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Sample records for consultant agreement ca-264

  1. 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...

  2. 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

  3. 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...

  4. Psychiatric patient disposition agreement between the emergency physician and the psychiatry consultant.

    Science.gov (United States)

    Chakravarthy, Bharath; Menchine, Michael; Thompson, Daniel E; Rajeev, Sindhya; Santos, Barbara-Jean

    2013-01-01

    Mental illness is prevalent, disabling, and costly. Emergency department (ED) visits for mental health-related reasons are on the increase. Determine the level of agreement between emergency physicians and psychiatrists regarding psychiatric patient disposition. We conducted a prospective, observational study at a private university hospital ED from October 2008-April 2009 using a convenience sample of patients of all ages with psychiatric complaints who received formal psychiatric consultation during their ED visit. The emergency physician completed a data sheet prior to psychiatric consultation, assessing the likelihood of admission for psychiatric evaluation. We evaluated the positive predictive value (PPV) and negative predictive value (NPV) of the emergency physician admission decision for all patients before psychiatric consultation, compared with the patients' actual disposition as determined by the consulting psychiatrist. The study captured 230 subjects, 53% of whom were suicidal patients. 74% of patients were eventually admitted. The emergency physician decision to admit for inpatient psychiatric evaluation had a PPV of 87.3% (CI 81.4-91.9%) and an NPV of 66.7% (CI 52.9-78.6%) compared to the psychiatrist decision for the total sample, and a PPV of 90% (CI 82.4-95.1%) and an NPV of 69.6% (CI 47.1-86.8%) for suicidal patients. Additionally, the κ score, a measure of agreement between emergency physician disposition decision and psychiatrist disposition decision, was 0.530 (Cl 0.404-0.656). 95% of patients with an ED assessment of "definitely admit" were eventually admitted by the psychiatrist. Emergency physician disposition has a high PPV (87.3%) and a moderate NPV (66.7%) compared to psychiatrist disposition.

  5. 29 CFR 1908.10 - Cooperative Agreements.

    Science.gov (United States)

    2010-07-01

    ... CONSULTATION AGREEMENTS § 1908.10 Cooperative Agreements. (a) Who may make Agreements. The Assistant Secretary... consultation services to private sector employers. (3) Renegotiation of existing Agreements funded under this part shall be initiated within 30 days of the effective date of these revisions. (c) Contents of...

  6. Observer agreement in the reporting of knee and lumbar spine magnetic resonance (MR) imaging examinations: Selectively trained MR radiographers and consultant radiologists compared with an index radiologist

    Energy Technology Data Exchange (ETDEWEB)

    Brealey, S., E-mail: stephen.brealey@york.ac.uk [Department of Health Sciences, University of York, York YO10 5DD (United Kingdom); Piper, K., E-mail: keith.piper@canterbury.ac.uk [Department of Allied Health Professions, Canterbury Christ Church University, Canterbury, Kent CT1 1QU (United Kingdom); King, D., E-mail: david.g.king@york.nhs.uk [York Hospital, Wigginton Road, York YO31 8HE (United Kingdom); Bland, M., E-mail: martin.bland@york.ac.uk [Department of Health Sciences, University of York, York YO10 5DD (United Kingdom); Caddick, J., E-mail: Julie.Caddick@york.nhs.uk [York Hospital, Wigginton Road, York YO31 8HE (United Kingdom); Campbell, P., E-mail: peter.campbell@york.nhs.uk [York Hospital, Wigginton Road, York YO31 8HE (United Kingdom); Gibbon, A., E-mail: anthony.j.gibbon@york.nhs.uk [York Hospital, Wigginton Road, York YO31 8HE (United Kingdom); Highland, A., E-mail: Adrian.Highland@sth.nhs.uk [Sheffield Teaching Hospitals, Herries Road, Sheffield S5 7AU (United Kingdom); Jenkins, N., E-mail: neil.jenkins@york.nhs.uk [York Hospital, Wigginton Road, York YO31 8HE (United Kingdom); Petty, D., E-mail: daniel.petty@york.nhs.uk [York Hospital, Wigginton Road, York YO31 8HE (United Kingdom); Warren, D., E-mail: david.warren@york.nhs.uk [York Hospital, Wigginton Road, York YO31 8HE (United Kingdom)

    2013-10-01

    Purpose: To assess agreement between trained radiographers and consultant radiologists compared with an index radiologist when reporting on magnetic resonance imaging (MRI) examinations of the knee and lumbar spine and to examine the subsequent effect of discordant reports on patient management and outcome. Methods: At York Hospital two MR radiographers, two consultant radiologists and an index radiologist reported on a prospective, random sample of 326 MRI examinations. The radiographers reported in clinical practice conditions and the radiologists during clinical practice. An independent consultant radiologist compared these reports with the index radiologist report for agreement. Orthopaedic surgeons then assessed whether the discordance between reports was clinically important. Results: Overall observer agreement with the index radiologist was comparable between observers and ranged from 54% to 58%; for the knee it was 46–57% and for the lumbar spine was 56–66%. There was a very small observed difference of 0.6% (95% CI −11.9 to 13.0) in mean agreement between the radiographers and radiologists (P = 0.860). For the knee, lumbar spine and overall, radiographers’ discordant reports, when compared with the index radiologist, were less likely to have a clinically important effect on patient outcome than the radiologists’ discordant reports. Less than 10% of observer's reports were sufficiently discordant with the index radiologist's reports to be clinically important. Conclusion: Carefully selected MR radiographers with postgraduate education and training reported in clinical practice conditions on specific MRI examinations of the knee and lumbar spine to a level of agreement comparable with non-musculoskeletal consultant radiologists.

  7. Observer agreement in the reporting of knee and lumbar spine magnetic resonance (MR) imaging examinations: Selectively trained MR radiographers and consultant radiologists compared with an index radiologist

    International Nuclear Information System (INIS)

    Brealey, S.; Piper, K.; King, D.; Bland, M.; Caddick, J.; Campbell, P.; Gibbon, A.; Highland, A.; Jenkins, N.; Petty, D.; Warren, D.

    2013-01-01

    Purpose: To assess agreement between trained radiographers and consultant radiologists compared with an index radiologist when reporting on magnetic resonance imaging (MRI) examinations of the knee and lumbar spine and to examine the subsequent effect of discordant reports on patient management and outcome. Methods: At York Hospital two MR radiographers, two consultant radiologists and an index radiologist reported on a prospective, random sample of 326 MRI examinations. The radiographers reported in clinical practice conditions and the radiologists during clinical practice. An independent consultant radiologist compared these reports with the index radiologist report for agreement. Orthopaedic surgeons then assessed whether the discordance between reports was clinically important. Results: Overall observer agreement with the index radiologist was comparable between observers and ranged from 54% to 58%; for the knee it was 46–57% and for the lumbar spine was 56–66%. There was a very small observed difference of 0.6% (95% CI −11.9 to 13.0) in mean agreement between the radiographers and radiologists (P = 0.860). For the knee, lumbar spine and overall, radiographers’ discordant reports, when compared with the index radiologist, were less likely to have a clinically important effect on patient outcome than the radiologists’ discordant reports. Less than 10% of observer's reports were sufficiently discordant with the index radiologist's reports to be clinically important. Conclusion: Carefully selected MR radiographers with postgraduate education and training reported in clinical practice conditions on specific MRI examinations of the knee and lumbar spine to a level of agreement comparable with non-musculoskeletal consultant radiologists

  8. Forums for consultation and follow-up of the peace agreements in Guatemala: lessons learnt for territorial peace in Colombia

    Directory of Open Access Journals (Sweden)

    Cécile Mouly

    2016-08-01

    Full Text Available This article considers the experience of the forums for consultation and the follow-up of the peace agreements in Guatemala and draws lessons for territorial peace in Colombia. Based on data from observation, interviews, and documents, it analyses how the consultation forums evolved into an infrastructure for peace, and the role they played in the decentralization of peace implementation. From this experience, It emphasizes the importance of the departmental level as a bridge between the grassroots and decision makers at the central level, and of the participation of traditionally marginalized groups for territorial peace. Additionally, the successful local peacebuilding initiatives that emerged during the war must be considered. It also discusses the role of multisectoral spaces in the peaceful transformation of local conflicts, and the need to maintain a balance between institutionalization and flexibility.

  9. 40 CFR 264.13 - General waste analysis.

    Science.gov (United States)

    2010-07-01

    ... 264.13 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED... waste management methods as specified in §§ 264.17, 264.314, 264.341, 264.1034(d), 264.1063(d), 264.1083... analysis of test data; and, (iii) The annual removal of residues which are not delisted under § 260.22 of...

  10. 40 CFR 264.14 - Security.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Security. 264.14 Section 264.14... Standards § 264.14 Security. (a) The owner or operator must prevent the unknowing entry, and minimize the...) for discussion of security requirements at disposal facilities during the post-closure care period...

  11. 40 CFR 264.1031 - Definitions.

    Science.gov (United States)

    2010-07-01

    ... used to separate a mixture of several volatile components of different boiling points in successive... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Definitions. 264.1031 Section 264.1031... Standards for Process Vents § 264.1031 Definitions. As used in this subpart, all terms not defined herein...

  12. Dicty_cDB: SLH264 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLH264 (Link to dictyBase) - - - Contig-U16382-1 SLH264Z (Link... to Original site) - - SLH264Z 532 - - - - Show SLH264 Library SL (Link to library) Clone ID SLH264 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLH2-C/SLH264Q.Seq.d/ Representative seq. ID SLH26...4Z (Link to Original site) Representative DNA sequence >SLH264 (SLH264Q) /CSM/SL/SLH2-C/SLH264Q.Seq.d/ XXXXX...g significant alignments: (bits) Value N ( AU039244 ) Dictyostelium discoideum slug cDNA, clone SLH2

  13. Royal Wine Corporation d/b/a/ Royal Kedem (Herzog Wine Cellars), Oxnard, CA; Consent Agreement and Final Order

    Science.gov (United States)

    Consent Agreement and Final Order (Proposed CA/FO), between the U.S. Environmental Protection Agency, Region 9 (EPA or Complainant), and Royal Wine Corporation, d/b/a Royal Kedem (Herzog Wine Cellars or Respondent). Docket Number CWA-09-2018-0004.

  14. Institutional Oversight of Faculty-Industry Consulting Relationships in U.S. Medical Schools: A Delphi Study.

    Science.gov (United States)

    Morain, Stephanie R; Joffe, Steven; Campbell, Eric G; Mello, Michelle M

    2015-01-01

    The conflicts of interest that may arise in relationships between academic researchers and industry continue to prompt controversy. The bulk of attention has focused on financial aspects of these relationships, but conflicts may also arise in the legal obligations that faculty acquire through consulting contracts. However, oversight of faculty members' consulting agreements is far less vigorous than for financial conflicts, creating the potential for faculty to knowingly or unwittingly contract away important rights and freedoms. Increased regulation could prevent this, but it is unclear what forms of oversight universities view as feasible and effective. In this article, we report on a Delphi study to evaluate several approaches for oversight of consulting agreements by medical schools. The panel was comprised of 11 senior administrators with responsibility for oversight of faculty consulting relationships. We found broad agreement among panelists regarding the importance of institutional oversight to protect universities' interests. There was strong support for two specific approaches: providing educational resources to faculty and submitting consulting agreements for institutional review. Notwithstanding the complexities of asserting authority to regulate private consulting agreements between faculty members and companies, medical school administrators reached consensus that several approaches to improving institutional oversight are feasible and useful. © 2015 American Society of Law, Medicine & Ethics, Inc.

  15. Evaluation agriculture morphological and analysis of yield components in twelve cañahua agreements (Chenopodium pallidicaule Aellen

    Directory of Open Access Journals (Sweden)

    Mayta-Mamani Adelio

    2015-11-01

    Full Text Available In the present investigation, they were carried out the analysis descriptive statistic, variance analysis, comparison of stockings of Duncan, multiple correlation and analysis of path coefficient, this I finish to determine the direct and indirect effects, in cañahua (Chenopodium pallidicaule Aellen. The study behaved at random under the design of blocks with four repetitions and twelve treatments (cañahua agreements, during the campaign agricultural 2009 and 2010. The results show, the grain production on the average general of 7.67 grain/plant, with a coefficient of variability of 23.1%, and with better yields they were the agreements 455, 222, ILLPA-INIA and CUPI, achieved to produce 12.28 grain/plant on the average, 10.58 grain/plant, 10.29 grain/plant and 10.16 grain/plant, respectively. Through the path analysis, selection approaches the components of yields were identified. In the agreement 455, the coefficient of determination of the system plants dear it reached 36.5%, and main yield components were constituted, number of branches, vegetable covering and height of the plant, with an association degree and direct effect of r=0.505 P=0.327, r=0.446 P=0.168 and r=0.417 P=0.196, respectively. In the agreement 222, the characters morphological that influence in the yield this explained in 40.5%, and as better yield component the number of branches has been constituted (r=0.462 (P=0.261, vegetable covering (r=0.514 (P=0.271 and height of the plant (r=0.383 (P=0.047. In the agreement ILLPA-INIA, it has been determined as better yield component, the number of branches (r=0.514 (P=0.318 and diameter of the shaft (r=0.479 (P=0.524, these characters in its group justify that the system plants defined total it was 44.7% of the direct influence. Agreement CUPI, in this cultivation the characters that influenced in the grain yield are implied in 36.4% and with better characters morphological that have been able to influence in a direct way they are

  16. 40 CFR 264.73 - Operating record.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Operating record. 264.73 Section 264.73 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED... System, Recordkeeping, and Reporting § 264.73 Operating record. (a) The owner or operator must keep a...

  17. Does professional-centred training improve consultation outcomes?

    DEFF Research Database (Denmark)

    Parkin, Tracey; Barnard, K.; Cradock, S.

    2006-01-01

    discussed and decisions made. Patients also completed the Health Care Climate Questionnaire (HCCQ). Pre-training results were fed back to the professionals to provide an objective measure of current practice. Training day one comprised 10 minutes' observation of videoed consultations of each professional......This study aimed to examine whether professional-centred training improves consultation outcomes. Using a pre- and post-data collection design. Immediately after consultations, professionals and patients completed a consultation review sheet which was coded for the level of agreement on issues...... in order to identify strengths and training needs. Each professional identified key areas of their consultation that they felt needed further development. Training day two centred on goal setting and negotiating agendas as these were identified as priority areas requiring more skills. Data from 110...

  18. 40 CFR 264.554 - Staging piles.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Staging piles. 264.554 Section 264.554... for Cleanup § 264.554 Staging piles. This section is written in a special format to make it easier to... staging pile? A staging pile is an accumulation of solid, non-flowing remediation waste (as defined in...

  19. 40 CFR 264.341 - Waste analysis.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Waste analysis. 264.341 Section 264... Incinerators § 264.341 Waste analysis. (a) As a portion of the trial burn plan required by § 270.62 of this chapter, or with part B of the permit application, the owner or operator must have included an analysis of...

  20. Ketamine inhibits tumor necrosis factor secretion by RAW264.7 murine macrophages stimulated with antibiotic-exposed strains of community-associated, methicillin-resistant Staphylococcus aureus

    Directory of Open Access Journals (Sweden)

    Aguirre Carlos

    2011-01-01

    Full Text Available Abstract Background Infections caused by community-associated strains of methicillin-resistant Staphylococcus aureus (CA-MRSA are associated with a marked and prolonged host inflammatory response. In a sepsis simulation model, we tested whether the anesthetic ketamine inhibits the macrophage TNF response to antibiotic-exposed CA-MRSA bacteria via its antagonism of N-methyl-D-aspartate (NMDA receptors. RAW264.7 cells were stimulated for 18 hrs with 105 to 107 CFU/mL inocula of either of two prototypical CA-MRSA isolates, USA300 strain LAC and USA400 strain MW2, in the presence of either vancomycin or daptomycin. One hour before bacterial stimulation, ketamine was added with or without MK-801 (dizocilpine, a chemically unrelated non-competitive NMDA receptor antagonist, APV (D-2-amino-5-phosphono-valerate, a competitive NMDA receptor antagonist, NMDA, or combinations of these agents. Supernatants were collected and assayed for TNF concentration by ELISA. Results RAW264.7 cells exposed to either LAC or MW2 in the presence of daptomycin secreted less TNF than in the presence of vancomycin. The addition of ketamine inhibited macrophage TNF secretion after stimulation with either of the CA-MRSA isolates (LAC, MW2 in the presence of either antibiotic. The NMDA inhibitors, MK-801 and APV, also suppressed macrophage TNF secretion after stimulation with either of the antibiotic-exposed CA-MRSA isolates, and the effect was not additive or synergistic with ketamine. The addition of NMDA substrate augmented TNF secretion in response to the CA-MRSA bacteria, and the addition of APV suppressed the effect of NMDA in a dose-dependent fashion. Conclusions Ketamine inhibits TNF secretion by MRSA-stimulated RAW264.7 macrophages and the mechanism likely involves NMDA receptor antagonism. These findings may have therapeutic significance in MRSA sepsis.

  1. 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.

  2. 40 CFR 264.140 - Applicability.

    Science.gov (United States)

    2010-07-01

    ... applying to a regulated unit with alternative requirements for financial assurance set out in the permit or... OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Financial...) Prescribes alternative requirements for the regulated unit under § 264.90(f) and/or § 264.110(c); and (2...

  3. 40 CFR 264.276 - Food-chain crops.

    Science.gov (United States)

    2010-07-01

    ...) Describe the procedures used in conducting any tests, including the sample selection criteria, sample size... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Food-chain crops. 264.276 Section 264... Treatment § 264.276 Food-chain crops. The Regional Administrator may allow the growth of food-chain crops in...

  4. 36 CFR 264.11 - Use of symbol.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Use of symbol. 264.11 Section... MANAGEMENT Mount St. Helens National Volcanic Monument Symbol § 264.11 Use of symbol. Except as provided in § 264.12, use of the Mount St. Helens National Volcanic Monument official symbol, including a facsimile...

  5. 40 CFR 264.250 - Applicability.

    Science.gov (United States)

    2010-07-01

    ... OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Waste Piles § 264.250... treat hazardous waste in piles, except as § 264.1 provides otherwise. (b) The regulations in this subpart do not apply to owners or operators of waste piles that are closed with wastes left in place. Such...

  6. H.264/AVC Video Compression on Smartphones

    Science.gov (United States)

    Sharabayko, M. P.; Markov, N. G.

    2017-01-01

    In this paper, we studied the usage of H.264/AVC video compression tools by the flagship smartphones. The results show that only a subset of tools is used, meaning that there is still a potential to achieve higher compression efficiency within the H.264/AVC standard, but the most advanced smartphones are already reaching the compression efficiency limit of H.264/AVC.

  7. 22 CFR 181.4 - Consultations with the Secretary of State.

    Science.gov (United States)

    2010-04-01

    ... international agreements of the United States are fully consistent with United States foreign policy objectives... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Consultations with the Secretary of State. 181.4 Section 181.4 Foreign Relations DEPARTMENT OF STATE INTERNATIONAL AGREEMENTS COORDINATION...

  8. 40 CFR 264.54 - Amendment of contingency plan.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Amendment of contingency plan. 264.54 Section 264.54 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES... Contingency Plan and Emergency Procedures § 264.54 Amendment of contingency plan. The contingency plan must be...

  9. 34 CFR 75.264 - Transfers among budget categories.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Transfers among budget categories. 75.264 Section 75.264 Education Office of the Secretary, Department of Education DIRECT GRANT PROGRAMS How Grants Are Made Miscellaneous § 75.264 Transfers among budget categories. A grantee may, notwithstanding any...

  10. 40 CFR 264.1086 - Standards: Containers.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Standards: Containers. 264.1086... Air Emission Standards for Tanks, Surface Impoundments, and Containers § 264.1086 Standards: Containers. (a) The provisions of this section apply to the control of air pollutant emissions from...

  11. Vascular neurology nurse practitioner provision of telemedicine consultations.

    Science.gov (United States)

    Demaerschalk, Bart M; Kiernan, Terri-Ellen J; Investigators, Starr

    2010-01-01

    Objective. The objective was to define and evaluate a role for the Vascular Neurology-Nurse Practitioner (VN-NP) in the delivery of telemedicine consultations in partnership with a vascular neurologist. Methods. Prospective stroke alert patients at participating hospitals underwent a two-way audio video telemedicine consultation with a VN-NP at a remotely located stroke center in partnership with a vascular neurologist. Demographic information, National Institutes of Health Stroke Scale (NIHSS) scores, diagnoses, CT contraindications to thrombolysis, thrombolysis eligibility, and time interval data were collected. The inter-rater agreement between VN-NP and vascular neurologist assessments was calculated. Results. Ten patients were evaluated. Four were determined to have ischemic stroke, one had a transient ischemic attack, two had intracerebral hemorrhages, and three were stroke mimics. Overall, three patients received thrombolysis. The inter-rater agreement between VN-NP and vascular neurologist assessments were excellent, ranging from 0.9 to 1.0. The duration of VN-NP consultation was 53.2 +/- 9.0 minutes, which included the vascular neurologist supervisory evaluation time of 12.0 +/- 9.6 minutes. Conclusion. This study illustrated that a stroke center VN-NP, in partnership with a vascular neurologist, could deliver timely telemedicine consultations, accurate diagnoses, and correct treatments in acute stroke patients who presented to remotely located rural emergency departments within a hub and spoke network. VN-NPs may fulfill the role of a telestroke provider.

  12. 29 CFR 779.264 - Excise taxes separately stated.

    Science.gov (United States)

    2010-07-01

    ... AS APPLIED TO RETAILERS OF GOODS OR SERVICES Employment to Which the Act May Apply; Enterprise Coverage Excise Taxes § 779.264 Excise taxes separately stated. A tax is separately stated where it clearly... 29 Labor 3 2010-07-01 2010-07-01 false Excise taxes separately stated. 779.264 Section 779.264...

  13. 40 CFR 60.264 - Emission monitoring.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 6 2010-07-01 2010-07-01 false Emission monitoring. 60.264 Section 60... Facilities § 60.264 Emission monitoring. (a) The owner or operator subject to the provisions of this subpart shall install, calibrate, maintain and operate a continuous monitoring system for measurement of the...

  14. 40 CFR 264.1065 - Reporting requirements.

    Science.gov (United States)

    2010-07-01

    ... Air Emission Standards for Equipment Leaks § 264.1065 Reporting requirements. (a) A semiannual report...). (iii) The equipment identification number of each compressor for which a leak was not repaired as... monitoring required by § 264.1060 and was not corrected within 24 hours, the duration and cause of each...

  15. 40 CFR 264.230 - Special requirements for incompatible wastes.

    Science.gov (United States)

    2010-07-01

    ... DISPOSAL FACILITIES Surface Impoundments § 264.230 Special requirements for incompatible wastes... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Special requirements for incompatible wastes. 264.230 Section 264.230 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED...

  16. 40 CFR 264.199 - Special requirements for incompatible wastes.

    Science.gov (United States)

    2010-07-01

    ... DISPOSAL FACILITIES Tank Systems § 264.199 Special requirements for incompatible wastes. (a) Incompatible... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Special requirements for incompatible wastes. 264.199 Section 264.199 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED...

  17. 40 CFR 264.257 - Special requirements for incompatible wastes.

    Science.gov (United States)

    2010-07-01

    ... DISPOSAL FACILITIES Waste Piles § 264.257 Special requirements for incompatible wastes. (a) Incompatible... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Special requirements for incompatible wastes. 264.257 Section 264.257 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED...

  18. 40 CFR 264.313 - Special requirements for incompatible wastes.

    Science.gov (United States)

    2010-07-01

    ... DISPOSAL FACILITIES Landfills § 264.313 Special requirements for incompatible wastes. Incompatible wastes... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Special requirements for incompatible wastes. 264.313 Section 264.313 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED...

  19. 40 CFR 264.177 - Special requirements for incompatible wastes.

    Science.gov (United States)

    2010-07-01

    ... DISPOSAL FACILITIES Use and Management of Containers § 264.177 Special requirements for incompatible wastes... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Special requirements for incompatible wastes. 264.177 Section 264.177 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED...

  20. 40 CFR 264.282 - Special requirements for incompatible wastes.

    Science.gov (United States)

    2010-07-01

    ... DISPOSAL FACILITIES Land Treatment § 264.282 Special requirements for incompatible wastes. The owner or... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Special requirements for incompatible wastes. 264.282 Section 264.282 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED...

