general hospital and mental health systems. The development process facilitated the engagement of key clinicians and administrators of these systems, the determination of quality improvement targets and greater transparency and accountability.

Relocation consequences on an ophthalmology consultation service from an inpatient to outpatient facility

Directory of Open Access Journals (Sweden)

Singh JS

2015-10-01

Full Text Available Jorawer S Singh,1 Vincent M Imbrogno,2 Mary K Howard,3 Amandip S Cheema,3 Ausra D Selvadurai,4 Surbhi Bansal5 1Department of Ophthalmology, George Washington University, Washington, DC, 2Contemporary Ophthalmology of Erie, Erie, PA, 3Department of Ophthalmology, University at Buffalo, Buffalo, NY, 4OcuSight Eye Care Center, Rochester, NY, 5Department of Ophthalmology, Virginia Commonwealth University, Richmond, VA, USA Importance: This study shows that relocation of an academic ophthalmology residency program from an inpatient to an outpatient setting in western New York does not affect the consult volume but affects management patterns and follow-up rates.Objective: To investigate the effects on the ophthalmology consultation service of an academic program with relocation from a Regional Level-1 Trauma center to an outpatient facility.Design: Consultation notes from 3 years before and 3 years after the University at Buffalo’s (UB Department of Ophthalmology relocation from a Regional Level-1 Trauma center (Erie County Medical Center to an outpatient facility (Ross Eye Institute were obtained from hospital electronic medical records and analyzed.Setting: Hospitalized care and institutional practice.Participants: All inpatient or Emergency Room Ophthalmology consultation patients from the Department of Ophthalmology at UB from 2004 to 2010 (1,379 patients.Exposures: None, this was a retrospective chart review.Main outcome measures: Patient demographics, reason for consult, diagnoses, and ophthalmic procedures performed by the UB Department of Ophthalmology before and after its relocation.Results: Relocation to the outpatient facility did not affect consult volume (P=0.15. The number of consults focusing on ophthalmic conditions, as a percentage of the yearly total, rose 460% (P=0.0001, while systemic condition consults with ocular manifestations fell 83% (P=0.0001. Consults for ocular trauma decreased 65% (P=0.0034. Consults ending with a

The economic and clinical impact of an inpatient palliative care consultation service: a multifaceted approach.

Science.gov (United States)

Ciemins, Elizabeth L; Blum, Linda; Nunley, Marsha; Lasher, Andrew; Newman, Jeffrey M

2007-12-01

While there has been a rapid increase of inpatient palliative care (PC) programs, the financial and clinical benefits have not been well established. Determine the effect of an inpatient PC consultation service on costs and clinical outcomes. Multifaceted study included: (1) interrupted time-series design utilizing mean daily costs preintervention and postintervention; (2) matched cohort analysis comparing PC to usual care patients; and (3) analysis of symptom control after consultation. Large private, not-for-profit, academic medical center in San Francisco, California, 2004-2006. Time series analysis included 282 PC patients; matched cohorts included 27 PC with 128 usual care patients; clinical outcome analysis of 48 PC patients. Mean daily patient costs and length of stay (LOS); pain, dyspnea, and secretions assessment scores. Mean daily costs were reduced 33% (p reduction in mean daily costs and LOS resulted in an estimated annual savings of $2.2 million in the study hospital. Our results extend the evidence base of financial and clinical benefits associated with inpatient PC programs. We recommend additional study of best practices for identifying patients and providing consultation services, in addition to progressive management support and reimbursement policy.

Quality Management in Project Management Consulting. A Case Study in an International Consulting Company

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.

An exploration of the role and scope of the clinical nurse consultant (CNC) in a metropolitan health service.

Science.gov (United States)

Bloomer, Melissa J; Cross, Wendy M

2011-01-01

Clinical nurse consultants have been a part of the nursing workforce for some time however a lack of clarity regarding this role has led to significant variations in health service expectations, workloads and scope for the Clinical nurse consultants working within this metropolitan health service. The aim of this study was to explore the role of the CNC as it is perceived by them, in the context of this health service. A qualitative approach was used for this study. Following ethics approval a single audio-taped focus group was undertaken to gather data. Guiding questions were used to elicit responses from the group, moderated by the co-investigators. The focus group was transcribed verbatim. Each researcher independently analysed the narrative data, using coding and clustering the data to develop primary and sub-themes. Whilst each participant experiences their role individually, there were four themes derived from comments expressed by the participants: 'Diversity and conflict', 'Leaders but powerless', 'Support systems' and 'The portfolio holder role'. The role of the Clinical nurse consultant is complex and diverse. The variability in the role suggests that organisational consensus of the role, scope and purpose of the CNC position has not been actualised, resulting in a lack of support systems, and an underutilisation of the Clinical nurse consultants as leaders, where they can challenge existing practice and guide future directions in care delivery.

48 CFR 227.7107 - Contracts for architect-engineer services.

Science.gov (United States)

2010-10-01

...-engineer services. 227.7107 Section 227.7107 Federal Acquisition Regulations System DEFENSE ACQUISITION... Rights in Technical Data 227.7107 Contracts for architect-engineer services. This section sets forth... of construction and architect-engineer services. ...

48 CFR 227.7206 - Contracts for architect-engineer services.

Science.gov (United States)

2010-10-01

... Rights in Computer Software and Computer Software Documentation 227.7206 Contracts for architect-engineer services. Follow 227.7107 when contracting for architect-engineer services. ...-engineer services. 227.7206 Section 227.7206 Federal Acquisition Regulations System DEFENSE ACQUISITION...

Accompanied consultations in occupational health.

Science.gov (United States)

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.

Le rapprochement Chercheur-Consultant en aménagement du territoire : un apport à haute valeur ajoutée ?

Directory of Open Access Journals (Sweden)

Christine Chemin

2010-02-01

Full Text Available En aménagement du territoire, de nouvelles pratiques partenariales semblent émerger lors de la réalisation d'expertises (études, ingénierie de projets, audits, etc.. Si le recours aux cabinets-conseils – au Consultant – et aux laboratoires scientifiques – au Chercheur – par les services de l'Etat ou les collectivités territoriales existe depuis de nombreuses années, le rapprochement et le partenariat entre les consultants et les chercheurs est récent. Certes, cette pratique n’est pas encore systématique en aménagement du territoire mais elle constitue, selon les commanditaires publics, un apport à haute valeur ajoutée dans les prestations de services.In urban planning new partnership practices seem to appear through the realization of expertises (studies, projects engineering, audits…. Although the appeal to consulting firms – to consultants – and in the scientific laboratories – to researchers – by the State services or local government, exists for a long time now, the partnership between consultants and researchers is recent. Even though this partnership is not systematic in urban planning, it brings a contribution with a high added value in the services, according to the public partners.

A Health System-wide Moral Distress Consultation Service: Development and Evaluation.

Science.gov (United States)

Hamric, Ann B; Epstein, Elizabeth G

2017-06-01

Although moral distress is now a well-recognized phenomenon among all of the healthcare professions, few evidence-based strategies have been published to address it. In morally distressing situations, the "presenting problem" may be a particular patient situation, but most often signals a deeper unit- or system-centered issue. This article describes one institution's ongoing effort to address moral distress in its providers. We discuss the development and evaluation of the Moral Distress Consultation Service, an interprofessional, unit/system-oriented approach to addressing and ameliorating moral distress.

Quality Management in Project Management Consulting. A Case Study in an International Consulting Company

OpenAIRE

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 ...

Cogeneration. Section 2: Products and services

International Nuclear Information System (INIS)

Anon.

1991-01-01

This is a directory of suppliers of products and services in the area of cogeneration. The subheadings of this directory include developers and owner operators, system packagers, manufacturers of prime movers, equipment manufacturers, instruments and controls manufacturing, consulting services, appraisal and valuation, computer services, environmental services, feasibility services, hydrology, marketing, measurements, meteorology, regulatory and licensing, research, testing, training and personnel, engineering and construction, operations and maintenance, and insurance, financial and legal services

[A successful attempt with a consulting service for boys].

Science.gov (United States)

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.

Energy consultancy services for end-user in the housing sector in Poland. Final report

Energy Technology Data Exchange (ETDEWEB)

Lange, M; Prebensen, K

1996-08-01

The idea of establishing consulting service schemes is based on the Polish needs to introduce energy saving measures at different levels. In connection with the financing of energy saving measures whether this is carried out through private banks or Energy Saving Companies (ESCOs) there is a need for an institutional component responsible for standardized procedures for appraisal and supervision of energy saving projects. The objective of the project is to reduce the energy consumption in the municipal and housing sector in Warsaw, Gdansk and Katowice, and subsequently implement the results and experience to a large number of other towns in Poland. Education and training of more than thousand energy consultants within a period of 2 years is planned. The fundamental idea of the project is education and training of Polish professionals, who will perform the subsequent training of Polish consultants within the framework of a Polish National Energy Consultant Scheme. A comprehensive compendium (approximately 500 pages) was worked out in English language. The scope of work for the consultant covers all energy aspects in the housing sector: Individual heat generation; Control systems; Heat distribution in the building and local district heating network; Domestic Hot Water; Electricity; Thermal renovation of the Building Envelope; Energy management; Financial aspects and applications for finance of the energy saving measures. The first training course with 41 participants in Poland took place from 4 to 9 December 1995. (EG)

Factors that influence the way local communities respond to consultation processes about major service change: A qualitative study.

Science.gov (United States)

Barratt, Helen; Harrison, David A; Raine, Rosalind; Fulop, Naomi J

2015-09-01

In England, proposed service changes such as Emergency Department closures typically face local opposition. Consequently, public consultation exercises often involve protracted, hostile debates. This study examined a process aimed at engaging a community in decision-making about service reconfiguration, and the public response to this process. A documentary analysis was conducted to map consultation methods used in an urban area of England where plans to consolidate hospital services on fewer sites were under discussion. In-depth interviews (n=20) were conducted with parents, older people, and patient representatives. The analysis combined inductive and deductive approaches, informed by risk communication theories. The commissioners provided a large volume of information about the changes, alongside a programme of public events. However, the complexity of the process, together with what members of the public perceived to be the commissioners' dismissal of their concerns, led the community to question their motivation. This was compounded by a widespread perception that the proposals were financially driven. Government policy emphasises the importance of clinical leadership and 'evidence' in public consultation. However, an engagement process based on this approach fuelled hostility to the proposals. Policymakers should not assume communities can be persuaded to accommodate service change which may result in reduced access to care. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

The relevance of clinical ethnography: reflections on 10 years of a cultural consultation service.

Science.gov (United States)

Dominicé Dao, Melissa; Inglin, Sophie; Vilpert, Sarah; Hudelson, Patricia

2018-01-11

Training health professionals in culturally sensitive medical interviewing has been widely promoted as a strategy for improving intercultural communication and for helping clinicians to consider patients' social and cultural contexts and improve patient outcomes. Clinical ethnography encourages clinicians to explore the patient's explanatory model of illness, recourse to traditional and alternative healing practices, healthcare expectations and social context, and to use this information to negotiate a mutually acceptable treatment plan. However, while clinical ethnographic interviewing skills can be successfully taught and learned, the "real-world" context of medical practice may impose barriers to such patient-centered interviewing. Creating opportunities for role modeling and critical reflection may help overcome some of these barriers, and contribute to improved intercultural communication in healthcare. We report and reflect on a retrospective analysis of 10 years experience with a "cultural consultation service" (CCS) whose aim is to provide direct support to clinicians who encounter intercultural difficulties and to model the usefulness of clinical ethnographic interviewing for patient care. We analyzed 236 cultural consultation requests in order to identify key patient, provider and consultation characteristics, as well as the cross cultural communication challenges that motivate health care professionals to request a cultural consultation. In addition, we interviewed 51 clinicians about their experience and satisfaction with the CCS. Requests for cultural consultations tended to involve patient care situations with complex social, cultural and medical issues. All patients had a migration background, two-thirds spoke French less than fluently. In over half the cases, patients had a high degree of social vulnerability, compromising illness management. Effective communication was hindered by language barriers and undetected or underestimated patient

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.

Medicaid Reimbursement for School Nursing Services: A Position Paper of the National Association of State School Nurse Consultants.

Science.gov (United States)

Journal of School Health, 1996

1996-01-01

This statement of the National Association of State School Nurse Consultants lists those school nursing services and procedures the organization believes should be reimbursable by Medicaid to school districts. Identified services are in the areas of case finding, nursing care procedures, care coordination, patient/student counseling, and emergency…

Improving the Quality of Services in Residential Treatment Facilities: A Strength-Based Consultative Review Process

Science.gov (United States)

Pavkov, Thomas W.; Lourie, Ira S.; Hug, Richard W.; Negash, Sesen

2010-01-01

This descriptive case study reports on the positive impact of a consultative review methodology used to conduct quality assurance reviews as part of the Residential Treatment Center Evaluation Project. The study details improvement in the quality of services provided to youth in unmonitored residential treatment facilities. Improvements were…

Experiences of Two Multidisciplinary Team Members of Systemic Consultations in a Community Learning Disability Service

Science.gov (United States)

Johnson, Clair; Viljoen, Nina

2017-01-01

Background: Systemic approaches can be useful in working with people with learning disabilities and their network. The evidence base for these approaches within the field of learning disabilities, however, is currently limited. Materials and Methods: This article presents part of a service evaluation of systemic consultations in a Community…

Independent Energy's Solar thermal products and services listing

International Nuclear Information System (INIS)

Anon.

1991-01-01

This article is a listing of companies offering products and services for the development of solar thermal electric power plants. The listing provides the company name under a heading describing the product or service the company provides. The products and services covered by the listing include developers and owner/operators, manufacturers of equipment, instruments and controls, consulting services, engineering and construction, and financial and legal services

Reasons for consulting a doctor on the Internet: Web survey of users of an Ask the Doctor service.

Science.gov (United States)

Umefjord, Göran; Petersson, Göran; Hamberg, Katarina

2003-10-22

In 1998 the Swedish noncommercial public health service Infomedica opened an Ask the Doctor service on its Internet portal. At no charge, anyone with Internet access can use this service to ask questions about personal health-related and disease-related matters. To study why individuals choose to consult previously-unknown doctors on the Internet. Between November 1, 2001, and January 31, 2002 a Web survey of the 3622 Ask the Doctor service users, 1036 men (29%) and 2586 (71%) women, was conducted. We excluded 186 queries from users. The results are based on quantitative and qualitative analysis of the answers to the question "Why did you choose to ask a question at Infomedica's 'Ask the Doctor' service?" 1223 surveys were completed (response rate 36 %). Of the participants in the survey 322 (26%) were male and 901 (74%) female. As major reasons for choosing to consult previously-unknown doctors on the Internet participants indicated: convenience (52%), anonymity (36%), "doctors too busy" (21%), difficult to find time to visit a doctor (16%), difficulty to get an appointment (13%), feeling uncomfortable when seeing a doctor (9%), and not being able to afford a doctors' visit (3%). Further motives elicited through a qualitative analysis of free-text answers were: seeking a second opinion, discontent with previous doctors and a wish for a primary evaluation of a medical problem, asking embarrassing or sensitive questions, seeking information on behalf of relatives, preferring written communication, and (from responses by expatriates, travelers, and others) living far away from regular health care. We found that that an Internet based Ask the Doctor service is primarily consulted because it is convenient, but it may also be of value for individuals with needs that regular health care services have not been able to meet.

Sport Psychology Service Provision: Preferences for Consultant Characteristics and Mode of Delivery among Elite Malaysian Athletes.

Science.gov (United States)

Ponnusamy, Vellapandian; Grove, J Robert

2014-09-01

Factors relevant to the working alliance between athletes and sport psychology consultants were investigated in a sample of elite Malaysian athletes (n = 217). The athletes represented a variety of team and individual sports, and they provided information about the perceived importance of seven consultant characteristics/behaviors as well as seven program delivery options. At a full-sample level, general preferences were expressed for consultants to lead a physically active lifestyle, regularly attend training sessions and competitions, and have prior experience as an athlete or coach. General preferences were also expressed for program content to be determined by the coach or consultant, and for regular, small doses of mental skills training to be delivered in a face-to-face context throughout the year. At a sub-group level, team sport athletes had stronger preferences than individual sport athletes for program delivery on a group/team basis, while individual sport athletes had stronger preferences than team sport athletes for having a role in determining program content. Findings are discussed in relation to dominant value themes within Malaysian society and the reinforcement of these themes within specific sport subcultures. Key pointsConsultant characteristics and program delivery methods have an impact on the effectiveness of sport psychology services.Preferred consultant characteristics and preferred methods of delivery may be affected by cultural and subcultural values.Elite Malaysian athletes prefer consultants to lead a physically active lifestyle; to regularly attend training/competition; and to have prior experience as an athlete or coach.Elite Malaysian athletes also prefer that the coach or consultant determine program content, and that mental skills training take place in a face-to-face context throughout the year.

Sport Psychology Service Provision: Preferences for Consultant Characteristics and Mode of Delivery among Elite Malaysian Athletes

Science.gov (United States)

Ponnusamy, Vellapandian; Grove, J. Robert

2014-01-01

Factors relevant to the working alliance between athletes and sport psychology consultants were investigated in a sample of elite Malaysian athletes (n = 217). The athletes represented a variety of team and individual sports, and they provided information about the perceived importance of seven consultant characteristics/behaviors as well as seven program delivery options. At a full-sample level, general preferences were expressed for consultants to lead a physically active lifestyle, regularly attend training sessions and competitions, and have prior experience as an athlete or coach. General preferences were also expressed for program content to be determined by the coach or consultant, and for regular, small doses of mental skills training to be delivered in a face-to-face context throughout the year. At a sub-group level, team sport athletes had stronger preferences than individual sport athletes for program delivery on a group/team basis, while individual sport athletes had stronger preferences than team sport athletes for having a role in determining program content. Findings are discussed in relation to dominant value themes within Malaysian society and the reinforcement of these themes within specific sport subcultures. Key points Consultant characteristics and program delivery methods have an impact on the effectiveness of sport psychology services. Preferred consultant characteristics and preferred methods of delivery may be affected by cultural and subcultural values. Elite Malaysian athletes prefer consultants to lead a physically active lifestyle; to regularly attend training/competition; and to have prior experience as an athlete or coach. Elite Malaysian athletes also prefer that the coach or consultant determine program content, and that mental skills training take place in a face-to-face context throughout the year. PMID:25177193

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...

Job competencies for the malaysian consultant project managers

Directory of Open Access Journals (Sweden)

Dr. Ilias Said

2009-12-01

Full Text Available Architects, engineers and quantity surveyors are among the main players in construction.Coming from different background and professional background, these professionals bring in their own respective styles and methods of project management practices. There is now a body of opinion among industry people and academics alike that the industry needs to establish competency standard especially for project managers. Irrespective of their professional background, competent project managers should hypothetically deliver high quality services to the clients. A study was conducted at the School of Housing, Building and Planning, University of Science Malaysia (USM, to develop a job competence model for Consultant Project Managers (CPMs. It attempts to determine a set of minimum standards of skills and competencies for CPMs. This paper reports the findings of the study. It provides an insight into the type of competencies needed by CPMs based on the “Job Competence Model for Consultant Project Managers” developed from the study.

Referral patterns and utilization of physiotherapy services following a one-time physiotherapist consultation in general practice.

NARCIS (Netherlands)

Hendriks, H.J.M.; Kerssens, J.J.; Heerkens, Y.F.; Elvers, J.W.H.; Dekker, J.; Zee, J. van der; Oostendorp, R.A.B.

2003-01-01

The purpose of this study was to describe the influence of a one-time consultation of physiotherapists (PRs) by primary care physicians (PDPs) on utilization of physiotherapy services, functional outcomes, and number of treatment sessions of treatment episode. A 7-months observational study with 59

42 CFR 431.105 - Consultation to medical facilities.

Science.gov (United States)

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...

Procurement of Architectural and Engineering Services for Sustainable Buildings: A Guide for Federal Project Managers

Energy Technology Data Exchange (ETDEWEB)

2004-06-01

This guide was prepared to be a resource for federal construction project managers and others who want to integrate the principles of sustainable design into the procurement of professional building design and consulting services. To economize on energy costs and improve the safety, comfort, and health of building occupants, building design teams can incorporate daylighting, energy efficiency, renewable energy, and passive solar design into all projects in which these elements are technically and economically feasible. The information presented here will help project leaders begin the process and manage the inclusion of sustainable design in the procurement process. The section on establishing selection criteria contains key elements to consider before selecting an architectural and engineering (A/E) firm. The section on preparing the statement of work discusses the broad spectrum of sustainable design services that an A/E firm can provide. Several helpful checklists are included.

40 CFR 35.937 - Subagreements for architectural or engineering services.

Science.gov (United States)

2010-07-01

... competence and qualifications for the type of professional services required and at fair and reasonable... announcement of the requirements for personal and professional services, including engineering services... engineering services. Those professional services associated with research, development, design and...

Core Competencies for Training Effective School Consultants

Science.gov (United States)

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…

Reasons for Consulting a Doctor on the Internet: Web Survey of Users of an Ask the Doctor Service

OpenAIRE

Umefjord, Göran; Petersson, Göran; Hamberg, Katarina

2003-01-01

Background In 1998 the Swedish noncommercial public health service Infomedica opened an Ask the Doctor service on its Internet portal. At no charge, anyone with Internet access can use this service to ask questions about personal health-related and disease-related matters. Objective To study why individuals choose to consult previously-unknown doctors on the Internet. Methods Between November 1, 2001, and January 31, 2002 a Web survey of the 3622 Ask the Doctor service users, 1036 men (29%) a...

Through-life engineering services motivation, theory, and practice

CERN Document Server

Roy, Rajkumar

2015-01-01

Demonstrating the latest research and analysis in the area of through-life engineering services (TES), this book utilizes case studies and expert analysis from an international array of practitioners and researchers – who together represent multiple manufacturing sectors: aerospace, railway and automotive – to maximize reader insights into the field of through-life engineering services. As part of the EPSRC Centre in Through-life Engineering Services program to support the academic and industrial community, this book presents an overview of non-destructive testing techniques and applications and provides the reader with the information needed to assess degradation and possible automation of through-life engineering service activities . The latest developments in maintenance-repair-overhaul (MRO) are presented with emphasis on cleaning technologies, repair and overhaul approaches and planning and digital assistance. The impact of these technologies on sustainable enterprises is also analyzed. This book wil...

Engineering Changes During the Service Phase

DEFF Research Database (Denmark)

Vianello, Giovanna; Ahmed, Saeema

2008-01-01

This paper focuses upon understanding the characteristics of engineering changes, in particular changes that emerge during the service phase of complex products, and on how these changes can be related to the product development process. For this purpose, a set of engineering change reports from...... an aerospace engine has been analyzed and the findings have been compared with change documentation from drilling machinery for the oil industry. These findings give insights into which phases of the design process should be modified in order to reduce the number of change requests from the service phase...... and to enable designers to efficiently answer the unavoidable change requests. This can be used to improve the product development process in order to take into account the factors leading to changes....

From Solution Shop to Boutique Consulting? Capturing Recent Developments on the German Consulting Marke

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.

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.

Managing outpatient consultations: from referral to discharge.

Science.gov (United States)

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/.

What are the cost savings associated with providing access to specialist care through the Champlain BASE eConsult service? A costing evaluation.

Science.gov (United States)

Liddy, Clare; Drosinis, Paul; Deri Armstrong, Catherine; McKellips, Fanny; Afkham, Amir; Keely, Erin

2016-06-23

This study estimates the costs and potential savings associated with all eConsult cases completed between 1 April 2014 and 31 March 2015. Costing evaluation from the societal perspective estimating the costs and potential savings associated with all eConsults completed during the study period. Champlain health region in Eastern Ontario, Canada. Primary care providers and specialists registered to use the eConsult service. Costs included (1) delivery costs; (2) specialist remuneration; (3) costs associated with traditional (face-to-face) referrals initiated as a result of eConsult. Potential savings included (1) costs of traditional referrals avoided; (2) indirect patient savings through avoided travel and lost wages/productivity. Net potential societal cost savings were estimated by subtracting total costs from total potential savings. A total of 3487 eConsults were completed during the study period. In 40% of eConsults, a face-to-face specialist visit was originally contemplated but avoided as result of eConsult. In 3% of eConsults, a face-to-face specialist visit was not originally contemplated but was prompted as a result of the eConsult. From the societal perspective, total costs were estimated at $207 787 and total potential savings were $246 516. eConsult led to a net societal saving of $38 729 or $11 per eConsult. Our findings demonstrate potential cost savings from the societal perspective, as patients avoided the travel costs and lost wages/productivity associated with face-to-face specialist visits. Greater savings are expected once we account for other costs such as avoided tests and visits and potential improved health outcomes associated with shorter wait times. Our findings are valuable for healthcare delivery decision-makers as they seek solutions to improve care in a patient-centred and efficient manner. 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/

Heartland Engineers: A Century of Superior Service 1907-2007

Science.gov (United States)

2009-01-01

original position during high-speed flight. 1989 Fall of Berlin Wall 1991 Desert Storm 1997 Grand Opening American Jazz Museum 1991 Emanuel Cleaver...Company Design and Layout: Mary Hemmingway-Emrich, Black & White Graphic Design Research and Writing: Kimberly Langas Project Consultant: Paul Feldman, US...District Public Affairs Officer q 9 INTRODUCTION George Washington appointed the first engineer officers of the Army on June 16, 1775, during the American

Reliability Engineering for Service Oriented Architectures

Science.gov (United States)

2013-02-01

Common Object Request Broker Architecture Ecosystem In software , an ecosystem is a set of applications and/or services that grad- ually build up over time...Enterprise Service Bus Foreign In an SOA context: Any SOA, service or software which the owners of the calling software do not have control of, either...SOA Service Oriented Architecture SRE Software Reliability Engineering System Mode Many systems exhibit different modes of operation. E.g. the cockpit

Options for change in the NHS consultant contract.

Science.gov (United States)

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.

Service software engineering for innovative infrastructure for global financial services

OpenAIRE

MAAD , Soha; MCCARTHY , James B.; GARBAYA , Samir; Beynon , Meurig; Nagarajan , Rajagopal

2010-01-01

International audience; The recent financial crisis motivates our re-thinking of the engineering principles for service software and infrastructures intended to create business value in vital sectors. Existing monolithic, inwarddirected, cost insensitive and highly regulated technical and organizational infrastructures for financial services make it difficult for the domain to benefit from opportunities offered by new computing models such as cloud computing, software as a service, hardware a...