  1. Vascular Neurology Nurse Practitioner Provision of Telemedicine Consultations

    Directory of Open Access Journals (Sweden)

    Bart M. Demaerschalk

    2010-01-01

    Full Text Available Objective. The objective was to define and evaluate a role for the Vascular Neurology-Nurse Practitioner (VN-NP in the delivery of telemedicine consultations in partnership with a vascular neurologist. Methods. Prospective stroke alert patients at participating hospitals underwent a two-way audio video telemedicine consultation with a VN-NP at a remotely located stroke center in partnership with a vascular neurologist. Demographic information, National Institutes of Health Stroke Scale (NIHSS scores, diagnoses, CT contraindications to thrombolysis, thrombolysis eligibility, and time interval data were collected. The inter-rater agreement between VN-NP and vascular neurologist assessments was calculated. Results. Ten patients were evaluated. Four were determined to have ischemic stroke, one had a transient ischemic attack, two had intracerebral hemorrhages, and three were stroke mimics. Overall, three patients received thrombolysis. The inter-rater agreement between VN-NP and vascular neurologist assessments were excellent, ranging from 0.9 to 1.0. The duration of VN-NP consultation was 53.2±9.0 minutes, which included the vascular neurologist supervisory evaluation time of 12.0±9.6 minutes. Conclusion. This study illustrated that a stroke center VN-NP, in partnership with a vascular neurologist, could deliver timely telemedicine consultations, accurate diagnoses, and correct treatments in acute stroke patients who presented to remotely located rural emergency departments within a hub and spoke network. VN-NPs may fulfill the role of a telestroke provider.

  2. Discrepancies between patient and professionals recall and perception of an outpatient consultation

    DEFF Research Database (Denmark)

    Parkin, T.; Skinner, T. C.

    2003-01-01

    was associated with greater autonomous motivation for self-care (r = 0.31; P perceptions......Aims: To explore the degree of agreement between patient and health care professional's perceptions of consultations. Methods: Immediately after 141 dietitian/nurse specialist consultations, patients and professional's completed the Health Care Climate questionnaire (HCC), Medical Interview...... Satisfaction Scale (MISS) and the Treatment Self-Regulation Questionnaire (TSRQ) In addition, both parties were asked about any key points or issues discussed in the consultation; any decisions that were made about their diabetes treatment today; any goals that were set as a result of today's consultation...

  3. 27 CFR 26.264 - Determination of tax on wine.

    Science.gov (United States)

    2010-04-01

    ... wine. 26.264 Section 26.264 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE... Procedure at Port of Entry From the Virgin Islands § 26.264 Determination of tax on wine. If the certificate prescribed in § 26.205 covers wine, the wine tax will be collected at the rates imposed by section 5041...

  4. Agreement at the Boundaries: Synchronic and Diachronic Approaches to phi-Agreement in the Left Periphery

    Science.gov (United States)

    Courtney, Sarah Gray

    2017-01-01

    This dissertation examines complementizer agreement (CA) phenomena in which phi-features appear on a complementizer, clause-linking marker, or otherwise, syntactically speaking, at the C[superscript 0] position. This dissertation will argue that CA is in fact a straightforward output of the syntax module under standard Minimalist assumptions, and…

  5. Public consultation: regulatory requirement or business principle?

    International Nuclear Information System (INIS)

    Seeley, R.

    1999-01-01

    A summary is included of knowledge and experiences related to planning and implementing a public consultation program over a number of years in Shell Canada's Athabasca Oil Sands development. This project consists of three major sub- projects with a total estimated capital investment of $4 billion. The three sub- projects are: the Muskeg River Mine, the Scotford Upgrader, and the Corridor Pipeline. The facilities will produce 150,000 bbl/day of synthetic crude for over 25 years and are targeted to begin production in late 2002. From the title of the paper, although public consultation is required under environmental legislation, many companies are adopting a more pro-active approach to public consultation and participation as a business principle. This commitment to engage in and dialogue with stakeholders must be open, transparent and long term, not just during the regulatory process. Successful consultation begins with the prerequisites: senior management commitment, buy-in from the project or operating team that the process adds value, and the ability to listen and make changes. A consultation program is not a short term activity, but is rather an ongoing process linked to a business or operating principle. It requires long term resources and follow through on agreements and commitments made to stakeholders and communities

  6. Public consultation: regulatory requirement or business principle?

    Energy Technology Data Exchange (ETDEWEB)

    Seeley, R. [Shell Canada Oil Sands, Calgary, AB (Canada)

    1999-07-01

    A summary is included of knowledge and experiences related to planning and implementing a public consultation program over a number of years in Shell Canada's Athabasca Oil Sands development. This project consists of three major sub- projects with a total estimated capital investment of $4 billion. The three sub- projects are: the Muskeg River Mine, the Scotford Upgrader, and the Corridor Pipeline. The facilities will produce 150,000 bbl/day of synthetic crude for over 25 years and are targeted to begin production in late 2002. From the title of the paper, although public consultation is required under environmental legislation, many companies are adopting a more pro-active approach to public consultation and participation as a business principle. This commitment to engage in and dialogue with stakeholders must be open, transparent and long term, not just during the regulatory process. Successful consultation begins with the prerequisites: senior management commitment, buy-in from the project or operating team that the process adds value, and the ability to listen and make changes. A consultation program is not a short term activity, but is rather an ongoing process linked to a business or operating principle. It requires long term resources and follow through on agreements and commitments made to stakeholders and communities.

  7. 40 CFR 264.173 - Management of containers.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Management of containers. 264.173... Use and Management of Containers § 264.173 Management of containers. (a) A container holding hazardous... container holding hazardous waste must not be opened, handled, or stored in a manner which may rupture the...

  8. 40 CFR 264.171 - Condition of containers.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Condition of containers. 264.171... Use and Management of Containers § 264.171 Condition of containers. If a container holding hazardous... leak, the owner or operator must transfer the hazardous waste from this container to a container that...

  9. Outcomes, impact on management, and costs of fungal eye disease consults in a tertiary care setting.

    Science.gov (United States)

    Ghodasra, Devon H; Eftekhari, Kian; Shah, Ankoor R; VanderBeek, Brian L

    2014-12-01

    To determine the frequency of clinical management changes resulting from inpatient ophthalmic consultations for fungemia and the associated costs. Retrospective case series. Three hundred forty-eight inpatients at a tertiary care center between 2008 and 2012 with positive fungal blood culture results, 238 of whom underwent an ophthalmologic consultation. Inpatient charts of all fungemic patients were reviewed. Costs were standardized to the year 2014. The Student t test was used for all continuous variables and the Pearson chi-square test was used for categorical variables. Prevalence of ocular involvement, rate of change in clinical management, mortality rate of fungemic patients, and costs of ophthalmic consultation. Twenty-two (9.2%) of 238 consulted patients with fungemia had ocular involvement. Twenty patients had chorioretinitis and 2 had endophthalmitis. Only 9 patients (3.7%) had a change in management because of the ophthalmic consultation. One patient underwent bilateral intravitreal injections. Thirty percent of consulted patients died before discharge or were discharged to hospice. The total cost of new consults was $36 927.54 ($204.19/initial level 5 visit and $138.63/initial level 4). The cost of follow-up visits was $13 655.44 ($104.24/visit). On average, 26.4 patients were evaluated to find 1 patient needing change in management, with an average cost of $5620.33 per change in 1 patient's management. Clinical management changes resulting from ophthalmic consultation in fungemic patients were uncommon. Associated costs were high for these consults in a patient population with a high mortality rate. Together, these data suggest that the usefulness of routine ophthalmic consultations for all fungemic patients is likely to be low. Copyright © 2014 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  10. Study of 40Ca-40Ca elastic scattering at intermediate energy

    International Nuclear Information System (INIS)

    Kumar, Ashok; Srivastava, B.B.

    1980-01-01

    The differential cross sections for 40 Ca- 40 Ca elastic scattering have been calculated at laboratory incident energy of 240 MeV using a sharp cut off of the partial waves below a critical angular momentum, 1sub(c)' to account for absorption. The effective 40 Ca- 40 Ca potential is taken to be the sum of a real nuclear potential and the Coulomb potential. The calculated differential cross sections which are in fair agreement with the experimental data are presented and discussed. (author)

  11. 40 CFR 264.51 - Purpose and implementation of contingency plan.

    Science.gov (United States)

    2010-07-01

    ... contingency plan. 264.51 Section 264.51 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... DISPOSAL FACILITIES Contingency Plan and Emergency Procedures § 264.51 Purpose and implementation of contingency plan. (a) Each owner or operator must have a contingency plan for his facility. The contingency...

  12. 40 CFR 264.254 - Monitoring and inspection.

    Science.gov (United States)

    2010-07-01

    ... Waste Piles § 264.254 Monitoring and inspection. (a) During construction or installation, liners (except in the case of existing portions of piles exempt from § 264.251(a)) and cover systems (e.g... increase in the permeability of the liner or cover. (b) While a waste pile is in operation, it must be...

  13. 40 CFR 264.35 - Required aisle space.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Required aisle space. 264.35 Section... Preparedness and Prevention § 264.35 Required aisle space. The owner or operator must maintain aisle space to... Regional Administrator that aisle space is not needed for any of these purposes. [Comment: Part 270 of this...

  14. The effects of urgency to reach agreement on the process and outcome of multi-party natural resource negotiations

    Science.gov (United States)

    Lamb, B.L.; Taylor, J.G.; Burkardt, N.; Gillette, S.C.

    2005-01-01

    We studied seven hydropower license consultations to examine the role of a sense of urgency to reach agreement. Hydropower licensing consultations were studied because the statutory requirement for consultation encourages negotiation, all such consultations are similar, and a negotiated settlement is not a foregone result. Cases selected for analysis met screening criteria. Structured interviews were conducted with participants after the negotiations had been concluded. Respondent recollections were checked against the documentary record. A sense of urgency to reach agreement was a significant factor in the completion of these negotiations; where there was no shared sense of urgency, purposeful delay adversely affected the negotiations. Although a sense of urgency was experienced by at least one party in each case, only a shared sense of urgency at the end of the process proved significant. Delay did not prevent ultimate agreement but a shared sense of urgency brought speedier agreement and greater satisfaction with the negotiation.

  15. 40 CFR 264.34 - Access to communications or alarm system.

    Science.gov (United States)

    2010-07-01

    ... FACILITIES Preparedness and Prevention § 264.34 Access to communications or alarm system. (a) Whenever... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Access to communications or alarm system. 264.34 Section 264.34 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID...

  16. Association of Dermatology Consultations With Patient Care Outcomes in Hospitalized Patients With Inflammatory Skin Diseases.

    Science.gov (United States)

    Milani-Nejad, Nima; Zhang, Myron; Kaffenberger, Benjamin H

    2017-06-01

    The value of inpatient dermatology consultations has traditionally been demonstrated with frequency in changes of diagnosis and management; however, the impact of dermatology consultations on metrics such as hospital length of stay and readmission rates remains unknown. To determine the association of dermatology consultations with patient care in hospitalized patients using objective values. We retrospectively queried the deidentified database of patients hospitalized between January 1, 2012, and December 31, 2014, at a single university medical center. A total of 413 patients with a primary inflammatory skin condition discharge diagnosis and 647 patients with primary inflammatory skin condition admission diagnosis were selected. Hospital length of stay and 1-year readmission with inflammatory skin conditions. The 413 patients with a primary inflammatory skin condition discharge diagnosis were 61.0% female and had a mean (SD) age of 55.1 (16.4) years. The 647 patients with primary inflammatory skin condition admission diagnosis were 50.8% female and had a mean (SD) age of 57.8 (15.9) years. Multivariable modeling showed that dermatology consultations were associated with a reduction of 1-year inflammatory skin condition readmissions among patients who were discharged primarily with an inflammatory skin condition (readmission probability, 0.0025; 95% CI, 0.00020-0.030 with dermatology consult vs 0.026; 95% CI, 0.0065-0.10 without; odds ratio, 0.093; 95% CI, 0.010-0.840; P = .03). No other confounding variable was associated with reduction in readmissions. Multivariable modeling also showed that dermatology consultations were associated with a reduction in the adjusted hospital length of stay by 2.64 days (95% CI, 1.75-3.53 days; P Dermatology consultations were associated with improvements of outcomes among hospitalized patients. The expansion of the role of dermatology consultation services may improve patient care in a cost-effective manner.

  17. 46 CFR 356.41 - Management agreements.

    Science.gov (United States)

    2010-10-01

    ... which the management company provides marketing services, consulting services or other services that are... otherwise effectively gain control over the management and operation of the vessel or vessel-owning entity... 46 Shipping 8 2010-10-01 2010-10-01 false Management agreements. 356.41 Section 356.41 Shipping...

  18. 76 FR 4369 - Interim Deputation Agreements; Interim BIA Adult Detention Facility Guidelines

    Science.gov (United States)

    2011-01-25

    ... Deputation Agreements are effective on January 25, 2011. FOR FURTHER INFORMATION CONTACT: Charles Addington... http://www.bia.gov/WhoWeAre/BIA/OJS/index.htm . The documents were the subject of tribal consultation in November and December 2010. The Office of Justice Services continues consultation on the Tribal...

  19. Improved Intra-coding Methods for H.264/AVC

    Directory of Open Access Journals (Sweden)

    Li Song

    2009-01-01

    Full Text Available The H.264/AVC design adopts a multidirectional spatial prediction model to reduce spatial redundancy, where neighboring pixels are used as a prediction for the samples in a data block to be encoded. In this paper, a recursive prediction scheme and an enhanced (block-matching algorithm BMA prediction scheme are designed and integrated into the state-of-the-art H.264/AVC framework to provide a new intra coding model. Extensive experiments demonstrate that the coding efficiency can be on average increased by 0.27 dB with comparison to the performance of the conventional H.264 coding model.

  20. The H.264/MPEG4 advanced video coding

    Science.gov (United States)

    Gromek, Artur

    2009-06-01

    H.264/MPEG4-AVC is the newest video coding standard recommended by International Telecommunication Union - Telecommunication Standardization Section (ITU-T) and the ISO/IEC Moving Picture Expert Group (MPEG). The H.264/MPEG4-AVC has recently become leading standard for generic audiovisual services, since deployment for digital television. Nowadays is commonly used in wide range of video application ranging like mobile services, videoconferencing, IPTV, HDTV, video storage and many more. In this article, author briefly describes the technology applied in the H.264/MPEG4-AVC video coding standard, the way of real-time implementation and the way of future development.

  1. 27 CFR 44.264a - To a foreign-trade zone.

    Science.gov (United States)

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false To a foreign-trade zone. 44.264a Section 44.264a Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE... Warehouses Notice of Removal of Shipment § 44.264a To a foreign-trade zone. Where cigars are withdrawn from a...

  2. Consultant tells how to reduce nuclear risk

    International Nuclear Information System (INIS)

    Smock, R.

    1983-01-01

    John Garrick of Pickard, Lowe, and Garrick, an Irvine, CA, consulting firm, thinks nuclear plant risks can be measured and managed through creative use of probabilistic risk assessments (PRA). PRAs can be used to quantify the likelihood of an accident from all causes except sabotage or war, says Garrick. Although that use has been criticized, the Nuclear Regulatory Commission is moving toward formal use of PRAs in its internal analyses. 7 figures, 1 table

  3. 40 CFR 264.53 - Copies of contingency plan.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Copies of contingency plan. 264.53... Contingency Plan and Emergency Procedures § 264.53 Copies of contingency plan. A copy of the contingency plan... called upon to provide emergency services. [Comment: The contingency plan must be submitted to the...

  4. 40 CFR 264.142 - Cost estimate for closure.

    Science.gov (United States)

    2010-07-01

    ... (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES... may be realized with the sale of hazardous wastes, or non-hazardous wastes if applicable under § 264... hazardous wastes, or non-hazardous wastes if applicable under § 264.113(d), that might have economic value...

  5. 40 CFR 264.312 - Special requirements for ignitable or reactive waste.

    Science.gov (United States)

    2010-07-01

    ..., AND DISPOSAL FACILITIES Landfills § 264.312 Special requirements for ignitable or reactive waste. (a... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Special requirements for ignitable or reactive waste. 264.312 Section 264.312 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY...

  6. 40 CFR 264.281 - Special requirements for ignitable or reactive waste.

    Science.gov (United States)

    2010-07-01

    ..., AND DISPOSAL FACILITIES Land Treatment § 264.281 Special requirements for ignitable or reactive waste... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Special requirements for ignitable or reactive waste. 264.281 Section 264.281 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY...

  7. 40 CFR 264.256 - Special requirements for ignitable or reactive waste.

    Science.gov (United States)

    2010-07-01

    ..., AND DISPOSAL FACILITIES Waste Piles § 264.256 Special requirements for ignitable or reactive waste... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Special requirements for ignitable or reactive waste. 264.256 Section 264.256 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY...

  8. 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)

  9. Emotional communication in medical consultations with native and non-native patients applying two different methodological approaches.

    Science.gov (United States)

    Kale, Emine; Skjeldestad, Kristin; Finset, Arnstein

    2013-09-01

    To explore the potential agreement between two different methods to investigate emotional communication of native and non-native patients in medical consultations. The data consisted of 12 videotaped hospital consultations with six native and six non-native patients. The consultations were coded according to coding rules of the Verona Coding definitions of Emotional Sequences (VR-CoDES) and afterwards analyzed by discourse analysis (DA) by two co-workers who were blind to the results from VR-CoDES. The agreement between VR-CoDES and DA was high in consultations with many cues and concerns, both with native and non-native patients. In consultations with no (or one cue) according to VR-CoDES criteria the DA still indicated the presence of emotionally salient expressions and themes. In some consultations cues to underlying emotions are communicated so vaguely or veiled by language barriers that standard VR-CoDES coding may miss subtle cues. Many of these sub-threshold cues could potentially be coded as cues according to VR-CoDES main coding categories, if criteria for coding vague or ambiguous cues had been better specified. Combining different analytical frameworks on the same dataset provide us new insights on emotional communication. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  10. Dentist–patient communication: what do patients and dentists remember following a consultation? Implications for patient compliance

    Directory of Open Access Journals (Sweden)

    Misra S

    2013-06-01

    Full Text Available Sara Misra, Blánaid Daly, Stephen Dunne, Brian Millar, Mark Packer, Koula AsimakopoulouDental Institute, King's College London, London, UKBackground: There is a lack of information about the extent to which patients recall key facts of dental consultations. Forgetting health advice undermines adherence with such instructions and is a potential problem. This study assessed the quantity and type of information recalled in a dental consultation, dentist–patient agreement over the contents of the consultation, and the relationship of such recall with patient satisfaction.Methods: Using a cross-sectional design, questionnaire data were obtained from patients recruited through a letter and presenting for a routine dental consultation. General issues discussed, specific information about oral health given, dentist-performed procedures, and agreed future actions were reported independently in writing, by patients and also by the treating dentist immediately postconsultation. Additionally, patients completed a dental visit satisfaction questionnaire.Results: Responses (n = 26, 55% response rate were content-analyzed, and data on the number and type of information that was recalled were obtained. Interrater reliability was established. Inferential testing showed differences in dentist–patient recall, dentist–patient agreement, and the association between patient recall and satisfaction. Dentists recalled more information than patients (P = 0.001. Dentists further reported giving more dental health education (P = 0.006 and discussing more future actions (P = 0.002 than patients actually remembered. Technical (eg, crowns/bridges rather than psychosocial (eg, pain/embarrassment issues were reported more often (P = 0.001 by both dentists and patients. Dentist–patient agreement over issues discussed and procedures performed was higher (kappa = 0.210–0.310 than dental health education agreement and agreed future actions (kappa = 0.060–0.110. There

  11. Understanding communication between emergency and consulting physicians: a qualitative study that describes and defines the essential elements of the emergency department consultation-referral process for the junior learner.

    Science.gov (United States)

    Chan, Teresa; Orlich, Donika; Kulasegaram, Kulamakan; Sherbino, Jonathan

    2013-01-01

    To define the important elements of an emergency department (ED) consultation request and to develop a simple model of the process. From March to September 2010, 61 physicians (21 emergency medicine [EM], 20 general surgery [GS], 20 internal medicine [IM]; 31 residents, 30 attending staff) were questioned about how junior learners should be taught about ED consultation. Two investigators independently reviewed focus group and interview transcripts using grounded theory to generate an index of themes until saturation was reached. Disagreements were resolved by consensus, yielding an inventory of themes and subthemes. All transcripts were coded using this index of themes; 30% of transcripts were coded in duplicate to determine the agreement. A total of 245 themes and subthemes were identified. The agreement between reviewers was 77%. Important themes in the process were as follows: initial preparation and review of investigations by EM physician (overall endorsement 87% [range 70-100% in different groups]); identification of involved parties (patient and involved physicians) (100%); hypothesis of patient's diagnosis (75% [range 62-83%]) or question for the consulting physician (70% [range 55-95%]); urgency (100%) and stability (74% [range 62-80%]); questions from the consultant (100%); discussion/communication (98% [range 95-100%]); and feedback (98% [range 95-100%]). These components were reorganized into a simple framework (PIQUED). Each clinical specialty significantly contributed to the model (χ2  =  7.9; p value  =  0.019). Each group contributed uniquely to the final list of important elements (percent contributions: EM, 57%; GS, 41%; IM, 64%). We define important elements of an ED consultation with input from emergency and consulting physicians. We propose a model that organizes these elements into a simple framework (PIQUED) that may be valuable for junior learners.

  12. Improved lossless intra coding for H.264/MPEG-4 AVC.

    Science.gov (United States)

    Lee, Yung-Lyul; Han, Ki-Hun; Sullivan, Gary J

    2006-09-01

    A new lossless intra coding method based on sample-by-sample differential pulse code modulation (DPCM) is presented as an enhancement of the H.264/MPEG-4 AVC standard. The H.264/AVC design includes a multidirectional spatial prediction method to reduce spatial redundancy by using neighboring samples as a prediction for the samples in a block of data to be encoded. In the new lossless intra coding method, the spatial prediction is performed based on samplewise DPCM instead of in the block-based manner used in the current H.264/AVC standard, while the block structure is retained for the residual difference entropy coding process. We show that the new method, based on samplewise DPCM, does not have a major complexity penalty, despite its apparent pipeline dependencies. Experiments show that the new lossless intra coding method reduces the bit rate by approximately 12% in comparison with the lossless intra coding method previously included in the H.264/AVC standard. As a result, the new method is currently being adopted into the H.264/AVC standard in a new enhancement project.

  13. Learning through inter- and intradisciplinary problem solving: using cognitive apprenticeship to analyse doctor-to-doctor consultation.

    Science.gov (United States)

    Pimmer, Christoph; Pachler, Norbert; Nierle, Julia; Genewein, Urs

    2012-12-01

    Today's healthcare can be characterised by the increasing importance of specialisation that requires cooperation across disciplines and specialities. In view of the number of educational programmes for interdisciplinary cooperation, surprisingly little is known on how learning arises from interdisciplinary work. In order to analyse the learning and teaching practices of interdisciplinary cooperation, a multiple case study research focused on how consults, i.e., doctor-to-doctor consultations between medical doctors from different disciplines were carried out: semi-structured interviews with doctors of all levels of seniority from two hospital sites in Switzerland were conducted. Starting with a priori constructs based on the 'methods' underpinning cognitive apprenticeship (CA), the transcribed interviews were analysed according to the principles of qualitative content analysis. The research contributes to three debates: (1) socio-cognitive and situated learning, (2) intra- and interdisciplinary learning in clinical settings, and (3), more generally, to cooperation and problem solving. Patient cases, which necessitate the cooperation of doctors in consults across boundaries of clinical specialisms, trigger intra- as well as interdisciplinary learning and offer numerous and varied opportunities for learning by requesting doctors as well as for on-call doctors, in particular those in residence. The relevance of consults for learning can also be verified from the perspective of CA which is commonly used by experts, albeit in varying forms, degrees of frequency and quality, and valued by learners. Through data analysis a model for collaborative problem-solving and help-seeking was developed which shows the interplay of pedagogical 'methods' of CA in informal clinical learning contexts.

  14. 40 CFR 264.114 - Disposal or decontamination of equipment, structures and soils.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Disposal or decontamination of equipment, structures and soils. 264.114 Section 264.114 Protection of Environment ENVIRONMENTAL PROTECTION... TREATMENT, STORAGE, AND DISPOSAL FACILITIES Closure and Post-Closure § 264.114 Disposal or decontamination...

  15. Diode-pumped femtosecond mode-locked Nd, Y-codoped CaF2 laser

    International Nuclear Information System (INIS)

    Zhu, Jiangfeng; Zhang, Lijuan; Gao, Ziye; Wang, Junli; Wang, Zhaohua; Wei, Zhiyi; Su, Liangbi; Zheng, Lihe; Wang, Jingya; Xu, Jun

    2015-01-01

    A passively mode-locked femtosecond laser based on an Nd, Y-codoped CaF 2 disordered crystal was demonstrated. The Y 3+ -codoping in Nd : CaF 2 markedly suppressed the quenching effect and improved the fluorescence quantum efficiency and emission spectra. With a fiber-coupled laser diode as the pump source, the continuous wave tuning range covering from 1042 to 1076 nm was realized, while the mode-locked operation generated 264 fs pulses with an average output power of 180 mW at a repetition rate of 85 MHz. The experimental results show that the Nd, Y-codoped CaF 2 disordered crystal has potential in a new generation diode-pumped high repetition rate chirped pulse amplifier. (letter)

  16. Improving the utility and effectiveness of the standing consultative commission

    International Nuclear Information System (INIS)

    Graybeal, S.N.; Krepon, M.

    1988-01-01

    The Standing Consultative Commission has been an indispensable channel of communication between the superpowers over SALT implementation and compliance. Other channels could have been used for these purposes, but none would have been as ideally suited, or specifically authorized to do so. If something like the SCC did not exist, it would have to be created. In recent years, the SCC has not been a forum of productive exchanges, its jurisdiction has been narrowed, and its reputation tarnished. Nevertheless, new bilateral arms reduction agreements will require effective consultation if they are to be implemented properly and with a minimum of compliance problems. Important lessons can be learned from the experience of the SCC, whether this body is strenghened or new mechanisms are created to perform similar functions for new agreements. The guidelines presented here can help minimize treaty implementation and compliance problems. No suggestions will be of much value, however, if the United States and Soviet Union are ambivalent about affirming the objectives and purposes of past agreements. During periods of strained political relations, negotiations over new agreements rarely proceed smoothly. While the SCC has been somewhat more insulated from the ups and downs of superpower relations, it clearly has not been immune from them. But when political relations between negotiating partners deteriorate to the point where intentions toward existing treaty obligations are called into question, no bilateral compliance mechanism can serve as an effective, problem-solving forum

  17. Digital learning objects in nursing consultation: technology assessment by undergraduate students.

    Science.gov (United States)

    Silveira, DeniseTolfo; Catalan, Vanessa Menezes; Neutzling, Agnes Ludwig; Martinato, Luísa Helena Machado

    2010-01-01

    This study followed the teaching-learning process about the nursing consultation, based on digital learning objects developed through the active Problem Based Learning method. The goals were to evaluate the digital learning objects about nursing consultation, develop cognitive skills on the subject using problem based learning and identify the students' opinions on the use of technology. This is an exploratory and descriptive study with a quantitative approach. The sample consisted of 71 students in the sixth period of the nursing program at the Federal University of Rio Grande do Sul. The data was collected through a questionnaire to evaluate the learning objects. The results showed positive agreement (58%) on the content, usability and didactics of the proposed computer-mediated activity regarding the nursing consultation. The application of materials to the students is considered positive.

  18. 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...

  19. 40 CFR 264.148 - Incapacity of owners or operators, guarantors, or financial institutions.

    Science.gov (United States)

    2010-07-01

    ..., guarantors, or financial institutions. 264.148 Section 264.148 Protection of Environment ENVIRONMENTAL... TREATMENT, STORAGE, AND DISPOSAL FACILITIES Financial Requirements § 264.148 Incapacity of owners or operators, guarantors, or financial institutions. (a) An owner or operator must notify the Regional...

  20. Ab-initio calculations of the Ruddlesden-Popper phases CaMnO3, CaO(CaMnO3) and CaO(CaMnO3)2

    International Nuclear Information System (INIS)

    Cardoso, C; Borges, R P; Gasche, T; Godinho, M

    2008-01-01

    The present work reports ab-initio density functional theory calculations for the Ruddlesden-Popper phase CaO(CaMnO 3 ) n compounds. In order to study the evolution of the properties with the number of perovskite layers, a detailed analysis of the densities of states calculated for each compound and for several magnetic configurations was performed. The effect of distortions of the crystal structure on the magnetic ground state is also analysed and the exchange constants and transition temperatures are calculated for the three compounds using a mean field model. The calculated magnetic ground state structures and magnetic moments are in good agreement with experimental results and previous calculations

  1. The Texts of the Agency's Relationship Agreements with Specialized Agencies

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1962-04-10

    The text of the relationship agreement which the Agency has concluded with the Inter-Governmental Maritime Consultative Organization, together with the protocol authenticating it, is reproduced in this document for the information of all Members of the Agency.

  2. The Texts of the Agency's Relationship Agreements with Specialized Agencies

    International Nuclear Information System (INIS)

    1962-01-01

    The text of the relationship agreement which the Agency has concluded with the Inter-Governmental Maritime Consultative Organization, together with the protocol authenticating it, is reproduced in this document for the information of all Members of the Agency

  3. Rates for some reactions involving 42Ca and 44Ca

    International Nuclear Information System (INIS)

    Cheng, C.W.; King, J.D.

    1980-01-01

    Ground-state reaction rates have been deduced from recent cross section measurements for the 42 CA(α, n) 45 Ti, 42 Ca(p, γ) 43 Sc, and 44 Ca(p, n) 44 Sc reactions. Comparison of these rates with those calculated from a statistical model of nuclear reactions. (Woosley et al) shows good agreement for the first two, but the 44 Ca(p, n) rate is more than a factor of 2 less than the theoretical prediction. Stellar reaction rates have been derived from the ground-state rates by multiplying the ground-state rates by the ratio of stellar to ground-state rates given by the statistical model. Both ground-state and stellar rates have been represented by analytic functions of the temperature. The role of these reactions in the approach to quasi-equilibrium during explosive silicon burning is discussed

  4. A prospective study assessing agreement and reliability of a geriatric evaluation

    OpenAIRE

    Locatelli, Isabella; Monod, St?fanie; Cornuz, Jacques; B?la, Christophe J.; Senn, Nicolas

    2017-01-01

    Background The present study takes place within a geriatric program, aiming at improving the diagnosis and management of geriatric syndromes in primary care. Within this program it was of prime importance to be able to rely on a robust and reproducible geriatric consultation to use as a gold standard for evaluating a primary care brief assessment tool. The specific objective of the present study was thus assessing the agreement and reliability of a comprehensive geriatric consultation. Method...

  5. Memorandum of Understanding on cooperation and consultation on nuclear installations near borders

    International Nuclear Information System (INIS)

    1977-01-01

    This Agreement signed on 27 September 1977 lays down that the Contracting Parties will inform each other about all nuclear installations constructed along the common border. Nuclear installations within the meaning of the Agreement are installations for the production, processing, reprocessing, manufacture or fission of nuclear fuels and radioactive waste storage. The information to be communicated includes plans and decisions on siting, construction and operation of such installations and relevant documents. The Agreement provides for consultation between the Parties on safety aspects and lays down in detail all the conditions for communication of information. (NEA) [fr

  6. 40 CFR 264.178 - Closure.

    Science.gov (United States)

    2010-07-01

    ... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Use and Management of Containers § 264.178 Closure. At closure, all hazardous waste and hazardous waste residues must be removed...

  7. Amelioration of inflammatory responses by Socheongryong-Tang, a traditional herbal medicine, in RAW 264.7 cells and rats

    Science.gov (United States)

    Kim, Youn Sook; Jung, Ji Yun; Park, Chung A.; Jegal, Kyung Hwan; Ku, Sae Kwang; Kim, Jae Kwang; Lee, Chul Won; Kim, Young Woo; Cho, Il Je; An, Won G.; Kim, Sang Chan

    2018-01-01

    Socheongryong-Tang (SCRT) is a natural medicine prescription that has been mainly used in East Asia for the treatment of inflammatory disorders, including asthma and allergic rhinitis. The present study evaluated the anti-inflammatory effects of SCRT on lipopolysaccharide (LPS)-stimulated RAW 264.7 cells and in a rat model of carrageenan (CA)-induced paw edema. Levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, IL-6 and prostaglandin E2 (PGE2) in the culture supernatant were quantified and nitric oxide (NO) production was monitored. In addition, the effect of SCRT on the protein expression of nuclear factor-κB (NF-κB), mitogen-activated protein kinases (MAPKs), inducible NO synthase (iNOS) and cyclooxygenase-2 (COX-2) was assessed by western blot analysis. Furthermore, the effects of SCRT on acute inflammation in vivo and changes in the histomorphometry and histopathology of paw skin were observed using CA-treated rats. SCRT (1 mg/ml) inhibited the LPS-induced changes in the protein expression of NF-κB, JNK, ERK1/2, iNOS and COX-2, as well as the production of NO, PGE2 and cytokines. In the rat paw edema assay, administration of 1 g/kg of lyophilized powder obtained from the aqueous extracts of SCRT for 3 consecutive days inhibited the CA-induced increases in skin thickness, mast cell degranulation, and infiltration of inflammatory cells in the ventral and dorsal pedis skin within 4 h. These results demonstrated that SCRT exerts its anti-inflammatory activities in LPS-stimulated RAW 264.7 cells through decreasing the production of inflammatory mediators, including PGE2, NO and cytokines, via suppression of the NF-κB and JNK and ERK1/2 signaling pathways. In addition, the data of the CA-induced paw edema indicated an anti-edema effect of SCRT. SCRT (1 g/kg) reduced acute edematous inflammation through inhibition of mast cell degranulation and infiltration of inflammatory cells. Therefore, the present study provided scientific evidence for the

  8. The CaO orange system in meteor spectra

    Science.gov (United States)

    Berezhnoy, A. A.; Borovička, J.; Santos, J.; Rivas-Silva, J. F.; Sandoval, L.; Stolyarov, A. V.; Palma, A.

    2018-02-01

    The CaO orange band system was simulated in the region 5900-6300 Å and compared with the experimentally observed spectra of Benešov bolide wake. The required vibronic Einstein emission coefficients were estimated by means of the experimental radiative lifetimes under the simplest Franck-Condon approximation. A moderate agreement was achieved, and the largest uncertainties come from modeling shape of FeO orange bands. Using a simple model the CaO column density in the wake of the Benešov bolide at the height of 29 km was estimated as (5 ± 2) × 1014 cm-2 by a comparison of the present CaO spectra with the AlO bands nicely observed at 4600-5200 Å in the same spectrum. The obtained CaO content is in a good agreement with the quenching model developed for the impact-produced cloud, although future theoretical and experimental studies of both CaO and FeO orange systems contribution would be needed to confirm these results.

  9. 40 CFR 264.198 - Special requirements for ignitable or reactive wastes.

    Science.gov (United States)

    2010-07-01

    ... waste, mixture, or dissolved material no longer meets the definition of ignitable or reactive waste... comply with the requirements for the maintenance of protective distances between the waste management... reactive wastes. 264.198 Section 264.198 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY...

  10. Consultation with First Nations stakeholders : an Alberta perspective

    Energy Technology Data Exchange (ETDEWEB)

    Rutwind, S. [Alberta Justice, Edmonton, AB (Canada). Aboriginal Law

    2005-07-01

    Aboriginal issues present risks and challenges to resource development in Alberta. This paper provided an overview of significant precedents and acts which may impact on oil and gas activities. The Constitution Act of 1982 acknowledged that existing Aboriginal and treaty rights of the Aboriginal peoples of Canada were recognized and confirmed. In the case of R v. Sparrow, justification was established where there was a valid legislative objective, such as conservation and resource management, and a precedent was set regarding the interpretation of disputes of section 35 subsection 1 concerning legal restriction of the exercise of treaty rights, such as hunting and fishing. In R v. Badger, the Supreme Court of Canada (SCC) advised that the framework applied to treaty rights as well as Aboriginal rights. The Natural Resources Transfer Agreement transferred powers over natural resources from Canada to Alberta in relation to hunting rights. Proof of rights issues were discussed in Taku River Tlingit First Nation v. Tulesequa Chief Mine Project, as well as in Haida Nation v. British Columbia, where it was concluded that an Aboriginal right need not be proven before a duty to consult arises. A review of Alberta's consultation practices was presented, as well as the Aboriginal issues and resource development initiative, which recognizes the importance of consultation with affected Aboriginal people and communities when regulatory and development activities infringe their existing treaty and other constitutional rights, such as the rights to hunt, fish and trap for food. Details of the Consultation Coordination Group were presented. A draft of the Government of Alberta's First Nations Consultation Policy on Land Management and Resource Development was also presented. tabs, figs.

  11. File list: Oth.Bld.05.AllAg.RAW_264PERIOD7 [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  12. File list: Oth.Bld.10.AllAg.RAW_264PERIOD7 [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  13. File list: DNS.Bld.20.AllAg.RAW_264PERIOD7 [Chip-atlas[Archive

    Lifescience Database Archive (English)

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    Lifescience Database Archive (English)

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    Lifescience Database Archive (English)

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    Lifescience Database Archive (English)

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    Lifescience Database Archive (English)

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  18. File list: DNS.Bld.05.AllAg.RAW_264PERIOD7 [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  19. 40 CFR 264.176 - Special requirements for ignitable or reactive waste.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Special requirements for ignitable or reactive waste. 264.176 Section 264.176 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE...

  20. 40 CFR 264.229 - Special requirements for ignitable or reactive waste.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Special requirements for ignitable or reactive waste. 264.229 Section 264.229 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE...

  1. 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

  2. Amelioration of inflammatory responses by Socheongryong-Tang, a traditional herbal medicine, in RAW 264.7 cells and rats.

    Science.gov (United States)

    Park, Sang Mi; Lee, Tae Hoon; Zhao, Rongjie; Kim, Youn Sook; Jung, Ji Yun; Park, Chung A; Jegal, Kyung Hwan; Ku, Sae Kwang; Kim, Jae Kwang; Lee, Chul Won; Kim, Young Woo; Cho, Il Je; An, Won G; Kim, Sang Chan

    2018-05-01

    Socheongryong-Tang (SCRT) is a natural medicine prescription that has been mainly used in East Asia for the treatment of inflammatory disorders, including asthma and allergic rhinitis. The present study evaluated the anti-inflammatory effects of SCRT on lipopolysaccharide (LPS)-stimulated RAW 264.7 cells and in a rat model of carrageenan (CA)-induced paw edema. Levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, IL-6 and prostaglandin E2 (PGE2) in the culture supernatant were quantified and nitric oxide (NO) production was monitored. In addition, the effect of SCRT on the protein expression of nuclear factor-κB (NF-κB), mitogen-activated protein kinases (MAPKs), inducible NO synthase (iNOS) and cyclooxygenase-2 (COX-2) was assessed by western blot analysis. Furthermore, the effects of SCRT on acute inflammation in vivo and changes in the histomorphometry and histopathology of paw skin were observed using CA-treated rats. SCRT (1 mg/ml) inhibited the LPS-induced changes in the protein expression of NF-κB, JNK, ERK1/2, iNOS and COX-2, as well as the production of NO, PGE2 and cytokines. In the rat paw edema assay, administration of 1 g/kg of lyophilized powder obtained from the aqueous extracts of SCRT for 3 consecutive days inhibited the CA-induced increases in skin thickness, mast cell degranulation, and infiltration of inflammatory cells in the ventral and dorsal pedis skin within 4 h. These results demonstrated that SCRT exerts its anti-inflammatory activities in LPS-stimulated RAW 264.7 cells through decreasing the production of inflammatory mediators, including PGE2, NO and cytokines, via suppression of the NF-κB and JNK and ERK1/2 signaling pathways. In addition, the data of the CA-induced paw edema indicated an anti-edema effect of SCRT. SCRT (1 g/kg) reduced acute edematous inflammation through inhibition of mast cell degranulation and infiltration of inflammatory cells. Therefore, the present study provided scientific evidence for

  3. File list: ALL.Bld.05.AllAg.RAW_264PERIOD7 [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available ALL.Bld.05.AllAg.RAW_264PERIOD7 mm9 All antigens Blood RAW 264.7 SRX218749,SRX26459...RX1471834,SRX019779,SRX264581 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/ALL.Bld.05.AllAg.RAW_264PERIOD7.bed ...

  4. File list: ALL.Bld.20.AllAg.RAW_264PERIOD7 [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  5. File list: ALL.Bld.10.AllAg.RAW_264PERIOD7 [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available ALL.Bld.10.AllAg.RAW_264PERIOD7 mm9 All antigens Blood RAW 264.7 SRX796809,SRX26459...RX1471833,SRX019779,SRX264581 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/ALL.Bld.10.AllAg.RAW_264PERIOD7.bed ...

  6. File list: ALL.Bld.50.AllAg.RAW_264PERIOD7 [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  7. High Definition Video Streaming Using H.264 Video Compression

    OpenAIRE

    Bechqito, Yassine

    2009-01-01

    This thesis presents high definition video streaming using H.264 codec implementation. The experiment carried out in this study was done for an offline streaming video but a model for live high definition streaming is introduced, as well. Prior to the actual experiment, this study describes digital media streaming. Also, the different technologies involved in video streaming are covered. These include streaming architecture and a brief overview on H.264 codec as well as high definition t...

  8. 40 CFR 264.1035 - Recordkeeping requirements.

    Science.gov (United States)

    2010-07-01

    ... management units in one recordkeeping system if the system identifies each record by each hazardous waste..., catalytic vapor incinerator, flare, boiler, process heater, condenser, or carbon adsorption system, the... Section 264.1035 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES...

  9. Bacterial lipopolysaccharide induces osteoclast formation in RAW 264.7 macrophage cells

    International Nuclear Information System (INIS)

    Islam, Shamima; Hassan, Ferdaus; Tumurkhuu, Gantsetseg; Dagvadorj, Jargalsaikhan; Koide, Naoki; Naiki, Yoshikazu; Mori, Isamu; Yoshida, Tomoaki; Yokochi, Takashi

    2007-01-01

    Lipopolysaccharide (LPS) is a potent bone resorbing factor. The effect of LPS on osteoclast formation was examined by using murine RAW 264.7 macrophage cells. LPS-induced the formation of multinucleated giant cells (MGC) in RAW 264.7 cells 3 days after the exposure. MGCs were positive for tartrate-resistant acid phosphatase (TRAP) activity. Further, MGC formed resorption pits on calcium-phosphate thin film that is a substrate for osteoclasts. Therefore, LPS was suggested to induce osteoclast formation in RAW 264.7 cells. LPS-induced osteoclast formation was abolished by anti-tumor necrosis factor (TNF)-α antibody, but not antibodies to macrophage-colony stimulating factor (M-CSF) and receptor activator of nuclear factor (NF)-κB ligand (RANKL). TNF-α might play a critical role in LPS-induced osteoclast formation in RAW 264.7 cells. Inhibitors of NF-κB and stress activated protein kinase (SAPK/JNK) prevented the LPS-induced osteoclast formation. The detailed mechanism of LPS-induced osteoclast formation is discussed

  10. 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.

  11. Mirror, mirror on the wall--evaluating Fair Market Value for manufacturer-physician consulting arrangements.

    Science.gov (United States)

    Eaton, Fred; Reid, Jaimee

    2010-01-01

    Pharmaceutical and medical device manufacturers contract with thousands of physicians each year, and struggle to comply with the Fair Market Value requirements of the Anti-Kickback Statute's "personal services" safe harbor. Consultant arrangements between physicians and manufactures have come under increasing scrutiny by regulators. In 2007, the five leading Hip & Knee manufacturers entered into settlement agreements related to their contract practices with physician consultants. Government sources do not provide guidance for calculating Fair Market Value; however, this article recommends four principles to use when evaluating Fair Market Value methodologies.

  12. 40 CFR 264.101 - Corrective action for solid waste management units.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Corrective action for solid waste management units. 264.101 Section 264.101 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Releases From Soli...

  13. File list: His.Bld.10.AllAg.RAW_264PERIOD7 [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  14. File list: His.Bld.20.AllAg.RAW_264PERIOD7 [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  15. File list: His.Bld.50.AllAg.RAW_264PERIOD7 [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  16. File list: His.Bld.05.AllAg.RAW_264PERIOD7 [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  17. 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)

  18. Analysis of responses to the microgeneration strategy and low carbon buildings programme consultation

    Energy Technology Data Exchange (ETDEWEB)

    Gibbard, J; Long, S; McCartney, K; Rushton, K

    2005-10-15

    This report summarises and analyses the written responses to the consultation document, 'Microgeneration Strategy and Low Carbon Buildings Programme', issued by the Department of Trade and Industry (DTI) in June 2005. Responses were received from 204 different organisations representing 29 stakeholder groups. The consultation document contained 41 core questions divided into eight sections: general; product development and deployment; communications; economics; installation; Low Carbon Buildings Programme; physical infrastructure; and local authorities and regional bodies. In the analysis, the responses to these questions were categorised according to whether they represented a 'clear consensus', a 'majority view', 'supporting themes' and 'divergent themes'. Using these categories, stakeholder agreement on the eight strategic issues is summarised in a matrix. The report is divided into three sections: introduction; summary of responses; and key findings. The respondents are listed in an appendix. Another appendix reproduces the consultation questions.

  19. 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.

  20. Nuclear spectroscopy of Ca and Sc isotopes from inelastic scattering and one-nucleon transfer reactions on a radioactive 41Ca target

    International Nuclear Information System (INIS)

    Vold, P.

    1978-04-01

    The structure of energy levels in 40 , 42 Ca and 42 Sc has been studied using inelastic proton scattering and one-nucleon stripping and pick-up transfer reactions on a 41 Ca target. Data has given the following information on the properties of the 41 Ca ground state wave function; i) the 41 Ca (g.s.) looks very much like an f (sub7/2) neutron coupled to the 40 Ca (g.s.) core. ii) The core-excited component of the 41 Ca (g.s.) is determined to be 10 or less. It was inferred that the main constituents of the spectroscopic strength leading to the (f(sub7/2)) 2 , (f(sub7/2)p(sub3/2))(subt=1) and (f(sub7/2)p(sub1/2))(subT=1) configurations have been identified. This was used to deduce the effective two-particle matrix elements for these configurations. The 42 Sc and 42 Ca data result in excellent agreement for the T=1 members of the (f(sub7/2)) 2 multiplet while the (f(sub7/2)p(sub3/2))(subT=1) matrix elements derived from the 42 Sc data are about 0.2 MeV more repulsive than those obtained from the 42 Ca data. The (f(sub7/2)d(sub3/2) -1 ) matrix elements derived from the present ( 3 He,α) data were compared to the corresponding values obtained from one-nucleon stripping to mass 34 nuclei. The two sets of matrix elements are in very good agreement. The 40 Ca values are also well reproduced by calculations using the modified surface delta interaction. The experimental spectroscopic factors to both the T=0 and T=1 states of the (f(sub7/2)) 2 multiplet are in remarkably good agreement with the predicted values of the coexistence model considering the simplicity of this model. (JIW)

  1. File list: InP.Bld.05.AllAg.RAW_264PERIOD7 [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  2. File list: InP.Bld.10.AllAg.RAW_264PERIOD7 [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  3. File list: InP.Bld.20.AllAg.RAW_264PERIOD7 [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  4. File list: InP.Bld.50.AllAg.RAW_264PERIOD7 [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  5. 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

  6. 40 CFR 264.1084 - Standards: Tanks.

    Science.gov (United States)

    2010-07-01

    ... enclosure by conveyor, vehicles, or other mechanical means; entry of permanent mechanical or electrical... in § 264.1087 of this subpart. (j) The owner or operator shall transfer hazardous waste to a tank subject to this section in accordance with the following requirements: (1) Transfer of hazardous waste...

  7. 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.

  8. Mode-dependent templates and scan order for H.264/AVC-based intra lossless coding.

    Science.gov (United States)

    Gu, Zhouye; Lin, Weisi; Lee, Bu-Sung; Lau, Chiew Tong; Sun, Ming-Ting

    2012-09-01

    In H.264/advanced video coding (AVC), lossless coding and lossy coding share the same entropy coding module. However, the entropy coders in the H.264/AVC standard were original designed for lossy video coding and do not yield adequate performance for lossless video coding. In this paper, we analyze the problem with the current lossless coding scheme and propose a mode-dependent template (MD-template) based method for intra lossless coding. By exploring the statistical redundancy of the prediction residual in the H.264/AVC intra prediction modes, more zero coefficients are generated. By designing a new scan order for each MD-template, the scanned coefficients sequence fits the H.264/AVC entropy coders better. A fast implementation algorithm is also designed. With little computation increase, experimental results confirm that the proposed fast algorithm achieves about 7.2% bit saving compared with the current H.264/AVC fidelity range extensions high profile.

  9. Superconducting TlCa2Ba2Cu3O9 thick films

    International Nuclear Information System (INIS)

    1994-01-01

    GE Corporate Research and Development's (GE-CRD) program to develop the two-zone silver addition (TZSA) process for fabricating superconducting films of TlCa 2 Ba 2 Cu 3 O 9 has activities in the areas of (1) precursor preparation, (2) the thallium oxide vapor process, (3) the effects of post-synthesis annealing ambient and temperature on superconducting properties, (4) the influence of film stoichiometry and composition on superconducting properties, (5) microstructure and film growth mechanism, (6) the preparation of thicker films, (7) the fabrication of films on flexible substrates, and (8) process scale-up. As part of its effort under the ANL Pilot Center Agreement, GE-CRD has supplied to ANL a complete two-zone furnace, has provided consultation on its use and on the planning of experiments, has processed ANL samples in GE's furnaces to help define optimum process conditions, and has provided precursor and finished films as requested. These contributions are described more fully in the descriptions of the work performed at ANL presented elsewhere in this report. Under the Pilot Center Agreement work at GE-CRD has been directed toward the optimization of the TZSA process with emphasis on (A) process improvement, (B) effects of silver content on film properties, (C) the relationship between microstructure and J c , and (D) toward the assessment of the compatibility of silver substrates with the process chemistry

  10. Analysis of responses to the microgeneration strategy and low carbon buildings programme consultation

    Energy Technology Data Exchange (ETDEWEB)

    Gibbard, J.; Long, S.; McCartney, K.; Rushton, K.