Consultation on the implementation of Engineering Recommendation ER G77. Volume 2: Subgroup report

Energy Technology Data Exchange (ETDEWEB)

Thornycroft, J.; Cotterell, M.; Crabtree, J.

2002-07-01

A Sub-Group report of a project whose main objective is to develop Engineering Recommendation ER G77/1 'Connection of Single-Phase Inverter Connected Photovoltaic (PV) Generating Equipment of up to 5kVA in Parallel with a Distribution Network Operators (DNOs) Distribution System' is presented. The paper specifically addresses the testing of inverters, including small integrated systems called 'AC Modules'. The report is linked to Volume 1 of report ETSU/P2/00400 'Research into Aspects of PV Inverters and Engineering Recommendation ER G77'. The sub-group's objectives were: (i) to develop a safety assessment and accreditation strategy for PV inverter topologies incorporating solid-state switched protection systems; (ii) develop strategies for safe and cost-effective installation of PV systems utilising AC Modules; (iii) consult with the main ER G77 Group on what to include in ER G77/1 and (iv) obtain independent views.

Trends in Otolaryngology Consultation Patterns at an Academic Quaternary Care Center.

Science.gov (United States)

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

48 CFR 225.7015 - Restriction on overseas architect-engineer services.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Restriction on overseas architect-engineer services. 225.7015 Section 225.7015 Federal Acquisition Regulations System DEFENSE... on overseas architect-engineer services. For restriction on award of architect-engineer contracts to...

Consultation for Parents of Young Gifted Children.

Science.gov (United States)

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)

Pharmacist-based Donepezil Outpatient Consultation Service to improve medication persistence

Directory of Open Access Journals (Sweden)

Watanabe N

2012-08-01

Full Text Available Norio Watanabe,1,2 Keiko Yamamura,3 Yusuke Suzuki,4 Hiroyuki Umegaki,4 Katsuro Shigeno,5 Ryo Matsushita,1 Yoshimichi Sai,1 Ken-ichi Miyamoto,1 Kiyofumi Yamada61Department of Clinical Pharmacy, Graduate School of Natural Science and Technology, Kanazawa University, Kanazawa, Ishikawa, Japan; 2Department of Pharmacy, Hashima Municipal Hospital, Hashima, Gifu, Japan; 3Department of Clinical Pharmacy, School of Pharmacy, Aichi Gakuin University, Nagoya, Aichi, Japan; 4Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan; 5Department of Pharmacy Practice and Sciences, School of Pharmacy, Aichi Gakuin University, Nagoya, Aichi, Japan; 6Department of Neuropsychopharmacology and Hospital Pharmacy, Nagoya University Graduate School of Medicine, Nagoya, Aichi, JapanAim: Donepezil is widely used to delay the progression of cognitive dysfunction in patients with Alzheimer's disease (AD, but the efficacy of pharmacotherapy is often reduced by poor adherence to medication. In order to improve adherence by providing information about AD and the significance of pharmacotherapy, the Donepezil Outpatient Consultation Service (DOCS was set up. The influence of this service on medication persistence was assessed in the present study.Methods: Among outpatients starting donepezil therapy, we enrolled 59 patients between April 2008 and September 2010 before establishment of the DOCS (non-DOCS group and 52 patients between October 2010 and March 2012 who attended the DOCS (DOCS group. Each patient's and their caregiver's understanding about the clinical features of AD and pharmacotherapy with donepezil were also assessed. Their understanding was compared before and after the DOCS, and the 1-year medication persistence rate and the reasons for discontinuation were also investigated.Results: The 1-year medication persistence rate was significantly higher in the DOCS group than in the non-DOCS group (73

Design and validation of a model to offer environmental consulting services to minimize oil pollution at gas stations: case study: a gas station in Costa Rica

International Nuclear Information System (INIS)

Calderon Hernandez, Teresita

2016-01-01

An environmental consulting service was designed and validated to minimize hydrocarbon contamination at gas stations, to be used by Migliore S.A. in order to strengthen and increase the number of services offered in the market niche of these companies. A matrix was synthesized with tools such as SWOT, deployment of the Quality Function Deployment (QFD) and international analysis. With the standardized protocols it will be possible to increase in a fluid way, the offer of consulting services. The final validation of the model allowed to verify the functionality of the same, through the generation of solid evaluation criteria that allowed a good knowledge of the gas station, case study, to offer a timely solution to your particular case, in a simple way and harmonious. The company providing environmental consulting services Migliore S.A. can count on a better commercial development, using the designed model [es

Use of Electronic Consultation System to Improve Access to Care in Pediatric Hematology/Oncology.

Science.gov (United States)

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.

Economic valuation of health care services in public health systems: a study about Willingness to Pay (WTP) for nursing consultations.

Science.gov (United States)

Martín-Fernández, Jesús; del Cura-González, Ma Isabel; Rodríguez-Martínez, Gemma; Ariza-Cardiel, Gloria; Zamora, Javier; Gómez-Gascón, Tomás; Polentinos-Castro, Elena; Pérez-Rivas, Francisco Javier; Domínguez-Bidagor, Julia; Beamud-Lagos, Milagros; Tello-Bernabé, Ma Eugenia; Conde-López, Juan Francisco; Aguado-Arroyo, Óscar; Sanz-Bayona, Ma Teresa; Gil-Lacruz, Ana Isabel

2013-01-01

Identifying the economic value assigned by users to a particular health service is of principal interest in planning the service. The aim of this study was to evaluate the perception of economic value of nursing consultation in primary care (PC) by its users. Economic study using contingent valuation methodology. A total of 662 users of nursing consultation from 23 health centers were included. Data on demographic and socioeconomic characteristics, health needs, pattern of usage, and satisfaction with provided service were compiled. The validity of the response was evaluated by an explanatory mixed-effects multilevel model in order to assess the factors associated with the response according to the welfare theory. Response reliability was also evaluated. Subjects included in the study indicated an average Willingness to Pay (WTP) of €14.4 (CI 95%: €13.2-15.5; median €10) and an average Willingness to Accept [Compensation] (WTA) of €20.9 (CI 95%: €19.6-22.2; median €20). Average area income, personal income, consultation duration, home visit, and education level correlated with greater WTP. Women and older subjects showed lower WTP. Fixed parameters explained 8.41% of the residual variability, and response clustering in different health centers explained 4-6% of the total variability. The influence of income on WTP was different in each center. The responses for WTP and WTA in a subgroup of subjects were consistent when reassessed after 2 weeks (intraclass correlation coefficients 0.952 and 0.893, respectively). The economic value of nursing services provided within PC in a public health system is clearly perceived by its user. The perception of this value is influenced by socioeconomic and demographic characteristics of the subjects and their environment, and by the unique characteristics of the evaluated service. The method of contingent valuation is useful for making explicit this perception of value of health services.

A TOTAL QUALITY MANAGEMENT APPROACH TO CIVIL ENGINEERING CONSULTING

Directory of Open Access Journals (Sweden)

G.A.L. Ambrose

2012-01-01

Full Text Available

ENGLISH ABSTRACT: The article describes the development of a framework for the implementation of a Total Quality Management (TQM approach in the civil consulting industry through the five phases of the typical civil engineering project. For any project to be successful the project team members must take collective and individual responsibility for their role in the project implementation. The organisational goal is “to make money now and in the future”. To achieve this goal the organization must provide value to its clientele. The clients are searching for the silver bullet; double the performance at half the price. TQM provides a means to achieve this goal.

AFRIKAANSE OPSOMMING: Die artikel beskryf die ontwikkeling van 'n raamwerk vir die implementering van 'n gehaltebestuurstelsel vir die siviele raadgewende bedryf soos dit deelneem aan die vyf fases van 'n tipiese siviele ingenieursprojek. Vir die suksesvolle afhandeling van 'n projek is dit noodsaaklik dat alle projekspanlede gesamentlik en afsonderlik verantwoordelikheid moet aanvaar vir hulle eie betrokkenheid by die projekimplementering. Die organisasie se oogmerk is om “nou en in die toekoms geld te maak”. Ten einde hierdie oogmerk te bereik moet die organisasie waarde vir sy kliënte bied. 'n Gehaltebestuurstelsel voorsien die gereedskap om hierdie doelwit te bereik.

There is no place like @home!: The value of home consultations in paediatric rehabilitation.

Science.gov (United States)

van Maren-Suir, I; Ketelaar, M; Brouns, B; van der Sanden, K; Verhoef, M

2018-07-01

Family-centred services (FCS) is widely regarded as the best practice approach in early interventions. Creating a therapeutic environment, which also stimulates collaboration between parents and service professionals, is a way to conform to the principles of FCS. The present paper describes the project entitled @home, involving the implementation of home consultations by a specialized team working with children aged 0-5 years at our rehabilitation centre in the Netherlands. The objectives of this article are to (a) describe the development and implementation of home consultations as part of regular care and (b) share the experiences of parents and service providers with home consultations. The implementation process was divided into 3 steps: (1) interviewing experts, (2) adjusting current rehabilitation trajectories, and (3) service providers offering consultations to children at home. The experiences with the home consultations were immediately incorporated in the system, making the implementation an iterative process. In 82% of the 133 home conducted consultations, the service professionals reported that it was more valuable to offer home consultations than seeing the child at the rehabilitation centre. The semistructured interviews revealed that parents and service providers found that they received and provided more tailored advice, perceived a more equal partnership between service professionals and parents, and reported that the home consultations provided a good natural therapeutic environment where a child can be itself and where the child performs best. By using the @home system based on the 3 service models, home consultations are now part of the regular paediatric rehabilitation system at our rehabilitation centre. © 2018 John Wiley & Sons Ltd.

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

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

Requirements Engineering for Pervasive Services

NARCIS (Netherlands)

Kolos, L.; Poulisse, Gert-Jan; van Eck, Pascal; Videira lopes, C.; Schaefer, S.; Clarke, S.; Elrad, T.; Jahnke, J.

2005-01-01

Developing pervasive mobile services for a mass market of end customers entails large up-front investments and therefore a good understanding of customer requirements is of paramount importance. This paper presents an approach for developing requirements engineering method that takes distinguishing

Activity-based funding: implications for mental health services and consultation-liaison psychiatry.

Science.gov (United States)

Wand, Anne

2014-06-01

The aim of this paper is to inform mental health professionals about Activity-based funding (ABF) and the implications for data collection and clinical practice, in particular for consultation-liaison (CL) psychiatry. Activity-based funding may provide an opportunity for mental health services to be more equitably resourced, but much needs to be done to demonstrate that the funding model works in mental health. It is important to ensure that data collected is meaningful and accurate and reflects the diverse roles of mental health clinicians, including in CL. Inpatient and community services should be integrated in the model, as well as safeguards against potential abuse. Clinicians, in partnership with initiatives such as the Australian Mental Health Outcomes and Classification Network, are best placed to guide the development of an ABF system for mental health which appropriately recognises the complexity and variability between patients in different settings. © The Royal Australian and New Zealand College of Psychiatrists 2014.

Foreign Direct Investment in Services and the Domestic Market for Expertise

OpenAIRE

Markusen, James; Rutherford, Thomas F.; Tarr, David

2000-01-01

A growing body of evidence suggests that the close availability of diverse business services is important for economic growth. Producer services such as managerial and engineering consulting can provide specialized knowledge to help domestic firms develop at lower unit cost. But these intermediate services are often nontraded, or costly to trade, which may be one reason that cities and ind...

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.

Advances in through-life engineering services

CERN Document Server

Roy, Rajkumar; Shaw, Andy

2017-01-01

This edited book offers further advances, new perspectives, and developments from world leaders in the field of through-life engineering services (TES). It builds up on the earlier book by the same authors entitled: “Through-life Engineering Services: Motivation, Theory and Practice.” This compendium introduces and discusses further, the developments in workshop-based and 'in situ' maintenance and support of high-value engineering products, as well as the application of drone technology for autonomous and self-healing product support. The links between ‘integrated planning’ and planned obsolescence, risk and cost modelling are also examined. The role of data, information, and knowledge management relative to component and system degradation and failure is also presented. This is supported by consideration of the effects upon the maintenance and support decision by the presence of 'No Fault Found' error signals within system data. Further to this the role of diagnostics and prognostics is also discusse...

Tapping into past design experiences : Knowledge sharing and creation during novice-expert design consultations

NARCIS (Netherlands)

Deken, F.; Kleinsmann, M.S.; Aurisicchio, M.; Lauche, K.; Bracewell, R.

2011-01-01

Designing is a knowledge-intensive activity. For novice design engineers, an important means of acquiring knowledge is to consult experienced colleagues. We observed novice–expert consultations as part of three engineering projects in a large aerospace company. Seven meetings were analysed in detail

Final draft consultants report. Consultants' meeting on requirements for reference materials and intercomparison runs - IAEA programme on Analytical Quality Control Services (AQCS), 17-21 April 1994, Kona, HI, USA

International Nuclear Information System (INIS)

2002-01-01

The purpose of the meeting was to define the aims of the Agency's Analytical Quality Control Services (AQCS) programme in view of its uniqueness as an international programme and to establish objectives for the organization of intercomparison runs and production of reference materials and the Agency's services to Member States in future years. This draft report contains the meeting agenda and recommendations made by the consultants. The recommendations are grouped as follows: Mission Statement; Laboratory Qualification; Training and Development; Resources and Technical Concepts; Standing Group of Experts

[Pain therapy in in-patients with cancer. Effects of a manual-based approach as guideline for pain-consulting service at a university hospital].

Science.gov (United States)

Brinkers, M; Pfau, Gernot; Lux, A; Pfau, Giselher; Schneemilch, C; Meyer, F; Grond, S

2016-03-01

Appropriate medication is an important and substantial part in the therapy of tumor-induced pain. The objective of this study was to investigate the efficiency of anaesthesiology-based consultant service characterizing the quality of this type of treatment in daily clinical practice of a university hospital, i. e., in the patient profile of a tertiary center (study design: systematic clinical, unicenter observational study reflecting clinical practice and study-based control of therapeutic care quality). In the course of consulting function with regard to pain care on the single wards a considerable portion of cancer patients are recieving drugs. For most patients such care comprises several consultations and subsequently initiated treatment modifications. The consulting function ends if the patients feel free of pain or report a substantial improvement. From 1/1/2010 to 12/31/2012 detailed information on the drug therapy applied prior to, during and after the consultation was prospectively documented.This data was retrospectively evaluated as "pre-vs.-post" comparison (Chi-squared test, Fisher's exact test and McNemar's test), in particular, focussing on the quality of pain medication using the WHO index as well as pain intensity obtained by means of the visual analogue scale (VAS). In total, 375 in-patients were treated. The modified pain medication by the anesthesiological consultant service led to a significant increase (p therapy for cancer-related pain. © Georg Thieme Verlag KG Stuttgart · New York.

QUANTITATIVE AND QUALITATIVE DIMENSIONS OF BUSINESS CONSULTING MARKET IN THE REPUBLIC OF MOLDOVA

Directory of Open Access Journals (Sweden)

Natalia LOBANOV

2016-06-01

Full Text Available Business-consulting services, as well as any other product, are designed to be sold;however, the recipients of such services shouldrecognize the need to invest in harnessing organizational knowledge of the enterprise, which requires a certain level of economic maturity,managerial intelligence and well developed management skills. On the other hand, the domain of business consulting services is determined by the availability of market knowledge, professional experience and technologies that match those organizational and production problems that require intervention to be resolved. These technologies and knowledge have to be systematized, adapted and incorporated into a form that allows its use and transmission by the consultant to the customer during advisory mission. This study has the aim to determine the interdependencies between supply for business consulting services in the Republic of Moldova,and for this purpose, there were investigated the following aspects: the identification of factors of influence and trends that are manifested on the local advisory services; market research performance made by an industrial survey in order to assess the situation on the market of consulting services, its advantages and constraints; formulating estimates of market development forecasts for consulting services in Moldova for the period of 2016-2020.

Correction of engineering servicing regularity of transporttechnological machines in operational process

Science.gov (United States)

Makarova, A. N.; Makarov, E. I.; Zakharov, N. S.

2018-03-01

In the article, the issue of correcting engineering servicing regularity on the basis of actual dependability data of cars in operation is considered. The purpose of the conducted research is to increase dependability of transport-technological machines by correcting engineering servicing regularity. The subject of the research is the mechanism of engineering servicing regularity influence on reliability measure. On the basis of the analysis of researches carried out before, a method of nonparametric estimation of car failure measure according to actual time-to-failure data was chosen. A possibility of describing the failure measure dependence on engineering servicing regularity by various mathematical models is considered. It is proven that the exponential model is the most appropriate for that purpose. The obtained results can be used as a separate method of engineering servicing regularity correction with certain operational conditions taken into account, as well as for the technical-economical and economical-stochastic methods improvement. Thus, on the basis of the conducted researches, a method of engineering servicing regularity correction of transport-technological machines in the operational process was developed. The use of that method will allow decreasing the number of failures.

[The Engineering and Technical Services Directorate at the Glenn Research Center

Science.gov (United States)

Moon, James

2004-01-01

My name is James Moon and I am a senior at Tennessee State University where my major is Aeronautical and Industrial Technology with a concentration in industrial electronics. I am currently serving my internship in the Engineering and Technical Services Directorate at the Glenn Research Center (GRC). The Engineering and Technical Service Directorate provides the services and infrastructure for the Glenn Research Center to take research concepts to reality. They provide a full range of integrated services including engineering, advanced prototyping and testing, facility management, and information technology for NASA, industry, and academia. Engineering and Technical Services contains the core knowledge in Information Technology (IT). This includes data systems and analysis, inter and intranet based systems design and data security. Including the design and development of embedded real-time s o h a r e applications for flight and supporting ground systems, Engineering and Technical Services provide a wide range of IT services and products specific to the Glenn Research Center research and engineering community. In the 7000 Directorate I work directly in the 7611 organization. This organization is known as the Aviation Environments Technical Branch. My mentor is Vincent Satterwhite who is also the Branch Chief of the Aviation Environments Technical Branch. In this branch, I serve as the Assistant program manager of the Engineering Technology Program. The Engineering Technology Program (ETP) is one of three components of the High School L.E.R.C.I.P. This is an Agency-sponsored, eight-week research-based apprenticeship program designed to attract traditionally underrepresented high school students that demonstrate an aptitude for and interest in mathematics, science, engineering, and technology.

Systems engineering implementation plan for the liquid effluents services program

International Nuclear Information System (INIS)

Lowe, S.S.

1995-01-01

A graded approach is being taken by the Liquid Effluents Services Program in implementing systems engineering because of the advanced state of the program. The approach is cost-effective and takes credit for related work already completed, yet retains the benefits of systems engineering. This plan describes how the Liquid Effluents Services Program will implement systems engineering so there is a common understanding. Systems engineering work to be performed and the products of that work are identified. The relation to the current planning process and integration with the sitewide systems engineering effort is described

Draft consultants' report. Consultants' meeting on requirements regarding the harmonization of laboratory quality assurance systems, 2-5 May 1995, Vienna, Austria

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

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

42 CFR 493.1457 - Standard; Clinical consultant responsibilities.

Science.gov (United States)

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...

Investigating issues and challenges for customer involvement in business services innovation

DEFF Research Database (Denmark)

Nicolajsen, Hanne Westh; Hugger, Ada Scupola

2011-01-01

innovation processes to different degrees. However, actively involving customers in radical services innovation require a relationship between the customer company and the service provider that might be described as a partnership in which ongoing learning takes place to develop new solutions. The findings......Purpose – The paper aims to investigate how customers may contribute to radical innovation in consultancy services and the conditions needed for customers to be involved in such radical service innovations. Design/methodology/approach – The paper uses a qualitative case study approach including...... rich descriptions based primarily on interviews to investigate an extreme example of successful customer involvement in the development of radical service innovations at Ramboll, a leading Scandinavian engineering consultancy. Findings – The study reveals that customers may be involved in radical...

A Comparison of General Medical and Clinical Ethics Consultations: What Can We Learn From Each Other?

Science.gov (United States)

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

ITER diagnostics ex-vessel engineering services

Energy Technology Data Exchange (ETDEWEB)

Arumugam, A.P., E-mail: arun.prakash@iter.org; Walker, C.I.; Andrew, P.; Barnsley, R.; Beltran, D.; Bertalot, L.; Dammann, A.; Direz, M.F.; Drevon, J.M.; Encheva, A.; Giacomin, T.; Hourtoule, J.; Kuehn, I.; Lanza, R.; Levesy, B.; Maquet, P.; Patel, K.M.; Patisson, L.; Pitcher, C.S.; Portales, M.; and others

2013-10-15

Highlights: • This paper describes about the ITER diagnostics ex-vessel engineering services. • It describes various diagnostics systems, its location and its environment. • Diagnostics interfaces with other services such as the buildings, HVAC, electrical services, cooling water, vacuum, liquid and gas distribution. • All the interfaces with these services are identified and defined. • Buildings services for diagnostics, such as penetrations, local shielding, embedment and temperature control are discussed. -- Abstract: Extensive diagnostics systems will be installed on the ITER machine to provide the measurements necessary to control, evaluate and optimize plasma performance in ITER and to further the understanding of plasma physics. These include measurements of temperature, density, impurity concentration, and particle and energy confinement times. ITER diagnostic systems extend from the center of the Tokamak to the various diagnostic areas, where they are controlled and acquired data is processed. This mainly includes the areas such as ports, port cells, gallery, diagnostics enclosures and cubicle areas. The diagnostics port plugs encloses the front end of the diagnostic systems and the diagnostics building houses the diagnostics equipment, instrumentation and control cubicles. There are several systems providing services to diagnostics. These mainly include ITER buildings, electrical power services, cooling water services, Heating Ventilation and Air Conditioning (HVAC), vacuum services, liquid and gas distribution services, cable engineering, de-tritiation systems, control cubicles, etc. Requirements of these service systems have to be defined, even though many of the diagnostics are at an early stage of development. It is a real challenge to define and to design diagnostics systems considering the constraints imposed by these service systems. This paper summarizes the provision of these services to the individual diagnostics and diagnostics areas

ITER diagnostics ex-vessel engineering services

International Nuclear Information System (INIS)

Arumugam, A.P.; Walker, C.I.; Andrew, P.; Barnsley, R.; Beltran, D.; Bertalot, L.; Dammann, A.; Direz, M.F.; Drevon, J.M.; Encheva, A.; Giacomin, T.; Hourtoule, J.; Kuehn, I.; Lanza, R.; Levesy, B.; Maquet, P.; Patel, K.M.; Patisson, L.; Pitcher, C.S.; Portales, M.

2013-01-01

Highlights: • This paper describes about the ITER diagnostics ex-vessel engineering services. • It describes various diagnostics systems, its location and its environment. • Diagnostics interfaces with other services such as the buildings, HVAC, electrical services, cooling water, vacuum, liquid and gas distribution. • All the interfaces with these services are identified and defined. • Buildings services for diagnostics, such as penetrations, local shielding, embedment and temperature control are discussed. -- Abstract: Extensive diagnostics systems will be installed on the ITER machine to provide the measurements necessary to control, evaluate and optimize plasma performance in ITER and to further the understanding of plasma physics. These include measurements of temperature, density, impurity concentration, and particle and energy confinement times. ITER diagnostic systems extend from the center of the Tokamak to the various diagnostic areas, where they are controlled and acquired data is processed. This mainly includes the areas such as ports, port cells, gallery, diagnostics enclosures and cubicle areas. The diagnostics port plugs encloses the front end of the diagnostic systems and the diagnostics building houses the diagnostics equipment, instrumentation and control cubicles. There are several systems providing services to diagnostics. These mainly include ITER buildings, electrical power services, cooling water services, Heating Ventilation and Air Conditioning (HVAC), vacuum services, liquid and gas distribution services, cable engineering, de-tritiation systems, control cubicles, etc. Requirements of these service systems have to be defined, even though many of the diagnostics are at an early stage of development. It is a real challenge to define and to design diagnostics systems considering the constraints imposed by these service systems. This paper summarizes the provision of these services to the individual diagnostics and diagnostics areas

Sport psychology group consultation using social networking web sites.

Science.gov (United States)

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.

Peer-to-Peer Consultations: Ancillary Services Peer Exchange with India: Experience from South Africa, Europe & the United States (Fact Sheet)

Energy Technology Data Exchange (ETDEWEB)

2014-05-01

In support of national and subnational decision makers, the 21st Century Power Partnership regularly works with country partners to organize peer-to-peer consultations on critical issues. In March 2014, 21CPP collaborated with the Regulatory Assistance Project - India to host two peer-to-peer exchanges among experts from India, South Africa, Europe, and the United States to discuss the provision of ancillary services, particularly in the context of added variability and uncertainty from renewable energy. This factsheet provides a high level summary of the peer-to-peer consultation.

Telemedicine in general neurology: use of audiovisual consultation for on call back-up service in an acute care hospital.

Science.gov (United States)

Janssen, Frank; Awadallah, Mohammed; Alhalabi, Awed; Körber, Barbara; Lang, Reinhard; Scibor, Mateusz; Handschu, René

2018-04-01

While telemedicine is in expanding use in acute stroke care, little is known about its use in general neurology, especially in acute care. We sought to investigate the feasibility and possible effects of a telemedicine device within the neurological back-up service of an acute care hospital. In a 450 bed academic teaching hospital an experienced neurologist (EN) is on call to support the junior doctor at the hospital. Support was possible whether by standard telephone advice (TA) or by audiovisual consultations (AVC). In AVC the expert used a mobile telemedicine device and so he could establish audiovisual contact from his home to the emergency room and examine newly admitted patients. Technical and patient details including timing and diagnosis were recorded. Video and audio quality as well as impact of AVC on diagnosis was rated by the EN. Out of about 1200 cases in off peak times, during the study period, 164 AVC including remote video examination were done (13.6%). Also 48 cases were documented by pure TA. Video quality was rated to a medium of 1.7, audio quality to 2.1. In 36 cases the audiovisual consultation was influenced by technical issues leading to cessation of AVC in 8 cases. Duration of teleconsultation was 17.3 min in AVC compared to 8.7 min for TA. The consultation diagnosis in AVC was confirmed in 74.4% of all cases compared to 57.7% in TA. AVC was rated as a valuable contribution to the diagnostic workup in 74.3% of all cases seen. In about 40% of all cases AVC was not possible due to technical or organizational reasons. Audiovisual consultation seems to be a feasible and useful support in routine neurology back-up service of an acute care hospital. Better mobility of devices and flexibility of service is needed to improve availability and quality of this valuable tool.

Business aspects and cost advantages of partnering for fossil engineering services

International Nuclear Information System (INIS)

Featham, M.D.; Sensenig, R.G.

1995-01-01

In today's environment where utility companies are attempting to reduce costs, alternative cost competitive approaches are being adopted to traditional fossil power plant engineering. One approach is to utilize Partnering of multiple organizations to provide cost competitive and quality engineering services. An approach to Partnering that involves Florida Power Corporation Partnering with multiple architect/engineers to provide the fossil plant engineering services is described in this paper

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.

Economic Valuation of Health Care Services in Public Health Systems: A Study about Willingness to Pay (WTP) for Nursing Consultations

Science.gov (United States)

Martín-Fernández, Jesús; del Cura-González, Mª Isabel; Rodríguez-Martínez, Gemma; Ariza-Cardiel, Gloria; Zamora, Javier; Gómez-Gascón, Tomás; Polentinos-Castro, Elena; Pérez-Rivas, Francisco Javier; Domínguez-Bidagor, Julia; Beamud-Lagos, Milagros; Tello-Bernabé, Mª Eugenia; Conde-López, Juan Francisco; Aguado-Arroyo, Óscar; Bayona, Mª Teresa Sanz-; Gil-Lacruz, Ana Isabel

2013-01-01

Background Identifying the economic value assigned by users to a particular health service is of principal interest in planning the service. The aim of this study was to evaluate the perception of economic value of nursing consultation in primary care (PC) by its users. Methods and Results Economic study using contingent valuation methodology. A total of 662 users of nursing consultation from 23 health centers were included. Data on demographic and socioeconomic characteristics, health needs, pattern of usage, and satisfaction with provided service were compiled. The validity of the response was evaluated by an explanatory mixed-effects multilevel model in order to assess the factors associated with the response according to the welfare theory. Response reliability was also evaluated. Subjects included in the study indicated an average Willingness to Pay (WTP) of €14.4 (CI 95%: €13.2–15.5; median €10) and an average Willingness to Accept [Compensation] (WTA) of €20.9 (CI 95%: €19.6–22.2; median €20). Average area income, personal income, consultation duration, home visit, and education level correlated with greater WTP. Women and older subjects showed lower WTP. Fixed parameters explained 8.41% of the residual variability, and response clustering in different health centers explained 4–6% of the total variability. The influence of income on WTP was different in each center. The responses for WTP and WTA in a subgroup of subjects were consistent when reassessed after 2 weeks (intraclass correlation coefficients 0.952 and 0.893, respectively). Conclusions The economic value of nursing services provided within PC in a public health system is clearly perceived by its user. The perception of this value is influenced by socioeconomic and demographic characteristics of the subjects and their environment, and by the unique characteristics of the evaluated service. The method of contingent valuation is useful for making explicit this perception of value of

Economic valuation of health care services in public health systems: a study about Willingness to Pay (WTP for nursing consultations.

Directory of Open Access Journals (Sweden)

Jesús Martín-Fernández

Full Text Available BACKGROUND: Identifying the economic value assigned by users to a particular health service is of principal interest in planning the service. The aim of this study was to evaluate the perception of economic value of nursing consultation in primary care (PC by its users. METHODS AND RESULTS: Economic study using contingent valuation methodology. A total of 662 users of nursing consultation from 23 health centers were included. Data on demographic and socioeconomic characteristics, health needs, pattern of usage, and satisfaction with provided service were compiled. The validity of the response was evaluated by an explanatory mixed-effects multilevel model in order to assess the factors associated with the response according to the welfare theory. Response reliability was also evaluated. Subjects included in the study indicated an average Willingness to Pay (WTP of €14.4 (CI 95%: €13.2-15.5; median €10 and an average Willingness to Accept [Compensation] (WTA of €20.9 (CI 95%: €19.6-22.2; median €20. Average area income, personal income, consultation duration, home visit, and education level correlated with greater WTP. Women and older subjects showed lower WTP. Fixed parameters explained 8.41% of the residual variability, and response clustering in different health centers explained 4-6% of the total variability. The influence of income on WTP was different in each center. The responses for WTP and WTA in a subgroup of subjects were consistent when reassessed after 2 weeks (intraclass correlation coefficients 0.952 and 0.893, respectively. CONCLUSIONS: The economic value of nursing services provided within PC in a public health system is clearly perceived by its user. The perception of this value is influenced by socioeconomic and demographic characteristics of the subjects and their environment, and by the unique characteristics of the evaluated service. The method of contingent valuation is useful for making explicit this perception

Transfers to psychiatry through the consultation-liaison psychiatry service: 11 years of experience

Directory of Open Access Journals (Sweden)

Michopoulos Ioannis

2008-08-01

Full Text Available Abstract Background There are only a few reports on issues related to patient transfer from medical and surgical departments to the psychiatric ward by the consultation-liaison psychiatry service, although it is a common practice. Here, we present a study assessing the factors that influence such transfers. Method We examined the demographic and clinical backgrounds of a group of patients transferred from internal medicine and surgery to the psychiatric ward over an 11-year period. A comparison was made of this data with data obtained from a group of non-transferred patients, also seen by the same consultation-liaison psychiatry service. Results According to our findings, the typical transferred patient, either female or male, is single, divorced or widowed, lives alone, belongs to a lower socioeconomic class, presents initially with (on the whole a disturbed and disruptive behaviour, has had a recent suicide attempt with persistent suicidal ideas, suffers from a mood disorder (mainly depressive and dysthymic disorders, has a prior psychiatric history as well as a prior psychiatric inpatient treatment, and a positive diagnosis on axis II of the five axis system used for mental health diagnosis. Conclusion The transfer of a patient to the psychiatric ward is a decision depending on multiple factors. Medical diagnoses do not seem to play a major role in the transfer to the psychiatric ward. From the psychiatric diagnosis, depressive and dysthymic disorders are the most common in the transferred population, whilst the transfer is influenced by social factors regarding the patient, the patient's behaviour, the conditions in the ward she/he is treated in and any recent occurrence(s that increase the anxiety of the staff.

76 FR 58155 - Defense Federal Acquisition Regulation Supplement; Construction and Architect-Engineer Services...

Science.gov (United States)

2011-09-20

... Federal Acquisition Regulation Supplement; Construction and Architect-Engineer Services Performance... performance evaluations for construction and architect-engineer services. DATES: Effective Date: September 20... past performance for construction and Architect- Engineer services. On April 19, 2011, DoD published a...

Quality of energy consultancy services - Requirements, criteria for evaluation, and a case report; Energieberatungsqualitaet - Anforderungen, Messung und ein Fallbeispiel

Energy Technology Data Exchange (ETDEWEB)

Hausser, K.

1999-07-01

The article initially pictures an optimized model of energy consultancy and continues with explaining an instrument available for quality assessment of services in general, (SERVQUAL), presenting approaches for modifying this tool so as to make it applicable to evaluating the quality of energy consultancy activities. Finally, the capabilities of the modified tool are discussed referring to a case study in an electric utility, the Neckarwerke Stuttgart. (orig./CB) [German] Energieberatung durch Energieversorgungsunternehmen wird in Deutschland fast flaechendeckend angeboten. Im Beitrag wird zuerst aufgezeigt, welche Anforderungen eine optimale Energieberatung erfuellen muss. Danach wird ein Instrument vorgestellt, das die Qualitaet von Dienstleistungen im allgemeinen misst und im Rahmen der o.g. Arbeit so weiterentwickelt wurde, dass es von nun an auch als Instrument zur Messung der Qualitaet von Energieberatung im Besonderen dienen kann: SERVQUAL (von SERVice QUALity). Zuletzt werden die Ergebnisse praesentiert, die in der o.g. Untersuchung unter Anwendung von SERVQUAL bei den Neckarwerken Stuttgart erzielt wurden. (orig./RHM)

Design Factors Influencing Quality of Building Projects in Nigeria: Consultants' Perception

Directory of Open Access Journals (Sweden)

Lukumon Oyedele

2012-11-01

Full Text Available Various factors identified from the literature that caninfluence quality of building projects in Nigeria have beenstudied by means of questionnaire survey sent to architects,engineers and quantity surveyors in the industry. From atotal response of 107 consultants, the importance of eachfactor was obtained via severity and frequency responsesof the factors. Data analysis includes comparisons ofranking among consultants using severity, frequency andimportance indexes, correlation analysis, and percentagerank agreement factor (PRAF to measure the agreement inthe importance ranking among the consultants.Correlation results between the professionals are architects/quantity surveyors (0.75, architects/engineers (0.21 ,and engineers/quantity surveyors (0.24. The percentagerank agreement factor (PRAF shows that the five mostimportant factors affecting quality are 'design changes'(78.9%; 'inadequate involvement of other professionalsduring the design stage' (78.9%; 'insufficient andunrealistic constraints of project cost' (71.1 %; 'poor levelof commitment to quality improvement among designprofessionals' (63.2%; and 'making design decisions oncost and not value of work' (55.3%. The results of this studywould provide feedback for the clients, project and qualitymangers and all the consultants in the industry, so thateffective management of quality can be ensured from theconceptual-design stage of the project.

Mental Health Consultation Among Ontario's Immigrant Populations.

Science.gov (United States)

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

Telemedicine to Reduce Medical Risk in Austere Medical Environments: The Virtual Critical Care Consultation (VC3) Service.

Science.gov (United States)

Powell, Douglas; McLeroy, Robert D; Riesberg, Jamie; Vasios, William N; Miles, Ethan A; Dellavolpe, Jeffrey; Keenan, Sean; Pamplin, Jeremy C

One of the core capabilities of prolonged field care is telemedicine. We developed the Virtual Critical Care Consult (VC3) Service to provide Special Operations Forces (SOF) medics with on-demand, virtual consultation with experienced critical care physicians to optimize management and improve outcomes of complicated, critically injured or ill patients. Intensive-care doctors staff VC3 continuously. SOF medics access this service via phone or e-mail. A single phone call reaches an intensivist immediately. An e-mail distribution list is used to share information such as casualty images, vital signs flowsheet data, and short video clips, and helps maintain situational awareness among the VC3 critical care providers and other key SOF medical leaders. This real-time support enables direct communication between the remote provider and the clinical subject matter expert, thus facilitating expert management from near the point of injury until definitive care can be administered. The VC3 pilot program has been extensively tested in field training exercises and validated in several real-world encounters. It is an immediately available capability that can reduce medical risk and is scalable to all Special Operations Command forces. 2016.

Conceptual model of integrated apiarian consultancy

OpenAIRE

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...

Early geriatric consultation increases adherence to TQIP Geriatric Trauma Management Guidelines.

Science.gov (United States)

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.

Virtual online consultations: advantages and limitations (VOCAL) study.

Science.gov (United States)

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

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...

Model-driven Service Engineering with SoaML

Science.gov (United States)

Elvesæter, Brian; Carrez, Cyril; Mohagheghi, Parastoo; Berre, Arne-Jørgen; Johnsen, Svein G.; Solberg, Arnor

This chapter presents a model-driven service engineering (MDSE) methodology that uses OMG MDA specifications such as BMM, BPMN and SoaML to identify and specify services within a service-oriented architecture. The methodology takes advantage of business modelling practices and provides a guide to service modelling with SoaML. The presentation is case-driven and illuminated using the telecommunication example. The chapter focuses in particular on the use of the SoaML modelling language as a means for expressing service specifications that are aligned with business models and can be realized in different platform technologies.

Practice Patterns, Attitudes, and Barriers to Palliative Care Consultation by Gynecologic Oncologists.

Science.gov (United States)

Buckley de Meritens, Alexandre; Margolis, Benjamin; Blinderman, Craig; Prigerson, Holly G; Maciejewski, Paul K; Shen, Megan J; Hou, June Y; Burke, William M; Wright, Jason D; Tergas, Ana I

2017-09-01

We sought to describe practice patterns, attitudes, and barriers to the integration of palliative care services by gynecologic oncologists. Members of the Society of Gynecologic Oncology were electronically surveyed regarding their practice of incorporating palliative care services and to identify barriers for consultation. Descriptive statistics were used, and two-sample z-tests of proportions were performed to compare responses to related questions. Of the 145 respondents, 71% were attending physicians and 58% worked at an academic medical center. The vast majority (92%) had palliative care services available for consultation at their hospital; 48% thought that palliative care services were appropriately used, 51% thought they were underused, and 1% thought they were overused. Thirty percent of respondents thought that palliative care services should be incorporated at first recurrence, whereas 42% thought palliative care should be incorporated when prognosis for life expectancy is ≤ 6 months. Most participants (75%) responded that palliative care consultation is reasonable for symptom control at any stage of disease. Respondents were most likely to consult palliative care services for pain control (53%) and other symptoms (63%). Eighty-three percent of respondents thought that communicating prognosis is the primary team's responsibility, whereas the responsibilities for pain and symptom control, resuscitation status, and goals of care discussions were split between the primary team only and both teams. The main barrier for consulting palliative care services was the concern that patients and families would feel abandoned by the primary oncologist (73%). Ninety-seven percent of respondents answered that palliative care services are useful to improve patient care. The majority of gynecologic oncologists perceived palliative care as a useful collaboration that is underused. Fear of perceived abandonment by the patient and family members was identified as a

Service Engineering as an Approach to Designing Industrial Product Service Systems

OpenAIRE

Schuh, G.; Gudergan, G.

2009-01-01

Organised by: Cranfield University Unique customer solutions which integrate products and services into a high value offering have the potential to successfully differentiate from competition even prices are dictating product markets. However, companies face tremendous challenges to develop customer solutions. Service engineering is considered to be the scientific discipline which supports the design task of intangible offerings and thus a foundation for solution design. We enh...

Dermatology consultations significantly contribute quality to care of hospitalized patients: a prospective study of dermatology inpatient consults at a tertiary care center.

Science.gov (United States)

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.

Mental health consultations in the perinatal period: a cost-analysis of Medicare services provided to women during a period of intense mental health reform in Australia.

Science.gov (United States)

Chambers, Georgina M; Randall, Sean; Mihalopoulos, Cathrine; Reilly, Nicole; Sullivan, Elizabeth A; Highet, Nicole; Morgan, Vera A; Croft, Maxine L; Chatterton, Mary Lou; Austin, Marie-Paule

2017-12-05

Objective To quantify total provider fees, benefits paid by the Australian Government and out-of-pocket patients' costs of mental health Medicare Benefits Schedule (MBS) consultations provided to women in the perinatal period (pregnancy to end of the first postnatal year). Method A retrospective study of MBS utilisation and costs (in 2011-12 A$) for women giving birth between 2006 and 2010 by state, provider-type, and geographic remoteness was undertaken. Results The cost of mental health consultations during the perinatal period was A$17.5million for women giving birth in 2007, rising to A$29million in 2010. Almost 9% of women giving birth in 2007 had a mental health consultation compared with more than 14% in 2010. An increase in women accessing consultations, along with an increase in the average number of consultations received, were the main drivers of the increased cost, with costs per service remaining stable. There was a shift to non-specialist care and bulk billing rates increased from 44% to 52% over the study period. In 2010, the average total cost (provider fees) per woman accessing mental health consultations during the perinatal period was A$689, and the average cost per service was A$133. Compared with women residing in regional and remote areas, women residing in major cities where more likely to access consultations, and these were more likely to be with a psychiatrist rather than an allied health professional or general practitioner. Conclusion Increased access to mental health consultations has coincided with the introduction of recent mental health initiatives, however disparities exist based on geographic location. This detailed cost analysis identifies inequities of access to perinatal mental health services in regional and remote areas and provides important data for economic and policy analysis of future mental health initiatives. What is known about the topic? The mental healthcare landscape in Australia has changed significantly over the

22 CFR 228.39 - Special source rules for construction and engineering services.

Science.gov (United States)

2010-04-01

... engineering services. 228.39 Section 228.39 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT RULES ON SOURCE, ORIGIN AND NATIONALITY FOR COMMODITIES AND SERVICES FINANCED BY USAID Conditions Governing the... engineering services. Advanced developing countries, eligible under Geographic Code 941, which have attained a...

What are the cost savings associated with providing access to specialist care through the Champlain BASE eConsult service? A costing evaluation

Science.gov (United States)

Liddy, Clare; Drosinis, Paul; Deri Armstrong, Catherine; McKellips, Fanny; Afkham, Amir; Keely, Erin

2016-01-01

Objective This study estimates the costs and potential savings associated with all eConsult cases completed between 1 April 2014 and 31 March 2015. Design Costing evaluation from the societal perspective estimating the costs and potential savings associated with all eConsults completed during the study period. Setting Champlain health region in Eastern Ontario, Canada. Population Primary care providers and specialists registered to use the eConsult service. Main outcome measures Costs included (1) delivery costs; (2) specialist remuneration; (3) costs associated with traditional (face-to-face) referrals initiated as a result of eConsult. Potential savings included (1) costs of traditional referrals avoided; (2) indirect patient savings through avoided travel and lost wages/productivity. Net potential societal cost savings were estimated by subtracting total costs from total potential savings. Results A total of 3487 eConsults were completed during the study period. In 40% of eConsults, a face-to-face specialist visit was originally contemplated but avoided as result of eConsult. In 3% of eConsults, a face-to-face specialist visit was not originally contemplated but was prompted as a result of the eConsult. From the societal perspective, total costs were estimated at $207 787 and total potential savings were $246 516. eConsult led to a net societal saving of $38 729 or $11 per eConsult. Conclusions Our findings demonstrate potential cost savings from the societal perspective, as patients avoided the travel costs and lost wages/productivity associated with face-to-face specialist visits. Greater savings are expected once we account for other costs such as avoided tests and visits and potential improved health outcomes associated with shorter wait times. Our findings are valuable for healthcare delivery decision-makers as they seek solutions to improve care in a patient-centred and efficient manner. PMID:27338880

Research and development related to the services engineering

International Nuclear Information System (INIS)

Rembado, J. L.

2000-01-01

In the present paper it is clarified what is understood by the expression R and D, Research and Development in the Servicie Engineering's which support the nuclear power plants exploitation, being more appropriated to talk about Innovation and Technological Development. In this paper it is analysed the need to have an innovation as per the marketing needs and to have a technological development to maintain an independence to let us to keep and increase the company's activity. It is described how the Services Engineering's with technological development turn to equipment suppliers which can be supplied to the nuclear sector as well as to other industrial sectors. Finally, it is described the innovation and technological development evolution, the technological polities objectives and the action lines of Tecnatom, S. A. as a Services Engineering's. (Author)

Data collection in consultation-liaison psychiatry: an evaluation of Casemix.

Science.gov (United States)

Ellen, Steven; Lacey, Cameron; Kouzma, Nadya; Sauvey, Nick; Carroll, Rhonda

2006-03-01

To evaluate the usefulness of Casemix as a data collection system for consultation-liaison psychiatry services. Health information staff were requested to code psychiatric assessments and diagnosis prospectively for admissions to the Alfred Hospital, Melbourne, between July 2002 and June 2004 using Casemix. Psychiatric assessments were requested on 2.5% of all hospital admissions (n = 2575). Casemix provided extensive demographic and hospital unit data for referred patients, is easy to set up, and is cost-free for the psychiatry service. Casemix can provide extensive meaningful data for consultation-liaison psychiatry services that could assist in the argument for greater funding of these services.

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.

Analysis of Parent, Teacher, and Consultant Speech Exchanges and Educational Outcomes of Students With Autism During COMPASS Consultation

OpenAIRE

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...

Inpatient consultations to an orthopaedic service: the hidden workload.

LENUS (Irish Health Repository)

O'Malley, N T

2011-12-01

While the quality and efficiency of out-patient orthopaedic referrals are well documented in the literature, there is little on the standard and appropriateness of inpatient orthopaedic consultations.

Challenges faced by engineering services group in meeting nuclear power project targets

International Nuclear Information System (INIS)

Phanse, N.R.

2001-01-01

Nuclear Power Corporation of India Ltd. (NPCIL) is an organisation building and operating nuclear power stations for which a number of different types of engineering services/activities are necessary. All these services are provided by Engineering Services Group of NPCIL. The activities and responsibilities of the group are discussed

Nurse consultants 10 years on: an insight to the role for nurse managers.

Science.gov (United States)

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.

Virtual Reference Services through Web Search Engines: Study of Academic Libraries in Pakistan

Directory of Open Access Journals (Sweden)

Rubia Khan

2017-03-01

Full Text Available Web search engines (WSE are powerful and popular tools in the field of information service management. This study is an attempt to examine the impact and usefulness of web search engines in providing virtual reference services (VRS within academic libraries in Pakistan. The study also attempts to investigate the relevant expertise and skills of library professionals in providing digital reference services (DRS efficiently using web search engines. Methodology used in this study is quantitative in nature. The data was collected from fifty public and private sector universities in Pakistan using a structured questionnaire. Microsoft Excel and SPSS were used for data analysis. The study concludes that web search engines are commonly used by librarians to help users (especially research scholars by providing digital reference services. The study also finds a positive correlation between use of web search engines and quality of digital reference services provided to library users. It is concluded that although search engines have increased the expectations of users and are really big competitors to a library’s reference desk, they are however not an alternative to reference service. Findings reveal that search engines pose numerous challenges for librarians and the study also attempts to bring together possible remedial measures. This study is useful for library professionals to understand the importance of search engines in providing VRS. The study also provides an intellectual comparison among different search engines, their capabilities, limitations, challenges and opportunities to provide VRS effectively in libraries.

48 CFR 36.702 - Forms for use in contracting for architect-engineer services.

Science.gov (United States)

2010-10-01

... contracting for architect-engineer services. 36.702 Section 36.702 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SPECIAL CATEGORIES OF CONTRACTING CONSTRUCTION AND ARCHITECT-ENGINEER CONTRACTS Standard and Optional Forms for Contracting for Construction, Architect-Engineer Services, and...

The Study of Staff Satisfaction in Consulting Center System-A Case Study of Job Consulting Centers in Ho Chi Minh City, Vietnam

OpenAIRE

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 ...

Starting a business as a nurse consultant: practical considerations.

Science.gov (United States)

Papp, E M

2000-03-01

Nursing experience translates well to self employment in the occupational and environmental health field. However, nurses must conduct a self assessment to determine whether owning a business is a good fit for their personality and work style. Exploring which services to offer is the next step in starting a business and consists of determining not only which service to offer (e.g., writing policies or protocols, providing clinical services) but also which type of consultation model to use (i.e., purchase of expertise, doctor/client, process consultation). Every business must have a plan. A business plan is essential to starting a business. It solidifies the entrepreneur's focus, lays the foundation for the business, provides a tool for evaluating success, and is a strong tool for soliciting financial support. The name of the business is an important consideration because it is often the first contact the customers have with the occupational health nurse consultant. The name must be descriptive, appropriate, and memorable.

Reko and the accounting consultant : A quantitative study of the effects of Reko

OpenAIRE

Johansson, Julia; Österman, Olof

2014-01-01

The demand for consultants have increased during the last decades, and not the least within the service industry. There are two major accounting occupations related to the service industry existing in Sweden nowadays: the auditor and the accounting consultants. These professions are commonly being mistaken as being the same thing. However, while the accounting consultant used to be mainly occupied with bookkeeping, the profession is currently evolving into becoming more of an advisory role pr...

APPLICATION FRAMEWORK IN ENGINEERING SERVICE ORIENTED ARCHITECTURE SYSTEM SERVICE

Directory of Open Access Journals (Sweden)

Ade Hodijah

2017-03-01

Full Text Available The Service Engineering (SE is understood as a framework to create innovative services in application development of information technology approach to Service Oriented Architecture (SOA. Implementing SOA is required methodology to identify services that can be used again in the application and organization of a company. in this research, software development model used is object-oriented methodologies, SOA itself is a collection consisting of tools, technologies, frameworks, and best practices that facilitate the implementation of a service quickly. in a study this uses the tools of Business Process Management System (BPMS to support the implementation of service-oriented software. the purpose of this study is to produce a model of activities and artifacts of the application software development models of the SE with a case study Rate Loans. Validation to the design of the model is done through testing of the software produced. The results showed that the application of the SE in the development of service-oriented software can use the object-oriented methodology by providing additional value-added analysis and redesign of business processes to be implemented on a BPMS. BPMS usage of the application of the SE on the SOA has the advantage of visualization in the management of business processes.

Manual for the energy consultant: Sector profiles: Part 3: Non Food and other services; Handboek voor de energieconsulent: Brancheprofielen: Deel 3: Non Food en overige dienstverlening

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-06-01

At the Information Center for the Built Environment of the Netherlands Agency for Energy and Environment (NOVEM) in Apeldoorn, Netherlands, manuals are available in the following categories: (1) Basic Information (f.e. indicators, climate data, calculation factors and examples); (2) Information on Energy Management (`seven-steps plan`, tasks for the energy consultant and the client, aftercare); (3) Information of the Target Groups (overall characteristics, energy conservation options, methods and approaches); and (4) sector profiles. The aim of this manual is to support the energy consultant in developing an energy strategy for the non-food and service sector. Special attention is paid to the home furnishing sector, the textile retail trade, service stations, repair services, beauty parlors, do-it-yourself stores, and dry-cleaners

Consultation and the TADS Experience. Occasional Paper Number 1.

Science.gov (United States)

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…

External Reviews, Internal Influences: Consultations and the Undergraduate Neuroscience Curriculum

OpenAIRE

Wiertelak, Eric P.

2012-01-01

In 2007 FUN established the FUN Program and Department Consultations Service, or FUN-PDCS. Since that founding, the service has provided numerous consultation recommendations to undergraduate programs seeking assistance with external program reviews, designing and improving courses and many other programmatic needs. FUN-PDCS, like FUN, is primarily a grassroots organization and draws on the expertise of the FUN membership to aid programs in their more personalized pursuit of the FUN mission: ...

An Exploratory Study of Informal Learning and Team Performance in the Pre-Consulting Phase

Science.gov (United States)

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…

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

HIGH SERVE '90 - nuclear engineering services

International Nuclear Information System (INIS)

Bauer, K.G.