    2005-10-15

    This report summarises and analyses the written responses to the consultation document, 'Microgeneration Strategy and Low Carbon Buildings Programme', issued by the Department of Trade and Industry (DTI) in June 2005. Responses were received from 204 different organisations representing 29 stakeholder groups. The consultation document contained 41 core questions divided into eight sections: general; product development and deployment; communications; economics; installation; Low Carbon Buildings Programme; physical infrastructure; and local authorities and regional bodies. In the analysis, the responses to these questions were categorised according to whether they represented a 'clear consensus', a 'majority view', 'supporting themes' and 'divergent themes'. Using these categories, stakeholder agreement on the eight strategic issues is summarised in a matrix. The report is divided into three sections: introduction; summary of responses; and key findings. The respondents are listed in an appendix. Another appendix reproduces the consultation questions.

  11. 40 CFR 264.1064 - Recordkeeping requirements.

    Science.gov (United States)

    2010-07-01

    ...) Method of compliance with the standard (e.g., “monthly leak detection and repair” or “equipped with dual... Air Emission Standards for Equipment Leaks § 264.1064 Recordkeeping requirements. (a)(1) Each owner or... equipment (e.g., a pump or pipeline valve). (iv) Percent-by-weight total organics in the hazardous waste...

  12. Temporal scalability comparison of the H.264/SVC and distributed video codec

    DEFF Research Database (Denmark)

    Huang, Xin; Ukhanova, Ann; Belyaev, Evgeny

    2009-01-01

    The problem of the multimedia scalable video streaming is a current topic of interest. There exist many methods for scalable video coding. This paper is focused on the scalable extension of H.264/AVC (H.264/SVC) and distributed video coding (DVC). The paper presents an efficiency comparison of SV...

  13. 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.

  14. 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.

  15. 40 CFR 264.316 - Disposal of small containers of hazardous waste in overpacked drums (lab packs).

    Science.gov (United States)

    2010-07-01

    ... HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Landfills § 264.316 Disposal of small containers of hazardous waste in overpacked drums (lab packs). Small containers of hazardous waste in overpacked... hazardous waste in overpacked drums (lab packs). 264.316 Section 264.316 Protection of Environment...

  16. 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.

  17. 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...

  18. 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.

  19. Agreements process: problems and opportunities for the states

    International Nuclear Information System (INIS)

    Hunter, T.

    1985-01-01

    The Nuclear Waste Policy Act of 1982 (the Act) directs the Secretary of the US Department of Energy (US DOE) to consult and cooperate with the Governor and legislature of each state within which a candidate site for a nuclear waste repository may exist. The Act further directs USDOE to begin negotiations and to seek to enter into a binding written agreement to address specific concerns of any candidate state which requests such an agreement or within which a site has been approved for site characterization. The written agreements are to address at least the eleven topic areas specified in the Act and are to be completed within six months if possible. The author has been a negotiator for the State of Washington in the repository siting agreements process over the past year. The experience of the author has shown that the agreements process as contemplated by the Act bears little resemblance to the institutional interaction process of the state and federal government on matters relating to consideration of the state for a nuclear waste repository. This paper seeks to analyze the agreements process as it has developed in one state, and identify the problems and opportunities in that process so that other states and USDOE may learn from that experience

  20. 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...

  1. Simulating Urban Growth Using a Random Forest-Cellular Automata (RF-CA Model

    Directory of Open Access Journals (Sweden)

    Courage Kamusoko

    2015-04-01

    Full Text Available Sustainable urban planning and management require reliable land change models, which can be used to improve decision making. The objective of this study was to test a random forest-cellular automata (RF-CA model, which combines random forest (RF and cellular automata (CA models. The Kappa simulation (KSimulation, figure of merit, and components of agreement and disagreement statistics were used to validate the RF-CA model. Furthermore, the RF-CA model was compared with support vector machine cellular automata (SVM-CA and logistic regression cellular automata (LR-CA models. Results show that the RF-CA model outperformed the SVM-CA and LR-CA models. The RF-CA model had a Kappa simulation (KSimulation accuracy of 0.51 (with a figure of merit statistic of 47%, while SVM-CA and LR-CA models had a KSimulation accuracy of 0.39 and −0.22 (with figure of merit statistics of 39% and 6%, respectively. Generally, the RF-CA model was relatively accurate at allocating “non-built-up to built-up” changes as reflected by the correct “non-built-up to built-up” components of agreement of 15%. The performance of the RF-CA model was attributed to the relatively accurate RF transition potential maps. Therefore, this study highlights the potential of the RF-CA model for simulating urban growth.

  2. Virtual clinics in glaucoma care: face-to-face versus remote decision-making.

    Science.gov (United States)

    Clarke, Jonathan; Puertas, Renata; Kotecha, Aachal; Foster, Paul J; Barton, Keith

    2017-07-01

    To examine the agreement in clinical decisions of glaucoma status made in a virtual glaucoma clinic with those made during a face-to-face consultation. A trained nurse and technicians entered data prospectively for 204 patients into a proforma. A subsequent face-to-face clinical assessment was completed by either a glaucoma consultant or fellow. Proformas were reviewed remotely by one of two additional glaucoma consultants, and 12 months later, by the clinicians who had undertaken the original clinical examination. The interobserver and intraobserver decision-making agreements of virtual assessment versus standard care were calculated. We identified adverse disagreement between face-to-face and virtual review in 7/204 (3.4%, 95% CI 0.9% to 5.9%) patients, where virtual review failed to predict a need to accelerated follow-up identified in face-to-face review. Misclassification events were rare, occurring in 1.9% (95% CI 0.3% to 3.8%) of assessments. Interobserver κ (95% CI) showed only fair agreement (0.24 (0.04 to 0.43)); this improved to moderate agreement when only consultant decisions were compared against each other (κ=0.41 (0.16 to 0.65)). The intraobserver agreement κ (95% CI) for the consultant was 0.274 (0.073 to 0.476), and that for the fellow was 0.264 (0.031 to 0.497). The low rate of adverse misclassification, combined with the slowly progressive nature of most glaucoma, and the fact that patients will all be regularly reassessed, suggests that virtual clinics offer a safe, logistically viable option for selected patients with glaucoma. 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/.

  3. 45 CFR 264.72 - What requirements are imposed on a State if it receives contingency funds?

    Science.gov (United States)

    2010-10-01

    ... receives contingency funds? 264.72 Section 264.72 Public Welfare Regulations Relating to Public Welfare... Contingency Fund? § 264.72 What requirements are imposed on a State if it receives contingency funds? (a)(1) A State must meet a Contingency Fund MOE level of 100 percent of historic State expenditures for FY 1994...

  4. 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)

  5. Selective encryption for H.264/AVC video coding

    Science.gov (United States)

    Shi, Tuo; King, Brian; Salama, Paul

    2006-02-01

    Due to the ease with which digital data can be manipulated and due to the ongoing advancements that have brought us closer to pervasive computing, the secure delivery of video and images has become a challenging problem. Despite the advantages and opportunities that digital video provide, illegal copying and distribution as well as plagiarism of digital audio, images, and video is still ongoing. In this paper we describe two techniques for securing H.264 coded video streams. The first technique, SEH264Algorithm1, groups the data into the following blocks of data: (1) a block that contains the sequence parameter set and the picture parameter set, (2) a block containing a compressed intra coded frame, (3) a block containing the slice header of a P slice, all the headers of the macroblock within the same P slice, and all the luma and chroma DC coefficients belonging to the all the macroblocks within the same slice, (4) a block containing all the ac coefficients, and (5) a block containing all the motion vectors. The first three are encrypted whereas the last two are not. The second method, SEH264Algorithm2, relies on the use of multiple slices per coded frame. The algorithm searches the compressed video sequence for start codes (0x000001) and then encrypts the next N bits of data.

  6. Wipro Consulting Services: Building an Effective Global Configuration in Business and IT Consulting Industry

    OpenAIRE

    Joseph Lampel; Ajay Bhalla; Kaivalya Vishnu

    2010-01-01

    The Wipro Consulting Services (WCS) case charts the evolution of the consulting initiative within Wipro Technologies; the strategic choices the management made during this evolution and the challenges facing the firm once it consolidated the various consulting initiatives to set up Wipro Consulting Services in 2008. The case deals with several questions facing the leadership team, such as the competencies to develop to move up the value chain in delivering consulting services and the extent t...

  7. 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...

  8. Comparison of RAW264.7, human whole blood and PBMC assays to screen for immunomodulators.

    Science.gov (United States)

    Elisia, Ingrid; Pae, Han Bee; Lam, Vivian; Cederberg, Rachel; Hofs, Elyse; Krystal, Gerald

    2018-01-01

    The RAW264.7 mouse macrophage cell line is used extensively to carry out in vitro screens for immunomodulators. Compounds that are effective at reducing the expression of pro-inflammatory cytokines or nitric oxide (NO) from lipopolysaccharide (LPS)-stimulated RAW264.7 cells are often considered candidate anti-inflammatory agents for humans. There is, however, very little data on the reliability of this screen to identify bona fide human immunomodulators. We compared the efficacy of 37 purported immunomodulators to modulate LPS or E. coli-induced inflammatory responses in RAW264.7 cell, whole human blood and human peripheral blood mononuclear cell (PBMC) assays. Interestingly, there was no significant correlation (R=0.315) between the responses obtained with RAW264.7 cells and the whole blood assay (WBA), suggesting that compounds demonstrating efficacy in RAW264.7 cells may be ineffective in humans, and, more importantly, compounds that are effective in humans may be missed with a RAW264.7 screen. Interestingly, there was also no significant correlation between the WBA and human PBMCs when the latter were cultured with 10% FCS, but a moderate correlation was seen when the PBMCs were cultured with 25% autologous plasma. The presence of plasma thus contributes to the overall inflammatory response observed in the WBA. We then asked if RAW264.7 cells, given that they are mouse macrophage-like cells, respond in a manner similar to primary murine derived macrophages. Intriguingly, there was no significant correlation (R=0.012) with the 37 putative immunomodulators, pointing to distinct inflammatory response mechanisms in the two model systems. We conclude that the use of a WBA to confirm potential immunomodulators obtained from high throughput screening with RAW264.7 cells is advisable and that future screens be carried out using a WBA. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. 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.

  10. A prospective study assessing agreement and reliability of a geriatric evaluation.

    Science.gov (United States)

    Locatelli, Isabella; Monod, Stéfanie; Cornuz, Jacques; Büla, Christophe J; Senn, Nicolas

    2017-07-19

    The present study takes place within a geriatric program, aiming at improving the diagnosis and management of geriatric syndromes in primary care. Within this program it was of prime importance to be able to rely on a robust and reproducible geriatric consultation to use as a gold standard for evaluating a primary care brief assessment tool. The specific objective of the present study was thus assessing the agreement and reliability of a comprehensive geriatric consultation. The study was conducted at the outpatient clinic of the Service of Geriatric Medicine, University of Lausanne, Switzerland. All community-dwelling older persons aged 70 years and above were eligible. Patients were excluded if they hadn't a primary care physician, they were unable to speak French, or they were already assessed by a geriatrician within the last 12 months. A set of 9 geriatricians evaluated 20 patients. Each patient was assessed twice within a 2-month delay. Geriatric consultations were based on a structured evaluation process, leading to rating the following geriatric conditions: functional, cognitive, visual, and hearing impairment, mood disorders, risk of fall, osteoporosis, malnutrition, and urinary incontinence. Reliability and agreement estimates on each of these items were obtained using a three-way Intraclass Correlation and a three-way Observed Disagreement index. The latter allowed a decomposition of overall disagreement into disagreements due to each source of error variability (visit, rater and random). Agreement ranged between 0.62 and 0.85. For most domains, geriatrician-related error variability explained an important proportion of disagreement. Reliability ranged between 0 and 0.8. It was poor/moderate for visual impairment, malnutrition and risk of fall, and good/excellent for functional/cognitive/hearing impairment, osteoporosis, incontinence and mood disorders. Six out of nine items of the geriatric consultation described in this study (functional

  11. Trivial topological phase of CaAgP and the topological nodal-line transition in CaAg (P1 -xA sx)

    Science.gov (United States)

    Xu, N.; Qian, Y. T.; Wu, Q. S.; Autès, G.; Matt, C. E.; Lv, B. Q.; Yao, M. Y.; Strocov, V. N.; Pomjakushina, E.; Conder, K.; Plumb, N. C.; Radovic, M.; Yazyev, O. V.; Qian, T.; Ding, H.; Mesot, J.; Shi, M.

    2018-04-01

    By performing angle-resolved photoemission spectroscopy and first-principles calculations, we address the topological phase of CaAgP and investigate the topological phase transition in CaAg (P1 -xA sx) . We reveal that in CaAgP, the bulk band gap and surface states with a large bandwidth are topologically trivial, in agreement with hybrid density functional theory calculations. The calculations also indicate that application of "negative" hydrostatic pressure can transform trivial semiconducting CaAgP into an ideal topological nodal-line semimetal phase. The topological transition can be realized by partial isovalent P/As substitution at x =0.38 .

  12. [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.

  13. The Diagnostic Agreement of Original and Faxed Copies of Electrocardiograms

    Directory of Open Access Journals (Sweden)

    Sadrihe Hajesmaeel-Gohari

    2013-02-01

    Full Text Available Background: General practitioners working in remote and rural areas sometimes need consultation with cardiologists. One practical and cost-effective way is transmission of patients’ electrocardiographic images via ordinary fax machine to the cardiologists, but there is an important question that how much agreement exists between the diagnoses made by reading an original electrocardiogram and its copy transmitted via fax.Materials and Methods: In this cross-sectional study, 60 original electrocardiographic images were given to cardiologists for diagnosis. In the next step those electrocardiographic images were faxed to the hospital through a simple cheap fax machine, one month later the same cardiologist was asked to put his diagnosis on the copied versions of electrocardiographs, and the results were compared. Results: In 59 studied cases, the two method of diagnoses were exactly the same and only in one case the diagnoses were different. Therefore, Kappa agreement coefficient was calculated as 96%.Conclusion: According to the results of this study, general practitioners working in deprived areas can be certainly recommended to send patients’ electrocardiographic images to the cardiologists via fax in the case of needing consultation.

  14. 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...

  15. 24 CFR 203.264 - Payment of periodic MIP.

    Science.gov (United States)

    2010-04-01

    ... Payment § 203.264 Payment of periodic MIP. The mortgagee shall pay each MIP in twelve equal monthly installments. Each monthly installment shall be due and payable to the Commissioner no later than the tenth day...

  16. Evaluation of an advanced-practice physiotherapist in triaging patients with lumbar spine pain: surgeon-physiotherapist level of agreement and patient satisfaction.

    Science.gov (United States)

    Robarts, Susan; Stratford, Paul; Kennedy, Deborah; Malcolm, Barry; Finkelstein, Joel

    2017-08-01

    Surgery for lumbar spine pain is indicated for specific etiologies. Given the majority of individuals referred to spine surgeons are not surgical candidates, care delivery is inefficient, with consultations being of limited value for most. Using specially trained physiotherapists in triage is a human resource strategy that may optimize surgeons' time and the patient experience. An advanced-practice physiotherapist (APP) and a surgeon assessed consecutive patients with lumbar spine pain presenting at an academic health centre's spine surgery clinic. The second assessor was blinded to the outcome of the first. We used the κ statistic to evaluate surgeon-APP level of chance-corrected agreement concerning patients' need for a surgical consultation. To assess satisfaction with the APP, patients completed a modified version of the validated Visit-specific Questionnaire. The sample included 102 participants (54 women) with a mean age of 54.3 ± 14.3 years and a mean Oswestry Disability Index score of 35.4 ± 16.6. The assessors' overall agreement was 86%. The κ coefficient for the need for a surgical consultation was 0.69 (95% confidence interval 0.54-0.84). The APP identified that 77% of patients did not require a surgical consultation. Twenty-one patients underwent surgery. Satisfaction scores for the APP were very high (mean score 92 out of 100). In triaging patients with lumbar spine pain, the APP and surgeon had a high level of agreement. An APP performing triage at a surgical centre can effectively reduce wait lists by 70%, reserving surgical consultations for those patients in whom they are indicated.

  17. IEA Agreement on the Production and utilization of hydrogen: 1998 annual report

    Energy Technology Data Exchange (ETDEWEB)

    Elam, Carolyn C. (National Renewable Energy Lab, Golden, CO (US)) (ed.)

    1999-01-31

    The annual report includes an overview of the IEA Hydrogen Agreement, including its guiding principles. The Chairman's report section includes highlights of the agreement for 1998. Annex reports are given on various tasks: Task 10, Photoproduction of Hydrogen, Task 11, Integrated Systems, and Task 12, Metal Hydrides and Carbon for Hydrogen Storage. Lastly, a feature article by Karsten Wurr, E3M Material Consulting, GmbH, Hamburg Germany, is included titled 'Hydrogen in Material Science and Technology: State of the Art and New Tendencies'.

  18. The value of empathy in dietetic consultations. A pilot study to investigate its effect on satisfaction, autonomy and agreement

    DEFF Research Database (Denmark)

    Goodchild, Claire E.; Skinner, T. C.; Parkin, T.

    2005-01-01

    Forty individuals with diabetes and three dietitians completed a questionnaire concerning their consultation. Empathy was examined using the Empathic Communication Coding System (ECCS) (Bylund & Makoul, 2002). The more empathic the professionals' response to emotional opportunities, the more sati...

  19. Lancaster Flexible Bag. Volume 3B - Technical appraisal. Consultants' 1983 report

    Energy Technology Data Exchange (ETDEWEB)

    1986-01-01

    A report is given by a team of Consultants on the estimated cost of converting wave energy to electrical energy by a 2 GW array of Lancaster Flexible Bag Devices and transmitting this to a sub-station on the west coast of Skye. Comparisons with the estimates made by the team developing the concept are made and discussed when not in agreement. A detailed engineering assessment is presented.

  20. Implementation of state - federal agreements: observations and suggestions from New Mexico

    International Nuclear Information System (INIS)

    Canepa, J.F.

    1985-01-01

    State - federal agreements have been authorized by Congress under the Nuclear Waste Policy Act of 1982 (the Act). The process for reaching such agreements as well as their content have been modeled after the State of New Mexico's experience with its lawsuit and resulting Agreement for Consultation and Cooperation with the United States Department of Energy (DOE) over the Waste Isolation Pilot Project (WIPP). New Mexico has been through the entire process, beginning with litigation and ending with a formal, written agreement with the federal government which addresses all aspects of a major nuclear waste repository within its borders. The process for reaching and implementing such agreements is not unlike the process for negotiating a treaty between countries. States entering into negotiations for such agreements should be aware of several important considerations which New Mexico learned the hard way. Avoiding the pitfalls inherent in this process is the key to producing a meaningful, working and enforceable document that protects the state's interests and affords a state continuing control over a long-term nuclear waste project within the state

  1. Segmentation-driven compound document coding based on H.264/AVC-INTRA.

    Science.gov (United States)

    Zaghetto, Alexandre; de Queiroz, Ricardo L

    2007-07-01

    In this paper, we explore H.264/AVC operating in intraframe mode to compress a mixed image, i.e., composed of text, graphics, and pictures. Even though mixed contents (compound) documents usually require the use of multiple compressors, we apply a single compressor for both text and pictures. For that, distortion is taken into account differently between text and picture regions. Our approach is to use a segmentation-driven adaptation strategy to change the H.264/AVC quantization parameter on a macroblock by macroblock basis, i.e., we deviate bits from pictorial regions to text in order to keep text edges sharp. We show results of a segmentation driven quantizer adaptation method applied to compress documents. Our reconstructed images have better text sharpness compared to straight unadapted coding, at negligible visual losses on pictorial regions. Our results also highlight the fact that H.264/AVC-INTRA outperforms coders such as JPEG-2000 as a single coder for compound images.

  2. 45 CFR 264.70 - What makes a State eligible to receive a provisional payment of contingency funds?

    Science.gov (United States)

    2010-10-01

    ... provisional payment of contingency funds? 264.70 Section 264.70 Public Welfare Regulations Relating to Public... Contingency Fund? § 264.70 What makes a State eligible to receive a provisional payment of contingency funds? (a) In order to receive a provisional payment of contingency funds, a State must: (1) Be a needy...

  3. Longer-term impact of cardiology e-consults.

    Science.gov (United States)

    Wasfy, Jason H; Rao, Sandhya K; Kalwani, Neil; Chittle, Melissa D; Richardson, Calvin A; Gallen, Kathleen M; Isselbacher, Eric M; Kimball, Alexandra B; Ferris, Timothy G

    2016-03-01

    Cardiac e-consults may be an effective way to deliver value-oriented outpatient cardiology care in an accountable care organization. Initial results of cardiac e-consults have demonstrated high satisfaction among both patients and referring providers, no known adverse events, and low rates of diagnostic testing. Nevertheless, differences between e-consults and traditional consults, effects of e-consults on traditional consult volume, and whether patients seek traditional consults after e-consults are unknown. We established a cardiac e-consult program on January 13, 2014. We then conducted detailed medical record reviews of all patients with e-consults to detect any adverse clinical events and detect subsequent traditional visits to cardiologists. We also performed 2 comparisons. First, we compared age, gender, and referral reason for e-consults vs traditional consults. Second, we compared changes in volume of referrals to cardiology vs other medical specialties that did not have e-consults. From January 13 to December 31, 2014, 1,642 traditional referrals and 165 e-consults were requested. The proportion of e-consults of all evaluations requested over that period was 9.1%. Gender balance was similar among traditional consults and e-consults (44.8% male for e-consults vs 45.0% for traditional consults, P = .981). E-consult patients were younger than traditional consult patients (55.3 vs 60.4 years, P cardiology visit during the follow-up period. E-consults are an effective and safe mechanism to enhance value in outpatient cardiology care, with low rates of bounceback to traditional consults. E-consults can account for nearly one-tenth of total outpatient consultation volume at 1 year within an accountable care organization and are associated with a reduction in traditional referrals to cardiologists. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Ca 3d unoccupied states in Bi2Sr2CaCu2O8 investigated by Ca L2,3 x-ray-absorption near-edge structure

    International Nuclear Information System (INIS)

    Borg, A.; King, P.L.; Pianetta, P.; Lindau, I.; Mitzi, D.B.; Kapitulnik, A.; Soldatov, A.V.; Della Longa, S.; Bianconi, A.

    1992-01-01

    The high-resolution Ca L 2,3 x-ray-absorption near-edge-structure (XANES) spectrum of a Bi 2 Sr 2 CaCu 2 O 8 single crystal has been measured by use of a magnetic-projection x-ray microscope probing a surface area of 200x200 μm 2 . The Ca L 2,3 XANES spectrum is analyzed by performing a multiple-scattering XANES calculation in real space and comparing the results with the spectrum of CaF 2 . Good agreement between the calculated and experimental crystal-field splitting Δ f of the Ca 3d final states is found and the splitting is shown to be smaller by 0.5 eV than in the initial state. The Ca 3d partial density of states is found to be close to the Fermi level in the initial state. The Ca-O(in plane) distance is shown to be a critical parameter associated with the shift of the Ca 3d states relative to the Fermi level; in particular, we have studied the effect of the out-of-plane dimpling mode of the in-plane oxygen atoms O(in plane) that will move the Ca 3d states on or off the Fermi level. This mode can therefore play a role in modulating the charge transfer between the two CuO 2 planes separated by the Ca ions

  5. Ca 3d unoccupied states in Bi2Sr2CaCu2O8 investigated by Ca L2,3 x-ray-absorption near-edge structure

    Energy Technology Data Exchange (ETDEWEB)

    Borg, A; King, P L; Pianetta, P; Lindau, I; Mitzi, D B

    1992-01-01

    The high-resolution Ca L(2,3) x-ray-absorption near-edge-structure (XANES) spectrum of a Bi2Sr2CaCu2O8 single crystal has been measured by use of a magnetic-projection x-ray microscope probing a surface area of 200x200 micrometers square. The Ca L(2,3) XANES spectrum is analyzed by performing a multiple-scattering XANES calculation in real space and comparing the results with the spectrum of CaF2. Good agreement between the calculated and experimental crystal-field splitting Delta f of the Ca 3d final states is found and the splitting is shown to be smaller by 0.5 eV than in the initial state. The Ca 3d partial density of states is found to be close to the Fermi level in the initial state. The Ca-O (in plane) distance is shown to be a critical parameter associated with the shift of the Ca 3d states relative to the Fermi level; in particular, the authors have studied the effect of the out-of-plane dimpling mode of the in-plane oxygen atoms O(in plane) that will move the Ca 3d states on or off the Fermi level. This mode can therefore play a role in modulating the charge transfer between the two CuO2 planes separated by the Ca ions.