1991-01-01

Nuclear engineering services do not start only with maintenance or repair, but already with the early detection of imminent problems long before they become problems. Services concerning the decommissioning of plants also belong to it. A selection of the extraordinary services rendered nowadays is presented in more than 20 papers in this booklet. These papers may roughly be divided into three groups of subjects: monitoring and operational management; maintenance, repair and improvements; radioactive waste treatment and management. The first group of subjects, in particular, covers papers dealing with early detection, monitoring and diagnosing systems, using highly advanced hard- and software technologies. Modernization of instrumentation and control systems and exchange of process computer systems is another task this service has to accomplish. Process computers of the past have developed into high performance process information systems. (orig./DG) [de

STUDY ON THE MOTIVES FOR PSYCHOLOGICAL CONSULTATION IN A UNIVERSITY POPULATION

Directory of Open Access Journals (Sweden)

SILVIA QUESADA

2004-01-01

Full Text Available This paper is elaborated within the context of the following Investigation Project called: «Construction of apsychopathic profile of the population that consult for a Psicology service at the Health and Social ServiceDepartment of the Buenos Aires University».On it, it is described its advanced state, revealing: 1 the consulting population regarding its distribution: faculty ofbelonging, age and gender. 2 the most frequent consulting reasons, and finally, 3 the changes on these reasons ; itwill be taken into account the consults between 1998-2001.The information to be evaluated are the interviews of admission. The methodology is the quali-quantitive analysisof the data obtained through this material. The results will not be considered definitive as the project is under aprocess, that it is dued to end on December 2003.

The feasibility of using UML to compare the impact of different brands of computer system on the clinical consultation.

Science.gov (United States)

Kumarapeli, Pushpa; de Lusignan, Simon; Koczan, Phil; Jones, Beryl; Sheeler, Ian

2007-01-01

UK general practice is universally computerised, with computers used in the consulting room at the point of care. Practices use a range of different brands of computer system, which have developed organically to meet the needs of general practitioners and health service managers. Unified Modelling Language (UML) is a standard modelling and specification notation widely used in software engineering. To examine the feasibility of UML notation to compare the impact of different brands of general practice computer system on the clinical consultation. Multi-channel video recordings of simulated consultation sessions were recorded on three different clinical computer systems in common use (EMIS, iSOFT Synergy and IPS Vision). User action recorder software recorded time logs of keyboard and mouse use, and pattern recognition software captured non-verbal communication. The outputs of these were used to create UML class and sequence diagrams for each consultation. We compared 'definition of the presenting problem' and 'prescribing', as these tasks were present in all the consultations analysed. Class diagrams identified the entities involved in the clinical consultation. Sequence diagrams identified common elements of the consultation (such as prescribing) and enabled comparisons to be made between the different brands of computer system. The clinician and computer system interaction varied greatly between the different brands. UML sequence diagrams are useful in identifying common tasks in the clinical consultation, and for contrasting the impact of the different brands of computer system on the clinical consultation. Further research is needed to see if patterns demonstrated in this pilot study are consistently displayed.

Career opportunities in clinical engineering.

Science.gov (United States)

Morse, W A

1992-01-01

The varied career opportunities open to clinical engineers are described in this paper. Many of these opportunities are within the medical device industry in research, development, manufacturing design, regulatory activities, production, operations, sales, marketing, service, and management. Additional opportunities are available in hospitals, with the Veterans Administration, or working as an entrepreneur or a consultant. Each of these careers requires specific training and skills, and they all require a fundamental scientific knowledge of physical principles and mathematics. Research and management, however, require different educational preparation. The research emphasis should be on theoretical principles and creativity; the management emphasis should be on financial and labor problems. In all clinical engineering careers, the individual is a problem solver.

‘Why does it happen like this?’ Consulting with users and providers prior to an evaluation of services for children with life limiting conditions and their families

Science.gov (United States)

Brown, Erica; Coad, Jane; Staniszewska, Sophie; Hacking, Suzanne; Chesworth, Brigit; Chambers, Lizzie

2015-01-01

Children with life limiting conditions and their families have complex needs. Evaluations must consider their views and perspectives to ensure care is relevant, appropriate and acceptable. We consulted with children, young people, their parents and local professionals to gain a more informed picture of issues affecting them prior to preparing a bid to evaluate services in the area. Multiple methods included focus groups, face-to-face and telephone interviews and participatory activities. Recordings and products from activities were analysed for content to identify areas of relevance and concern. An overarching theme from parents was ‘Why does it happen like this?’ Services did not seem designed to meet their needs. Whilst children and young people expressed ideas related to quality of environment, services and social life, professionals focused on ways of meeting the families’ needs. The theme that linked families’ concerns with those of professionals was ‘assessing individual needs’. Two questions to be addressed by the evaluation are (1) to what extent are services designed to meet the needs of children and families and (2) to what extent are children, young people and their families consulted about what they need? Consultations with families and service providers encouraged us to continue their involvement as partners in the evaluation. PMID:24270996

BPELPower—A BPEL execution engine for geospatial web services

Science.gov (United States)

Yu, Genong (Eugene); Zhao, Peisheng; Di, Liping; Chen, Aijun; Deng, Meixia; Bai, Yuqi

2012-10-01

The Business Process Execution Language (BPEL) has become a popular choice for orchestrating and executing workflows in the Web environment. As one special kind of scientific workflow, geospatial Web processing workflows are data-intensive, deal with complex structures in data and geographic features, and execute automatically with limited human intervention. To enable the proper execution and coordination of geospatial workflows, a specially enhanced BPEL execution engine is required. BPELPower was designed, developed, and implemented as a generic BPEL execution engine with enhancements for executing geospatial workflows. The enhancements are especially in its capabilities in handling Geography Markup Language (GML) and standard geospatial Web services, such as the Web Processing Service (WPS) and the Web Feature Service (WFS). BPELPower has been used in several demonstrations over the decade. Two scenarios were discussed in detail to demonstrate the capabilities of BPELPower. That study showed a standard-compliant, Web-based approach for properly supporting geospatial processing, with the only enhancement at the implementation level. Pattern-based evaluation and performance improvement of the engine are discussed: BPELPower directly supports 22 workflow control patterns and 17 workflow data patterns. In the future, the engine will be enhanced with high performance parallel processing and broad Web paradigms.

Re-engineering pre-employment check-up systems: a model for improving health services.

Science.gov (United States)

Rateb, Said Abdel Hakim; El Nouman, Azza Abdel Razek; Rateb, Moshira Abdel Hakim; Asar, Mohamed Naguib; El Amin, Ayman Mohammed; Gad, Saad abdel Aziz; Mohamed, Mohamed Salah Eldin

2011-01-01

The purpose of this paper is to develop a model for improving health services provided by the pre-employment medical fitness check-up system affiliated to Egypt's Health Insurance Organization (HIO). Operations research, notably system re-engineering, is used in six randomly selected centers and findings before and after re-engineering are compared. The re-engineering model follows a systems approach, focusing on three areas: structure, process and outcome. The model is based on six main components: electronic booking, standardized check-up processes, protected medical documents, advanced archiving through an electronic content management (ECM) system, infrastructure development, and capacity building. The model originates mainly from customer needs and expectations. The centers' monthly customer flow increased significantly after re-engineering. The mean time spent per customer cycle improved after re-engineering--18.3 +/- 5.5 minutes as compared to 48.8 +/- 14.5 minutes before. Appointment delay was also significantly decreased from an average 18 to 6.2 days. Both beneficiaries and service providers were significantly more satisfied with the services after re-engineering. The model proves that re-engineering program costs are exceeded by increased revenue. Re-engineering in this study involved multiple structure and process elements. The literature review did not reveal similar re-engineering healthcare packages. Therefore, each element was compared separately. This model is highly recommended for improving service effectiveness and efficiency. This research is the first in Egypt to apply the re-engineering approach to public health systems. Developing user-friendly models for service improvement is an added value.

Federal Consulting: Strategies and Tools for the Career Development Professional.

Science.gov (United States)

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…

Engineering and service activities in the Cogema group

International Nuclear Information System (INIS)

1998-03-01

This short document presents the engineering and service daughter companies of the Cogema group: SGN (nuclear engineering, fuel cycle, wastes and spent fuels management, decontamination and dismantling); Euriware group (advice, expertise and information systems in nuclear, pharmacy, petroleum, automotive and steel making industries); Game group (industrial maintenance in nuclear, chemistry, petroleum, automotive and steel making industries); Eurisys Mesures (nuclear measurements, instrumentation, radiation protection and nuclear imaging); SICN (mechanics); STMI and Socodei (nuclear cleansing and management of low level radioactive wastes); Krebs/Speichim (chemical engineering, divisions of SGN and Technip). (J.S.)

Coevolution in management fashion: an agent-based model of consultant-driven innovation.

Science.gov (United States)

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.

Teleconferencing using multimedia messaging service (MMS) for long-range consultation of patients with neurosurgical problems in an acute situation.

Science.gov (United States)

Waran, Vicknes; Selladurai, Benedict M; Bahuri, Nor Faizal Ahmad; George, George John K Thomas; Lim, Grace P S; Khine, Myo

2008-02-01

: We present our initial experience using a simple and relatively cost effective system using existing mobile phone network services and conventional handphones with built in cameras to capture carefully selected images from hard copies of scan images and transferring these images from a hospital without neurosurgical services to a university hospital with tertiary neurosurgical service for consultation and management plan. : A total of 14 patients with acute neurosurgical problems admitted to a general hospital in a 6 months period had their images photographed and transferred in JPEG format to a university neurosurgical unit. This was accompanied by a phone conference to discuss the scan and the patients' condition between the neurosurgeon and the referring physician. All images were also reviewed by a second independent neurosurgeon on a separate occasion to asses the agreement on the diagnosis and the management plan. : There were nine patients with acute head injury and five patients with acute nontraumatic neurosurgical problems. In all cases both neurosurgeons were in agreement that a diagnosis could be made on the basis of the images that were transferred. With respect to the management advice there were differences in opinion on three of the patients but these were considered to be minor. : Accurate diagnosis can be made on images of acute neurosurgical problems transferred using a conventional camera phone and meaningful decisions can be made on these images. This method of consultation also proved to be highly convenient and cost effective.

Consulting Basics for the Teacher-Turned-Technology Consultant.

Science.gov (United States)

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)

Research ethics consultation: ethical and professional practice challenges and recommendations.

Science.gov (United States)

Sharp, Richard R; Taylor, Holly A; Brinich, Margaret A; Boyle, Mary M; Cho, Mildred; Coors, Marilyn; Danis, Marion; Havard, Molly; Magnus, David; Wilfond, Benjamin

2015-05-01

The complexity of biomedical research has increased considerably in the last decade, as has the pace of translational research. This complexity has generated a number of novel ethical issues for clinical investigators, institutional review boards (IRBs), and other oversight committees. In response, many academic medical centers have created formal research ethics consultation (REC) services to help clinical investigators and IRBs navigate ethical issues in biomedical research. Key functions of a REC service include assisting with research design and implementation, providing a forum for deliberative exploration of ethical issues, and supplementing regulatory oversight. As increasing numbers of academic research institutions establish REC services, there is a pressing need for consensus about the primary aims and policies that should guide these activities. Establishing clear expectations about the aims and policies of REC services is important if REC programs are to achieve their full potential. Drawing on the experiences of a Clinical and Translational Science Award Research Ethics Consultation Working Group, this article describes three major ethical and professional practice challenges associated with the provision of REC: (1) managing multiple institutional roles and responsibilities, (2) managing sensitive information, and (3) communicating with consultation requestors about how these issues are managed. The paper also presents several practical strategies for addressing these challenges and enhancing the quality of REC services.

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.

ETICS: the international software engineering service for the grid

Energy Technology Data Exchange (ETDEWEB)

Meglio, A D; Begin, M-E [CERN (Switzerland); Couvares, P [University of Wisconsin-Madison (United States); Ronchieri, E [INFN CNAF (Italy); Takacs, E [4D SOFT Ltd (Hungary)], E-mail: alberto.di.meglio@cern.ch

2008-07-15

The ETICS system is a distributed software configuration, build and test system designed to fulfil the needs of improving the quality, reliability and interoperability of distributed software in general and grid software in particular. The ETICS project is a consortium of five partners (CERN, INFN, Engineering Ingegneria Informatica, 4D Soft and the University of Wisconsin-Madison). The ETICS service consists of a build and test job execution system based on the Metronome software and an integrated set of web services and software engineering tools to design, maintain and control build and test scenarios. The ETICS system allows taking into account complex dependencies among applications and middleware components and provides a rich environment to perform static and dynamic analysis of the software and execute deployment, system and interoperability tests. This paper gives an overview of the system architecture and functionality set and then describes how the EC-funded EGEE, DILIGENT and OMII-Europe projects are using the software engineering services to build, validate and distribute their software. Finally a number of significant use and test cases will be described to show how ETICS can be used in particular to perform interoperability tests of grid middleware using the grid itself.

ETICS: the international software engineering service for the grid

Science.gov (United States)

Meglio, A. D.; Bégin, M.-E.; Couvares, P.; Ronchieri, E.; Takacs, E.

2008-07-01

The ETICS system is a distributed software configuration, build and test system designed to fulfil the needs of improving the quality, reliability and interoperability of distributed software in general and grid software in particular. The ETICS project is a consortium of five partners (CERN, INFN, Engineering Ingegneria Informatica, 4D Soft and the University of Wisconsin-Madison). The ETICS service consists of a build and test job execution system based on the Metronome software and an integrated set of web services and software engineering tools to design, maintain and control build and test scenarios. The ETICS system allows taking into account complex dependencies among applications and middleware components and provides a rich environment to perform static and dynamic analysis of the software and execute deployment, system and interoperability tests. This paper gives an overview of the system architecture and functionality set and then describes how the EC-funded EGEE, DILIGENT and OMII-Europe projects are using the software engineering services to build, validate and distribute their software. Finally a number of significant use and test cases will be described to show how ETICS can be used in particular to perform interoperability tests of grid middleware using the grid itself.

ETICS: the international software engineering service for the grid

International Nuclear Information System (INIS)

Meglio, A D; Begin, M-E; Couvares, P; Ronchieri, E; Takacs, E

2008-01-01

The ETICS system is a distributed software configuration, build and test system designed to fulfil the needs of improving the quality, reliability and interoperability of distributed software in general and grid software in particular. The ETICS project is a consortium of five partners (CERN, INFN, Engineering Ingegneria Informatica, 4D Soft and the University of Wisconsin-Madison). The ETICS service consists of a build and test job execution system based on the Metronome software and an integrated set of web services and software engineering tools to design, maintain and control build and test scenarios. The ETICS system allows taking into account complex dependencies among applications and middleware components and provides a rich environment to perform static and dynamic analysis of the software and execute deployment, system and interoperability tests. This paper gives an overview of the system architecture and functionality set and then describes how the EC-funded EGEE, DILIGENT and OMII-Europe projects are using the software engineering services to build, validate and distribute their software. Finally a number of significant use and test cases will be described to show how ETICS can be used in particular to perform interoperability tests of grid middleware using the grid itself

Impact of Knowledge Intensive Business Services on Economic Performance of Sectors and Regions

Directory of Open Access Journals (Sweden)

Laurenţiu Tăchiciu

2016-02-01

Full Text Available The role of knowledge intensive services in today's economy are among the topics most frequently addressed in recent years by researchers. The major interest is targeting in particular services provided to enterprises, known internationally as knowledge intensive business services or, by abbreviation, KIBS. As a sector of the economy, KIBS consists of enterprises specializing in providing to other businesses services that require intensive use of advanced knowledge, thus characterized by the fact that intellectual input has a decisive share in the value added. Usually are considered part of this sector undertakings which have as object of activity the provision of services in the fields of research and development, design and technical assistance in implementing of new technologies including information and communication, training, management consulting, marketing and advertising, quality assurance and certification, accounting and auditing, legal consulting and assistance, architecture and construction engineering. According to the statistical classification NACE rev2, much of KIBS can be found in divisions 62, 63, 69, 71-74.

Traumatic Brain Injury service (TBI) Service

Data.gov (United States)

Department of Veterans Affairs — This Service provides access to Tramatic Brain injury patient data consult notes. The service also provides one write service method writeNote. The Service supports...

The use of Skype in a community hospital inpatient palliative medicine consultation service.

Science.gov (United States)

Brecher, David B

2013-01-01

Skype™, an Internet-based communication tool, has enhanced communication under numerous circumstances. As telemedicine continues to be an increasing part of medical practice, there will be more opportunities to use Skype and similar tools. Numerous scenarios in the lay literature have helped to highlight the potential uses. Although most commonly used to enhance physician-to-patient communication, there has been limited reported use of Skype for patient-to-family communication, especially in end of life and palliative care. Our inpatient Palliative Medicine Consultation Service has offered and used this technology to enhance our patients' quality of life. The objective was to provide another tool for our patients to use to communicate with family and/or friends, especially under circumstances in which clinical symptoms, functional status, financial concerns, or geographic limitations preclude in-person face-to face communication.

Outsourced design services lessons learned from LHC civil engineering

CERN Document Server

Watson, T

2003-01-01

In April 1996 CERN awarded three contracts for the provision of civil engineering design and site supervision services associated with the LHC Project. These three contracts with an average value at signature of 12MCHF were placed using the “two envelope” award system. Eight firms from six member states were integrated into three Joint Ventures. For Projects prior to the LHC, CERN would have carried out the design and supervision using in-house staff. The change to out-sourced services represented a major step for CERN. After seven years, the contracts are now coming to their conclusion. This paper aims to discuss the reasons why these contracts were originally implemented, the lessons than have been learnt over the last seven years and conclusions on how CERN could approach the need for civil engineering design services in the future.

Global polar geospatial information service retrieval based on search engine and ontology reasoning

Science.gov (United States)

Chen, Nengcheng; E, Dongcheng; Di, Liping; Gong, Jianya; Chen, Zeqiang

2007-01-01

In order to improve the access precision of polar geospatial information service on web, a new methodology for retrieving global spatial information services based on geospatial service search and ontology reasoning is proposed, the geospatial service search is implemented to find the coarse service from web, the ontology reasoning is designed to find the refined service from the coarse service. The proposed framework includes standardized distributed geospatial web services, a geospatial service search engine, an extended UDDI registry, and a multi-protocol geospatial information service client. Some key technologies addressed include service discovery based on search engine and service ontology modeling and reasoning in the Antarctic geospatial context. Finally, an Antarctica multi protocol OWS portal prototype based on the proposed methodology is introduced.

Survey of patients' view on functional split of consultant psychiatrists.

Science.gov (United States)

Begum, Millia; Brown, Keith; Pelosi, Anthony; Crabb, Jim; McTaggart, John; Mitchell, Caroline; Julyan, Everett; Donegan, Tony; Gotz, Michael

2013-09-27

The functional split model of consultant psychiatrist care for inpatients has been one of the major service redesign that has occurred in the NHS in the last decade. It is unclear if this new split model offers any advantages over the previous sectorised model of working. More recent evidence has suggested that patients, carers and professionals have varied views regarding the benefits of this model. This survey of patient's views on models of consultant working is the first in Scotland and we have attempted to include a large sample size. The results suggest that after providing sufficient information on both models, the majority of patients from various Scottish health boards have opted for the traditional sectorised model of working. During a four week period consecutive patients across 4 health boards attending the General Adult consultant outpatient clinics and those who were admitted to their inpatient ward were offered a structured questionnaire regarding their views on the functional split versus traditional sectorised model. Space was provided for additional comments. The study used descriptive statistical measures for analysis of its results. Ethical approval was confirmed as not being required for this survey of local services. We had a response rate of 67%. A significant majority (76%) of service users across the four different health boards indicated a preference for the same consultant to manage their care irrespective of whether they were an inpatient or in the community (Chi-squared = 65, df = 1, p survey suggests that most patients prefer the traditional model where they see a single consultant throughout their journey of care. The views of patients should be sought as much as possible and should be taken into account when considering the best way to organize psychiatric services.

Consulting Psychiatry within an Integrated Primary Care Model

Science.gov (United States)

Schreiter, Elizabeth A. Zeidler; Pandhi, Nancy; Fondow, Meghan D. M.; Thomas, Chantelle; Vonk, Jantina; Reardon, Claudia L.; Serrano, Neftali

2014-01-01

Summary After implementation of an integrated consulting psychiatry model and psychology services within primary care at a federally qualified health center, patients have increased access to needed mental health services, and primary care clinicians receive the support and collaboration needed to meet the psychiatric needs of the population. PMID:24185149

Data Management Consulting at the Johns Hopkins University

Science.gov (United States)

Varvel, Virgil E., Jr.; Shen, Yi

2013-01-01

As research data complexity and quantity grows and funding agency requirements for data management are articulated, there is a growing need for data management services (DMS). Within these services, one important role emerging is that of data management consultant (DMC). Roles were analyzed that these professionals play through case study analysis…

Sociodemographic profile and psychiatric diagnosis of patients referred to consultation-liaison psychiatric services of general hospital psychiatric unit at a Tertiary Care Center

Directory of Open Access Journals (Sweden)

Shri Gopal Goyal

2017-01-01

Full Text Available Context: Previous studies have reported high psychiatric comorbidity with physical illness. However, referral rate to consultation-liaison (C-L psychiatry from other departments is very low. There is a paucity of literature from India in this subspecialty of psychiatry. Aims: This study was conducted to assess the sociodemographic profile and psychiatric diagnosis of patients referred to C-L psychiatric services at a tertiary care center. Settings and Design: This was a descriptive cross-sectional study conducted in a tertiary care multispecialty teaching institution. Patients and Methods: The study population comprised all the patients who were referred for psychiatric consultation from other departments to C-L services of psychiatry department for 2 months. Information was collected using semi-structured pro forma, and diagnosis was made based on the International Classification of Diseases-10 criteria. Results: A total of 160 patients were referred for C-L psychiatric services. Majority of the patients were in the age group of 31–45 years, married, educated matriculation or beyond, belonged to Hindu religion, nuclear family, and residing in urban area. The maximum referrals were from internal medicine department (17.5 followed by nephrology (15.0% and neurology (10.6%. The most common psychiatric diagnosis was depression (12% followed by delirium (8%. The most common reason for seeking psychiatric consultation was psychiatric clearance of prospective kidney donor and bone marrow transplant/stem cell transplant recipient. Conclusions: Psychiatric comorbidity may present with chronic physical illness. The C-L psychiatry would play a major role in the management of psychiatric comorbidity.

48 CFR 53.236-2 - Architect-engineer services (SF's 252 and 330).

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Architect-engineer... ACQUISITION REGULATION (CONTINUED) CLAUSES AND FORMS FORMS Prescription of Forms 53.236-2 Architect-engineer...-engineer and related services: (a) SF 252 (Rev. 10/83), Architect-Engineer Contract. SF 252 is prescribed...

77 FR 23283 - Tribal Consultation Policy

Science.gov (United States)

2012-04-18

... and Waivers VII. Consultation Process Guidelines VIII. Performance and Accountability IX. Designated..., improving working conditions, and assuring work-related benefits and rights of workers and retirees in the... services. The Department's Women's Bureau (WB) has an ongoing relationship with the United Indians of All...

78 FR 57858 - Tribal Consultation Meeting

Science.gov (United States)

2013-09-20

... and posted on the Early Childhood Learning and Knowledge Center Web site at http://eclkc.ohs.acf.hhs... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Tribal Consultation Meeting AGENCY: Administration for Children and Families' Office of Head Start (OHS), HHS. ACTION...

78 FR 20658 - Tribal Consultation Meeting

Science.gov (United States)

2013-04-05

... been sent to tribal leaders via email and posted on the Early Childhood Learning and Knowledge Center... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Tribal Consultation Meeting AGENCY: Administration for Children and Families' Office of Head Start (OHS), HHS. ACTION...

NUKEM. Innovative solutions for nuclear engineering; Innovative Loesungen rund um nukleares Engineering

Energy Technology Data Exchange (ETDEWEB)

Scheffler, Beate [NUKEM Technologies GmbH, Alzenau (Germany)

2011-03-15

Management of radioactive waste, handling spent fuel elements, decommissioning of nuclear facilities, and engineering and consulting activities are services associated with the name of NUKEM all over the world. The company's scientists and engineers develop solution concepts combining the latest technologies with proven techniques and many years of experience. The company;s history and the services offered to the nuclear industry began more than 5 decades ago. The predecessor, NUKEM Nuklear-Chemie-Metallurgie, was founded in 1960 as one of the earliest nuclear companies in Germany. Originally, the firm produced fuel elements for a variety of reactor lines. As early as in the 1970s, logical extensions of these business activities were nuclear engineering and plant construction. In the meantime, NUKEM Technologies GmbH has developed a worldwide reputation for its activities. Numerous reference projects bear witness to optimum project management and customer satisfaction. Since 2009, NUKEM Technologies has been a wholly owned subsidiary of the Russian Atomstroyexport. NUKEM Technologies operates sales and project offices outside Germany, e.g. in Russia, China, Lithuania, France, and Bulgaria. In this way, the company is present in its target markets of Russia, Western and Eastern Europe as well as Asia, offering customers and partners fast and direct contacts. (orig.)

Client Perceptions of Occupational Health and Safety Management System Assistance Provided by OSHA On-Site Consultation: Results of a Survey of Colorado Small Business Consultation Clients.

Science.gov (United States)

Autenrieth, Daniel A; Brazile, William J; Gilkey, David P; Reynolds, Stephen J; June, Cathy; Sandfort, Del

2015-01-01

The Occupational Safety and Health Administration (OSHA) On-Site Consultation Service provides assistance establishing occupational health and safety management systems (OHSMS) to small businesses. The Safety and Health Program Assessment Worksheet (Revised OSHA Form 33) is the instrument used by consultants to assess an organization's OHSMS and provide feedback on how to improve a system. A survey was developed to determine the usefulness of the Revised OSHA Form 33 from the perspective of Colorado OSHA consultation clients. One hundred and seven clients who had received consultation services within a six-year period responded to the survey. The vast majority of respondents indicated that the Revised OSHA Form 33 accurately reflected their OHSMS and that information provided on the Revised OSHA Form 33 was helpful for improving their systems. Specific outcomes reported by the respondents included increased safety awareness, reduced injuries, and improved morale. The results indicate that the OHSMS assistance provided by OSHA consultation is beneficial for clients and that the Revised OSHA Form 33 can be an effective tool for assessing and communicating OHSMS results to business management. Detailed comments and suggestions provided on the Revised OSHA Form 33 are helpful for clients to improve their OHSMS.

Power Product Equipment Technician: Outboard-Engine Systems and Service. Teacher Edition [and] Student Edition.

Science.gov (United States)

Hilley, Robert

This curriculum guide contains teacher and student materials for a course on outboard-engine boat systems and service for power product equipment technician occupations. The course contains the following four units of instruction: (1) Outboard-Engine Design and Identification; (2) Operation and Service of Engine-Support Systems; (3) Operation and…

Towards Trust Engineering for Opportunistic Cloud Services

DEFF Research Database (Denmark)

Kuada, Eric

2014-01-01

The systematic review methodology has been employed to review trust related studies in cloud computing. It was observed that trusted computing technologies and reputation based approaches are the main approaches to trust engineering in cloud computing. Also, trusted third party approaches...... and the deployment model play a significant role in enhancing trust between service providers and consumers. It was observed that the concept of trust is used loosely without any formal specification in cloud computing discussions and trust engineering in general. As a first step towards addressing this problem, we...... have contextualized the formal trust specification in multi-agent environments for cloud computing....

[Clinical ethics consultation - an integrative model for practice and reflection].

Science.gov (United States)

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.

Effects of School Counselors' Cognitive Behavioral Consultation on Irrational and Efficacy Beliefs of Elementary School Teachers

Science.gov (United States)

Warren, Jeffrey M.; Gerler, Edwin R., Jr.

2013-01-01

Consultation is an indirect service frequently offered as part of comprehensive school counseling programs. This study explored the efficacy of a specific model of consultation, rational emotive-social behavior consultation (RE-SBC). Elementary school teachers participated in face-to-face and online consultation groups aimed at influencing…

77 FR 48159 - Tribal Consultation Meeting

Science.gov (United States)

2012-08-13

... Anchorage Hotel, 500 West Third Avenue, Anchorage, AK 99501. FOR FURTHER INFORMATION CONTACT: Ann Linehan... convention. As much as possible, OHS Tribal Consultations are scheduled in conjunction with other Tribal... delivery of Head Start services in their geographic locations. In addition, OHS will share actions taken...

46 CFR 11.518 - Service requirements for chief engineer (limited oceans) of steam and/or motor vessels.

Science.gov (United States)

2010-10-01

... 46 Shipping 1 2010-10-01 2010-10-01 false Service requirements for chief engineer (limited oceans... Requirements for Engineer Officer § 11.518 Service requirements for chief engineer (limited oceans) of steam... engineer (limited oceans) of steam and/or motor vessels is five years total service in the engineroom of...

SemMat: Federated Semantic Services Platform for Open materials Science and Engineering

Science.gov (United States)

2017-01-01

SEMMAT: FEDERATED SEMANTIC SERVICES PLATFORM FOR OPEN MATERIALS SCIENCE AND ENGINEERING WRIGHT STATE UNIVERSITY JANUARY 2017 FINAL TECHNICAL...COVERED (From - To) JUL 2013 – JUN 2016 4. TITLE AND SUBTITLE SemMat: FEDERATED SEMANTIC SERVICES PLATFORM FOR OPEN MATERIALS SCIENCE AND ENGINEERING...models to represent materials data. This provides a data exchange scheme for materials science , which also includes provenance information to promote

Research Ethics Consultation: Ethical and Professional Practice Challenges and Recommendations

Science.gov (United States)

Sharp, Richard R.; Taylor, Holly A.; Brinich, Margaret A.; Boyle, Mary M.; Cho, Mildred; Coors, Marilyn; Danis, Marion; Havard, Molly; Magnus, David; Wilfond, Benjamin

2015-01-01

The complexity of biomedical research has increased considerably in the last decade, as has the pace of translational research. This complexity has generated a number of novel ethical issues for clinical investigators, institutional review boards (IRBs), and other oversight committees. In response, many academic medical centers have created formal research ethics consultation (REC) services to help clinical investigators and IRBs navigate ethical issues in biomedical research. Key functions of a REC service include: assisting with research design and implementation, providing a forum for deliberative exploration of ethical issues, and supplementing regulatory oversight. As increasing numbers of academic research institutions establish REC services, there is a pressing need for consensus about the primary aims and policies that should guide these activities. Establishing clear expectations about the aims and policies of REC services is important if REC programs are to achieve their full potential. Drawing on the experiences of a Clinical Translational Science Award (CTSA) Research Ethics Consultation Working Group, this article describes three major ethical and professional practice challenges associated with the provision of REC: 1) managing multiple institutional roles and responsibilities, 2) managing sensitive information, and 3) communicating with consultation requestors about how these issues are managed. The paper also presents several practical strategies for addressing these challenges and enhancing the quality of REC services. PMID:25607942

School Neuropsychology Consultation in Neurodevelopmental Disorders

Science.gov (United States)

Decker, Scott L.

2008-01-01

The role of school psychologists with training in neuropsychology is examined within the context of multitiered models of service delivery and educational reform policies. An expanded role is suggested that builds on expertise in the assessment of neurodevelopmental disorders and extends to broader tiers through consultation practice. Changes in…

Governmentality and Social Capital in Tribal/Federal Relations Regarding Heritage Consultation

Science.gov (United States)

2016-04-08

for improved tribal/federal heritage consultation; this will be accomplished by working collaboratively with tribal heritage specialists toward...during this period and will receive scholarships or fellowships for further studies in science, mathematics , engineering or technology fields...graduated during this period with a degree in science, mathematics , engineering, or technology fields: The number of undergraduates funded by your

Motivation and reward systems in service provision: exploring motivators for people providing engineering services

DEFF Research Database (Denmark)

Kreye, Melanie; Nandrup-Bus, Troels

2015-01-01

It is becoming a distinctive feature for manufacturing firms to compete strategically through service provision. In relation to reward systems the aim of this thesis is to investigate what motivates employees of servitized manufacturing firms when providing engineering services and why. Through...... quantitative and qualitative data collection with an international company within the European healthcare sector, the findings show that key motivating factors were to “delight” the customer and being able to take responsibility and accountability for ones work. Service employees were found to feel proud...

Engineering factors influencing Corbicula fouling in nuclear-service water systems

International Nuclear Information System (INIS)

Henager, C.H.; Johnson, K.I.; Page, T.L.

1983-06-01

Corbicula fouling is a continuing problem in nuclear-service water systems. More knowledge of biological and engineering factors is needed to develop effective detection and control methods. A data base on Corbicula fouling was compiled from nuclear and non-nuclear power stations and industries using raw water. This data base was used in an analysis to identify systems and components which are conducive to fouling by Corbicula. Bounds on several engineering parameters such as velocity and temperature which support Corbicula growth are given. Service water systems found in BWR and PWR reactors are listed and those that show fouling are identified. Possible safety implications of Corbicula fouling are discussed for specific service water systems. Several effective control methods in current use include backflushing with heated water, centrifugal strainers, and continuous chlorination during spawning seasons

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...

Exploring, Documenting, and Improving Humanitarian Service Learning through Engineers Without Borders USA

OpenAIRE

Buchanan, Elizabeth; Berg, Devin; Lee, Tina; Buchanan, Elizabeth; Lacksonen, Tom

2017-01-01

Exploring, Documenting, and Improving Humanitarian Service Learning through Engineers without Borders-USA is a four-year project exploring a variety of challenges and opportunities in university-based service learning programs. Specifically, this project looks holistically at the inception and evolution of a new Engineers Without Borders USA chapter, while analyzing characteristics, values, and demographics of individuals involved in EWB community-based humanitarian projects in multiple chapt...

Influence of Critical Success Factors on Business Development in IT Consulting

Directory of Open Access Journals (Sweden)

Roman Vasiliev

2015-08-01

Full Text Available This study is intended to explore identification and usage of critical success factors in the activity of IT consulting service providers. Critical success factors and their measures are identified at the industrial level. For the corporate level, the study provides recommendations on elaboration of critical success factors for their further usage. Particular attention is paid to the role of critical success factors in activities of IT consulting service providers involving strategic management, project management, partnership and client relations. This issue has become the subject of the study.

Energy-saving construction. A practice book for architects, engineers and energy consultants; Energiesparendes Bauen. Ein Praxisbuch fuer Architekten, Ingenieure und Energieberater

Energy Technology Data Exchange (ETDEWEB)

Marquardt, Helmut

2011-07-01

Due to a rapid amendment of the Energy Saving Ordinance in 2007 and 2009, the opportunities for energy conservation in buildings come more clearly into the public consciousness. The energy consultancy increasingly is in demand. Under this aspect, the author of te book under consideration reports on the fundamentals of thermal protection, on designs for compliance with the Energy Saving Ordinance, on the appropriate plant engineering as well as on the calculation of residential buildings according to the Energy Saving Ordinance and Act on Power Generation from Renewable Energy Sources.

Child abuse consultations initiated by child protective services: the role of expert opinions.

Science.gov (United States)

McGuire, Lindsay; Martin, Kimberly D; Leventhal, John M

2011-01-01

To describe consultations provided by child abuse pediatricians for cases referred by child protective services (CPS); compare the opinions of the likelihood of child maltreatment of the initial physician, CPS, and the child abuse pediatrician; and examine predictors of the experts' opinions. Cases were referred by CPS for consultations between March 1, 1998, and June 30, 2005, to 2 child abuse pediatricians at Yale-New Haven Children's Hospital. We abstracted demographic and clinical information and the opinions of the initial physician, CPS, and the child abuse expert, each coded using a 5-point scale from definite maltreatment to definite benign cause (eg, accident). Of 187 cases, 50.3% occurred in children younger than 1 year of age. Children's most serious injuries were fractures (50.8%), burns (16.6%), and bruises/abrasions (15.0%). The child abuse experts' opinions were 47.6% definite or probable maltreatment, 8.6% uncertain, and 43.9% definite or probable benign. Of the 119 cases with opinions from all 3 assessors, the expert agreed with the physician in 57.1% of cases (κ = 0.34) and with CPS in 64.7% (κ = 0.42). The best predictor of the expert's opinion that the injury was due to maltreatment was agreement between the physician and CPS that maltreatment had occurred. Levels of agreement were fair to poor between the child abuse expert and either the physician or CPS. Child abuse experts' opinions have important value in selected cases to confirm previous assessments by the physician and/or CPS, or to change the opinion of the case. Copyright © 2011 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

What Chemistry To Teach Engineers?

Science.gov (United States)

Hawkes, Stephen J.

2000-01-01

Examines possible general chemistry topics that would be most relevant and practical for engineering majors. Consults the Accreditation Board for Engineering and Technology (ABET), engineering textbooks, texts from other required subjects, and practicing engineers for recommendations. (Contains 24 references.) (WRM)

Motivation and reward systems in service provision: exploring motivators for people providing engineering services

OpenAIRE

Kreye, Melanie; Nandrup-Bus, Troels

2015-01-01

It is becoming a distinctive feature for manufacturing firms to compete strategically through service provision. In relation to reward systems the aim of this thesis is to investigate what motivates employees of servitized manufacturing firms when providing engineering services and why. Through quantitative and qualitative data collection with an international company within the European healthcare sector, the findings show that key motivating factors were to “delight” the customer and being ...

The Role of Agricultural Consultants in New Zealand in Environmental Extension

Science.gov (United States)

Botha, Neels; Coutts, Jeff; Roth, Hein

2008-01-01

The aim of this study was to understand the role that agricultural consultants in New Zealand were undertaking in the Research, Development and Extension (RD&E) system--and in particular in relation to environmental extension. New Zealand does not have a public extension service and hence there is a strong reliance on consultants and regional…

DIESEL ENGINE SYSTEMS. AGRICULTURAL MACHINERY--SERVICE OCCUPATIONS, MODULE NUMBER 15.

Science.gov (United States)

Ohio State Univ., Columbus. Center for Vocational and Technical Education.

ONE OF A SERIES DESIGNED TO HELP TEACHERS PREPARE POSTSECONDARY STUDENTS FOR AGRICULTURAL MACHINERY SERVICE OCCUPATIONS AS PARTS MEN, MECHANICS, MECHANIC'S HELPERS, AND SERVICE SUPERVISORS, THIS GUIDE AIMS TO DEVELOP STUDENT UNDERSTANDING OF THE CONSTRUCTION AND OPERATING PRINCIPLES OF DIESEL ENGINES. IT WAS DEVELOPED BY A NATIONAL TASK FORCE ON…

Web Services as Product Experience Augmenters and the Implications for Requirements Engineering: A Position Paper

NARCIS (Netherlands)

van Eck, Pascal; Nijholt, Antinus; Wieringa, Roelf J.

There is currently little insight into what requirement engineering for web services is and in which context it will be carried out. In this position paper, we investigate requirements engineering for a special kind of web services, namely web services that are used to augment the perceived value of

Relationships among Relational Communication Processes and Consultation Outcomes for Students with Attention Deficit Hyperactivity Disorder

Science.gov (United States)

Erchul, William P.; DuPaul, George J.; Grissom, Priscilla F.; Junod, Rosemary E. Vile; Jitendra, Asha K.; Mannella, Mark C.; Tresco, Katy E.; Flammer-Rivera, Lizette M.; Volpe, Robert J.

2007-01-01

Consultation has been shown to be an effective means to deliver school-based psychological services. The purpose of this study was to link patterns of consultant and teacher verbal interactions to consultation outcomes. Relational communication (Rogers & Escudero, 2004) was the research perspective taken, and the source of the consultation…

33 CFR 385.10 - Implementation responsibilities, consultation, and coordination.

Science.gov (United States)

2010-07-01

... a de facto veto power. This part authorizes the Corps of Engineers and the non-Federal sponsor to... agencies and tribes may consider relevant considerations such as sequencing of projects, planning, contracting and funding, and any factor listed for setting time limits for consulting under the National...

The Contemporary Consultant

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...

Real-World Implementation of Video Outpatient Consultations at Macro, Meso, and Micro Levels: Mixed-Method Study.

Science.gov (United States)

Greenhalgh, Trisha; Shaw, Sara; Wherton, Joseph; Vijayaraghavan, Shanti; Morris, Joanne; Bhattacharya, Satya; Hanson, Philippa; Campbell-Richards, Desirée; Ramoutar, Seendy; Collard, Anna; Hodkinson, Isabel

2018-04-17

There is much interest in virtual consultations using video technology. Randomized controlled trials have shown video consultations to be acceptable, safe, and effective in selected conditions and circumstances. However, this model has rarely been mainstreamed and sustained in real-world settings. The study sought to (1) define good practice and inform implementation of video outpatient consultations and (2) generate transferable knowledge about challenges to scaling up and routinizing this service model. A multilevel, mixed-method study of Skype video consultations (micro level) was embedded in an organizational case study (meso level), taking account of national context and wider influences (macro level). The study followed the introduction of video outpatient consultations in three clinical services (diabetes, diabetes antenatal, and cancer surgery) in a National Health Service trust (covering three hospitals) in London, United Kingdom. Data sources included 36 national-level stakeholders (exploratory and semistructured interviews), longitudinal organizational ethnography (300 hours of observations; 24 staff interviews), 30 videotaped remote consultations, 17 audiotaped face-to-face consultations, and national and local documents. Qualitative data, analyzed using sociotechnical change theories, addressed staff and patient experience and organizational and system drivers. Quantitative data, analyzed via descriptive statistics, included uptake of video consultations by staff and patients and microcategorization of different kinds of talk (using the Roter interaction analysis system). When clinical, technical, and practical preconditions were met, video consultations appeared safe and were popular with some patients and staff. Compared with face-to-face consultations for similar conditions, video consultations were very slightly shorter, patients did slightly more talking, and both parties sometimes needed to make explicit things that typically remained implicit in

Research on Credit Evaluation of Mobile Medical APP Interactive Online Consultation Service-Take Haodaifu APP Online Payment Service as an Example

Science.gov (United States)

Xiong, Dandan; Zhao, Lei

2017-10-01

Mobile medical industry is developing rapidly, but the relevant credit evaluation system is still in the exploratory stage. Haodaifu in the interactive online consulting services more representatives and has a credit evaluation system, but the system is not perfect. There are many problems in the system, such as credits indicators cannot better reflect the results of user’s evaluation, the lack of user qualification supervision, evaluation index system and assessment channels are not perfect. On the basis of drawing on the advantages of E-commerce evaluation system and combining with the characteristics of mobile medical itself, two suggestions are put forward: Improve the credit evaluation model (Generate physician static credit index, Change the doctor 's dynamic credit index algorithm, Update the dynamic credit index), Improve the basic mechanism of credit evaluation.

An overview of game-based learning in building services engineering education

Science.gov (United States)

Alanne, Kari

2016-03-01

To ensure proper competence development and short graduation times for engineering students, it is essential that the study motivation is encouraged by new learning methods. In game-based learning, the learner's engagement is increased and learning is made meaningful by applying game-like features such as competition and rewarding through virtual promotions or achievement badges. In this paper, the state of the art of game-based learning in building services engineering education at university level is reviewed and discussed. A systematic literature review indicates that educational games have been reported in the field of related disciplines, such as mechanical and civil engineering. The development of system-level educational games that realistically simulate work life in building services engineering is still in its infancy. Novel rewarding practices and more comprehensive approaches entailing the state-of-the-art information tools such as building information modelling, geographic information systems, building management systems and augmented reality are needed in the future.

A Mental Health Consultation Program for Project Head Start.

Science.gov (United States)

Kawin, Marjorie R.

The Psychological Center provided a family oriented mental health consultation service to 17 delegate agencies who had contracts with Head Start programs in 1966-67. This paper presents an overview of the services which an interdisciplinary staff of 52 professionals provided to 6,780 families and 1,500 agency staff members. Gerald Caplan's (1964)…

Behavior Analytic Consultation for Academic Referral Concerns

Science.gov (United States)

Dufrene, Brad A.; Zoder-Martell, Kimberly A.; Dieringe, Shannon Titus; Labrot, Zachary

2016-01-01

Applied behavior analysis provides a technology of human behavior that demonstrates great potential for improving socially important outcomes for individuals. School-based consultation may provide a vehicle for delivering applied behavior analysis services in schools to address academic referral concerns. In this article, we propose that…

The Impact of the Internet on Health Consultation Market Concentration: An Econometric Analysis of Secondary Data.

Science.gov (United States)

Li, Jia; Zhang, Ya; Ma, Ling; Liu, Xuan

2016-10-28

Many markets have traditionally been dominated by a few best-selling products, and this is also the case for the health care industry. However, we do not know whether the market will be more or less concentrated when health care services are delivered online (known as E-consultation), nor do we know how to reduce the concentration of the E-consultation market. The aim of this study was to investigate the concentration of the E-consultation market and how to reduce its concentration through information disclosure mechanisms (online reputation and self-representation). We employed a secondary data econometric analysis using transaction data obtained from an E-consultation Website (haodf.com) for three diseases (infantile pneumonia, diabetes, and pancreatic cancer) from 2008 to 2015. We included 2439 doctors in the analysis. The E-consultation market largely follows the 20/80 principle, namely that approximately 80% of orders are fulfilled by nearly 20% of doctors. This is much higher than the offline health care market. Meanwhile, the market served by doctors with strong online reputations (beta=0.207, P<.001) or strong online self-representation (beta=0.386, P<.001) is less concentrated. When health care services are delivered online, the market will be more concentrated (known as the "Superstar" effect), indicating poor service efficiency for society as a whole. To reduce market concentration, E-consultation websites should provide important design elements such as ratings of doctors (user feedback), articles contributed by doctors, and free consultation services (online representation). A possible and important way to reduce the market concentration of the E-consultation market is to accumulate enough highly rated or highly self-represented doctors. ©Jia Li, Ya Zhang, Ling Ma, Xuan Liu. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 28.10.2016.

Applying research to practice: generalist and specialist (visual ergonomics) consultancy.

Science.gov (United States)

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.

Telephone Consultation as a Substitute for Routine Out-patient Face-to-face Consultation for Children With Inflammatory Bowel Disease: Randomised Controlled Trial and Economic Evaluation.

Science.gov (United States)

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

Engineering Compensations in Web Service Environment

DEFF Research Database (Denmark)

Schäfer, Micahel; Dolog, Peter; Nejdl, Wolfgang

2007-01-01

Business to business integration has recently been performed by employing Web service environments. Moreover, such environments are being provided by major players on the technology markets. Those environments are based on open specifications for transaction coordination. When a failure in such a......Business to business integration has recently been performed by employing Web service environments. Moreover, such environments are being provided by major players on the technology markets. Those environments are based on open specifications for transaction coordination. When a failure...... in such an environment occurs, a compensation can be initiated to recover from the failure. However, current environments have only limited capabilities for compensations, and are usually based on backward recovery. In this paper, we introduce an engineering approach and an environment to deal with advanced...... compensations based on forward recovery principles. We extend the existing Web service transaction coordination architecture and infrastructure in order to support flexible compensation operations. A contract-based approach is being used, which allows the specification of permitted compensations at runtime. We...

The impact of a standardized consultation form for facial trauma on billing and evaluation and management levels.

Science.gov (United States)

Levesque, Andre Y; Tauber, David M; Lee, Johnson C; Rodriguez-Feliz, Jose R; Chao, Jerome D

2014-02-01

Facial trauma is among the most frequent consultations encountered by plastic surgeons. Unfortunately, the reimbursement from these consultations can be low, and qualified plastic surgeons may exclude facial trauma from their practice. An audit of our records found insufficient documentation to justify higher evaluation and management (EM) levels of service resulting in lower reimbursement. Utilizing a standardized consultation form can improve documentation resulting in higher billing and EM levels. A facial trauma consultation form was developed in conjunction with the billing department. Three plastic surgery residents completed 30 consultations without the aid of the consult form followed by 30 consultations with the aid of the form. The EM levels and billing data for each consultation were obtained from the billing department for analysis. The 2 groups were compared using χ2 analysis and t tests to determine statistical significance. Using our standardized consultation form, the mean EM level increased from 2.97 to 3.60 (P = 0.002). In addition, the mean billed amount increased from $391 to $501 per consult (P = 0.051) representing a 28% increase in billing. In our institution, the development and implementation of a facial trauma consultation form has resulted in more complete documentation and a subsequent increase in EM level and billed services.

Analysis of Parent, Teacher, and Consultant Speech Exchanges and Educational Outcomes of Students With Autism During COMPASS Consultation.

Science.gov (United States)

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.

Deployment of e-health services - a business model engineering strategy.

Science.gov (United States)

Kijl, Björn; Nieuwenhuis, Lambert J M; Huis in 't Veld, Rianne M H A; Hermens, Hermie J; Vollenbroek-Hutten, Miriam M R

2010-01-01

We designed a business model for deploying a myofeedback-based teletreatment service. An iterative and combined qualitative and quantitative action design approach was used for developing the business model and the related value network. Insights from surveys, desk research, expert interviews, workshops and quantitative modelling were combined to produce the first business model and then to refine it in three design cycles. The business model engineering strategy provided important insights which led to an improved, more viable and feasible business model and related value network design. Based on this experience, we conclude that the process of early stage business model engineering reduces risk and produces substantial savings in costs and resources related to service deployment.

Quality of Life for Individuals with Hearing Impairment Who Have Not Consulted for Services and Their Significant Others: Same- and Different-Sex Couples

Science.gov (United States)

Kelly, Rebecca J.; Atcherson, Samuel R.

2011-01-01

The purpose of this exploratory study was to assess perceptions of quality of life for individuals with hearing impairment who have not consulted for services and their significant others who are in same-sex relationships vs. those who are in different-sex relationships. Data were collected on a total of 20 older couples: 10 in same-sex…

Experience in accident liquidation at the Chernobyl' NPP and problems of organization of the emergency-engineering service

International Nuclear Information System (INIS)

Andreev, Yu.B.; Samojlenko, Yu.N.

1989-01-01

The efficiency of measures realized in order to eliminate the Chernobyl' accident effects is estimated. The principles of organization of the emergency-engineering service for accident elimination in nuclear power engineering are described. The automated information safety system should from the technical basis for this service. The information system structure is determined. The list of main directions of research and design works realized in the emergency-engineering service interests is given. It is noted that all parts of the emergency-engineering service must prepare the plants of works together with the USSR civil defense service, and they should interact in the process of accident elimination basing on coordinated organizational and technical solutions

Implementing online consultations in primary care: a mixed-method evaluation extending normalisation process theory through service co-production.

Science.gov (United States)

Farr, Michelle; Banks, Jonathan; Edwards, Hannah B; Northstone, Kate; Bernard, Elly; Salisbury, Chris; Horwood, Jeremy

2018-03-19

To examine patient and staff views, experiences and acceptability of a UK primary care online consultation system and ask how the system and its implementation may be improved. Mixed-method evaluation of a primary care e-consultation system. Primary care practices in South West England. Qualitative interviews with 23 practice staff in six practices. Patient survey data for 756 e-consultations from 36 practices, with free-text survey comments from 512 patients, were analysed thematically. Anonymised patients' records were abstracted for 485 e-consultations from eight practices, including consultation types and outcomes. Descriptive statistics were used to analyse quantitative data. Analysis of implementation and the usage of the e-consultation system were informed by: (1) normalisation process theory, (2) a framework that illustrates how e-consultations were co-produced and (3) patients' and staff touchpoints. We found different expectations between patients and staff on how to use e-consultations 'appropriately'. While some patients used the system to try and save time for themselves and their general practitioners (GPs), some used e-consultations when they could not get a timely face-to-face appointment. Most e-consultations resulted in either follow-on phone (32%) or face-to-face appointments (38%) and GPs felt that this duplicated their workload. Patient satisfaction of the system was high, but a minority were dissatisfied with practice communication about their e-consultation. Where both patients and staff interact with technology, it is in effect 'co-implemented'. How patients used e-consultations impacted on practice staff's experiences and appraisal of the system. Overall, the e-consultation system studied could improve access for some patients, but in its current form, it was not perceived by practices as creating sufficient efficiencies to warrant financial investment. We illustrate how this e-consultation system and its implementation can be improved

Biomedical scientists' perceptions of ethical and social implications: is there a role for research ethics consultation?

Directory of Open Access Journals (Sweden)

Jennifer B McCormick

Full Text Available Research ethics consultation programs are being established with a goal of addressing the ethical, societal, and policy considerations associated with biomedical research. A number of these programs are modelled after clinical ethics consultation services that began to be institutionalized in the 1980s. Our objective was to determine biomedical science researchers' perceived need for and utility of research ethics consultation, through examination of their perceptions of whether they and their institutions faced ethical, social or policy issues (outside those mandated by regulation and examination of willingness to seek advice in addressing these issues. We conducted telephone interviews and focus groups in 2006 with researchers from Stanford University and a mailed survey in December 2006 to 7 research universities in the U.S.A total of 16 researchers were interviewed (75% response rate, 29 participated in focus groups, and 856 responded to the survey (50% response rate. Approximately half of researchers surveyed (51% reported that they would find a research ethics consultation service at their institution moderately, very or extremely useful, while over a third (36% reported that such a service would be useful to them personally. Respondents conducting human subjects research were more likely to find such a service very to extremely useful to them personally than respondents not conducting human subjects research (20% vs 10%; chi(2 p<0.001.Our findings indicate that biomedical researchers do encounter and anticipate encountering ethical and societal questions and concerns and a substantial proportion, especially clinical researchers, would likely use a consultation service if they were aware of it. These findings provide data to inform the development of such consultation programs in general.