  6. Management Consultancy As Practice: A Study Of The Duality Of The Management Consultants' Role

    OpenAIRE

    Hartley, Jeanette

    2017-01-01

    The central question addressed in this research is: “How do practicing management consultants cope with the duality of their role?” Management consultants are often responsible for internal business leadership roles as well as developing business, people and knowledge alongside client delivery (Richter et al., 2008). The research sought to understand the nature of the potentially conflicting demands of their client-facing and consultancy-facing roles on management consultants, how conflicts a...

  7. 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.

  8. The Dream Consultant

    DEFF Research Database (Denmark)

    Muhr, Sara Louise; Kirkegaard, Line

    2013-01-01

    Consultants are known to work extreme hours. We show empirically how consultants fantasize about off-work activities, which are impossible to realize with their work schedule. These fantasies are, however, not obstructing their work, but important to justify the extreme hours and sustain desire f...

  9. 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.

  10. Shared consultant physician posts.

    LENUS (Irish Health Repository)

    Cooke, J

    2012-01-31

    Our aim was to assess the acceptability and cost-efficiency of shared consultancy posts. Two consultant physicians worked alternate fortnights for a period of twelve months. Questionnaires were distributed to general practitioners, nurses, consultants and junior doctors affected by the arrangement. Patients or their next of kin were contacted by telephone. 1\\/17 of consultants described the experience as negative. 14\\/19 junior doctors reported a positive experience. 11 felt that training had been improved while 2 felt that it had been adversely affected. 17\\/17 GPs were satisfied with the arrangement. 1\\/86 nurses surveyed reported a negative experience. 1\\/48 patients were unhappy with the arrangement. An extra 2.2 (p<0.001) patients were seen per clinic. Length of stay was shortened by 2.49 days (p<0.001). A saving of 69,212 was made due to decreased locum requirements. We present data suggesting structured shared consultancy posts can be broadly acceptable and cost efficient in Ireland.

  11. 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.

  12. Starting a nursing consultation practice.

    Science.gov (United States)

    Schulmeister, L

    1999-03-01

    Because the clinical nurse specialist (CNS) role has been changed or eliminated in many hospital organizations, many CNSs in career transition are considering establishing collaborative or independent nursing consultation practices. Opportunities for consultants exist in diverse practice settings and specialties. Before starting a consultation practice, the CNS should carefully examine goals, identify resources, and begin contacting potential referral sources. He or she must also decide what form of business organization to establish and write a business plan to solidify ideas and prepare for the unexpected. Most CNS consultants rely on personal savings to cover initial business and personal expenses, and many continue working as a CNS until the consultation practice is established. Fees can be set based on community standards, what the market will bear, desired projected income, or a third-party payor's fee schedule. The consultation practice can be marketed by word of mouth, inexpensive advertising techniques such as distributing flyers and business cards, direct mall, and media advertising. In today's healthcare marketplace, opportunities abound for the CNS risk-taker interested in starting a nursing consultation practice.

  13. Conducting Participatory Culture-Specific Consultation: A Global Perspective on Multicultural Consultation.

    Science.gov (United States)

    Nastasi, Bonnie K.; Varjas, Kristen; Bernstein, Rachel; Iavasena, Asoka

    2000-01-01

    Describes a participatory approach to consultation that builds upon contemporary models of research and practice and is designed to address the culture-specific needs of individuals and systems. The Participatory Culture-Specific Consultation (PCSC) model embodies a participatory interpersonal process and relies on ethnographic and action research…

  14. Efficiency principles of consulting entrepreneurship

    OpenAIRE

    Moroz Yustina S.; Drozdov Igor N.

    2015-01-01

    The article reviews the primary goals and problems of consulting entrepreneurship. The principles defining efficiency of entrepreneurship in the field of consulting are generalized. The special attention is given to the importance of ethical principles of conducting consulting entrepreneurship activity.

  15. Capture reactions of 40Ca and 48Ca with targets of 197Au and 208Pb

    International Nuclear Information System (INIS)

    Stokstad, R.; Chan, Y.; Chavez, E.

    1988-03-01

    The reactions of 40 Ca and 48 Ca with targets of 197 Au and 208 Pb have been measured in the region from below the interaction barrier to about twice the barrier energy. The fission-like fragments were detected in a pair of position-sensitive, multi-wire proportional counters and were identified from measurements of position and time using two-body kinematics. In the region above the barrier the cross sections for capture are less than those given by the touching condition, indicating that an /open quotes/extra push/close quotes/ is required to induce capture. The observations for 40 Ca and 48 Ca show different fissilities for the onset of the extra push and indicate that charge equilibration may be an important factor governing capture reactions. Below the barrier the cross sections show an enhancement relative to the prediction for a one dimensional barrier. The enhancements are larger for 40 Ca than for 48 Ca (for both targets) and this is in qualitative agreement with predictions based on the coupling of the relative motion to low-lying collective states. Both above and below the barrier, we find that the change in the light partner, from 48 Ca to 40 Ca, has a larger effect on the cross sections than the change from 208 Pb to 197 Au, after correction for the change in the Coulomb barrier. 16 refs., 7 figs

  16. 40 CFR 264.150 - State assumption of responsibility.

    Science.gov (United States)

    2010-07-01

    ... FACILITIES Financial Requirements § 264.150 State assumption of responsibility. (a) If a State either assumes legal responsibility for an owner's or operator's compliance with the closure, post-closure care, or... 40 Protection of Environment 25 2010-07-01 2010-07-01 false State assumption of responsibility...

  17. The art of consultation.

    Science.gov (United States)

    Bhangoo, Kulwant S

    2014-05-01

    Sophisticated marketing and practice-enhancing strategies can help bring patients to a surgeon's practice. However, the ability to retain these patients and also convert the consultations into surgical procedures depends on the art of consultation. This very important aspect of clinical practice is seldom taught in the medical school. In this paper, the author discusses many aspects of the art of consultation, which he has learned in his practice over the years.

  18. Tribal Consultation Tracking System

    Data.gov (United States)

    U.S. Environmental Protection Agency — The consultation-related information the AIEO Consultation Team working with our Tribal Portal contractors has developed a Lotus Notes Database that is capable of...

  19. Addressing Palliative Sedation during Expert Consultation: A Descriptive Analysis of the Practice of Dutch Palliative Care Consultation Teams.

    Science.gov (United States)

    Hoek, Patrick; Grandjean, Ilse; Verhagen, Constans A H H V M; Jansen-Landheer, Marlies L E A; Schers, Henk J; Galesloot, Cilia; Vissers, Kris C P; Engels, Yvonne; Hasselaar, Jeroen G J

    2015-01-01

    Since palliative sedation is considered a complex intervention, consultation teams are increasingly established to support general practice. This study aims to offer insight into the frequency and characteristics of expert consultations regarding palliative sedation. We performed a retrospective analysis of a longitudinal database. This database contained all patient-related consultations by Dutch Palliative Care Consultation teams, that were requested between 2004 and 2011. We described the frequency and characteristics of these consultations, in particular of the subgroup of consultations in which palliative sedation was addressed (i.e. PSa consultations). We used multivariate regression analysis to explore consultation characteristics associated with a higher likelihood of PSa consultations. Of the 44,443 initial consultations, most were requested by general practitioners (73%) and most concerned patients with cancer (86%). Palliative sedation was addressed in 18.1% of all consultations. Palliative sedation was relatively more often discussed during consultations for patients with a neurologic disease (OR 1.79; 95% CI: 1.51-2.12) or COPD (OR 1.39; 95% CI: 1.15-1.69) than for patients with cancer. We observed a higher likelihood of PSa consultations if the following topics were also addressed during consultation: dyspnoea (OR 1.30; 95% CI: 1.22-1.40), agitation/delirium (OR 1.57; 95% CI: 1.47-1.68), exhaustion (OR 2.89; 95% CI: 2.61-3.20), euthanasia-related questions (OR 2.65; 95% CI: 2.37-2.96) or existential issues (OR 1.55; 95% CI: 1.31-1.83). In conclusion, PSa consultations accounted for almost one-fifth of all expert consultations and were associated with several case-related characteristics. These characteristics may help clinicians in identifying patients at risk for a more complex disease trajectory at the end of life.

  20. Addressing Palliative Sedation during Expert Consultation: A Descriptive Analysis of the Practice of Dutch Palliative Care Consultation Teams.

    Directory of Open Access Journals (Sweden)

    Patrick Hoek

    Full Text Available Since palliative sedation is considered a complex intervention, consultation teams are increasingly established to support general practice. This study aims to offer insight into the frequency and characteristics of expert consultations regarding palliative sedation.We performed a retrospective analysis of a longitudinal database. This database contained all patient-related consultations by Dutch Palliative Care Consultation teams, that were requested between 2004 and 2011. We described the frequency and characteristics of these consultations, in particular of the subgroup of consultations in which palliative sedation was addressed (i.e. PSa consultations. We used multivariate regression analysis to explore consultation characteristics associated with a higher likelihood of PSa consultations.Of the 44,443 initial consultations, most were requested by general practitioners (73% and most concerned patients with cancer (86%. Palliative sedation was addressed in 18.1% of all consultations. Palliative sedation was relatively more often discussed during consultations for patients with a neurologic disease (OR 1.79; 95% CI: 1.51-2.12 or COPD (OR 1.39; 95% CI: 1.15-1.69 than for patients with cancer. We observed a higher likelihood of PSa consultations if the following topics were also addressed during consultation: dyspnoea (OR 1.30; 95% CI: 1.22-1.40, agitation/delirium (OR 1.57; 95% CI: 1.47-1.68, exhaustion (OR 2.89; 95% CI: 2.61-3.20, euthanasia-related questions (OR 2.65; 95% CI: 2.37-2.96 or existential issues (OR 1.55; 95% CI: 1.31-1.83.In conclusion, PSa consultations accounted for almost one-fifth of all expert consultations and were associated with several case-related characteristics. These characteristics may help clinicians in identifying patients at risk for a more complex disease trajectory at the end of life.

  1. The art of consultation

    Directory of Open Access Journals (Sweden)

    Kulwant S Bhangoo

    2014-01-01

    Full Text Available Sophisticated marketing and practice-enhancing strategies can help bring patients to a surgeon′s practice. However, the ability to retain these patients and also convert the consultations into surgical procedures depends on the art of consultation. This very important aspect of clinical practice is seldom taught in the medical school. In this paper, the author discusses many aspects of the art of consultation, which he has learned in his practice over the years.

  2. Ethics in Management Consulting

    OpenAIRE

    Carlo Vallini

    2007-01-01

    Ethics is a relevant value in business and management consulting. The presence of recognized ethics tends to reduce the need for informative or legal-contractual precautions in the formalization of relationships, for both of the parts involved in a negotiation. Management Consulting on ethics will develop more and more. Law will consider more and more ethics in business and management consulting. The ethics of corporations influences their workers and behaviour with the customers. It is an e...

  3. Efficient reversible data hiding in encrypted H.264/AVC videos

    Science.gov (United States)

    Xu, Dawen; Wang, Rangding

    2014-09-01

    Due to the security and privacy-preserving requirements for cloud data management, it is sometimes desired that video content is accessible in an encrypted form. Reversible data hiding in the encrypted domain is an emerging technology, as it can perform data hiding in encrypted videos without decryption, which preserves the confidentiality of the content. Furthermore, the original cover can be losslessly restored after decryption and data extraction. An efficient reversible data hiding scheme for encrypted H.264/AVC videos is proposed. During H.264/AVC encoding, the intraprediction mode, motion vector difference, and the sign bits of the residue coefficients are encrypted using a standard stream cipher. Then, the data-hider who does not know the original video content, may reversibly embed secret data into the encrypted H.264/AVC video by using a modified version of the histogram shifting technique. A scale factor is utilized for selecting the embedding zone, which is scalable for different capacity requirements. With an encrypted video containing hidden data, data extraction can be carried out either in the encrypted or decrypted domain. In addition, real reversibility is realized so that data extraction and video recovery are free of any error. Experimental results demonstrate the feasibility and efficiency of the proposed scheme.

  4. 40 CFR 264.227 - Emergency repairs; contingency plans.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Emergency repairs; contingency plans... FACILITIES Surface Impoundments § 264.227 Emergency repairs; contingency plans. (a) A surface impoundment... days after detecting the problem. (c) As part of the contingency plan required in subpart D of this...

  5. Why do people consult the doctor?

    Science.gov (United States)

    Campbell, S M; Roland, M O

    1996-02-01

    Symptoms are an everyday part of most peoples' lives and many people with illness do not consult their doctor. The decision to consult is not based simply on the presence or absence of medical problems. Rather it is based on a complex mix of social and psychological factors. This literature review seeks to explore some of the pathways to care and those factors associated with low and high rates of consultation. The paper examines the impact of socioeconomic and demographic factors on consultation rates and, using a revised version of the Health Belief Model, it highlights the psychological factors which influence decisions to seek medical care. Barriers which can inhibit consultation are discussed, as the decision to seek care will only result in a consultation if there is adequate access to care. Whilst poor health status and social disadvantage increase both "objective" medical need and in turn, consultation rates, a range of other social and psychological factors have been shown to influence consulting behaviour.

  6. Consultation on urological specimens from referred cancer patients using real-time digital microscopy: Optimizing the workflow

    Directory of Open Access Journals (Sweden)

    Henrik Holten-Rossing

    2016-01-01

    , depending on the number of digital slides included. Only in two cases could a consensus regarding the diagnosis not be reached during live consultation; this did not, it should be noted, affect patient treatment. Complete agreement between conventional and digital histopathology diagnosis was reached in all the 53 patients referred to central pathology units. The participating pathologists were in general comfortable using live digital microscopy, but they emphasized that a fast internet connection was essential for a smooth consultation. Discussion and Conclusion: An almost perfect agreement between live digital and conventional microscopy was observed in this study. Live digital consultation allowed cases to be referred from local hospitals to central cancer units without the standard delay caused by shipment. Only a few preselected specimen slides for each patient were presented in live consultation, which reduced the time spent on diagnosis compared to using the conventional method. Implementation of real-time digital microscopy would result in quicker turnaround and patient referral time, and with careful selection of relevant specimen slides for consultation, diagnostic safety would not be compromised.

  7. Endoplasmic Reticulum Stress Cooperates in Zearalenone-Induced Cell Death of RAW 264.7 Macrophages

    Directory of Open Access Journals (Sweden)

    Fenglei Chen

    2015-08-01

    Full Text Available Zearalenone (ZEA is a fungal mycotoxin that causes cell apoptosis and necrosis. However, little is known about the molecular mechanisms of ZEA toxicity. The objective of this study was to explore the effects of ZEA on the proliferation and apoptosis of RAW 264.7 macrophages and to uncover the signaling pathway underlying the cytotoxicity of ZEA in RAW 264.7 macrophages. This study demonstrates that the endoplasmic reticulum (ER stress pathway cooperated in ZEA-induced cell death of the RAW 264.7 macrophages. Our results show that ZEA treatment reduced the viability of RAW 264.7 macrophages in a dose- and time-dependent manner as shown by the 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide assay (MTT and flow cytometry assay. Western blots analysis revealed that ZEA increased the expression of glucose-regulated protein 78 (GRP78 and CCAAT/enhancer binding protein homologous protein (CHOP, two ER stress-related marker genes. Furthermore, treating the cells with the ER stress inhibitors 4-phenylbutyrate (4-PBA or knocking down CHOP, using lentivirus encoded short hairpin interfering RNAs (shRNAs, significantly diminished the ZEA-induced increases in GRP78 and CHOP, and cell death. In summary, our results suggest that ZEA induces the apoptosis and necrosis of RAW 264.7 macrophages in a dose- and time-dependent manner via the ER stress pathway in which the activation of CHOP plays a critical role.

  8. Upregulating Nonneuronal Cholinergic Activity Decreases TNF Release from Lipopolysaccharide-Stimulated RAW264.7 Cells

    Directory of Open Access Journals (Sweden)

    Yi Lv

    2014-01-01

    Full Text Available Nonneuronal cholinergic system plays a primary role in maintaining homeostasis. It has been proved that endogenous neuronal acetylcholine (ACh could play an anti-inflammatory role, and exogenous cholinergic agonists could weaken macrophages inflammatory response to lipopolysaccharide (LPS stimulation through activation of α7 subunit-containing nicotinic acetylcholine receptor (α7nAChR. We assumed that nonneuronal cholinergic system existing in macrophages could modulate inflammation through autocrine ACh and expressed α7nAChR on the cells. Therefore, we explored whether LPS continuous stimulation could upregulate the nonneuronal cholinergic activity in macrophages and whether increasing autocrine ACh could decrease TNF release from the macrophages. The results showed that, in RAW264.7 cells incubated with LPS for 20 hours, the secretion of ACh was significantly decreased at 4 h and then gradually increased, accompanied with the enhancement of α7nAChR expression level. The release of TNF was greatly increased from RAW264.7 cells at 4 h and 8 h exposure to LPS; however, it was suppressed at 20 h. Upregulating choline acetyltransferase (ChAT expression through ChAT gene transfection could enhance ACh secretion and reduce TNF release from the infected RAW264. 7cells. The results indicated that LPS stimulation could modulate the activity of nonneuronal cholinergic system of RAW264.7 cells. Enhancing autocrine ACh production could attenuate TNF release from RAW264.7 cells.

  9. Global Consultation Processes: Lessons Learned from Refugee Teacher Consultation Research in Malaysia

    Science.gov (United States)

    O'Neal, Colleen R.; Gosnell, Nicole M.; Ng, Wai Sheng; Clement, Jennifer; Ong, Edward

    2018-01-01

    The process of global consultation has received little attention despite its potential for promoting international mutual understanding with marginalized communities. This article details theory, entry, implementation, and evaluation processes for global consultation research, including lessons learned from our refugee teacher intervention. The…

  10. Consultant's Playbook: A Survey of Pharmacy Consultant Experiences Among Hospitals In the University HealthSystem Consortium.

    Science.gov (United States)

    Hicks, Dave; McCarthy, Bryan; Fanikos, John; Emamifar, Amir; Nedved, Andrea; Thompson, Bruce; Bender, Fred; McMahon, Patrick

    2013-10-01

    Our team surveyed a group of pharmacy directors to learn about their experiences with pharmacy consultants so that the directors might be able to use their consulting resources in a more effective manner. In May 2012, the University HealthSystem Consortium (UHC) Pharmacy Council Financial Performance Committee developed an electronic survey that collectively measured the characteristics, goals, and methodology of historical pharmacy consultant engagements and level of satisfaction. After e-mailing the initial electronic survey, we conducted follow-up telephone interviews with respondents from July through November 2012. These interviews were designed to include questions about expected outcomes, recommendations for evaluation processes, timelines for implementing the recommendations, consultants' expenses, and insights gained. A total of 23 pharmacy directors responded to the initial electronic survey; their organizations had engaged at least one consultant within the previous 5 years. Data were collected for 28 consultant engagements. Subsequent telephone interviews were conducted with 20 of the 23 pharmacy directors (87%) who completed the initial electronic survey, accounting for 25 of the 28 consultant engagements (89%). Cost reduction along with revenue enhancement was most often the focus of these engagements. These engagements were also mainly within the scope of an organization-wide effort initiated by the executive board or executive team. Consultant experiences varied greatly in terms of (1) the degree to which assistance was provided to the organization, (2) benchmarking methodologies and resources, and (3) timelines for implementing the consultants' recommendations. In general, most respondents rated their consultant experience as positive and were able to provide "pearls of wisdom" or lessons learned.

  11. 40 CFR 264.315 - Special requirements for containers.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Special requirements for containers... FACILITIES Landfills § 264.315 Special requirements for containers. Unless they are very small, such as an ampule, containers must be either: (a) At least 90 percent full when placed in the landfill; or (b...

  12. 36 CFR 264.3 - Licensing for commercial use.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Licensing for commercial use... PROPERTY MANAGEMENT Official Forest Service Insignia § 264.3 Licensing for commercial use. (a) Each commercial license granted for the use of the insignia or likeness thereof shall contain the following terms...

  13. Guidelines for Education and Training at the Doctoral and Postdoctoral Levels in Consulting Psychology/Organizational Consulting Psychology

    Science.gov (United States)

    American Psychologist, 2007

    2007-01-01

    The purpose of these "Guidelines for Education and Training at the Doctoral and Postdoctoral Levels in Consulting Psychology/Organizational Consulting Psychology" is to provide a common framework for use in the development, evaluation, and review of education and training in consulting psychology/organizational consulting psychology (CP/OCP). The…

  14. Video clip transfer of radiological images using a mobile telephone in emergency neurosurgical consultations (3G Multi-Media Messaging Service).

    Science.gov (United States)

    Waran, Vicknes; Bahuri, Nor Faizal Ahmad; Narayanan, Vairavan; Ganesan, Dharmendra; Kadir, Khairul Azmi Abdul

    2012-04-01

    The purpose of this study was to validate and assess the accuracy and usefulness of sending short video clips in 3gp file format of an entire scan series of patients, using mobile telephones running on 3G-MMS technology, to enable consultation between junior doctors in a neurosurgical unit and the consultants on-call after office hours. A total of 56 consecutive patients with acute neurosurgical problems requiring urgent after-hours consultation during a 6-month period, prospectively had their images recorded and transmitted using the above method. The response to the diagnosis and the management plan by two neurosurgeons (who were not on site) based on the images viewed on a mobile telephone were reviewed by an independent observer and scored. In addition to this, a radiologist reviewed the original images directly on the hospital's Patients Archiving and Communication System (PACS) and this was compared with the neurosurgeons' response. Both neurosurgeons involved in this study were in complete agreement with their diagnosis. The radiologist disagreed with the diagnosis in only one patient, giving a kappa coefficient of 0.88, indicating an almost perfect agreement. The use of mobile telephones to transmit MPEG video clips of radiological images is very advantageous for carrying out emergency consultations in neurosurgery. The images accurately reflect the pathology in question, thereby reducing the incidence of medical errors from incorrect diagnosis, which otherwise may just depend on a verbal description.

  15. Vickers Terminator. Volume 3C(VT) - Technical appraisal. Consultants' 1983 report

    Energy Technology Data Exchange (ETDEWEB)

    1986-01-01

    A report is given by a team of consultants on the estimated cost of converting wave energy to electrical energy by a 2 GW array of Vickers Terminator wave energy devices and delivering the electricity to a sub-station on the west coast of Skye. Comparisons with the estimates made by the team developing the concept are presented and are largely in agreement, except for the capital cost per device and the power chain efficiency. A detailed engineering assessment is given.

  16. Robust Transmission of H.264/AVC Streams Using Adaptive Group Slicing and Unequal Error Protection

    Science.gov (United States)

    Thomos, Nikolaos; Argyropoulos, Savvas; Boulgouris, Nikolaos V.; Strintzis, Michael G.

    2006-12-01

    We present a novel scheme for the transmission of H.264/AVC video streams over lossy packet networks. The proposed scheme exploits the error-resilient features of H.264/AVC codec and employs Reed-Solomon codes to protect effectively the streams. A novel technique for adaptive classification of macroblocks into three slice groups is also proposed. The optimal classification of macroblocks and the optimal channel rate allocation are achieved by iterating two interdependent steps. Dynamic programming techniques are used for the channel rate allocation process in order to reduce complexity. Simulations clearly demonstrate the superiority of the proposed method over other recent algorithms for transmission of H.264/AVC streams.

  17. 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 ...

  18. Psychiatric Consultation at Your Fingertips: Descriptive Analysis of Electronic Consultation From Primary Care to Psychiatry.