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

Online health consultation: examining uses of an interactive cancer communication tool by low-income women with breast cancer.

Science.gov (United States)

Lu, Hsueh-Yi; Shaw, Bret R; Gustafson, David H

2011-07-01

To examine how psychosocial variables predicted use of an online health consultation service among low-income breast cancer patients and in turn how using this service affected these same psychosocial outcomes. This retrospective study included 231 recently diagnosed, low-income (at or below 250% of the federal poverty level) breast cancer patients provided a free computer with 16 weeks of access to the Internet-based 'Ask an Expert' service offered as part of the Comprehensive Health Enhancement Support System (CHESS) "Living with Breast Cancer" program. The use activity included a total of 502 messages submitted to the online health consultation service. The data included five psychosocial variables: information seeking, social support, health self efficacy, participation in health care, and doctor-patient relationship, were collected at both the pre-test and 16-week post-test after using the service. Correlation tests were conducted to examine the relationship between pre- and post-test, and use activity. A multiple regression model was formed for each of five psychosocial variables to examine how use activity of the consultation service was associated with various psychosocial measurements. In total, 865 distinct consulting queries from 502 messages were identified as measurement of patients' use activities (3.74 consulting queries per participant). Use activity had significant negative relationships with pre-test scores across all five psychosocial variables. The regression models found significant positive main effects (use activity) associated with three of these psychosocial variables: health self efficacy, participation in health care and doctor-patient relationship. Use activity of the online consultation service did not have significant relationships with the dependent variables of information seeking and perceived social support. Low-income breast cancer patients sought out information from an online cancer information expert. Patients with more

Agile Service Development: A Rule-Based Method Engineering Approach

NARCIS (Netherlands)

dr. Martijn Zoet; Stijn Hoppenbrouwers; Inge van de Weerd; Johan Versendaal

2011-01-01

Agile software development has evolved into an increasingly mature software development approach and has been applied successfully in many software vendors’ development departments. In this position paper, we address the broader agile service development. Based on method engineering principles we

MANAGEMENT COACHING VERSUS MANAGEMENT CONSULTING: WHICH COMES FIRST?

Directory of Open Access Journals (Sweden)

Maria HERMEL STĂNESCU

2014-04-01

Full Text Available In the fast growing business services market today, one manager may wonder whether to use coaching services or consultancy services. Questions might arise: which are the differences between the two types of services, their common points and the relationship between the two? This paper aims to explore the above mentioned questions while pleading for both services. The fact is that they are powerful processes that can bring added value to the organization through use of knowledge. The bottom line is that they work best in different situations, and they should not be regarded as a “one or the other” but as synergy knowledge related tools.

Patient's expectation and perception for preorthodontic treatment consultation: A study in a dental school

Directory of Open Access Journals (Sweden)

Supanee Suntornlohanakul

2018-01-01

Full Text Available Objectives: The aim of the study is to explore the desired expectation (DE, adequate expectation (AE, zone of tolerance (ZoT, and perceived level (PL from the patients attending a preorthodontic treatment consultation at Orthodontic Clinic, Dental School, Prince of Songkla University, Thailand. Materials and Methods: A total of 170 patients aged 15 years and older were asked to express their DE and AE before the consultation and to give their PL after the consultation. Two sets of questionnaires were used in this study. The first set was designed to gain data regarding general information and the measured level of expectation. The second set was used to measure the PL of patients after the preorthodontic consultation. Both questionnaires contained four dimensions of the service: Dentist's courtesy, dentist's care and examination, dentist's communication, and convenience of the services. Results: The communication dimension especially information regarding the orthodontic treatment need got rather low PL compared to others. Conclusion: The information regarding the orthodontic treatment need was the main item that patients need to receive in the consultation.

Online written consultation, telephone consultation and offline appointment: An examination of the channel effect in online health communities.

Science.gov (United States)

Wu, Hong; Lu, Naiji

2017-11-01

The emergence of online health communities broadens and diversifies channels for patient-doctor interaction. Given limited medical resources, online health communities aim to provide better treatment by decreasing medical costs, making full use of available resources and providing more diverse channels for patients. This research examines how online channel usage affects offline channels, i.e., "Online Booking, Service in Hospitals" (OBSH), and how the channel effects change with doctors' online and offline reputation. The study uses data of 4254 doctors from a Chinese online health community. Our findings demonstrate a strong relationship between online health communities and offline hospital communication with an important moderating role for reputation. There are significant channel effects, wherein written consultation complements OBSH (β=3.320, ponline and offline reputations can attract more patients to use the OBSH (β online =0.433, ponline and offline reputations: doctors with higher online reputations mitigate substitution effects between telephone consultation and OBSH (β=0.064, ponline services, especially for these physicians who do not have enough patients. Copyright © 2017 Elsevier B.V. All rights reserved.

Video-conferencing Telehealth Linkage attempts to Schools to Facilitate Mental Health Consultation.

Science.gov (United States)

McLennan, John D

2018-04-01

Telehealth to schools may be a strategic approach to expand child mental health service delivery, however, there are only a few published examples. This report describes video-conferencing telehealth linkage attempts to schools to facilitate mental health consultation. A series of synchronous video-conferencing linkage strategies were attempted to connect a mental health consultation service to multiple schools in a Canadian setting. Consultation to support the implementation of the Daily Report Card, for students with attentional and behavioural problems, was the core content of this pilot linkage attempt. Synchronous video conference consultations were successfully delivered to six elementary schools across three school districts. Two of three linkage strategies were functional. One used existing health centre-based telehealth units to connect to school-based dedicated tablets with a video collaboration app and reliance on existing school Wi-Fi. A second used existing laptops in both the health and school system linked through a communication platform. A third connection, using 3G/4G hotspots to obviate the need to access school Wi-Fi, was deemed too expensive in this setting. The potential to use existing computer hardware to connect mental health providers and schools could facilitate scale-up. However, it is unknown whether mental health systems and school sectors will invest in such linkages and reorganize core mental health services to be delivered in this way.

Ethics consultation on demand: concepts, practical experiences and a case study.

Science.gov (United States)

Reiter-Theil, S

2000-06-01

Despite the increasing interest in clinical ethics, ethics consultation as a professional service is still rare in Europe. In this paper I refer to examples in the United States. In Germany, university hospitals and medical faculties are still hesitant about establishing yet another "committee". One of the reasons for this hesitation lies in the ignorance that exists here about how to provide medical ethics services; another reason is that medical ethics itself is not yet institutionalised at many German universities. The most important obstacle, however, may be that medical ethics has not yet demonstrated its relevance to the needs of those caring for patients. The Centre for Ethics and Law, Freiburg, has therefore taken a different approach from that offered elsewhere: clinical ethics consultation is offered on demand, the consultation being available to clinician(s) in different forms. This paper describes our experiences with this approach; practical issues are illustrated by a case study.

NUKEM. Innovative solutions for nuclear engineering

International Nuclear Information System (INIS)

Scheffler, Beate

2011-01-01

Management of radioactive waste, handling spent fuel elements, decommissioning of nuclear facilities, and engineering and consulting activities are services associated with the name of NUKEM all over the world. The company's scientists and engineers develop solution concepts combining the latest technologies with proven techniques and many years of experience. The company;s history and the services offered to the nuclear industry began more than 5 decades ago. The predecessor, NUKEM Nuklear-Chemie-Metallurgie, was founded in 1960 as one of the earliest nuclear companies in Germany. Originally, the firm produced fuel elements for a variety of reactor lines. As early as in the 1970s, logical extensions of these business activities were nuclear engineering and plant construction. In the meantime, NUKEM Technologies GmbH has developed a worldwide reputation for its activities. Numerous reference projects bear witness to optimum project management and customer satisfaction. Since 2009, NUKEM Technologies has been a wholly owned subsidiary of the Russian Atomstroyexport. NUKEM Technologies operates sales and project offices outside Germany, e.g. in Russia, China, Lithuania, France, and Bulgaria. In this way, the company is present in its target markets of Russia, Western and Eastern Europe as well as Asia, offering customers and partners fast and direct contacts. (orig.)

Occupational therapy consultation for case managers in community mental health: exploring strategies to improve job satisfaction and self-efficacy.

Science.gov (United States)

Chapleau, Ann; Seroczynski, A D; Meyers, Susan; Lamb, Kristen; Haynes, Susan

2011-01-01

The purpose of this study was 2-fold: (1) to examine to what extent case managers' job satisfaction and self-efficacy were impacted by the addition of an occupational therapy consultation model and (2) to identify factors that both positively and negatively impacted the occupational therapy consultation services. The study was conducted at a mental health community support program in a local homeless center. In a 2-year study, a mixed-methods design was used to study changes over time in job satisfaction and perceived self-efficacy among 14 case managers who received ongoing occupational therapy consultation. Job satisfaction and self-efficacy data were obtained using standardized questionnaires. Qualitative data related to factors impacting the consultation program were obtained using open-ended written questions, focus groups, and individual interviews. Statistically significant differences in job satisfaction and perceptions of self-efficacy were found 18 months into the study, when case managers were more actively seeking occupational therapy consultation services and were reporting improved client outcomes from occupational therapy intervention. In addition, themes related to both positive and negative factors impacting the occupational therapy consultation program were identified and provided useful data for development of future consultation services. IMPLICATION FOR CASE MANAGEMENT PRACTICE: Results suggest that ongoing training and professional support for case managers who are paraprofessionals and/or new to mental health practice may improve job satisfaction and efficacy. Occupational therapy consultation may be helpful in developing services for health promotion, including self-care management, cognitive assessments, activity-based programming, and home safety evaluation and modification. In addition, new graduates and paraprofessional case managers working with clients who are high utilizers of services may benefit from smaller caseloads and support

Classificatory multiplicity: intimate partner violence diagnosis in emergency department consultations.

Science.gov (United States)

Olive, Philippa

2017-08-01

To explore the naming, or classification, of physical assaults by a partner as 'intimate partner violence' during emergency department consultations. Research continues to evidence instances when intimate partner physical violence is 'missed' or unacknowledged during emergency department consultations. Theoretically, this research was approached through complexity theory and the sociology of diagnosis. Research design was an applied, descriptive and explanatory, multiple-method approach that combined qualitative semistructured interviews with service-users (n = 8) and emergency department practitioners (n = 9), and qualitative and quantitative document analysis of emergency department health records (n = 28). This study found that multiple classifications of intimate partner violence were mobilised during emergency department consultations and that these different versions of intimate partner violence held different diagnostic categories, processes and consequences. The construction of different versions of intimate partner violence in emergency department consultations could explain variance in people's experiences and outcomes of consultations. The research found that the classificatory threshold for 'intimate partner violence' was too high. Strengthening systems of diagnosis (identification and intervention) so that all incidents of partner violence are named as 'intimate partner violence' would reduce the incidence of missed cases and afford earlier specialist intervention to reduce violence and limit its harms. This research found that identification of and response to intimate partner violence, even in contexts of severe physical violence, was contingent. By lowering the classificatory threshold so that all incidents of partner violence are named as 'intimate partner violence', practitioners could make a significant contribution to reducing missed intimate partner violence during consultations and improving health outcomes for this population. This

Information needs of engineers. The methodology developed by the WFEO Committee on Engineering Information and the use of value analysis for improving information services

International Nuclear Information System (INIS)

Darjoto, S.W.; Martono, A.; Michel, J.

1990-05-01

The World Federation of Engineering Organizations - WFEO - through the work of its Committee on Engineering Information, aims at improving the efficiency of engineers and particularly at developing new attitudes and practices concerning the specialized information mastering. One important part of the WFEO/CEI programme of activities during the last years and for the next years was and is devoted to a better understanding of the information needs of engineers. But also, it seems now essential to WFEO/CEI to better evaluate information services in order to correctly adapt them to the identified needs of engineers. The following communication will emphasize these two main and related perspectives: identifying the information needs of engineers; developing Value Analysis approaches for engineering information services. (author). 3 refs

Information needs of engineers. The methodology developed by the WFEO Committee on Engineering Information and the use of value analysis for improving information services

Energy Technology Data Exchange (ETDEWEB)

Darjoto, S W [Indonesian Inst. of Sciences, Bandung (Indonesia); Martono, A [Indonesian Inst. of Engineers, Jakarta (Indonesia); Michel, J [Ecole Nationale des Ponts et Chaussees, Paris (France)

1990-05-01

The World Federation of Engineering Organizations - WFEO - through the work of its Committee on Engineering Information, aims at improving the efficiency of engineers and particularly at developing new attitudes and practices concerning the specialized information mastering. One important part of the WFEO/CEI programme of activities during the last years and for the next years was and is devoted to a better understanding of the information needs of engineers. But also, it seems now essential to WFEO/CEI to better evaluate information services in order to correctly adapt them to the identified needs of engineers. The following communication will emphasize these two main and related perspectives: identifying the information needs of engineers; developing Value Analysis approaches for engineering information services. (author). 3 refs.

Evaluation of a Digital Consultation and Self-Care Advice Tool in Primary Care: A Multi-Methods Study

Directory of Open Access Journals (Sweden)

Julie Cowie

2018-05-01

Full Text Available Digital services are often regarded as a solution to the growing demands on primary care services. Provision of a tool offering advice to support self-management as well as the ability to digitally consult with a General Practitioner (GP has the potential to alleviate some of the pressure on primary care. This paper reports on a Phase II, 6-month evaluation of eConsult, a web-based triage and consultation system that was piloted across 11 GP practices across Scotland. Through a multi-method approach the evaluation explored eConsult use across practices, exposing both barriers and facilitators to its adoption. Findings suggest that expectations that eConsult would offer an additional and alternative method of accessing GP services were largely met. However, there is less certainty that it has fulfilled expectations of promoting self-help. In addition, low uptake meant that evaluation of current effectiveness was difficult for practices to quantify. The presence of an eConsult champion(s within the practice was seen to be a significant factor in ensuring successful integration of the tool. A lack of patient and staff engagement, insufficient support and lack of protocols around processes were seen as barriers to its success.

Genetic consultation embedded in a gynecologic oncology clinic improves compliance with guideline-based care.

Science.gov (United States)

Senter, Leigha; O'Malley, David M; Backes, Floor J; Copeland, Larry J; Fowler, Jeffery M; Salani, Ritu; Cohn, David E

2017-10-01

Analyze the impact of embedding genetic counseling services in gynecologic oncology on clinician referral and patient uptake of cancer genetics services. Data were reviewed for a total of 737 newly diagnosed epithelial ovarian cancer patients seen in gynecologic oncology at a large academic medical center including 401 from 11/2011-7/2014 (a time when cancer genetics services were provided as an off-site consultation). These data were compared to data from 8/2014-9/2016 (n=336), when the model changed to the genetics embedded model (GEM), incorporating a cancer genetic counselor on-site in the gynecologic oncology clinic. A statistically significant difference in proportion of patients referred pre- and post-GEM was observed (21% vs. 44%, pgenetics consultation and post-GEM 82% were scheduled (pgenetics was also statistically significant (3.92months pre-GEM vs. 0.79months post-GEM, pgenetics consultation (2.52months pre-GEM vs. 1.67months post-GEM, pgenetic counselor on the same day as the referral. Providing cancer genetics services on-site in gynecologic oncology and modifying the process by which patients are referred and scheduled significantly increases referral to cancer genetics and timely completion of genetics consultation, improving compliance with guideline-based care. Practice changes are critical given the impact of genetic test results on treatment and familial cancer risks. Copyright © 2017 Elsevier Inc. All rights reserved.

The Impact of the Internet on Health Consultation Market Concentration: An Econometric Analysis of Secondary Data

Science.gov (United States)

2016-01-01

Background Many markets have traditionally been dominated by a few best-selling products, and this is also the case for the health care industry. However, we do not know whether the market will be more or less concentrated when health care services are delivered online (known as E-consultation), nor do we know how to reduce the concentration of the E-consultation market. Objective The aim of this study was to investigate the concentration of the E-consultation market and how to reduce its concentration through information disclosure mechanisms (online reputation and self-representation). Methods We employed a secondary data econometric analysis using transaction data obtained from an E-consultation Website (haodf.com) for three diseases (infantile pneumonia, diabetes, and pancreatic cancer) from 2008 to 2015. We included 2439 doctors in the analysis. Results The E-consultation market largely follows the 20/80 principle, namely that approximately 80% of orders are fulfilled by nearly 20% of doctors. This is much higher than the offline health care market. Meanwhile, the market served by doctors with strong online reputations (beta=0.207, Ponline self-representation (beta=0.386, Ponline, the market will be more concentrated (known as the “Superstar” effect), indicating poor service efficiency for society as a whole. To reduce market concentration, E-consultation websites should provide important design elements such as ratings of doctors (user feedback), articles contributed by doctors, and free consultation services (online representation). A possible and important way to reduce the market concentration of the E-consultation market is to accumulate enough highly rated or highly self-represented doctors. PMID:27793793

Locum tenens consultant doctors in a rural general hospital - an essential part of the medical workforce or an expensive stopgap?

Science.gov (United States)

Sim, Andrew Jw

2011-01-01

Maintaining hospital consultant staffing levels often requires the employment of locum tenens to meet service needs. This is particularly so in hospitals where core clinical services are run by a small number of permanently appointed consultants. The problems associated with locum employment are underestimated and little attention has been directed towards addressing the issue in the rural general hospitals of Scotland. This study looked at the permanent and short- and long-term locum consultant usage over an 8 year period in one Scottish rural general hospital, the Western Isles Hospital in Stornoway. Data were extracted from the Human Resources Department of NHS Western Isles' list of locum consultants for most weeks from the beginning of January 2002 to the end of December 2009. The Western Isles Hospital in Stornoway has an establishment of 17 permanent consultants. During the 8 year study period 239 different consultants were employed, 20 held substantive permanent positions, 31 were long-term locums (employed >3 months) and 188 were short-term locums. The short-term locums worked for 535 different locum episodes. The pattern of usage varied according to service configuration. Study data revealed the alarming scope of the locum tenens issue, which will increase unless action is taken. For sustainable medical services to continue in the rural general hospitals of Scotland, staffing models must minimise the need to employ locum consultants.

An Employer's Guide to Child Care Consultants.

Science.gov (United States)

Eichman, Caroline

This guide is designed to help employers hire a qualified child care consultant who will evaluate child care options in light of employees' needs and help develop and implement appropriate child care options. These options include: (1) establishment of a child care facility; (2) financial assistance; (3) a resource and referral service; (4)…

A new approach for psychological consultation: the psychologist at the chemist's

Directory of Open Access Journals (Sweden)

Molinari Enrico

2012-07-01

Full Text Available Abstract Background The prevalence of mental illness and psychological suffering is greater than the availability of primary care services in Europe and, in particular, in Italy. The main barriers that hinder the access to these services are economic, the lack of proximity of services and some prejudices that may promote stigma and shame. A new mental health service, named “Psychologist in the Neighbourhood” was created to intercept unexpressed needs for psychological assistance. The service allows everyone to ask for free psychological consultation, consisting of no more than four meetings with a psychologist, in certain chemists’ shops around the city of Milan. This article aims to present the service specific features of this initiative and the results of a pilot study. Methods Information gathered on all users included socio-demographic data, the reasons why they approached this specific service, how they learnt about it, the main presented problem and, for a random sub-group, the level of psychological well-being (as measured by the PGWBI. Socio-demographic data were compared with previously collected information about general users of psychological services. The outcome of the intervention was assessed by the clinicians. Results During the two-year project a total of 1,775 people accessed the service. Compared to traditional users of psychological services, the participants in this service were characterized by a higher presence of females, unemployed and retired people. The main factors encouraging access were proximity and the fact that the service was free of charge. Many of the users were redirected to more specific services, while for about a third of the sample the consultation cycle was sufficient to resolve the presented problem. Conclusions The interest and participation of the population was high and this initiative intercepted an unexpressed requirement for psychological support. Free access and home proximity, were the

Small Business & Consultancy: Exploration of an Experiment with Student Consultants

NARCIS (Netherlands)

I. Hollaender

2007-01-01

In this paper I’ll 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

Consulting in Electronic Commerce

Directory of Open Access Journals (Sweden)

Florentina Loredana Tache

2010-10-01

Full Text Available Economic development of electronic services provide advice and many agents of existingreferral systems to recommend and provide products, information and customized views of thecommunity through a personalized interaction in real time. Distributed systems of autonomous agentsare becoming increasingly important in electronic comet because the basic decisions of agents adviceon trust and reputation are taken in a similar way human society. If these decisions will be as a realconsumer protection, when new aspects of online consumer legislation will become usefulinformation in advice and consulting of electronic commerce.

International telemedicine consultations for neurodevelopmental disabilities.

Science.gov (United States)

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

Consultancy As Employment Options for Library And Information ...

African Journals Online (AJOL)

If pursued independently it can actually function as an 'employer of labour and developed further to provide services both within and outside the immediate library environment. This paper examines the nature and prospects of consultancy as a suitable employment option for graduates of library and information science.

Consultant paediatric outreach clinics--a practical step in integration.

Science.gov (United States)

Spencer, N J

1993-04-01

Ten years' experience of paediatric outreach clinics is reviewed and evaluated. The advantages and disadvantages of paediatric outreach and its possible place in the new era of contracting and more developed community paediatric services are discussed. It is concluded that paediatric outreach increases parental and professional choice and access to paediatric consultant services, increases service flexibility, reduces unnecessary hospital visits, and enables more rational and relevant clinical decision making. Outreach is particularly relevant in areas of deprivation where paediatric needs are greatest.

ETICS the international software engineering service for the grid

CERN Document Server

Di Meglio, A; Couvares, P; Ronchieri, E; Takács, E

2008-01-01

The ETICS system is a distributed software configuration, build and test system designed to fulfil the needs of improving the quality, reliability and interoperability of distributed software in general and grid software in particular. The ETICS project is a consortium of five partners (CERN, INFN, Engineering Ingegneria Informatica, 4D Soft and the University of Wisconsin-Madison). The ETICS service consists of a build and test job execution system based on the Metronome software and an integrated set of web services and software engineering tools to design, maintain and control build and test scenarios. The ETICS system allows taking into account complex dependencies among applications and middleware components and provides a rich environment to perform static and dynamic analysis of the software and execute deployment, system and interoperability tests. This paper gives an overview of the system architecture and functionality set and then describes how the EC-funded EGEE, DILIGENT and OMII-Europe projects ...

46 CFR 11.522 - Service requirements for assistant engineer (limited oceans) of steam and/or motor vessels.

Science.gov (United States)

2010-10-01

... oceans) of steam and/or motor vessels. 11.522 Section 11.522 Shipping COAST GUARD, DEPARTMENT OF HOMELAND... Requirements for Engineer Officer § 11.522 Service requirements for assistant engineer (limited oceans) of... assistant engineer (limited oceans) of steam and/or motor vessels is three years of service in the...

[Differences in the nursing consultation utilization in primary care, Spain].

Science.gov (United States)

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.

75 FR 54064 - Consultation Agreements: Proposed Changes to Consultation Procedures

Science.gov (United States)

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...

Performance-based service acquisition (PBSA) of TRIDENT strategic weapons systems (SWS) technical engineering support (TES) services

OpenAIRE

Arcidiacono, William J.

2003-01-01

CIVINS (Civilian Institutions) Thesis document Approved for public release ; distribution is unlimited The objective of this thesis is to determine whether the Strategic Systems Programs (SSP) should apply the concepts of Performance-Based Service Acquisition (PBSA) to Strategic Weapons Systems (SWS) Technical Engineering Support (TES) Services. This thesis provides a Department of Defense (DoD), Department of the Navy (DON), and SSP SWS program acquisition and PBSA history background, ...

Evolution of External Consultant Involvement in Human Resource Management in Eastern Europe (1990-2007

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.

Team- and project work in engineering practices

DEFF Research Database (Denmark)

Buch, Anders; Andersen, Vibeke

2015-01-01

in teamwork practices, and, thirdly, how team- and project work affect engineering professionalism and collaborative work practices. A practice theoretical framework informs the analysis. Teamwork is investigated as a phenomenon enacted through the sayings, doings and relatings of practitioners in landscapes......In this paper we investigate teamwork amongst professionals in engineering consultancy companies in order to discern how teamwork affects the collaboration and work practices of the professionals. The paper investigates how professional engineering practices are enacted in two engineering...... consultancy companies in Denmark where teamwork has been or is an ideal for organizing work. Through a practice-based lens the article sets out to investigate, firstly, how discourses about teamand project work affect engineering work practices, secondly, how technology-mediated management is reconciled...

Examining adherence to components of cognitive-behavioral therapy for youth anxiety after training and consultation.

Science.gov (United States)

Edmunds, Julie M; Brodman, Douglas M; Ringle, Vanesa A; Read, Kendra L; Kendall, Philip C; Beidas, Rinad S

2017-02-01

The present study examined 115 service providers' adherence to components of cognitive-behavioral therapy (CBT) for youth anxiety prior to training, post workshop training, and after three months of weekly consultation. Adherence was measured using a role-play with a trained actor. We examined differences in individual adherence to CBT components across time and the relationship between number of consultation sessions attended and adherence ratings following consultation. Findings indicated that somatic arousal identification and relaxation were the most used treatment components prior to training. Adherence to all components of CBT increased following workshop training, except the usage of problem-solving. Adherence to problem-solving, positive reinforcement, the identification of anxious self-talk, and the creation of coping thoughts increased following consultation but usage of problem-solving remained low compared to other treatment components. Overall adherence remained less than optimal at the final measurement point. Number of consultation sessions attended predicted post-consultation adherence to identification of somatic arousal, identification of anxious self-talk, and positive reinforcement. Implications include tailoring future training based on baseline levels of adherence and spending more time during training and consultation on underutilized CBT components, such as problem-solving. Limitations of the present study, including how adherence was measured, are discussed. This study adds to the implementation science literature by providing more nuanced information on changes in adherence over the course of training and consultation of service providers.

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

Doctor-patient communication: a comparison between telemedicine consultation and face-to-face consultation.

Science.gov (United States)

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.

Examining adherence to components of cognitive-behavioral therapy for youth anxiety after training and consultation

OpenAIRE

Edmunds, Julie M.; Brodman, Douglas M.; Ringle, Vanesa A.; Read, Kendra L.; Kendall, Philip C.; Beidas, Rinad S.