    Science.gov (United States)

    Lowenstein, Margaret; Bamgbose, Olusinmi; Gleason, Nathaniel; Feldman, Mitchell D

    2017-08-04

    Mental health problems are commonly encountered in primary care, with primary care providers (PCPs) experiencing challenges referring patients to specialty mental health care. Electronic consultation (eConsult) is one model that has been shown to improve timely access to subspecialty care in a number of medical subspecialties. eConsults generally involve a PCP-initiated referral for specialty consultation for a clinical question that is outside their expertise but may not require an in-person evaluation. Our aim was to describe the implementation of eConsults for psychiatry in a large academic health system. We performed a content analysis of the first 50 eConsults to psychiatry after program implementation. For each question and response, we coded consults as pertaining to diagnosis and/or management as well as categories of medication choice, drug side effects or interactions, and queries about referrals and navigating the health care system. We also performed a chart review to evaluate the timeliness of psychiatrist responses and PCP implementation of recommendations. Depression was the most common consult template selected by PCPs (20/50, 40%), followed by the generic template (12/50, 24%) and anxiety (8/50, 16%). Most questions (49/50, 98%) pertained primarily to management, particularly for medications. Psychiatrists commented on both diagnosis (28/50, 56%) and management (50/50, 100%), responded in an average of 1.4 days, and recommended in-person consultation for 26% (13/50) of patients. PCPs implemented psychiatrist recommendations 76% (38/50) of the time. For the majority of patients, psychiatrists provided strategies for ongoing management in primary care without an in-person evaluation, and PCPs implemented most psychiatrist recommendations. eConsults show promise as one means of supporting PCPs to deliver mental health care to patients with common psychiatric disorders. ©Margaret Lowenstein, Olusinmi Bamgbose, Nathaniel Gleason, Mitchell D Feldman

  19. Mechanical and thermal-expansion characteristics of Ca10(PO46(OH2-Ca3(PO42 composites

    Directory of Open Access Journals (Sweden)

    Ruseska G.

    2006-01-01

    Full Text Available Three types of composites consisting of Ca10(PO46(OH2 and Ca3(PO42 with composition: 75% (wt Ca10(PO46(OH2: 25%(wt Ca3(PO42; 50%(wt Ca10(PO46(OH2: 50%(wtCa3(PO42 and 25 %(wt Ca10(PO46(OH2: 75%(wt Ca3(PO42 were the subject of our investigation. Sintered compacts were in thermal equilibrium, which was proved by the absence of hysteresis effect of the dependence ΔL/L=f(T during heating /cooling in the temperature interval 20-1000-200C. Sintered compacts with the previously mentioned composition possess 26-50% higher values of the E-modulus, G-modulus and K-modulus indicating the presence of a synergism effect. Several proposed model equations for predicting the thermal expansion coefficient in dependence of the thermal and elastic properties of the constitutive phases and their volume fractions, given by: Turner, Kerner, Tummala and Friedberg, Thomas and Taya, were used for making correlations between mechanical and thermal-expansion characteristics of the Ca10(PO46(OH2 - Ca3(PO42 composites. Application of the previously mentioned model equations to all kinds of composites leads to the conclusion that the experimentally obtained results for the thermal expansion coefficient are in an excellent agreement with the theoretical calculated values on account of the volume fraction of each constitutive phase and with all applied model equations, with a coefficient of correlation from 98.16-99.86 %.

  20. The multilateral Agreement on Investment: Implications and Policy Recommendations

    Directory of Open Access Journals (Sweden)

    Kwanho Kim

    1997-12-01

    Full Text Available Consultations that were kept under the discussions in the Organization for Economic Cooperation and Development (OECD are Multilateral Agreements on Investment (MAI and their aim was to be signed before April 1998. The significance of the agreement was to establish a transparent and predictable institutional environment for international investment. The agreement is about the nations participating to have the obligation to make sure that foreign investment and investors will to appreciate the national treatment (treated on the same basics with its citizens, and legally binding in the MAI system, the governmental protection for domestic enterprises will become difficult, and domestic enterprise which does not have international competitiveness will face the pressure of structural adjustment. But Korea should positively approach participation into MAI from the point of promoting the internationalization of Korean economies. Although the participation into MAI would also create new challenges of the Korean economy, but it also becomes an opportunity to promote the Korean economy for transferring to a more competitive economic structure.

  1. Autophagy in RAW264.7 Cells Treated with Surface-Functionalized Graphene Oxides

    Directory of Open Access Journals (Sweden)

    Chang Seok Park

    2015-01-01

    Full Text Available This study investigated cytotoxicity, particularly autophagy, in RAW264.7 cells exposed to graphene oxide (GO and its derivatives (dodecylamine-GO (DA-GO, reduced GO (rGO, and sodium dodecyl sulfate-rGO (SDS-rGO. Appearance of amine stretching bands, out-of-plane C-H stretching vibrations, and S=O stretching bands in infrared spectra indicated the formation of DA-GO, rGO, and SDS-rGO, respectively. Light microscopy and microculture tetrazolium assay showed that all the GO types exerted cytotoxic effects on RAW264.7 cells in a concentration-dependent manner. Higher concentrations of the GO types downregulated the expression of PU.1, a unique transcription factor in monocytes and macrophages, and decreased the conversion of LC3A/B-I to LC3A/B-II, suggesting that PU.1 was associated with autophagy in RAW264.7 cells. These results suggested that surface-functionalized GOs exerted cytotoxic effects in a concentration-dependent manner by changing the expression of critical genes and inducing autophagy in macrophages.

  2. Consultant breast radiographers: Where are we now?

    International Nuclear Information System (INIS)

    Rees, Zebby

    2014-01-01

    Introduction: The aim of this study is to: • Evaluate the current role of the consultant breast radiographer. • Compare current practice with the four key components for consultant practice. • Gauge the support of radiologist colleagues. • Determine the other professional commitments involved with the role. This study could be the precursor for a macro study of all consultant radiographer practice in other specialities. Methodology: Methodology used was a comparative ethnographic study. Questionnaires to the 24 consultant breast radiographers currently in post, and consultant breast radiologists, who work with them, were conducted. Data collection was a qualitative thematic approach. Conclusion: Consultant breast radiographers provide high quality care to patients through excellent clinical practice, leadership and good communication. However, this study shows hospital Trusts emphasis for non medical consultants is for clinical practice first. Some radiologists are still a barrier to progression for consultant breast radiographers, and radiologists have a big influence in recruitment decisions. Consultant breast radiographer posts are well established, their numbers are increasing through recognition of the role and of their abilities and performance. Consultant breast radiographers state that becoming a consultant is the major achievement of their career, proving the Society of Radiographers' vision of the four-tier career structure has been well received by the radiography profession

  3. Agreement and conversion formula between mini-mental state examination and montreal cognitive assessment in an outpatient sample.

    Science.gov (United States)

    Helmi, Luqman; Meagher, David; O'Mahony, Edmond; O'Neill, Donagh; Mulligan, Owen; Murthy, Sutha; McCarthy, Geraldine; Adamis, Dimitrios

    2016-09-22

    To explore the agreement between the mini-mental state examination (MMSE) and montreal cognitive assessment (MoCA) within community dwelling older patients attending an old age psychiatry service and to derive and test a conversion formula between the two scales. Prospective study of consecutive patients attending outpatient services. Both tests were administered by the same researcher on the same day in random order. The total sample (n = 135) was randomly divided into two groups. One to derive a conversion rule (n = 70), and a second (n = 65) in which this rule was tested. The agreement (Pearson's r) of MMSE and MoCA was 0.86 (P < 0.001), and Lin's concordance correlation coefficient (CCC) was 0.57 (95%CI: 0.45-0.66). In the second sample MoCA scores were converted to MMSE scores according to a conversion rule from the first sample which achieved agreement with the original MMSE scores of 0.89 (Pearson's r, P < 0.001) and CCC of 0.88 (95%CI: 0.82-0.92). Although the two scales overlap considerably, the agreement is modest. The conversion rule derived herein demonstrated promising accuracy and warrants further testing in other populations.

  4. 20 CFR 1002.264 - Is the employee allowed to repay a previous distribution from a pension benefits plan upon being...

    Science.gov (United States)

    2010-04-01

    ... distribution from a pension benefits plan upon being reemployed? 1002.264 Section 1002.264 Employees' Benefits... and Benefits Pension Plan Benefits § 1002.264 Is the employee allowed to repay a previous distribution from a pension benefits plan upon being reemployed? Yes, provided the plan is a defined benefit plan...

  5. 4kUHD H264 Wireless Live Video Streaming Using CUDA

    Directory of Open Access Journals (Sweden)

    A. O. Adeyemi-Ejeye

    2014-01-01

    Full Text Available Ultrahigh definition video streaming has been explored in recent years. Most recently the possibility of 4kUHD video streaming over wireless 802.11n was presented, using preencoded video. Live encoding for streaming using x264 has proven to be very slow. The use of parallel encoding has been explored to speed up the process using CUDA. However there hasnot been a parallel implementation for video streaming. We therefore present for the first time a novel implementation of 4kUHD live encoding for streaming over a wireless network at low bitrate indoors, using CUDA for parallel H264 encoding. Our experimental results are used to verify our claim.

  6. FPSoC-Based Architecture for a Fast Motion Estimation Algorithm in H.264/AVC

    Directory of Open Access Journals (Sweden)

    Obianuju Ndili

    2009-01-01

    Full Text Available There is an increasing need for high quality video on low power, portable devices. Possible target applications range from entertainment and personal communications to security and health care. While H.264/AVC answers the need for high quality video at lower bit rates, it is significantly more complex than previous coding standards and thus results in greater power consumption in practical implementations. In particular, motion estimation (ME, in H.264/AVC consumes the largest power in an H.264/AVC encoder. It is therefore critical to speed-up integer ME in H.264/AVC via fast motion estimation (FME algorithms and hardware acceleration. In this paper, we present our hardware oriented modifications to a hybrid FME algorithm, our architecture based on the modified algorithm, and our implementation and prototype on a PowerPC-based Field Programmable System on Chip (FPSoC. Our results show that the modified hybrid FME algorithm on average, outperforms previous state-of-the-art FME algorithms, while its losses when compared with FSME, in terms of PSNR performance and computation time, are insignificant. We show that although our implementation platform is FPGA-based, our implementation results compare favourably with previous architectures implemented on ASICs. Finally we also show an improvement over some existing architectures implemented on FPGAs.

  7. Lay Consultations in Heart Failure Symptom Evaluation.

    Science.gov (United States)

    Reeder, Katherine M; Sims, Jessica L; Ercole, Patrick M; Shetty, Shivan S; Wallendorf, Michael

    2017-01-01

    Lay consultations can facilitate or impede healthcare. However, little is known about how lay consultations for symptom evaluation affect treatment decision-making. The purpose of this study was to explore the role of lay consultations in symptom evaluation prior to hospitalization among patients with heart failure. Semi-structured interviews were conducted with 60 patients hospitalized for acute decompensated heart failure. Chi-square and Fisher's exact tests, along with logistic regression were used to characterize lay consultations in this sample. A large proportion of patients engaged in lay consultations for symptom evaluation and decision-making before hospitalization. Lay consultants provided attributions and advice and helped make the decision to seek medical care. Men consulted more often with their spouse than women, while women more often consulted with adult children. Findings have implications for optimizing heart failure self-management interventions, improving outcomes, and reducing hospital readmissions.

  8. Transcoding method from H.264/AVC to high efficiency video coding based on similarity of intraprediction, interprediction, and motion vector

    Science.gov (United States)

    Liu, Mei-Feng; Zhong, Guo-Yun; He, Xiao-Hai; Qing, Lin-Bo

    2016-09-01

    Currently, most video resources on line are encoded in the H.264/AVC format. More fluent video transmission can be obtained if these resources are encoded in the newest international video coding standard: high efficiency video coding (HEVC). In order to improve the video transmission and storage on line, a transcoding method from H.264/AVC to HEVC is proposed. In this transcoding algorithm, the coding information of intraprediction, interprediction, and motion vector (MV) in H.264/AVC video stream are used to accelerate the coding in HEVC. It is found through experiments that the region of interprediction in HEVC overlaps that in H.264/AVC. Therefore, the intraprediction for the region in HEVC, which is interpredicted in H.264/AVC, can be skipped to reduce coding complexity. Several macroblocks in H.264/AVC are combined into one PU in HEVC when the MV difference between two of the macroblocks in H.264/AVC is lower than a threshold. This method selects only one coding unit depth and one prediction unit (PU) mode to reduce the coding complexity. An MV interpolation method of combined PU in HEVC is proposed according to the areas and distances between the center of one macroblock in H.264/AVC and that of the PU in HEVC. The predicted MV accelerates the motion estimation for HEVC coding. The simulation results show that our proposed algorithm achieves significant coding time reduction with a little loss in bitrates distortion rate, compared to the existing transcoding algorithms and normal HEVC coding.

  9. 34 CFR 75.191 - Consultation costs.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Consultation costs. 75.191 Section 75.191 Education... Development of Curricula Or Instructional Materials § 75.191 Consultation costs. An applicant may budget reasonable consultation fees or planning costs in connection with the development of curricula or...

  10. Academic Development for Careers in Management Consulting

    Science.gov (United States)

    Adams, Susan M.; Zanzi, Alberto

    2004-01-01

    Explores the extent to which academic offerings are serving the consulting industry and identifies ways that academia can help. The numbers of management consulting courses, field experiences in consulting and consulting concentrations by graduate business schools were tracked over a three-year period to assess the current state of offerings. A…

  11. Consultations

    International Development Research Centre (IDRC) Digital Library (Canada)

    IDRC CRDI

    Qu'arrive-t-il si j'engage des dépenses avant d'avoir signé mon contrat? Combien de ... Facture-type de consultant. Cette fiche ... Le représentant du CRDI dont le nom figure dans votre contrat est votre source d'information la plus fiable.

  12. Anti-inflammatory effects of ursodeoxycholic acid by lipopolysaccharide-stimulated inflammatory responses in RAW 264.7 macrophages.

    Directory of Open Access Journals (Sweden)

    Wan-Kyu Ko

    Full Text Available The aim of this study was to investigate the anti-inflammatory effects of Ursodeoxycholic acid (UDCA in lipopolysaccharide (LPS-stimulated RAW 264.7 macrophages.We induced an inflammatory process in RAW 264.7 macrophages using LPS. The anti-inflammatory effects of UDCA on LPS-stimulated RAW 264.7 macrophages were analyzed using nitric oxide (NO. Pro-inflammatory and anti-inflammatory cytokines were analyzed by quantitative real time polymerase chain reaction (qRT-PCR and enzyme-linked immunosorbent assay (ELISA. The phosphorylations of extracellular signal-regulated kinase (ERK, c-Jun N-terminal kinase (JNK, and p38 in mitogen-activated protein kinase (MAPK signaling pathways and nuclear factor kappa-light polypeptide gene enhancer in B-cells inhibitor, alpha (IκBα signaling pathways were evaluated by western blot assays.UDCA decreased the LPS-stimulated release of the inflammatory mediator NO. UDCA also decreased the pro-inflammatory cytokines tumor necrosis factor-α (TNF-α, interleukin 1-α (IL-1α, interleukin 1-β (IL-1β, and interleukin 6 (IL-6 in mRNA and protein levels. In addition, UDCA increased an anti-inflammatory cytokine interleukin 10 (IL-10 in the LPS-stimulated RAW 264.7 macrophages. UDCA inhibited the expression of inflammatory transcription factor nuclear factor kappa B (NF-κB in LPS-stimulated RAW 264.7 macrophages. Furthermore, UDCA suppressed the phosphorylation of ERK, JNK, and p38 signals related to inflammatory pathways. In addition, the phosphorylation of IκBα, the inhibitor of NF-κB, also inhibited by UDCA.UDCA inhibits the pro-inflammatory responses by LPS in RAW 264.7 macrophages. UDCA also suppresses the phosphorylation by LPS on ERK, JNK, and p38 in MAPKs and NF-κB pathway. These results suggest that UDCA can serve as a useful anti-inflammatory drug.

  13. 15 CFR 923.57 - Continuing consultation.

    Science.gov (United States)

    2010-01-01

    ... § 923.57 Continuing consultation. (a) As required by subsection 306(d)(3)(B) of the Act, a State must establish an effective mechanism for continuing consultation and coordination between the management agency... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Continuing consultation. 923.57...

  14. Learning to consult with computers.

    Science.gov (United States)

    Liaw, S T; Marty, J J

    2001-07-01

    To develop and evaluate a strategy to teach skills and issues associated with computers in the consultation. An overview lecture plus a workshop before and a workshop after practice placements, during the 10-week general practice (GP) term in the 5th year of the University of Melbourne medical course. Pre- and post-intervention study using a mix of qualitative and quantitative methods within a strategic evaluation framework. Self-reported attitudes and skills with clinical applications before, during and after the intervention. Most students had significant general computer experience but little in the medical area. They found the workshops relevant, interesting and easy to follow. The role-play approach facilitated students' learning of relevant communication and consulting skills and an appreciation of issues associated with using the information technology tools in simulated clinical situations to augment and complement their consulting skills. The workshops and exposure to GP systems were associated with an increase in the use of clinical software, more realistic expectations of existing clinical and medical record software and an understanding of the barriers to the use of computers in the consultation. The educational intervention assisted students to develop and express an understanding of the importance of consulting and communication skills in teaching and learning about medical informatics tools, hardware and software design, workplace issues and the impact of clinical computer systems on the consultation and patient care.

  15. Making consultations run smoothly

    DEFF Research Database (Denmark)

    Jespersen, Astrid Pernille; Elgaard Jensen, Torben

    2012-01-01

    This article investigates the skilful use of time in general practice consultations. It argues that consultation work involves social and material interactions, which are only partially conceptualized in existing medical practice literatures. As an alternative, this article employs ideas from the......-inspired analysis opens up a wider discussion of time as a complex resource and problem in general practice....

  16. Patient assessment: effective consultation and history taking.

    Science.gov (United States)

    Kaufman, Gerri

    This article explores patient consultation with specific reference to the Calgary-Cambridge consultation guide. It provides an overview of history taking and explores the patient's perspective during the consultation. The article also discusses the skills required to provide information effectively. In addition, the article addresses 'safety netting' and emphasises the interdependence of communication and consultation skills.

  17. 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.

  18. 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.

  19. Electric Dipole Polarizability of ^{48}Ca and Implications for the Neutron Skin.

    Science.gov (United States)

    Birkhan, J; Miorelli, M; Bacca, S; Bassauer, S; Bertulani, C A; Hagen, G; Matsubara, H; von Neumann-Cosel, P; Papenbrock, T; Pietralla, N; Ponomarev, V Yu; Richter, A; Schwenk, A; Tamii, A

    2017-06-23

    The electric dipole strength distribution in ^{48}Ca between 5 and 25 MeV has been determined at RCNP, Osaka from proton inelastic scattering experiments at forward angles. Combined with photoabsorption data at higher excitation energy, this enables the first extraction of the electric dipole polarizability α_{D}(^{48}Ca)=2.07(22)  fm^{3}. Remarkably, the dipole response of ^{48}Ca is found to be very similar to that of ^{40}Ca, consistent with a small neutron skin in ^{48}Ca. The experimental results are in good agreement with ab initio calculations based on chiral effective field theory interactions and with state-of-the-art density-functional calculations, implying a neutron skin in ^{48}Ca of 0.14-0.20 fm.

  20. Consultation document Energy Market Concentrations

    International Nuclear Information System (INIS)

    De Maa, J.; Van Gemert, M.; Karel, A.; La Bastide, G.; Giesbertz, P.; Buijs, F.; Vermeulen, M.; Beusmans, P.

    2006-06-01

    This the second consultation document of the Netherlands Competition Authority (NMa) on the title subject (the first was in 2002). The purpose of the consultation is to involve all the relevant and interested parties in the development of the energy market in the Netherlands and to consult those parties on studies that have been carried out by the NMa so far: (1) defining (possible) relevant markets in the electricity sector, and (2) the vision and opinion of the NMa with respect to mergers and take-overs. Also, the consultation document is a contribution to the response of the letter from the Dutch Minister of Economic Affairs of May 2005 in which the NMa was requested to give an overview of the preconditions with regard to competition and it's legal aspects [nl

  1. Compress compound images in H.264/MPGE-4 AVC by exploiting spatial correlation.

    Science.gov (United States)

    Lan, Cuiling; Shi, Guangming; Wu, Feng

    2010-04-01

    Compound images are a combination of text, graphics and natural image. They present strong anisotropic features, especially on the text and graphics parts. These anisotropic features often render conventional compression inefficient. Thus, this paper proposes a novel coding scheme from the H.264 intraframe coding. In the scheme, two new intramodes are developed to better exploit spatial correlation in compound images. The first is the residual scalar quantization (RSQ) mode, where intrapredicted residues are directly quantized and coded without transform. The second is the base colors and index map (BCIM) mode that can be viewed as an adaptive color quantization. In this mode, an image block is represented by several representative colors, referred to as base colors, and an index map to compress. Every block selects its coding mode from two new modes and the previous intramodes in H.264 by rate-distortion optimization (RDO). Experimental results show that the proposed scheme improves the coding efficiency even more than 10 dB at most bit rates for compound images and keeps a comparable efficient performance to H.264 for natural images.

  2. Simvastatin induces caspase-independent apoptosis in LPS-activated RAW264.7 macrophage cells

    International Nuclear Information System (INIS)

    Kim, Yong Chan; Song, Seok Bean; Lee, Mi Hee; Kang, Kwang Il; Lee, Hayyoung; Paik, Sang-Gi; Kim, Kyoon Eon; Kim, Young Sang

    2006-01-01

    Macrophages participate in several inflammatory pathologies such as sepsis and arthritis. We examined the effect of simvastatin on the LPS-induced proinflammatory macrophage RAW264.7 cells. Co-treatment of LPS and a non-toxic dose of simvastatin induced cell death in RAW264.7 cells. The cell death was accompanied by disruption of mitochondrial membrane potential (MMP), genomic DNA fragmentation, and caspase-3 activation. Surprisingly, despite caspase-dependent apoptotic cascade being completely blocked by Z-VAD-fmk, a pan-caspase inhibitor, the cell death was only partially repressed. In the presence of Z-VAD-fmk, DNA fragmentation was blocked, but DNA condensation, disruption of MMP, and nuclear translocation of apoptosis inducing factor were obvious. The cell death by simvastatin and LPS was effectively decreased by both the FPP and GGPP treatments as well as mevalonate. Our findings indicate that simvastatin triggers the cell death of LPS-treated RAW264.7 cells through both caspase-dependent and -independent apoptotic pathways, suggesting a novel mechanism of statins for the severe inflammatory disease therapy

  3. Anti-inflammatory Potential of Petiveria alliacea on Activated RAW264.7 Murine Macrophages.

    Science.gov (United States)

    Gutierrez, Rosa Martha Perez; Hoyo-Vadillo, Carlos

    2017-07-01

    Defense and protection to multiple harmful stimuli are the inflammation, when is self-amplified and uncontrolled is the basis of the pathogenesis of a wide variety of inflammatory illness. The aim of this study was to evaluate if Petiveria alliacea could attenuate inflammation in a murine model of RAW264 macrophages the involved model and its involved mechanism. The ethanol extract from P. alliacea was precipitated with water and supernatant was used for this study (PW). The anti-inflammatory effects of PW were investigated through evaluating of the production of several cytokines, chemokines, and expression of nuclear factor-kappa B (NF-κB) in lipopolysaccharide (LPS)-stimulated RAW264.7 macrophages. Also was determined the ability to decrease the oxidative stress in RAW264.7 cells with carboxy-2',7'-dichloro-dihydro-fluorescein diacetate. PW significantly suppress the secretion of prostaglandin E 2 , leukotriene C 4 , interleukin (IL)-1 β, IL-6, IL-10, interferon gamma nitric oxide (NO), inducible NO synthase, IL-1 β, IL-4, in RAW264.7 cells in a dose-dependent manner. In addition, PW also markedly inhibited the transcriptional activity of NF-κB. PW produced significant anti-inflammatory activity through inhibiting the production of inflammatory mediators through the NF-κB inactivation in the LPS-stimulated RAW24.7 cells. PW exerts significant antioxidant and anti-inflammatory activities, and this effect can be attributed in part, to the presence of dibenzyl disulfide, dibenzyl trisulfide pinitol, coumarin, myricetin, glutamyl-S-benzyl cysteine, and petiveriins A and B. Treatment with ethanol extract from Petiveria alliacea which was previously precipitated with water and supernatant (PE) was tested in LPS-stimulated RAW264.7 cells. PE suppressed the level of oxidative stress and the induction of proinflammatory mediators, as PGE2, LTC4, IL-1 ß, IL-6, IL-10, IFN- NO, iNOS, IL-1 ß, IL-4, in RAW264.7 macrophages through NF-B inactivation. These findings

  4. Postpartum consultation: Occurrence, requirements and expectations

    Directory of Open Access Journals (Sweden)

    Carlgren Ingrid

    2008-07-01

    Full Text Available Abstract Background As a matter of routine, midwives in Sweden have spoken with women about their experiences of labour in a so-called 'postpartum consultation'. However, the possibility of offering women this kind of consultation today is reduced due to shortage of both time and resources. The aim of this study was to explore the occurrence, women's requirements of, and experiences of a postpartum consultation, and to identify expectations from women who wanted but did not have a consultation with the midwife assisting during labour. Methods All Swedish speaking women who gave birth to a live born child at a University Hospital in western Sweden were consecutively included for a phone interview over a three-week period. An additional phone interview was conducted with the women who did not have a postpartum consultation, but who wanted to talk with the midwife assisting during labour. Data from the interviews were analysed using qualitative content analysis. Results Of the 150 interviewed women, 56% (n = 84 had a postpartum consultation of which 61.9% (n = 52 had this with the midwife assisting during labour. Twenty of the 28 women who did not have a consultation with anyone still desired to talk with the midwife assisting during labour. Of these, 19 were interviewed. The content the women wanted to talk about was summarized in four categories: to understand the course of events during labour; to put into words, feelings about undignified management; to describe own behaviour and feelings, and to describe own fear. Conclusion The survey shows that the frequency of postpartum consultation is decreasing, that the majority of women who give birth today still require it, but only about half of them receive it. It is crucial to develop a plan for these consultations that meets both the women's needs and the organization within current maternity care.