2016-01-01

The present study examined 115 service providers’ adherence to components of cognitive-behavioral therapy (CBT) for youth anxiety prior to training, post workshop training, and after three months of weekly consultation. Adherence was measured using a role-play with a trained actor. We examined differences in individual adherence to CBT components across time and the relationship between number of consultation sessions attended and adherence ratings following consultation. Findings indicated t...

UFISA: electric facility engineering for the service of emergy market

International Nuclear Information System (INIS)

Gutierrez Zapico, A.

1997-01-01

UFISA is the engineering company with the experience of UNION ELECTRICA FENOSA S.A. It activity began in 1990. This company offers to national and international markets the services for energy consumers and for the electricity costumers. (Author)

Exploratory Analysis of the Effect of Consultants on the Use of World Wide Web Sites in SMEs

Directory of Open Access Journals (Sweden)

Sigi Goode

2002-11-01

Full Text Available There is little published research on the role of consultants in technology adoption. Given the increasing popularity of the World Wide Web in commercial environments and the number of consultants now offering web development services, some analysis into the effects of their engagement would be of benefit. In an extension of an ongoing study, an existing sample of 113 World Wide Web adopters was used to examine the nature of World Wide Web site use with respect to consultant and Internet Service Provider (ISP engagement. Analysis was also conducted into the use of consultants and ISPs as developers and maintainers of these sites. This preliminary research finds a number of interesting outcomes. No significant relationship is found between consultant or ISP engagement and World Wide Web site use, regardless of whether the consultant was engaged as site developer or site maintainer. The study raises a number of additional findings that are of interest but are not directly related to this study. These findings merit further research.

Multiple Learning Strategies Project. Small Engine Repair Service. Regular Vocational. [Vol. 1.

Science.gov (United States)

Pitts, Jim; And Others

This instructional package is one of two designed for use by regular vocational students in the vocational area of small engine repair service. Contained in this document are forty-four learning modules organized into ten units: engine block; air cleaner; starters; fuel tanks; lines, filters, and pumps; carburetors; electrical; magneto systems;…

Consultancy to dairy farmers relating to animal health and herd health management on small- and medium-sized farms.

Science.gov (United States)

Pothmann, H; Nechanitzky, K; Sturmlechner, F; Drillich, M

2014-02-01

The objectives of this study were to obtain information about animal health challenges for dairy farmers of small- and medium-sized herds and about the fields in which consultancy services should be improved. The hyperlink to an internet-based survey was sent to 9,021 farmers in Austria. The survey included questions about the participants and their farms, about who is consulting with the farmers with regard to animal health, feeding, sire selection, construction of barns and animal husbandry, about animal health issues farmers find most challenging, and about their demands for improved consultancy services. The questionnaire was completed anonymously. Analyses were stratified by milk yield (categorized) and whether farmers worked full-time or part-time. The overall response rate was 11.3% (n=1,018). The majority of farms kept less than 20 cows (54.0%) or 20 to 50 cows (40.1%). With regard to animal health, the veterinarian was the most important consultant for the majority of farmers (84.6%). On issues related to feeding, sire selection, and stable construction, the veterinarian was seen as a less important consultant than specialists in these fields (20.4, 11.6, and 7.9% suggested the veterinarian as an important consultant in these areas). The survey indicated that reproductive disorders, udder disease, poor conception rate, lameness, and calf diarrhea represent the most important challenges to farmers. Of these, concerns about calf diarrhea were affected by milk yield of the herds and management. More high- than low-yielding farms (11.7 vs. 6.4%) and more full-time than part-time managed herds (9.6 vs.4.3%) regarded calf diarrhea as an important problem. Farmers would welcome improved consultancy with regard to fertility, feeding, and sire selection. The results indicated which animal health issues farmers find particularly challenging and displayed which areas farmers require improved consultancy services. Veterinarians and organizations offering consultancy

Service on demand for ISS users

Science.gov (United States)

Hüser, Detlev; Berg, Marco; Körtge, Nicole; Mildner, Wolfgang; Salmen, Frank; Strauch, Karsten

2002-07-01

Since the ISS started its operational phase, the need of logistics scenarios and solutions, supporting the utilisation of the station and its facilities, becomes increasingly important. Our contribution to this challenge is a SERVICE On DEMAND for ISS users, which offers a business friendly engineering and logistics support for the resupply of the station. Especially the utilisation by commercial and industrial users is supported and simplified by this service. Our industrial team, consisting of OHB-System and BEOS, provides experience and development support for space dedicated hard- and software elements, their transportation and operation. Furthermore, we operate as the interface between customer and the envisaged space authorities. Due to a variety of tailored service elements and the ongoing servicing, customers can concentrate on their payload content or mission objectives and don't have to deal with space-specific techniques and regulations. The SERVICE On DEMAND includes the following elements: ITR is our in-orbit platform service. ITR is a transport rack, used in the SPACEHAB logistics double module, for active and passive payloads on subrack- and drawer level of different standards. Due to its unique late access and early retrieval capability, ITR increases the flexibility concerning transport capabilities to and from the ISS. RIST is our multi-functional test facility for ISPR-based experiment drawer and locker payloads. The test program concentrates on physical and functional interface and performance testing at the payload developers site prior to the shipment to the integration and launch. The RIST service program comprises consulting, planning and engineering as well. The RIST test suitcase is planned to be available for lease or rent to users, too. AMTSS is an advanced multimedia terminal consulting service for communication with the space station scientific facilities, as part of the user home-base. This unique ISS multimedia kit combines

Computerized system for hospital engineering service management

International Nuclear Information System (INIS)

Centeno, C A; Gonzalez, E A; Cagnolo, F J; Olmos, C E

2007-01-01

When a Hospital Engineering Service (HES) is implemented within a health care environment, the idea is to improve service conditions and costs as well as to provide timely responses to equipment preventive maintenance and infrastructure requirements. An HES must, within the shortest possible period of time, meet the above requirements at the cost necessary to provide the service quality sought. In many cases there is a lack of minimal materials and staff who are qualified to attain the objectives that have been set. Therefore, external assistance becomes necessary. In this context, actions are often taken which, because they are not recorded, cannot be assessed in order to evaluate the HES. Since all action taken is appraised from the purely economic point of view, in the final analysis the contributions from staff remain invisible. This situation works against the possibility of quantifying the convenience of possessing an internal HES. The software support system we have developed here is oriented toward providing all the necessary data to address this issue

Systematic Heuristic Evaluation of Computerized Consultation Order Templates: Clinicians' and Human Factors Engineers' Perspectives.

Science.gov (United States)

Savoy, April; Patel, Himalaya; Flanagan, Mindy E; Weiner, Michael; Russ, Alissa L

2017-08-01

We assessed the usability of consultation order templates and identified problems to prioritize in design efforts for improving referral communication. With a sample of 26 consultation order templates, three evaluators performed a usability heuristic evaluation. The evaluation used 14 domain-independent heuristics and the following three supplemental references: 1 new domain-specific heuristic, 6 usability goals, and coded clinicians' statements regarding ease of use for 10 sampled templates. Evaluators found 201 violations, a mean of 7.7 violations per template. Minor violations outnumbered major violations almost twofold, 115 (57%) to 62 (31%). Approximately 68% of violations were linked to 5 heuristics: aesthetic and minimalist design (17%), error prevention (16%), consistency and standards (14%), recognition rather than recall (11%), and meet referrers' information needs (10%). Severe violations were attributed mostly to meet referrers' information needs and recognition rather than recall. Recorded violations yielded potential negative consequences for efficiency, effectiveness, safety, learnability, and utility. Evaluators and clinicians demonstrated 80% agreement in usability assessment. Based on frequency and severity of usability heuristic violations, the consultation order templates reviewed may impede clinical efficiency and risk patient safety. Results support the following design considerations: communicate consultants' requirements, facilitate information seeking, and support communication. While the most frequent heuristic violations involved interaction design and presentation, the most severe violations lacked information desired by referring clinicians. Violations related to templates' inability to support referring clinicians' information needs had the greatest potential negative impact on efficiency and safety usability goals. Heuristics should be prioritized in future design efforts.

The Clinical Impact of Cardiology Consultation Prior to Major Vascular Surgery.

Science.gov (United States)

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.

An analysis on the marketing of engineering services for the cement manufacturing industry in Sub-Saharan Africa

CSIR Research Space (South Africa)

Meyer, JAM

2017-09-01

Full Text Available South African organisations that offer engineering services to the local and foreign market contribute significantly towards South Africa’s overall Gross Domestic Product (GDP). The importance of engineering services in South Africa motivates...

Impact of palliative care consultative service on disease awareness for patients with terminal cancer.

Science.gov (United States)

Chou, Wen-Chi; Hung, Yu-Shin; Kao, Chen-Yi; Su, Po-Jung; Hsieh, Chia-Hsun; Chen, Jen-Shi; Liau, Chi-Ting; Lin, Yung-Chang; Liaw, Chuang-Chi; Wang, Hung-Ming

2013-07-01

Awareness of the status of disease among terminally ill cancer patients is an important part of the end-of-life care. We have evaluated how palliative care consultative service (PCCS) affects patient disease awareness and determined who may benefit from such services in Taiwan. In total, 2,887 terminally ill cancer patients consecutively received PCCS between January 2006 and December 2010 at a single medical center in Taiwan, after which they were evaluated for disease awareness. At the beginning of PCCS, 31 % of patients (n = 895) were unaware of their disease status. The characteristics of these 895 patients were analyzed retrospectively to determine variables pertinent to patient disease awareness after PCCS. In total, 485 (50 %) of the 895 patients became aware of their disease at the end of PCCS. Factors significantly associated with higher disease awareness included a longer interval between the date of hospital admission and that of PCCS referral (>4 weeks versus ≤2 weeks), a longer duration of PCCS (>14 days versus ≤7 days), the male gender, divorced marital status (versus married), and family awareness (versus lack of family awareness). Lower disease awareness was associated with older age (age > 75 years versus age = 18-65 years), referral from non-oncology departments, and primary cancer localization (lung, colon-rectum, or urological versus liver). Disease awareness is affected by multiple factors related to the patients, their families, and the clinicians. The promotion of PCCS increased disease awareness among terminally ill cancer patients in Taiwan.

Applied Ontology Engineering in Cloud Services, Networks and Management Systems

CERN Document Server

Serrano Orozco, J Martín

2012-01-01

Metadata standards in today’s ICT sector are proliferating at unprecedented levels, while automated information management systems collect and process exponentially increasing quantities of data. With interoperability and knowledge exchange identified as a core challenge in the sector, this book examines the role ontology engineering can play in providing solutions to the problems of information interoperability and linked data. At the same time as introducing basic concepts of ontology engineering, the book discusses methodological approaches to formal representation of data and information models, thus facilitating information interoperability between heterogeneous, complex and distributed communication systems. In doing so, the text advocates the advantages of using ontology engineering in telecommunications systems. In addition, it offers a wealth of guidance and best-practice techniques for instances in which ontology engineering is applied in cloud services, computer networks and management systems. �...

Consultation Models Revisited

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)

Service Cart For Engines

Science.gov (United States)

Ng, Gim Shek

1995-01-01

Cart supports rear-mounted air-cooled engine from Volkswagen or Porsche automobile. One person removes, repairs, tests, and reinstalls engine of car, van, or home-built airplane. Consists of framework of wood, steel, and aluminum components supported by four wheels. Engine lifted from vehicle by hydraulic jack and gently lowered onto waiting cart. Jack removed from under engine. Rear of vehicle raised just enough that engine can be rolled out from under it. Cart easily supports 200-lb engine. Also used to hold transmission. With removable sheet-metal top, cart used as portable seat.

Consultancy driven Business Process Re-engineering in Denmark and its impact on Organizations and Working Environment

DEFF Research Database (Denmark)

Manske, Fred; Koch, Christian; Vogelius, Peter

1998-01-01

The articel present some interim results from a Danish research project on social constitution of BPR in Denmark and the consequences for working environment. The consultants play a key role in developing and promoting management concepts internationally. Also in the development and diffusion...... of BPR in Denmark consultants are central but they are in interaction with enterprises, professional associations, publishers, the press, a/o. Whether this interaction leads to a special national (e.g. Danish) variant of BPR. is an central question in the discussion, On the basis of it interviews...... with consultants it concluded that we can't identify any special Danish version of BPR informed by a sort of "Scandinavian tradition"....

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. �

Job share a consultant post.

OpenAIRE

Thornicroft, G.; Strathdee, G.

1992-01-01

Job sharing offers advantages to both employer and employee but it is still uncommon in medicine. Based on the experiences of two psychiatrists sharing a consultant post this article describes some of the problems in obtaining a job share. The most difficult part can be getting an interview, and once a post has been obtained the terms and conditions of service may have to be modified to suit job sharing. Getting on well with your job sharing partner and good communication will not only help o...

The Effect of the Strictness of Consultation Requirements on Fraud Consultation

NARCIS (Netherlands)

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

[Hospital admisions and consultations in a dialysis population].

Science.gov (United States)

Reichert, J

2007-01-01

The hemodialysis (HD) population continues growing and aging, reason why they are required to adapt the human, economic and materials resources to be taken care of. To analyze the distribution of the consultations and the times of admissions in the different Hospital services of which an peripheral arranged HD Center depends. We analyzed all the consultations to the Hospital Urgencies Departments and Hospitable admissions of all the patients who received HD in the arranged Center Ponfedial, (sanitary area Ponferrada of 150,000 inhabitants) in period 01/12/02 to the 31/05/05. We prospectively examined a population of 87 HD patients (71.0+/-12.5 years, 77.9 % male, 31.4% diabetics) time in HD 21.0+/-22.7 months. They were a total of 286 (9.5/month) consultations in the Service of Urgencies (2.31 consult/patient/year), 37.4% of them did not motivate admissions. The most frequent consultation (28,9%) was the complications of vascular access (70,9% of them required positioning a transitory catheter; 1.1 complication of catheter/months, 1 permanent catheter is placed/1.2 months and 1 fistulography/1.2 months), cardiac causes 10.3%, acute pulmonar edema: 9.3%, infectious: 8.4% and traumatologic: 8.4%. There were 179 admissions (5.9/month; 1.44 hospitalizations/patient/year; 4.0+/-14.2 days of admissions): cardiovascular cause: 37.4%, by vascular access: 18.4%, infectious disease: 17.0%, digestive: 6.7%, traumatologic: 3.9% and by other causes: 11.0%. The cardiovascular group takes 46.5% (60.8% of them by vascular peripheral disease) of the total of days of hospitalizations, infectious 16.7%, neoplasic 8.4% and vascular access 7.6%. The neoplasic causes were the greater average with 36.0+/-21.6 days of hospitalization, by amputations 23.0+/-38.1 days, by stroke 14.5+/-10.6 days, infected ulcers of lower extremities members 10.0+/-19.0, other vascular treatments 10.0+/-4.7, ischemic heart disease 8.5+/-20.3 and heart failure 7.5+/-5.2 days. Our prevalent population of 49

Inpatient Consultative Dermatology.

Science.gov (United States)

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.

Breaking out of the biomed box: an audit assessment and recommendations for an in-house biomedical engineering program.

Science.gov (United States)

Dickey, David M; Jagiela, Steven; Fetters, Dennis

2003-01-01

In order to assess the current performance and to identify future growth opportunities of an in-house biomedical engineering (BME) program, senior management of Lehigh Valley Hospital (Allentown, Penn) engaged (in July 2001) the services of a clinical engineering consultant. Although the current in-house program was both functionally and financially sound, an independent audit had not been performed in over 4 years, and there were growing concerns by the BME staff related to the department's future leadership and long-term support from senior management. After an initial 2-month audit of the existing program, the consultant presented 41 separate recommendations for management's consideration. In order to refine and implement these recommendations, 5 separate committees were established to further evaluate a consolidated version of them, with the consultant acting as the facilitator for each group. Outcomes from each of the committees were used in the development of a formal business plan, which, upon full implementation, would not only strengthen and refine the current in-house service model but could also result in a substantial 3-year cost savings for the organization ($1,100,000 from existing operations, $500,000 in cost avoidance by in-sourcing postwarranty support of future capital equipment acquisitions). Another key outcome of the project was related to the development of a new master policy, titled the "Medical Equipment Management Program," complete with a newly defined state-of-the-art equipment scheduled inspection frequency model.

Developing social marketed individual preconception care consultations: Which consumer preferences should it meet?

Science.gov (United States)

van Voorst, Sabine F; Ten Kate, Chantal A; de Jong-Potjer, Lieke C; Steegers, Eric A P; Denktaş, Semiha

2017-10-01

Preconception care (PCC) is care that aims to improve the health of offspring by addressing risk factors in the pre-pregnancy period. Consultations are recognized as a method to promote perinatal health. However, prospective parents underutilize PCC services. Uptake can improve if delivery approaches satisfy consumer preferences. Aim of this study was to identify preferences of women (consumers) as a first step to social marketed individual PCC consultations. In depth, semi-structured interviews were performed to identify women's views regarding the four components of the social marketing model: product (individual PCC consultation), place (setting), promotion (how women are made aware of the product) and price (costs). Participants were recruited from general practices and a midwife's practice. Content analysis was performed by systematic coding with NVIVO software. The 39 participants reflected a multiethnic intermediately educated population. Product: Many participants had little knowledge of the need and the benefits of the product. Regarding the content of PCC, they wish to address fertility concerns and social aspects of parenthood. PCC was seen as an informing and coaching service with a predominant role for health-care professionals. the general practitioner and midwife setting was the most mentioned setting. Promotion: A professional led promotion approach was preferred. Price: Introduction of a fee for PCC consultations will make people reconsider their need for a consultation and could exclude vulnerable patients from utilization. This study provides consumer orientated data to design a social marketed delivery approach for individual PCC consultations. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Quality of Work and Team- and Project Based Work Practices in Engineering

DEFF Research Database (Denmark)

Buch, Anders; Andersen, Vibeke

2015-01-01

It is the aim of this paper to investigate teamwork amongst professionals in engineering consultancy companies in order to discern how teamwork affects the collaboration and work practices of the professionals and eventually their quality of work. The paper investigates how professional engineering...... ractices are enacted in two engineering consultancy companies in Denmark where ‘teamwork’ has been or is an ideal for organizing work....

After-sales service of engineering industrial assets a reference framework for warranty management

CERN Document Server

González-Prida Díaz, Vicente

2014-01-01

This book explores the practical implementation of an advanced after-sales management framework devoted to warranty management. The framework is intended for companies producing either standardized or customized products, and such a management tool will facilitate organizational improvement and support innovative decision making processes for technical assistance in after-sales services.  “After–sales Service of Engineering Industrial Assets” comprises a proposal for a warranty management framework, with an account of the different methods that can be used to improve decision making in the different stages of the after-sales service management process, and strategies for strengthening the structure and foundations of the framework. A review of the fundamental issues and current research topics in warranty management and after sales services is also provided, which is exemplified by a case study. This book is intended for postgraduates, researchers and engineers who are interested in aftersales manageme...

Engine Tune-Up Service. Unit 4: Secondary Circuit. Posttests. Automotive Mechanics Curriculum.

Science.gov (United States)

Morse, David T.

This book of posttests is designed to accompany the Engine Tune-Up Service Student Guide for Unit 4, Secondary Circuit, available separately as CE 031 214. Focus of the posttests is testing and servicing the secondary ignition circuit. One multiple choice posttest is provided that covers the seven performance objectives contained in the unit. (No…

Defining the role of the consultant psychiatrist in a public mental health service.

Science.gov (United States)

Boyce, P; Tobin, M

1998-10-01

The aim of this paper is to clarify elements of the role of a psychiatrist working in the public sector. The relevant literature was examined to help clarify some of the reasons psychiatrists have been leaving the public sector and to help define the key roles of a psychiatrist working in the public sector. Two principal roles for the consultant psychiatrist in the public sector are identified: the psychiatrist as a clinician and the psychiatrist as a manager. The management role is contrasted with the role as an administrator and important differences between these roles are identified. The management role includes planning, advocacy and managing human resources. The importance of professional development in the career path for the newly qualified psychiatrist is discussed. The role of the psychiatrist in public sector psychiatry is a challenging and exciting one. Psychiatrists will start to return to the public sector when they recognise this new role for the consultant psychiatrist. This will be to the advantage of public sector psychiatry in general and to the job satisfaction of psychiatrists. The key features of the clinical role are the demonstration of sophisticated clinical skills, providing clinical leadership via supervision, being accountable for patient care and providing consultant opinion on complex clinical problems.

Ongoing Evaluation of Clinical Ethics Consultations as a Form of Continuous Quality Improvement.

Science.gov (United States)

Volpe, Rebecca

2017-01-01

Ongoing evaluation of a clinical ethics consultation service (ECS) allows for continuous quality improvement, a process-based, data-driven approach for improving the quality of a service. Evaluations by stakeholders involved in a consultation can provide real-time feedback about what is working well and what might need to be improved. Although numerous authors have previously presented data from research studies on the effectiveness of clinical ethics consultation, few ECSs routinely send evaluations as an ongoing component of their everyday clinical activities. The primary purpose of this article is to equip and encourage others to engage in ongoing evaluation of their own ECS. Toward that end, the following resources are shared: (1) the survey tool used to gather the evaluation data, (2) the procedure used to elicit and collate responses, and (3) how the resulting data are used to support continuous quality improvement and justify the continued financial support of the ECS to hospital administration. Copyright 2017 The Journal of Clinical Ethics. All rights reserved.

40 CFR 1048.401 - What testing requirements apply to my engines that have gone into service?

Science.gov (United States)

2010-07-01

... engines that have gone into service? 1048.401 Section 1048.401 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR POLLUTION CONTROLS CONTROL OF EMISSIONS FROM NEW, LARGE NONROAD SPARK-IGNITION ENGINES Testing In-use Engines § 1048.401 What testing requirements apply to my engines that have...

DESIGN AND DEVELOPMENT OF A REMOTE MEDICAL CONSULTATION SYSTEM

Directory of Open Access Journals (Sweden)

"A. Delrobaee

2006-05-01

Full Text Available Telemedicine is an indispensable tool in the hands of doctors to accelerate and facilitate the process of data interchange. To publicize and distribute the culture of utilizing this technology and providing the necessary equipment for this purpose and also to commence some useful activities in this field of science in Iran, the researchers group have designed and performed a telemedicine internet site with the goal of medical consultation. Software was designed and prepared, which is accessible to three groups of users with definite level of access for each one: normal users, doctors and site administrators. There are four main forums on this website with the following titles: medical consultation (Q&A, doctors’ special forum, scientific and research centers and also special disease groups, and the forum of graduates and medical students. Ultimately, we could achieve a new horizon to expand telemedicine activities in the field of medical consultation. A free web-based system was developed through the address of www.teleteb.com with the aim of remote medical consultation, developing the public health services and creating a powerful scientific and research link in the society of medicine.

Application of Value Engineering to Improve upon Customer Services Performance in Mazandaran Water and Sewage Company

Directory of Open Access Journals (Sweden)

Reza Tavakkoli-Mogahddam

2007-06-01

Full Text Available Over the course of producing and marketing goods and services, it appears that industry faces a new challenge in which information and science form the basis for any organizational movement. In this regard, the competitive preference of the organization concentrates on customer and value creation in the organization. Value engineering recognizes product/service functions and produces those with the maximum value at the lowest cost without the loss of production or service quality and safety. In this paper, using value engineering based on the international job plan of the SAVE (Society of American Value Engineering, various alternatives are proposed to improve upon the performance of Customer Services of Water and Sewage Co. The results indicate possible savings of about 714 Million Rials for the water authority in the city of Sari and 4860 Million Rials across Mazandaran Province.

The OHS consultant as a facilitator of learning in workplace design processes

DEFF Research Database (Denmark)

Broberg, Ole; Hermund, Ingelise

2007-01-01

Occupational health service (OHS) consultancy on workplace design proc-esses in client enterprises is expected also to entail some elements of learn-ing. When the OHS consultant has performed the task the enterprise should have learned something on how to integrate health and safety aspects...... into the workplace design process, thereby making it easier for the enterprise to manage such a change in the future. The objective of this explorative study was to survey current practice of OHS consultants and put forward recom-mendations on how to improve the learning aspects of OHS consultancy. Four cases were...... devices between different communities of practice. Certain boundary objects work better than others in promoting learning and collaborative workplace design processes. For both industry and OHS units it is of importance to properly understand learning models and to align their mutual expectations...

On founding of the science and technology intelligence (STI) research system for the grand engineering research organization

International Nuclear Information System (INIS)

Li Zhimin; Tang Yong; Shi Yi; Wang Yirong

2010-01-01

This article discusses the science and technology intelligence (STI) research system for grand engineering research organization, and pose that this system should be composed of five elements of research category, research form, service patterns , quality control and fruit evaluation and precession with ability, and describes its definition, connotation and function for each element. research category includes strategy intelligence, technology route and develop trend, technology detail; research form has dynamic track, investigation and analysis, consult study; service patterns involve demand or induction service, independence or mutual action service; quality control and fruit evaluation should be conducted by a group of technologist and intelligence expert; precession with ability should be an organized system with good configuration and learning ability. (authors)

An integrative fuzzy Kansei engineering and Kano model for logistics services

Science.gov (United States)

Hartono, M.; Chuan, T. K.; Prayogo, D. N.; Santoso, A.

2017-11-01

Nowadays, customer emotional needs (known as Kansei) in product and especially in services become a major concern. One of the emerging services is the logistics services. In obtaining a global competitive advantage, logistics services should understand and satisfy their customer affective impressions (Kansei). How to capture, model and analyze the customer emotions has been well structured by Kansei Engineering, equipped with Kano model to strengthen its methodology. However, its methodology lacks of the dynamics of customer perception. More specifically, there is a criticism of perceived scores on user preferences, in both perceived service quality and Kansei response, whether they represent an exact numerical value. Thus, this paper is proposed to discuss an approach of fuzzy Kansei in logistics service experiences. A case study in IT-based logistics services involving 100 subjects has been conducted. Its findings including the service gaps accompanied with prioritized improvement initiatives are discussed.

[Consultation/liaison addiction medicine: Tools and specificities].