  5. Knowledge Sharing in IT Consultant and SME Interactions

    Directory of Open Access Journals (Sweden)

    Adrian Bradshaw

    2015-10-01

    Full Text Available Many small and medium enterprises (SMEs depend on consultants to overcome knowledge barriers, especially for IT projects. This paper aims to determine how IT consultants affect the IT knowledge of SMEs when IT consultants and SMEs interact. Data were collected using face-to-face interviews with both IT consultants and SME managers. The study is the first to identify what and how SMEs learn from consultants during an IT implementation project. Consultants help SMEs gain different types of knowledge, employing a broad range of knowledge sharing mechanisms. As consultants are an important part of the knowledge creation processes of SMEs, SMEs should strive to form long-term relationships with consultants and use these interactions to develop IT knowledge within the SME.

  6. Political consultation and large-scale research

    International Nuclear Information System (INIS)

    Bechmann, G.; Folkers, H.

    1977-01-01

    Large-scale research and policy consulting have an intermediary position between sociological sub-systems. While large-scale research coordinates science, policy, and production, policy consulting coordinates science, policy and political spheres. In this very position, large-scale research and policy consulting lack of institutional guarantees and rational back-ground guarantee which are characteristic for their sociological environment. This large-scale research can neither deal with the production of innovative goods under consideration of rentability, nor can it hope for full recognition by the basis-oriented scientific community. Policy consulting knows neither the competence assignment of the political system to make decisions nor can it judge succesfully by the critical standards of the established social science, at least as far as the present situation is concerned. This intermediary position of large-scale research and policy consulting has, in three points, a consequence supporting the thesis which states that this is a new form of institutionalization of science: These are: 1) external control, 2) the organization form, 3) the theoretical conception of large-scale research and policy consulting. (orig.) [de

  7. Understanding the consultation processes

    International Nuclear Information System (INIS)

    Laing, A.C.

    1998-01-01

    This presentation focuses on the consultation processes between industry, government and First Nations communities regarding resource development. The expectations of the Crown are to facilitate capacity building within First Nations, to promote traditional use studies and to participate with industry proponents on certain consultation issues. The role of industry is to encourage partnerships between established contractors and First Nations contracting firms to allow First Nations firms to grow and experience success under the guidance of a mentor company. It is important to realize that solid First Nations relations are the key to shorter time lines and lower costs in developing projects. However, consultation and involvement must be 'real' with benefits and participation that fall within the First Nations Communities' definition of success

  8. Line list for the ground state of CaF

    Science.gov (United States)

    Hou, Shilin; Bernath, Peter F.

    2018-05-01

    The molecular potential energy function and electronic dipole moment function for the ground state of CaF were studied with MRCI, ACPF, and RCCSD(T) ab initio calculations. The RCCSD(T) potential function reproduces the experimental vibrational intervals to within ∼2 cm-1. The RCCSD(T) dipole moment at the equilibrium internuclear separation agrees well with the experimental value. Over a wide range of internuclear separations, far beyond the range associated with the observed spectra, the ab initio dipole moment functions are similar and highly linear. An extended Morse oscillator (EMO) potential function was also obtained by fitting the observed lines of the laboratory vibration-rotation and pure rotation spectra of the 40CaF X2Σ+ ground state. The fitted potential reproduces the observed transitions (v ≤ 8, N ≤ 121, Δv = 0, 1) within their experimental uncertainties. With this EMO potential and the RCCSD(T) dipole moment function, line lists for 40CaF, 42CaF, 43CaF, 44CaF, 46CaF, and 48CaF were computed for v ≤ 10, N ≤ 121, Δv = 0-10. The calculated emission spectra are in good agreement with an observed laboratory spectrum of CaF at a sample temperature of 1873 K.

  9. Nuclear consultant - a new profession

    International Nuclear Information System (INIS)

    Hardung von Hardung, H.

    1976-01-01

    The nuclear field is an area fraugh with particular difficulties for industries, banks, public authorities etc. in acquiring the precise knowledge needed for decision making. This gap can be filled by the activities of nuclear consultants; in view of the size of the market which, in Europe, probably involves a capital investment by far exceeding DM 100 billion, chances are promising. These consultant activities include technological problems as well as economics, organization, strategy, and training in nuclear technology. Of course, the consultant staff must have broad and specialized knowledge. (orig.) [de

  10. Nuclear consultant: a new profession

    Energy Technology Data Exchange (ETDEWEB)

    Hardung von Hardung, H

    1976-02-01

    The nuclear field is an area fraught with particular difficulties for industries, banks, and public authorities etc. in acquiring the precise knowledge needed for decision making. This gap can be filled by the activities of nuclear consultants; in view of the size of the market which, in Europe, probably involves a capital investment by far exceeding DM 100 billion, chances are promising. These consultant activities include technological problems as well as economics, organization, strategy, and training in nuclear technology. Of course, the consultant staff must have broad and specialized knowledge.

  11. Canada-United States air quality agreement: Making progress

    International Nuclear Information System (INIS)

    1992-01-01

    The Canada-USA Air Quality Agreement was signed in March 1991. Canada's commitment under the agreement is to reduce emissions of SO 2 in the seven easternmost provinces to 2.3 million tonnes/y by 1994 and to cap these emissions at 3.2 million tonnes/y by 2000; in addition, Canada agrees to reduce nitrogen oxide emissions from stationary sources by 100,000 tonnes/y by 2000 and to implement more stringent nitrogen oxide emission standards for vehicles from 1994-96. The USA agrees to reduce SO 2 emissions by ca 10 million tons/y below 1980 levels by 2000, to achieve a permanent cap of 8.95 million tons/y for electric utilities by 2010, to ensure that industrial emissions do not exceed 5.6 million tons, and to reduce total nitrogen oxide emissions by ca 2 million tons/y below 1980 levels, primarily through new regulations for power plants and automobiles. In Canada, SO 2 emissions are now within 16% of target, with control efforts centered around metal smelters and power plants. In the USA, considerable progress has been made in promulgating regulations that will implement the acid rain control provisions of the agreement. Both countries are sharing information, are continuing a variety of scientific and technical activities, and cooperating in areas such as emission inventorying, atmospheric modelling, deposition monitoring, effects research and monitoring, human health studies, and control technologies. In the USA, market based incentives are being used in controlling acid emissions and are being assessed for their potential use in Canada. 13 figs., 3 tabs

  12. Depletion of H2S during obesity enhances store-operated Ca2+ entry in adipose tissue macrophages to increase cytokine production.

    Science.gov (United States)

    Velmurugan, Gopal V; Huang, Huiya; Sun, Hongbin; Candela, Joseph; Jaiswal, Mukesh K; Beaman, Kenneth D; Yamashita, Megumi; Prakriya, Murali; White, Carl

    2015-12-15

    The increased production of proinflammatory cytokines by adipose tissue macrophages (ATMs) contributes to chronic, low-level inflammation during obesity. We found that obesity in mice reduced the bioavailability of the gaseous signaling molecule hydrogen sulfide (H2S). Steady-state, intracellular concentrations of H2S were lower in ATMs isolated from mice with diet-induced obesity than in ATMs from lean mice. In addition, the intracellular concentration of H2S in the macrophage cell line RAW264.7 was reduced during an acute inflammatory response evoked by the microbial product lipopolysaccharide (LPS). Reduced intracellular concentrations of H2S led to increased Ca(2+) influx through the store-operated Ca(2+) entry (SOCE) pathway, which was prevented by the exogenous H2S donor GYY4137. Furthermore, GYY4137 inhibited the Orai3 channel, a key component of the SOCE machinery. The enhanced production of proinflammatory cytokines by RAW264.7 cells and ATMs from obese mice was reduced by exogenous H2S or by inhibition of SOCE. Together, these data suggest that the depletion of macrophage H2S that occurs during acute (LPS-induced) or chronic (obesity) inflammation increases SOCE through disinhibition of Orai3 and promotes the production of proinflammatory cytokines. Copyright © 2015, American Association for the Advancement of Science.

  13. 12 CFR 264b.4 - Gifts of minimal value.

    Science.gov (United States)

    2010-01-01

    ... RULES REGARDING FOREIGN GIFTS AND DECORATIONS § 264b.4 Gifts of minimal value. (a) Board employees may... occur on the same day. (b) Board employees may determine at the time a gift is offered whether it is of... for valuation. (c) Disagreements over whether a gift is of minimal value will be resolved by an...

  14. 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.

  15. SOME INDICATORS OF CONSULTATIVE SERVICES DEVELOPMENT IN SERBIA

    Directory of Open Access Journals (Sweden)

    Vesna PARAUSIC

    2012-01-01

    Full Text Available Transition process and Serbia's entering into the European Union is possible to hasten by adequate and timely consultative services, before all during the programs and methodologies creation for conducting the enterprises' restructuring processes. In such conditions, the consultative organizations help the enterprises in accomplishing their goals, solving problems in business and management, identifying and using new possibilities, increasing their knowledge and applying suggested changes in the practice. Consulting is a result of manager need for integrated and complex business information. To obtain the transfer of consultant knowledge and manager skills development, a certain conditions must be fulfilled. First of all, business integrity and consultant competence are the most important. Business integrity, i.e. consultant ethics contributes image and reputation and is important competitiveness factor on consultant services market. Regarding actual consulting trends in countries within our region, as well as developmental level of consulting in EU countries, the market of consultative services in Serbia has not significantly changed in previous period (as we saw, the acknowledgement of it was got also by empirical research. The owners and managers of enterprises still do not feel a need for external services, in order to solve business problems. Having in mind a level and quality of demand, neither a supply of consultative services had not reached satisfactory level.

  16. Correlation or Limits of Agreement? Applying the Bland-Altman Approach to the Comparison of Cognitive Screening Instruments.

    Science.gov (United States)

    Larner, A J

    2016-01-01

    Calculation of correlation coefficients is often undertaken as a way of comparing different cognitive screening instruments (CSIs). However, test scores may correlate but not agree, and high correlation may mask lack of agreement between scores. The aim of this study was to use the methodology of Bland and Altman to calculate limits of agreement between the scores of selected CSIs and contrast the findings with Pearson's product moment correlation coefficients between the test scores of the same instruments. Datasets from three pragmatic diagnostic accuracy studies which examined the Mini-Mental State Examination (MMSE) vs. the Montreal Cognitive Assessment (MoCA), the MMSE vs. the Mini-Addenbrooke's Cognitive Examination (M-ACE), and the M-ACE vs. the MoCA were analysed to calculate correlation coefficients and limits of agreement between test scores. Although test scores were highly correlated (all >0.8), calculated limits of agreement were broad (all >10 points), and in one case, MMSE vs. M-ACE, was >15 points. Correlation is not agreement. Highly correlated test scores may conceal broad limits of agreement, consistent with the different emphases of different tests with respect to the cognitive domains examined. Routine incorporation of limits of agreement into diagnostic accuracy studies which compare different tests merits consideration, to enable clinicians to judge whether or not their agreement is close. © 2016 S. Karger AG, Basel.

  17. 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

  18. Negotiating climate change agreements - the view from the mineral wool sector

    International Nuclear Information System (INIS)

    Loudon, Robert

    2001-01-01

    Trade associations representing energy-intensive industrial sectors in the UK have negotiated agreements with the Department of the Environment, Transport and the Regions (DETR) to enable their members to receive an 80% rebate on the climate change levy (CCL) providing they meet agreed energy saving targets. Insulation manufacturing is represented by Eurisol and the Mineral Wool Energy Savings Company (MINESCO). Rock wool and glass wool manufacture uses energy for blending, melting, fiberising, curing, cooling, cutting and packaging. However the mineral wool sector has already made significant improvements in energy efficiency over the last 20 years. Confidentiality issues led to Eurisol appointing consultants to advise on how individual plants could achieve further energy savings. Cadogan Consultants developed a strategy that incorporated both qualitative and quantitative issues and allowed the energy saving potential at each site to be identified. MINESCO agreed energy saving targets with the DETR in December 2000, but much work remains to be done

  19. 40 CFR 264.317 - Special requirements for hazardous wastes FO20, FO21, FO22, FO23, FO26, and FO27.

    Science.gov (United States)

    2010-07-01

    ... HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Landfills § 264.317 Special requirements for... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Special requirements for hazardous wastes FO20, FO21, FO22, FO23, FO26, and FO27. 264.317 Section 264.317 Protection of Environment...

  20. 40 CFR 264.283 - Special requirements for hazardous wastes FO20, FO21, FO22, FO23, FO26, and FO27.

    Science.gov (United States)

    2010-07-01

    ... HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Land Treatment § 264.283 Special requirements... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Special requirements for hazardous wastes FO20, FO21, FO22, FO23, FO26, and FO27. 264.283 Section 264.283 Protection of Environment...

  1. Electric giant resonances in sup 4 sup 0 Ca and sup 4 sup 8 Ca probed with electron and proton scattering coincidence experiments

    CERN Document Server

    Strauch, S

    1999-01-01

    Excitation and particle decay of electric giant resonances in sup 4 sup 0 Ca and sup 4 sup 8 Ca are studied with electron and proton beams. Recent results of a sup 4 sup 8 Ca(e,e'n) measurement performed at the S-DALINAC in Darmstadt with kinematics that selectively populate electric monopole, dipole and quadrupole excitations are presented. The extracted B(E1) strength distribution is in good agreement with photo nuclear data and the predictions of microscopic calculations. The summed B(E2+E0) strength distribution, however disagrees with the result of these calculations. The neutron emission of the giant dipole resonance in sup 4 sup 8 Ca shows a large fraction of direct decay to sup 4 sup 7 Ca hole states. In addition, isoscalar giant monopole resonance strength in sup 4 sup 0 Ca was extracted from (e,e'alpha sub 0) and (e,e'alpha sub 1) angular correlations. A study of the quadrupole strength in the alpha sub 0 decay channel of sup 4 sup 0 Ca with a (p,p'alpha) coincidence measurement reiterates the unsol...

  2. Should consultation recording use be a practice standard? A systematic review of the effectiveness and implementation of consultation recordings.

    Science.gov (United States)

    Rieger, Kendra L; Hack, Thomas F; Beaver, Kinta; Schofield, Penelope

    2018-04-01

    To conduct a systematic review of the effectiveness of consultation recordings and identify factors contributing to their successful implementation in health-care settings. A systematic review was conducted for quantitative studies examining the effectiveness of consultation recordings in health care. Two independent reviewers assessed the relevance and quality of retrieved quantitative studies by using standardized criteria. Study findings were examined to determine consultation recording effectiveness and to identify barriers and facilitators to implementation. A supplementary review of qualitative evidence was performed to further explicate implementation factors. Of the 3373 articles retrieved in the quantitative search, 26 satisfied the standardized inclusion criteria (12 randomized controlled trials, 1 quasi-experiment, and 13 cross-sectional studies). Most patients found consultation recordings beneficial. Statistically significant evidentiary support was found for the beneficial impact of consultation recordings on the following patient reported outcomes: knowledge, perception of being informed, information recall, decision-making factors, anxiety, and depression. Implementation barriers included strength of evidence concerns, patient distress, impact of the recording on consultation quality, clinic procedures, medico-legal issues, and resource costs. Facilitators included comfort with being recorded, clinical champions, legal strategies, efficient recording procedures, and a positive consultation recording experience. Consultation recordings are valuable to patients and positively associated with patient-reported outcomes. Successful integration of consultation recording use into clinical practice requires an administratively supported, systematic approach to addressing implementation factors. Copyright © 2017 John Wiley & Sons, Ltd.

  3. The guideline "consultation psychiatry" of the Netherlands Psychiatric Association.

    Science.gov (United States)

    Leentjens, Albert F G; Boenink, Annette D; Sno, Herman N; Strack van Schijndel, Rob J M; van Croonenborg, Joyce J; van Everdingen, Jannes J E; van der Feltz-Cornelis, Christina M; van der Laan, Niels C; van Marwijk, Harm; van Os, Titus W D P

    2009-06-01

    In 2008, the Netherlands Psychiatric Association authorized a guideline "consultation psychiatry." To set a standard for psychiatric consultations in nonpsychiatric settings. The main objective of the guideline is to answer three questions: Is psychiatric consultation effective and, if so, which forms are most effective? How should a psychiatric consultations be performed? What increases adherence to recommendations given by the consulting psychiatrist? Systematic literature review. Both in general practice and in hospital settings psychiatric consultation is effective. In primary care, the effectiveness of psychiatric consultation is almost exclusively studied in the setting of "collaborative care." Procedural guidance is given on how to perform a psychiatric consultation. In this guidance, psychiatric consultation is explicitly looked upon as a complex activity that requires a broad frame of reference and adequate medical and pharmacological expertise and experience and one that should be performed by doctors. Investing in a good relation with the general practitioner, and the use of a "consultation letter" increased efficacy in general practice. In the hospital setting, investing in liaison activities and an active psychiatric follow-up of consultations increased adherence to advice. Psychiatric consultations are effective and constitute a useful contribution to the patients' treatment. With setting a standard consultations will become more transparent and checkable. It is hoped that this will increase the quality of consultation psychiatry.

  4. Services of strategic consulting: special features and types

    Directory of Open Access Journals (Sweden)

    Klenin Oleh Volodymyrovych

    2016-09-01

    Full Text Available In the article essence of terms “consulting” and “strategic consulting” was studied. It was proved that strategic consulting must be analyzed as professional activity in the system of enterprise strategic management. Specific features of consultative services and its composition was added from the point of view of strategic management and innovative development were studied. In the process of providing consulting services it was suggested to take into account the strategic orientation of human capital of consulting company that was accepted to determine as professional actions of consultants. It was found out main problems that could prevent stable activity of industrial enterprises. It was proved necessity of researches concerning authentication factors of industrial enterprises innovative development and the role of consulting company in its decision making. It was made review of the most widespread classifications of consulting services. Was shown author`s view concerning forming more demanded services of strategic consulting by subject basis.

  5. Video traffic characteristics of modern encoding standards: H.264/AVC with SVC and MVC extensions and H.265/HEVC.

    Science.gov (United States)

    Seeling, Patrick; Reisslein, Martin

    2014-01-01

    Video encoding for multimedia services over communication networks has significantly advanced in recent years with the development of the highly efficient and flexible H.264/AVC video coding standard and its SVC extension. The emerging H.265/HEVC video coding standard as well as 3D video coding further advance video coding for multimedia communications. This paper first gives an overview of these new video coding standards and then examines their implications for multimedia communications by studying the traffic characteristics of long videos encoded with the new coding standards. We review video coding advances from MPEG-2 and MPEG-4 Part 2 to H.264/AVC and its SVC and MVC extensions as well as H.265/HEVC. For single-layer (nonscalable) video, we compare H.265/HEVC and H.264/AVC in terms of video traffic and statistical multiplexing characteristics. Our study is the first to examine the H.265/HEVC traffic variability for long videos. We also illustrate the video traffic characteristics and statistical multiplexing of scalable video encoded with the SVC extension of H.264/AVC as well as 3D video encoded with the MVC extension of H.264/AVC.

  6. ARL/OMS Consultant Training Program.

    Science.gov (United States)

    Euster, Joanne R.

    1982-01-01

    Describes Academic Library Consultant Training Program begun in 1979, sponsored by Office of Management Studies (OMS) and designed to provide 80 consultants to aid academic libraries in improving performance. Viewpoints are included from OMS Director and participants concerning program objectives, trainee selection, workshops, internships, and the…

  7. Improving Indonesian Construction Consulting Services

    Directory of Open Access Journals (Sweden)

    Rizal Z. Tamin

    2015-05-01

    Full Text Available Indonesian construction consulting services are facing a complex problem in fulfilling the nation’s expectations regarding high quality infrastructure development and the construction industry’s competitiveness. A study of this problem and a formulation of solutions to improve the situation are presented in this paper. A survey was carried out in Jakarta, West Java, East Java, and North Sumatra provinces to collect data related to this problem. A focus group discussion and a workshop with all stakeholders were conducted to formulate improvement actions that need to be taken. It was revealed that the problems faced include, among others, the limited number of professional engineers compared to the number of national consultancy companies, the uneven distribution of engineers in Indonesian regions, an imperfect procurement system, and low-quality work output in general. Recommended actions include improvement of the government’s role in consulting services nurturing and facilitation, development of partnerships, and amelioration of the professional engineer and consultant certification system.

  8. The rose of Sharon: what is the ideal timing for palliative care consultation versus ethics consultation?

    Science.gov (United States)

    La Via, Jennifer; Schiedermayer, David

    2012-01-01

    Ethics committees and palliative care consultants can function in a complementary fashion, seamlessly and effectively. Ethics committees can "air" and help resolves issues, and palliative care consultants can use a low-key, longitudinal approach.

  9. 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.

  10. 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.

  11. Compensation Consultants and CEO Pay

    NARCIS (Netherlands)

    Kabir, Mohammed Rezaul; Minhat, Marizah

    2014-01-01

    The study examines the practice of employing multiple compensation consultants. Examining data of a sample of UK companies over the period 2003–2006 we find that CEOs receive higher equity-based pay when firms employ more than one compensation consultant. An increase in the number of compensation

  12. The Lawyer-Therapist Consultation Team.

    Science.gov (United States)

    Korelitz, Ann; Schulder, Diane

    1982-01-01

    Discusses a pilot study in which joint consultations with a family therapist and a matrimonial attorney were offered to 10 couples and one woman contemplating divorce. Videotaped sessions. Suggests joint consultations can be useful in helping couples understand the psychological and legal implications of conflicts expressed during separation.…

  13. Discussing patient's lifestyle choices in the consulting room: analysis of GP-patient consultations between 1975 and 2008

    Directory of Open Access Journals (Sweden)

    van Dulmen Sandra

    2010-11-01

    Full Text Available Abstract Background The increasing prevalence of chronic diseases and the growing understanding that lifestyle behaviour plays an essential role in improving overall health suggest a need for increased attention to lifestyle choices in the consulting room. This study aims to examine whether or not healthy and unhealthy lifestyle choices of patients are currently being discussed more often in primary care consultations than in former decades. Furthermore, we are interested in GPs' approach to lifestyle behaviour during consultations. Lastly, we examine whether lifestyle behaviour is discussed more with certain patients during consultations, depending on gender, age and educational background. Method We analysed video-recordings of medical consultations, collected between 1975 and 2008 in Dutch GP practices. Data were analysed using logistic regression. Results This study shows that discussion of smoking behaviour and physical activity has increased somewhat over time. A change in discussion of nutrition and alcohol is, however, less clear. Overall, alcohol use is the least discussed and physical activity the most discussed during consultations. GPs mainly refer to lifestyle when it is relevant to the patient's complaints (symptom approach. GPs' approach to lifestyle behaviour did not change over time. In general, lifestyle behaviour is discussed more with older, male patients (except for nutrition. GPs talk about lifestyle behaviour with patients from different educational backgrounds equally (except for physical activity. Conclusion In recent years there is greater awareness of a healthy lifestyle, which is reflected to a limited extent in this study. Still, lifestyle behaviour is discussed in only a minority of consultations. GPs do not refer to lifestyle behaviour as a routine procedure, i.e. do not include it in primary prevention. This highlights the importance of the introduction of prevention consultations, where GPs can discuss lifestyle

  14. Adaptive deblocking and deringing of H.264/AVC video sequences

    DEFF Research Database (Denmark)

    Nadernejad, Ehsan; Burini, Nino; Forchhammer, Søren

    2013-01-01

    We present a method to reduce blocking and ringing artifacts in H.264/AVC video sequences. For deblocking, the proposed method uses a quality measure of a block based coded image to find filtering modes. Based on filtering modes, the images are segmented to three classes and a specific deblocking...

  15. 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…

  16. Edgar Schein's Process versus Content Consultation Models.

    Science.gov (United States)

    Rockwood, Gary F.