Science.gov (United States)

Poloméni, P; Cleirec, G; Icard, C; Ramos, A; Rolland, B

2018-03-23

Since the 1970s, the concept of "consultation/liaison (CL) psychiatry" has pertained to specialized mobile teams which meet inpatients hospitalized in non-psychiatric settings to offer them on-the-spot psychiatric assessment, treatment, and, if needed, adequate referral. Since the birth of CL psychiatry, a long set of theoretical books and articles has aimed at integrating CL psychiatry into the wider scope of psychosomatic medicine. In the year 2000, a circular issued by the Health Ministry defined the organization of "CL addiction services" in France. Official CL addiction teams are named "Équipes de Liaison et de Soins en Addictologie" (ELSAs) which are separated from CL psychiatry units. Though this separation can be questioned, it actually emphasizes that the work provided by CL addiction teams has some very specific features. The daily practice of ELSAs somewhat differs from that of psychiatric CL teams. Addictive behaviors often result from progressive substance misuse. In this respect, the ELSAs' practice frequently involves screening, brief intervention, and referral to treatment (SBIRT) interventions, which are rather specific of addiction medicine and consist more of prevention interventions than actual addiction treatment. Moreover, for patients with characterized substance use disorders substantial skills in motivational interviewing are required in ELSA consultations. Though motivational interviewing is not specific to addiction medicine, its regular use is uncommon for other liaison teams in France. Furthermore, substance misuse can induce many types of acute or delayed substance-specific medical consequences. These consequences are often poorly known and thus poorly explored by physicians of other specialties. ELSAs have therefore the role of advising their colleagues for a personalized somatic screening among patients with substance misuse. In this respect, the service undertaken by ELSAs is not only based on relational skills but also comprises a

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.

Virtualized healthcare delivery: understanding users and their usage patterns of online medical consultations.

Science.gov (United States)

Jung, Changmi; Padman, Rema

2014-12-01

Virtualization of healthcare delivery via patient portals has facilitated the increasing interest in online medical consultations due to its benefits such as improved convenience and flexibility, lower cost, and time savings. Despite this growing interest, adoption by both consumers and providers has been slow, and little is known about users and their usage and adoption patterns. To learn characteristics of online healthcare consumers and understand their patterns of adoption and usage of online clinical consultation services (or eVisits delivered via the portal) such as adoption time for portal users, whether adoption hazard changes over time, and what factors influence patients to become early/late adopters. Using online medical consultation records between April 1, 2009 and May 31, 2010 from four ambulatory practices affiliated with a major healthcare provider, we conduct simple descriptive analysis to understand the users of online clinical consults and their usage patterns. Multilevel Logit regression is employed to measure the effect of patient and primary care provider characteristics on the likelihood of eVisit adoption by the patient, and survival analysis and Ordered Logit regression are applied to study eVisit adoption patterns that delineate elements describing early or late adopters. On average, eVisit adopters are younger and predominantly female. Their primary care providers participate in the eVisit service, highlighting the importance of physician's role in encouraging patients to utilize the service. Patients who are familiar with the patient portal are more likely to use the service, as are patients with more complex health issues. Younger and female patients have higher adoption hazard, but gender does not affect the decision of adopting early vs. late. These adopters also access the patient portal more frequently before adoption, indicating that they are potentially more involved in managing their health. The majority of eVisits are submitted

Architectural Engineers

DEFF Research Database (Denmark)

Petersen, Rikke Premer

engineering is addresses from two perspectives – as an educational response and an occupational constellation. Architecture and engineering are two of the traditional design professions and they frequently meet in the occupational setting, but at educational institutions they remain largely estranged....... The paper builds on a multi-sited study of an architectural engineering program at the Technical University of Denmark and an architectural engineering team within an international engineering consultancy based on Denmark. They are both responding to new tendencies within the building industry where...... the role of engineers and architects increasingly overlap during the design process, but their approaches reflect different perceptions of the consequences. The paper discusses some of the challenges that design education, not only within engineering, is facing today: young designers must be equipped...

Exploring the research domain of consultant practice: Perceptions and opinions 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 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.

Ideas of holistic engineering meet engineering work practices

DEFF Research Database (Denmark)

Buch, Anders

2016-01-01

This article critically reflects on the viability of the idea that reforming engineering education will result in more holistic engineering work practices. Drawing on an empirical study, the article aims to demonstrate that in order to change existing engineering work practices, it might...... be necessary to change engineers’ knowledge and skills; however, such changes are far from sufficient. Conditions and circumstances external to practitioners’ knowledge and skills are crucial if engineering work is to become more holistic. To illustrate this point, the article outlines an empirical study...... of a small team of professionals who engage in holistic engineering work practices in an engineering consultancy company. The work practices are investigated using a philosophical empirical method that inquires into the doings, sayings, and relatings of the practitioners. The study describes the practice...

A novel AIDS/HIV intelligent medical consulting system based on expert systems.

Science.gov (United States)

Ebrahimi, Alireza Pour; Toloui Ashlaghi, Abbas; Mahdavy Rad, Maryam

2013-01-01

The purpose of this paper is to propose a novel intelligent model for AIDS/HIV data based on expert system and using it for developing an intelligent medical consulting system for AIDS/HIV. In this descriptive research, 752 frequently asked questions (FAQs) about AIDS/HIV are gathered from numerous websites about this disease. To perform the data mining and extracting the intelligent model, the 6 stages of Crisp method has been completed for FAQs. The 6 stages include: Business understanding, data understanding, data preparation, modelling, evaluation and deployment. C5.0 Tree classification algorithm is used for modelling. Also, rational unified process (RUP) is used to develop the web-based medical consulting software. Stages of RUP are as follows: Inception, elaboration, construction and transition. The intelligent developed model has been used in the infrastructure of the software and based on client's inquiry and keywords related FAQs are displayed to the client, according to the rank. FAQs' ranks are gradually determined considering clients reading it. Based on displayed FAQs, test and entertainment links are also displayed. The accuracy of the AIDS/HIV intelligent web-based medical consulting system is estimated to be 78.76%. AIDS/HIV medical consulting systems have been developed using intelligent infrastructure. Being equipped with an intelligent model, providing consulting services on systematic textual data and providing side services based on client's activities causes the implemented system to be unique. The research has been approved by Iranian Ministry of Health and Medical Education for being practical.

A Web portal for the Engineering and Equipment Data Management System at CERN

International Nuclear Information System (INIS)

Tsyganov, A; Petit, S; Martel, P; Milenkovic, S; Suwalska, A; Delamare, C; Widegren, D; Amerigo, S Mallon; Pettersson, T

2010-01-01

CERN, the European Laboratory for Particle Physics, located in Geneva - Switzerland, has recently started the Large Hadron Collider (LHC), a 27 km particle accelerator. The CERN Engineering and Equipment Data Management Service (EDMS) provides support for managing engineering and equipment information throughout the entire lifecycle of a project. Based on several both in-house developed and commercial data management systems, this service supports management and follow-up of different kinds of information throughout the lifecycle of the LHC project: design, manufacturing, installation, commissioning data, maintenance and more. The data collection phase, carried out by specialists, is now being replaced by a phase during which data will be consulted on an extensive basis by non-experts users. In order to address this change, a Web portal for the EDMS has been developed. It brings together in one space all the aspects covered by the EDMS: project and document management, asset tracking and safety follow-up. This paper presents the EDMS Web portal, its dynamic content management and its 'one click' information search engine.

Expansion of the consultation-liaison psychiatry paradigm at a university medical center: integration of diversified clinical and funding models.

Science.gov (United States)

Bourgeois, James A; Hilty, Donald M; Klein, Sally C; Koike, Alan K; Servis, Mark E; Hales, Robert E

2003-01-01

The perspective of the contemporary Consultation-Liason Service (CLS) psychiatrist is increasingly one of consultant to medical and surgical colleagues in models other than inpatient medical and surgical units. Simultaneously, the need for a clinically and educationally robust inpatient CLS persists despite funding pressures. The University of California, Davis Medical Center Department of Psychiatry has made use of creative organizational and financial models to accomplish the inpatient CLS clinical and educational missions in a fiscally responsible manner. In addition, the department has in recent years expanded the delivery of psychiatry consultation-liaison clinical and educational services to other models of care delivery, broadening the role and influence of the CLS. Several of the initiatives described in this paper parallel an overall evolution of the practice of consultation-liaison psychiatry in response to managed care influences and other systems pressures. This consultation-liaison paradigm expansion with diversified sources of funding support facilitates the development of consultation-liaison psychiatry along additional clinical, administrative, research, and educational dimensions. Other university medical centers may consider adaptation of some of the initiatives described here to their institutions.

How Knowledge Accumulation changed the Competitive Advantage of Strategy Consulting Firms

NARCIS (Netherlands)

F.A.J. van den Bosch (Frans); M.G. Baaij (Marc); H.W. Volberda (Henk)

2005-01-01

textabstractResearch evidence confirms that the accumulation of knowledge contributes to the competitive advantage of firms. In the strategy consulting industry, one of the most knowledge-intensive professional services industries, however, established firms that exploited their knowledge

Geriatric consultation services-are wards more effective than teams?

Science.gov (United States)

Cameron, Ian D; Kurrle, Susan

2013-02-22

Geriatric consultation teams are one of the models for bringing comprehensive geriatric assessment to vulnerable and frail older people in the acute care hospital setting. While ward-based comprehensive geriatric assessment has been established as effective with reference to improving functional status and other outcomes, the team-based variant remains unproven for outcomes other than mortality in the medium term, as shown in a recent study published in BMC Medicine by Deschodt and colleagues. Further research might establish the effectiveness of the team-based model but, for current clinical practice, the emphasis should be on streaming older people with complex problems needing multidisciplinary assessment and treatment to ward-based models of comprehensive geriatric assessment.

Studies on Experimental Ontology and Knowledge Service Development in Bio-Environmental Engineering

Science.gov (United States)

Zhang, Yunliang

2018-01-01

The existing domain-related ontology and information service patterns are analyzed, and the main problems faced by the experimental scheme knowledge service were clarified. The ontology framework model for knowledge service of Bio-environmental Engineering was proposed from the aspects of experimental materials, experimental conditions and experimental instruments, and this ontology will be combined with existing knowledge organization systems to organize scientific and technological literatures, data and experimental schemes. With the similarity and priority calculation, it can improve the related domain research.

Team and Project Work in Engineering Practices

Directory of Open Access Journals (Sweden)

Anders Buch

2015-11-01

Full Text Available In this article, we investigate teamwork amongst professionals in engineering consultancy companies in order to discern how teamwork affects the collaboration and work practices of the professionals. The article investigates how professional engineering practices are enacted in two engineering consultancy companies in Denmark where teamwork has been or is an ideal for organizing work. Through a practice-based lens, the article sets out to investigate, firstly, how discourses about team and project work affect engineering work practices; secondly, how technologymediated management is reconciled in teamwork practices; and thirdly, how team and project work affect engineering professionalism and collaborative work practices. A practice theoretical framework informs the analysis. Teamwork is investigated as a phenomenon enacted through the sayings, doings and relatings of practitioners in landscapes of practices and the interconnectedness of the practices is traced through the setup of specific ecologies in the sites.

Ongkharak Nuclear Research Center-the role of the consultant

International Nuclear Information System (INIS)

Jacobi, A.; De Haller, L.

1998-01-01

The Ongkharak Nuclear Research Center Project is known to have started on 26 June 1997. At that date the Contract for the turnkey delivery of the three nuclear facilities, the Reactor Island [RI] , Isotope Production Facility [IPF] and the Waste Processing and Storage Facilities [WPSF], was signed by the Office of the Atomic Energy for Peace [OAEP] with General Atomics [GA]. The involvement of Atomic Consultant - Electrowatt Engineering Ltd. (EWE) - already started more than 2 years earlier than the official start of this ambitious project. Since mid 1995 EWE has been serving in a variety of functions and has been requested to perform numerous tasks in support of OAEP. By acting in the function of the Consultant, EWE was aiming firstly to help the project to proceed as quickly as possible. Secondly EWE was overseeing constantly that the quality of the Center, once finished, will meet the present state of the art, will be licensable in Thailand (or elsewhere) and will be internationally recognised as a safe, reliable and modern research and production installation. The role of EWE covers a multitude of engineering disciplines, such as architecture; civil, mechanical, nuclear, I and C and electrical engineering; nuclear and reactor physics; chemistry and radiopharmacy; economy and price estimation. Besides, EWE has to use its skills in conducting and/or supervising large projects, e.g., by appropriate scheduling, QA surveys, licensing support, document control, etc. Furthermore, EWE is actively involved in know-how transfer to Thai engineers and scientists by working in close co-operation with OAEP's project personnel and - if required - by giving special training courses. This paper presents some highlights as well as routine activities performed by EWE so far in the Project

Child consultation patterns in general practice comparing "high" and "low" consulting families.

OpenAIRE

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...

Disentangling trade-offs and synergies around ecosystem services with the influence network framework: illustration from a consultative process over the French Alps

Directory of Open Access Journals (Sweden)

Emilie Crouzat

2016-06-01

Full Text Available An important aspect of sustainability is to maintain biodiversity and ecosystem functioning while improving human well-being. For this, the ecosystem service (ES approach has the potential to bridge the still existing gap between ecological management and social development, especially by focusing on trade-offs and synergies between ES and between their beneficiaries. Several frameworks have been proposed to account for trade-offs and synergies between ES, and between ES and other components of social-ecological systems. However, to date, insufficient explicit attention has been paid to the three facets encompassed in the ES concept, namely potential supply, demand, and use, leading to incomplete descriptions of ES interactions. We expand on previous frameworks by proposing a new influence network framework (INF based on an explicit consideration of influence relationships between these three ES facets, biodiversity, and external driving variables. We tested its ability to provide a comprehensive view of complex social-ecological interactions around ES through a consultative process focused on environmental management in the French Alps. We synthetized the interactions mentioned during this consultative process and grouped variables according to their overall propensity to influence or be influenced by the system. The resulting directed sequence of influences distinguished between: (1 mostly influential variables (dynamic social variables and ecological state variables, (2 target variables (provisioning and cultural services, and (3 mostly impacted variables (regulating services and biodiversity parameters. We discussed possible reasons for the discrepancies between actual and perceived influences and proposed options to overcome them. We demonstrated that the INF holds the potential to deliver collective assessments of ES relations by: (1 including ecological as well as social aspects, (2 providing opportunities for colearning processes between

Redesigning an intensive insulin service for patients with type 1 diabetes: a patient consultation exercise

Directory of Open Access Journals (Sweden)

Ozcan S

2013-06-01

enhancement identified in the focus groups and observational exercise. Clinical feedback and professional continuity (median = 5, interquartile range = 1 were the most highly rated. Conclusion: The patient consultation process had generated important ideas on how the clinical team and service can improve the care provided. Key areas for service development were: a stronger emphasis of collaborative care planning; improved patient choice in the use of health technology; more resources for self-management support; and a more explicit format for the process of care in the clinic. Keywords: service development, type 1 diabetes, patient feedback, quality improvement, intensive insulin treatment

Skills for Effective Consultation.

Science.gov (United States)

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)

European Consulting Survey 2012 : The Future of European Management Consulting Firms' Business Models

OpenAIRE

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...

Engine Tune-up Service. Unit 6: Emission Control Systems. Posttests. Automotive Mechanics Curriculum.

Science.gov (United States)

Morse, David T.; May, Theodore R.

This book of posttests is designed to accompany the Engine Tune-Up Service Student Guide for Unit 6, Emission Control Systems, available separately as CE 031 220. Focus of the posttests is inspecting, testing, and servicing emission control systems. One multiple choice posttest is provided that covers the seven performance objectives contained in…

Image intelligence online consulting: A flexible and remote access to strategic information applied to verification of declaration

International Nuclear Information System (INIS)

Chassy, A.F. de; Denizot, L.

2001-01-01

Commercial satellite imagery is giving International Institutions specialized Information Departments access to a great source of valuable intelligence. High resolution and multiple sensors have also led to a growing complexity of interpretation that calls for a greater need of consulting, verification and training in the field in order to make it eligible as an operational source of verification. Responding to this need, Fleximage is extending its Image Intelligence (IMINT) training program to include a fully operational and flexible online consulting and training program. Image Intelligence (IMINT) Online Program, a new approach to acquiring IMINT expertise, supported by Internet technologies, and managed by a professional team of experts and technical staff. Fleximage has developed a virtual learning environment on the Internet for acquiring IMINT expertise. Called the IMINT Online Program, this dynamic learning environment provides complete flexibility and personalization of the process for acquiring expertise. The IMINT online program includes two services: Online Consulting and Online Training. The Online Consulting service is designed for the technical staff of an organization who are already operational in the field of image intelligence. Online Consulting enables these staff members to acquire pertinent expertise online that can be directly applied to their professional activity, such as IAEA verification tasks. The IMINT virtual Consulting and Training services indicated above are made possible thanks to the latest in Internet-based technologies including: multimedia CD-ROM, Internet technologies, rich media content (Audio, Video and Flash), application sharing, platform Maintenance Tools, secured connections and authentication, knowledge database technologies. IMINT Online Program operates owing to: specialized experts in fields relating to IMINT. These experts carry out the tasks of consultants, coaches, occasional speakers, and course content designers

Bioethics Consultations and Resources

OpenAIRE

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.

How the Kano model contributes to Kansei engineering in services.

Science.gov (United States)

Hartono, Markus; Chuan, Tan Kay

2011-11-01

Recent studies show that products and services hold great appeal if they are attractively designed to elicit emotional feelings from customers. Kansei engineering (KE) has good potential to provide a competitive advantage to those able to read and translate customer affect and emotion in actual product and services. This study introduces an integrative framework of the Kano model and KE, applied to services. The Kano model was used and inserted into KE to exhibit the relationship between service attribute performance and customer emotional response. Essentially, the Kano model categorises service attribute quality into three major groups (must-be [M], one-dimensional [O] and attractive [A]). The findings of a case study that involved 100 tourists who stayed in luxury 4- and 5-star hotels are presented. As a practical matter, this research provides insight on which service attributes deserve more attention with regard to their significant impact on customer emotional needs. STATEMENT OF RELEVANCE: Apart from cognitive evaluation, emotions and hedonism play a big role in service encounters. Through a focus on delighting qualities of service attributes, this research enables service providers and managers to establish the extent to which they prioritise their improvement efforts and to always satisfy their customer emotions beyond expectation.

78 FR 19530 - RG Steel Sparrows Point LLC, Formerly Known as Severstal Sparrows Point LLC, a Subsidiary of RG...

Science.gov (United States)

2013-04-01

... Leased Workers From Echelon Service Company, Sun Associated Industries, Inc., MPI Consultants LLC... Services LLC, and Recycling & Treatment Technologies of Baltimore, LLC Sparrows Point, Maryland; Amended... Service Company, Sun Associated Industries, Inc., MPI Consultants LLC, Alliance Engineering, Inc...

7 CFR 1767.31 - Administrative and general expenses.

Science.gov (United States)

2010-01-01

... other payroll taxes, injuries and damages, and other consideration for services, but not including..., bulletins, and subscriptions to newspapers, newsletters, and tax services. 4. Building service expenses for... accountants and auditors, actuaries, appraisers, attorneys, engineering consultants, management consultants...

[Psychiatric consultations for nursing-home residents: aspects and course of such consultations].

Science.gov (United States)

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.

Community voices: barriers and opportunities for programmes to successfully prevent vertical transmission of HIV identified through consultations among people living with HIV.

Science.gov (United States)

Anderson, Ginna; Caswell, Georgina; Edwards, Olive; Hsieh, Amy; Hull, Beri; Mallouris, Christoforos; Mason, Naisiadet; Nöstlinger, Christiana

2012-07-11

In 2010, two global networks of people living with HIV, the International Community of Women Living with HIV (ICW Global) and the Global Network of People living with HIV (GNP+) were invited to review a draft strategic framework for the global scale up of prevention of vertical transmission (PVT) through the primary prevention of HIV and the prevention of unintended pregnancies among women living with HIV. In order to ensure recommendations were based on expressed needs of people living with HIV, GNP+ and ICW Global undertook a consultation amongst people living with HIV which highlighted both facilitators and barriers to prevention services. This commentary summarizes the results of that consultation. The consultation was comprised of an online consultation (moderated chat-forum with 36 participants from 16 countries), an anonymous online e-survey (601 respondents from 58 countries), and focus-group discussions with people living with HIV in Jamaica (27 participants). The consultation highlighted the discrepancies across regions with respect to access to essential packages of PVT services. However, the consultation participants also identified common barriers to access, including a lack of trustworthy sources of information, service providers' attitudes, and gender-based violence. In addition, participant responses revealed common facilitators of access, including quality counselling on reproductive choices, male involvement, and decentralized services. The consultation provided some understanding and insight into the participants' experiences with and recommendations for PVT strategies. Participants agreed that successful, comprehensive PVT programming require greater efforts to both prevent primary HIV infection among young women and girls and, in particular, targeted efforts to ensure that women living with HIV and their partners are supported to avoid unintended pregnancies and to have safe, healthy pregnancies instead. In addition to providing the insights

Benefits of a telepsychiatry consultation service for rural nursing home residents.

Science.gov (United States)

Rabinowitz, Terry; Murphy, Katharine M; Amour, Judith L; Ricci, Michael A; Caputo, Michael P; Newhouse, Paul A

2010-01-01

Psychiatric care for nursing home residents is difficult to obtain, especially in rural areas, and this deficiency may lead to significant morbidity or death. Providing this service by videoconference may be a helpful, cost-effective, and acceptable alternative to face-to-face treatment. We analyzed data for 278 telepsychiatry encounters for 106 nursing home residents to estimate potential cost and time savings associated with this modality compared to in-person care. A total of 843.5 hours (105.4 8-hour work days) of travel time was saved compared to in-person consultation for each of the 278 encounters if they had occurred separately. If four resident visits were possible for each trip, the time saved would decrease to 26.4 workdays. Travel distance saved was 43,000 miles; 10,750 miles if four visits per trip occurred. More than $3,700 would be spent on gasoline for 278 separate encounters; decreased to $925 for four visits per roundtrip. Personnel cost savings estimates ranged from $33,739 to $67,477. Physician costs associated with additional travel time ranged from $84,347 to $253,040 for 278 encounters, or from $21,087 to $63,260 for four encounters per visit. The telepsychiatry approach was enthusiastically accepted by virtually all residents, family members, and nursing home personnel, and led to successful patient management. Providing psychiatric care to rural nursing home residents by videoconference is cost effective and appears to be a medically acceptable alternative to face-to-face care. In addition, this approach will allow many nursing homes to provide essential care that would not otherwise be available.

78 FR 48342 - Consultation Agreements: Proposed Changes to Consultation Procedures

Science.gov (United States)

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...

Virtual slides: application in pulmonary pathology consultations.

Directory of Open Access Journals (Sweden)

Michał Wojciechowski

2008-02-01

Full Text Available The Virtual Slide (VS is an interactive microscope emulator that presents a complete digitized tissue section via the Internet. A successful implementation of VS has been observed for educational, research venues and quality control. VS acquisition for consultative pathology is not so common. The purpose of this study was to explore the efficacy and usability of VS in the consultative pulmonary telepathology. 20 lung tumors entered the study. The performance was programmed for 2 medical centers specialized in pulmonary pathology (beginner and advancer in telepathology. A high-quality VSs were prepared by Coolscope (Nikon, Eclipsnet VSL, Japan, and were evaluated via the Internet. The cases were reviewed for the second time with conventional light microscope. VS diagnostic accuracy and the interobserver variability were evaluated. Also the time taken by examiners to render the diagnoses and time needed to scan the microscopic slide were analyzed. Percentage concordance between original glass-slides diagnosis and diagnosis for VSs was very high. Pathologists found the download speed of VSs adequate; experience in telepathology reduced the time of VS diagnosis. VS implementation suggests advantages for teleconsulation and education but also indicate some technical limitations. This is the first Polish trial of VS implementation in telepathology consultative service.

3 CFR - Tribal Consultation

Science.gov (United States)

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...

[Consultation in a baby clinic of the PMI (mother and infant welfare service): a survey in a French department].

Science.gov (United States)

Fanello, Serge; Hassani, Anne; Meunier, Brice; Dagorne, Carole; Parot, Elsa

2007-01-01

A dual survey carried out amongst the users and the professionals of PMI showed that proximity, the range of advice available, the exchanges on parenthood, and the assessment of the child's physical and mental progress and of his/her development are the key elements that parents are looking for. It is also noted that the majority of these parents deliberately consult these services. The objectives when consulting vary, going from a model based on the body and physical abilities, found especially in lower and disadvantaged groups, to one emphasising the child's psychological aspect and potential, which is the prerogative of the middle and higher classes. Indeed, although the PMI is particularly aimed at families in difficulties, all the social classes are now represented among the users. The primary role of prevention of PMI means that few parents go there specifically for the treatment of a medical disease. The majority of families maintain a parallel follow-up with another medical professional, usually a general practitioner with whom the PMI has very little contact. Given the decrease in the current medical demography and the governmental directives aimed at improving care in the prenatal period, the prospect of a closer working relationship between these two parties involved in infant welfare would seem to be a way of the future.

Advancing the practice of systems engineering at JPL

Science.gov (United States)

Jansma, Patti A.; Jones, Ross M.

2006-01-01

In FY 2004, JPL launched an initiative to improve the way it practices systems engineering. The Lab's senior management formed the Systems Engineering Advancement (SEA) Project in order to "significantly advance the practice and organizational capabilities of systems engineering at JPL on flight projects and ground support tasks." The scope of the SEA Project includes the systems engineering work performed in all three dimensions of a program, project, or task: 1. the full life-cycle, i.e., concept through end of operations 2. the full depth, i.e., Program, Project, System, Subsystem, Element (SE Levels 1 to 5) 3. the full technical scope, e.g., the flight, ground and launch systems, avionics, power, propulsion, telecommunications, thermal, etc. The initial focus of their efforts defined the following basic systems engineering functions at JPL: systems architecture, requirements management, interface definition, technical resource management, system design and analysis, system verification and validation, risk management, technical peer reviews, design process management and systems engineering task management, They also developed a list of highly valued personal behaviors of systems engineers, and are working to inculcate those behaviors into members of their systems engineering community. The SEA Project is developing products, services, and training to support managers and practitioners throughout the entire system lifecycle. As these are developed, each one needs to be systematically deployed. Hence, the SEA Project developed a deployment process that includes four aspects: infrastructure and operations, communication and outreach, education and training, and consulting support. In addition, the SEA Project has taken a proactive approach to organizational change management and customer relationship management - both concepts and approaches not usually invoked in an engineering environment. This paper'3 describes JPL's approach to advancing the practice of

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