    1993-01-01

    Describes Schein's three models of consultation based on assumptions inherent in different helping styles: purchase of expertise and doctor-patient models, which focus on content of organization problems; and process consultation model, which focuses on how organizational problems are solved. Notes that Schein has suggested that consultants begin…

  17. Inconsistency of residents' communication performance in challenging consultations.

    Science.gov (United States)

    Wouda, Jan C; van de Wiel, Harry B M

    2013-12-01

    Communication performance inconsistency between consultations is usually regarded as a measurement error that jeopardizes the reliability of assessments. However, inconsistency is an important phenomenon, since it indicates that physicians' communication may be below standard in some consultations. Fifty residents performed two challenging consultations. Residents' communication competency was assessed with the CELI instrument. Residents' background in communication skills training (CST) was also established. We used multilevel analysis to explore communication performance inconsistency between the two consultations. We also established the relationships between inconsistency and average performance quality, the type of consultation, and CST background. Inconsistency accounted for 45.5% of variance in residents' communication performance. Inconsistency was dependent on the type of consultation. The effect of CST background training on performance quality was case specific. Inconsistency and average performance quality were related for those consultation combinations dissimilar in goals, structure, and required skills. CST background had no effect on inconsistency. Physician communication performance should be of high quality, but also consistent regardless of the type and complexity of the consultation. In order to improve performance quality and reduce performance inconsistency, communication education should offer ample opportunities to practice a wide variety of challenging consultations. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  18. DISTRIBUTION OF CCR2-64I GENE AMONG THE TRIBES AND CASTE POPULATION OF VIDARBHA, INDIA.

    Directory of Open Access Journals (Sweden)

    Arvind B Chavhan

    2013-08-01

    Results: The genotyping for the CCR2-64I mutation among the selected tribe and a caste reveal that all of the tribes and a caste was found to be heterozygous for the CCR2-64I mutation. Among the tribes Gonds showed highest genotype frequency (29.28% and (11.76% for heterozygous (CCR2/64I and Homozygous (64I/64I respectively, having an allelic frequency (0.233. A pooled allelic frequencies of the wild-type allele CCR2 and CCR2 64I the variant were found to be 0.854 and 0.146, respectively. No significant deviations from the HWE were observed for tribes and a caste population for the CCR2- 64I mutant χ2=2.76. The study reports the presence of mutant CCR2- 64I gene in tribes and caste population from Vidarbha region.

  19. 26 CFR 1.264-4 - Other life insurance, endowment, or annuity contracts.

    Science.gov (United States)

    2010-04-01

    ... (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Items Not Deductible § 1.264-4 Other life insurance... insurer, insured, or any other person (other than by gift, bequest, or inheritance, or in a transaction to...

  20. 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

  1. 12 CFR 264b.2 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... the United States at the time of acceptance of $285 or less as of January 1, 2002, and at 3-year... consultation with the Secretary of State, to reflect changes in the consumer price index for the immediately...

  2. Immunomodulatory effects of hydroxyethylated Hericium erinaceus polysaccharide on macrophages RAW264.7.

    Science.gov (United States)

    Ren, Zhe; Qin, Tao; Qiu, Fuan; Song, Yulong; Lin, Dandan; Ma, Yufang; Li, Jian; Huang, Yifan

    2017-12-01

    Hericium erinaceus polysaccharide (HEP) has been shown to possess a variety of biological activities. In present study, HEP was successfully modified to obtain its hydroxyethylated derivative hHEP. Its potential immunomodulatory activities on RAW264.7 macrophages were investigated. Results showed that the hHEP were significantly stronger than that of the corresponding unmodified polysaccharide, HEP. Meanwhile, the NO, IL-6 and TNF-α production activities of macrophages were enhanced in the RAW264.7 macrophages by stimulation of hHEP. In addition, the hHEP increase significantly higher iNOS expression than HEP. These results indicated that the hydroxyethylated derivative hHEP could enhance the activation of peritoneal macrophages, and hydroxyethylation modification can enhance the immunomodulation function of HEP. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. 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...

  4. "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.

  5. I did eat my vegetables. Agreement between parent and child food intake diaries.

    Science.gov (United States)

    Rangelov, Natalie; Suggs, L Suzanne; Marques-Vidal, Pedro

    2016-12-01

    To assess the level of agreement between children and their parents when reporting a child's food consumption. Cross-sectional study in which children and parents independently completed 7 d food diaries describing the foods and drinks the child consumed at every meal and snack. The association between child and parent reporting was assessed for nineteen food groups using Kendall's tau-b non-parametric correlations, Spearman's rank correlations, kappa coefficients and Lin's concordance measure of agreement. Results were also stratified by gender of the child and his/her grade at school. Households in Ticino, Switzerland, April-June 2014. Two hundred and ninety-nine children aged 6-12 years and one of their parents participated, with 264 providing complete data (35 % completion rate). Results showed a high level of agreement between child and parent reporting. Spearman correlations ranged from 0·55 (sauces) and 0·57 (fatty meat) to 0·80 (fruit), 0·83 (starchy foods) and 0·84 (pastries). All nineteen Spearman correlations were significant at the 0·001 level. Kendall's tau-b correlations ranged from 0·44 (fat meat) to 0·81 (puff pastry). Kappa values showed low to high levels of agreement, ranging from 0·15 (sweets) to 0·77 (puff pastry). Lin's concordance correlation coefficients ranged from 0·39 (whole grains) to 0·86 (puff pastry). When assessing the eating behaviour of children using a 7 d food diary, children's reports might be as reliable as their parents'.

  6. Consultant radiographers: Profile of the first generation

    International Nuclear Information System (INIS)

    Forsyth, Lesley J.; Maehle, Valerie

    2010-01-01

    Aim: The aim of this research is to examine the profile of first generation consultant radiographers: their demographics, educational backgrounds, qualifications and training, career experience and progression, teaching, lecturing and research activities. Method: Participant recruitment was drawn from the Society and College of Radiographers consultant radiographer group. Data collection involved a self-administered paper based and web based questionnaire. Results: Participant response rate of 55% (n = 11). Conclusions: The profile of the first consultant radiographer cohort reflects a diverse and eclectic mix. While some aspects of their development such as educational background, clinical training and skills enhancement are comparable to nurse consultants, clinical experience and employment history show some differences. Commitment to development of expert clinical skills is evident within the profile of the first generation cohort of consultant radiographers however research and leadership training are not strong features.

  7. Consultant radiographers: Profile of the first generation

    Energy Technology Data Exchange (ETDEWEB)

    Forsyth, Lesley J., E-mail: l.forsyth@rgu.ac.u [School of Health Sciences, Robert Gordon University, Aberdeen, AB10 7QG (United Kingdom); Maehle, Valerie [Faculty of Health and Social Care, Robert Gordon University, Aberdeen, AB10 7QG (United Kingdom)

    2010-11-15

    Aim: The aim of this research is to examine the profile of first generation consultant radiographers: their demographics, educational backgrounds, qualifications and training, career experience and progression, teaching, lecturing and research activities. Method: Participant recruitment was drawn from the Society and College of Radiographers consultant radiographer group. Data collection involved a self-administered paper based and web based questionnaire. Results: Participant response rate of 55% (n = 11). Conclusions: The profile of the first consultant radiographer cohort reflects a diverse and eclectic mix. While some aspects of their development such as educational background, clinical training and skills enhancement are comparable to nurse consultants, clinical experience and employment history show some differences. Commitment to development of expert clinical skills is evident within the profile of the first generation cohort of consultant radiographers however research and leadership training are not strong features.

  8. A retrospective analysis of medical record use in e-consultations.

    Science.gov (United States)

    Pecina, Jennifer L; North, Frederick

    2017-06-01

    Introduction Under certain circumstances, e-consultations can substitute for a face-to-face consultation. A basic requirement for a successful e-consultation is that the e-consultant has access to important medical history and exam findings along with laboratory and imaging results. Knowing just what information the specialist needs to complete an e-consultation is a major challenge. This paper examines differences between specialties in their need for past information from laboratory, imaging and clinical notes. Methods This is a retrospective study of patients who had an internal e-consultation performed at an academic medical centre. We reviewed a random sample of e-consultations that occurred in the first half of 2013 for the indication for the e-consultation and whether the e-consultant reviewed data in the medical record that was older than one year to perform the e-consultation. Results Out of 3008 total e-consultations we reviewed 360 (12%) randomly selected e-consultations from 12 specialties. Questions on management (35.8%), image results (27.2%) and laboratory results (25%) were the three most common indications for e-consultation. E-consultants reviewed medical records in existence more than one year prior to the e-consultation 146 (40.6%) of the time with e-consultants in the specialties of endocrinology, haematology and rheumatology, reviewing records older than one year more than half the time. Labs (20.3%), office notes (20%) and imaging (17.8%) were the types of medical data older than one year that were reviewed the most frequently overall. Discussion Management questions appear to be the most common reason for e-consultation. E-consultants frequently reviewed historical medical data that is older than one year at the time of the e-consultation, especially in endocrinology, haematology and rheumatology specialties. Practices engaging in e-consultations that require transfer of data may want to include longer time frames of historical information

  9. CCR2-64I polymorphism is not associated with altered CCR5 expression or coreceptor function.

    Science.gov (United States)

    Mariani, R; Wong, S; Mulder, L C; Wilkinson, D A; Reinhart, A L; LaRosa, G; Nibbs, R; O'Brien, T R; Michael, N L; Connor, R I; Macdonald, M; Busch, M; Koup, R A; Landau, N R

    1999-03-01

    A polymorphism in the gene encoding CCR2 is associated with a delay in progression to AIDS in human immunodeficiency virus (HIV)-infected individuals. The polymorphism, CCR2-64I, changes valine 64 of CCR2 to isoleucine. However, it is not clear whether the effect on AIDS progression results from the amino acid change or whether the polymorphism marks a genetically linked, yet unidentified mutation that mediates the effect. Because the gene encoding CCR5, the major coreceptor for HIV type 1 primary isolates, lies 15 kb 3' to CCR2, linked mutations in the CCR5 promoter or other regulatory sequences could explain the association of CCR2-64I with slowed AIDS pathogenesis. Here, we show that CCR2-64I is efficiently expressed on the cell surface but does not have dominant negative activity on CCR5 coreceptor function. A panel of peripheral blood mononuclear cells (PBMC) from uninfected donors representing the various CCR5/CCR2 genotypes was assembled. Activated primary CD4(+) T cells of CCR2 64I/64I donors expressed cell surface CCR5 at levels comparable to those of CCR2 +/+ donors. A slight reduction in CCR5 expression was noted, although this was not statistically significant. CCR5 and CCR2 mRNA levels were nearly identical for each of the donor PBMC, regardless of genotype. Cell surface CCR5 and CCR2 levels were more variable than mRNA transcript levels, suggesting that an alternative mechanism may influence CCR5 cell surface levels. CCR2-64I is linked to the CCR5 promoter polymorphisms 208G, 303A, 627C, and 676A; however, in transfected promoter reporter constructs, these did not affect transcriptional activity. Taken together, these findings suggest that CCR2-64I does not act by influencing CCR5 transcription or mRNA levels.

  10. The transition to hospital consultant

    DEFF Research Database (Denmark)

    Westerman, Michiel; Teunissen, Pim W.; Jorgensen, Rasmus Lundhus

    2013-01-01

    Danish and Dutch new consultants' perceptions regarding the transition to consultant were compared to gain insight into this period, particularly the influence of contextual factors concerning the organisation of specialty training and health care therein. Preparation for medical and generic comp...... competencies, perceived intensity and burnout were compared. Additionally, effects of differences in working conditions and cultural dimensions were explored....

  11. CYP264B1 from Sorangium cellulosum So ce56: a fascinating norisoprenoid and sesquiterpene hydroxylase.

    Science.gov (United States)

    Ly, Thuy T B; Khatri, Yogan; Zapp, Josef; Hutter, Michael C; Bernhardt, Rita

    2012-07-01

    Many terpenes and terpenoid compounds are known as bioactive substances with desirable fragrance and medicinal activities. Modification of such compounds to yield new derivatives with desired properties is particularly attractive. Cytochrome P450 monooxygenases are potential enzymes for these reactions due to their capability of performing different reactions on a variety of substrates. We report here the characterization of CYP264B1 from Sorangium cellulosum So ce56 as a novel sesquiterpene hydroxylase. CYP264B1 was able to convert various sesquiterpenes including nootkatone and norisoprenoids (α-ionone and β-ionone). Nootkatone, an important grapefruit aromatic sesquiterpenoid, was hydroxylated mainly at position C-13. The product has been shown to have the highest antiproliferative activity compared with other nootkatone derivatives. In addition, CYP264B1 was found to hydroxylate α- and β-ionone, important aroma compounds of floral scents, regioselectively at position C-3. The products, 3-hydroxy-β-ionone and 13-hydroxy-nootkatone, were confirmed by (1)H and (13)C NMR. The kinetics of the product formation was analyzed by high-performance liquid chromatography, and the K ( m ) and k (cat) values were calculated. The results of docking α-/β-ionone and nootkatone into a homology model of CYP264B1 revealed insights into the structural basis of these selective hydroxylations.

  12. 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.

  13. Development of a Collaborative Practice Agreement Template to Promote the Role of the Pharmacist in Managing Urinary Tract Infections in Long-term Care Residents

    OpenAIRE

    Fehrenbacher, Lynne; McDevitt, Kimberly; Palmer, Matthew; Traynor, Laura; Boero, Joe; Crnich, Christopher

    2017-01-01

    Abstract Background One of the CDC core elements of antimicrobial stewardship in nursing homes emphasizes the promotion of clinical practice change and integration of the dispensing and consultant pharmacist to improve antibiotic use. An opportunity to support this element is via collaborative practice agreements (CPA). A CPA is a voluntary agreement between one or more prescribers and pharmacists which delegates physician authority under defined conditions and/or limitations toward a common ...

  14. Efficient MPEG-2 to H.264/AVC Transcoding of Intra-Coded Video

    Directory of Open Access Journals (Sweden)

    Vetro Anthony

    2007-01-01

    Full Text Available This paper presents an efficient transform-domain architecture and corresponding mode decision algorithms for transcoding intra-coded video from MPEG-2 to H.264/AVC. Low complexity is achieved in several ways. First, our architecture employs direct conversion of the transform coefficients, which eliminates the need for the inverse discrete cosine transform (DCT and forward H.264/AVC transform. Then, within this transform-domain architecture, we perform macroblock-based mode decisions based on H.264/AVC transform coefficients, which is possible using a novel method of calculating distortion in the transform domain. The proposed method for distortion calculation could be used to make rate-distortion optimized mode decisions with lower complexity. Compared to the pixel-domain architecture with rate-distortion optimized mode decision, simulation results show that there is a negligible loss in quality incurred by the direct conversion of transform coefficients and the proposed transform-domain mode decision algorithms, while complexity is significantly reduced. To further reduce the complexity, we also propose two fast mode decision algorithms. The first algorithm ranks modes based on a simple cost function in the transform domain, then computes the rate-distortion optimal mode from a reduced set of ranked modes. The second algorithm exploits temporal correlations in the mode decision between temporally adjacent frames. Simulation results show that these algorithms provide additional computational savings over the proposed transform-domain architecture while maintaining virtually the same coding efficiency.

  15. Modelling Ca2+ bound Troponin in Excitation Contraction Coupling

    Directory of Open Access Journals (Sweden)

    Henry G. Zot

    2016-09-01

    Full Text Available To explain disparate decay rates of cytosolic Ca2+ and structural changes in the thin filaments during a twitch, we model the time course of Ca2+ bound troponin (Tn resulting from the free Ca2+ transient of fast skeletal muscle. In fibers stretched beyond overlap, the decay of Ca2+ as measured by a change in fluo 3 fluorescence is significantly slower than the intensity decay of the meridional 1/38.5 nm-1 reflection of Tn; this is not simply explained by considering only the Ca2+ binding properties of Tn alone (Matsuo, T., Iwamoto, H., and Yagi, N. (2010. Biophys. J. 99, 193-200. We apply a comprehensive model that includes the known Ca2+ binding properties of Tn in the context of the thin filament with and without cycling crossbridges. Calculations based on the model predict that the transient of Ca2+ bound Tn correlates with either the fluo 3 time course in muscle with overlapping thin and thick filaments or the intensity of the meridional 1/38.5 nm-1 reflection in overstretched muscle. Hence, cycling crossbridges delay the dissociation of Ca2+ from Tn. Correlation with the fluo 3 fluorescence change is not causal given that the transient of Ca2+ bound Tn depends on sarcomere length, whereas the fluo-3 fluorescence change does not. Transient positions of tropomyosin calculated from the time course of Ca2+ bound Tn are in reasonable agreement with the transient of measured perturbations of the Tn repeat in overlap and non-overlap muscle preparations.

  16. H.264/AVC error resilience tools suitable for 3G mobile video services

    Institute of Scientific and Technical Information of China (English)

    LIU Lin; YE Xiu-zi; ZHANG San-yuan; ZHANG Yin

    2005-01-01

    The emergence of third generation mobile system (3G) makes video transmission in wireless environment possible,and the latest 3GPP/3GPP2 standards require 3G terminals support H.264/AVC. Due to high packet loss rate in wireless environment, error resilience for 3G terminals is necessary. Moreover, because of the hardware restrictions, 3G mobile terminals support only part of H.264/AVC error resilience tool. This paper analyzes various error resilience tools and their functions, and presents 2 error resilience strategies for 3G mobile streaming video services and mobile conversational services. Performances of the proposed error resilience strategies were tested using off-line common test conditions. Experiments showed that the proposed error resilience strategies can yield reasonably satisfactory results.

  17. Probable mode prediction for H.264 advanced video coding P slices using removable SKIP mode distortion estimation

    Science.gov (United States)

    You, Jongmin; Jeong, Jechang

    2010-02-01

    The H.264/AVC (advanced video coding) is used in a wide variety of applications including digital broadcasting and mobile applications, because of its high compression efficiency. The variable block mode scheme in H.264/AVC contributes much to its high compression efficiency but causes a selection problem. In general, rate-distortion optimization (RDO) is the optimal mode selection strategy, but it is computationally intensive. For this reason, the H.264/AVC encoder requires a fast mode selection algorithm for use in applications that require low-power and real-time processing. A probable mode prediction algorithm for the H.264/AVC encoder is proposed. To reduce the computational complexity of RDO, the proposed method selects probable modes among all allowed block modes using removable SKIP mode distortion estimation. Removable SKIP mode distortion is used to estimate whether or not a further divided block mode is appropriate for a macroblock. It is calculated using a no-motion reference block with a few computations. Then the proposed method reduces complexity by performing the RDO process only for probable modes. Experimental results show that the proposed algorithm can reduce encoding time by an average of 55.22% without significant visual quality degradation and increased bit rate.

  18. 42 CFR 493.1419 - Standard; Clinical consultant responsibilities.

    Science.gov (United States)

    2010-10-01

    ... Testing Laboratories Performing Moderate Complexity Testing § 493.1419 Standard; Clinical consultant... clinical consultation to the laboratory's clients; (b) Be available to assist the laboratory's clients in... 42 Public Health 5 2010-10-01 2010-10-01 false Standard; Clinical consultant responsibilities. 493...

  19. Scalable Content Authentication in H.264/SVC Videos Using Perceptual Hashing based on Dempster-Shafer theory

    Directory of Open Access Journals (Sweden)

    Ye Dengpan

    2012-09-01

    Full Text Available The content authenticity of the multimedia delivery is important issue with rapid development and widely used of multimedia technology. Till now many authentication solutions had been proposed, such as cryptology and watermarking based methods. However, in latest heterogeneous network the video stream transmission has been coded in scalable way such as H.264/SVC, there is still no good authentication solution. In this paper, we firstly summarized related works and proposed a scalable content authentication scheme using a ratio of different energy (RDE based perceptual hashing in Q/S dimension, which is used Dempster-Shafer theory and combined with the latest scalable video coding (H.264/SVC construction. The idea of aldquo;sign once and verify in scalable wayardquo; can be realized. Comparing with previous methods, the proposed scheme based on perceptual hashing outperforms previous works in uncertainty (robustness and efficiencies in the H.264/SVC video streams. At last, the experiment results verified the performance of our scheme.

  20. 40 CFR 725.17 - Consultation with EPA.

    Science.gov (United States)

    2010-07-01

    ... ACT REPORTING REQUIREMENTS AND REVIEW PROCESSES FOR MICROORGANISMS General Provisions and..., ATTN: Biotechnology Notice Consultation. Persons wishing to consult with EPA by telephone should call...

  1. Internal bremsstrahlung spectral shapes of 45Ca and 35S

    International Nuclear Information System (INIS)

    Babu, R.P.; Murty, K.N.; Murty, V.A.N.

    1976-01-01

    The internal bremsstrahlung spectra emitted in the beta decays of 45 Ca and 35 S were measured using a multichannel NaI(Tl) scintillation spectrometer with a standard geometrical arrangement. After making all the necessary corrections, the experimental results were compared with the allowed theory of Knipp and Uhlenbeck (Physica; 3:425 (1936)) and of Bloch (Phys. Rev.; 50:272 (1936)) (KUB theory) and also with the Coulomb-corrected theories of Lewis and Ford (Phys. Rev.; 107:756 (1957)) and of Nilsson (Ark. Fys.; 10:467 (1956)). In the case of 45 Ca, fairly good agreement with KUB theory was obtained from 30 to 155 keV and above 155 keV the experimental results were in agreement with the Lewis and Ford theory up to 210 keV, the maximum limit of the photon energy investigated. For 35 S, the experimental results are in quite good agreement with KUB theory from 25 to 45 keV, but beyond 45 keV the values are greater than the Coulomb-corrected theories due to both Lewis and Ford and to Nilsson, the experimental excess over Nilsson Coulomb-corrected theory being by factors of 1.07, 1.12 and 1.63 at energies 60, 90 and 110 keV respectively. (author)

  2. 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/.

  3. The optimization of H.264/AVC baseline decoder on low-cost TriMedia DSP processor

    Science.gov (United States)

    Wang, Sung-Wen; Yang, Ya-Ting; Li, Chia-Ying; Tung, Yi-Shin; Wu, Ja-Ling

    2004-11-01

    The emerging video coding standard, H.264/AVC, exhibits the unprecedented coding performance. Comparing to traditional coders, e.g., MPEG-2 and MEPG-4 ASP, about half bitrate saving is shown in the official verification test. Such outstanding performance makes it become the video compression candidate for the upcoming HD-DVD. As a side effect, it was also blamed that H.264/AVC is much more logically complex and requires more computation power than any of the existing standards. A low-cost and efficient implementation of the international standard hence plays an important role of its success. In this paper, we realize an H.264/AVC baseline decoder by a low-cost DSP processor, i.e., Philips" TriMedia TM-1300, and illustrate that less computation demand for H.264/AVC decoding becomes feasible by using effective software core. To this end, we first consider different approaches and take advantage of SIMD instruction set to optimize critical time-consuming coding modules, such as the fractional motion compensation, spatial prediction and inverse transform. Next, we also present some other optimization approaches for entropy decoding and in-loop deblocking filtering, even though they cannot get benefits from utilizing SIMD. In our experiments, by exploiting appropriate instruction level parallelism and efficient algorithms, the decoding speed can be improved by a factor of 8~10; a CIF video sequence can be decoded at up to 19.74~28.97 fps on a 166-MHz TriMedia TM-1300 processor compared to 2.40~2.98 fps by the standard reference software.

  4. The International Consultant: Substance and Culture.

    Science.gov (United States)

    Fest, Thorrel B.

    To function effectively in crosscultural settings, international consultants, development specialists, and trainers should be prepared to examine objectively a number of personal qualities. Problems arise in crosscultural relationships when either the client or the consultant fails to identify objectives, fails to accommodate different views of…

  5. Helicobacter pylori protein HP0986 (TieA) interacts with mouse TNFR1 and triggers proinflammatory and proapoptotic signaling pathways in cultured macrophage cells (RAW 264.7).

    Science.gov (United States)

    Ansari, Suhail A; Devi, Savita; Tenguria, Shivendra; Kumar, Ashutosh; Ahmed, Niyaz

    2014-08-01

    HP0986 protein of Helicobacter pylori has been shown to trigger induction of proinflammatory cytokines (IL-8 and TNF-α) through the activation of NF-κB and also to induce Fas mediated apoptosis of human macrophage cells (THP-1). In this study, we unravel mechanistic details of the biological effects of this protein in a murine macrophage environment. Up regulation of MCP-1 and TNF-α in HP0986-induced RAW 264.7 cells occurred subsequent to the activation and translocation of NF-κB to the cell nucleus. Further, HP0986 induced apoptosis of RAW 264.7 cells through Fas activation and this was in agreement with previous observations made with THP-1 cells. Our studies indicated activation of TNFR1 through interaction with HP0986 and this elicited the aforementioned responses independent of TLR2, TLR4 or TNFR2. We found that mouse TNFR1 activation by HP0986 facilitates formation of a complex comprising of TNFR1, TRADD and TRAF2, and this occurs upstream of NF-κB activation. Furthermore, FADD also forms a second complex, at a later stage, together with TNFR1 and TRADD, resulting in caspase-8 activation and thereby the apoptosis of RAW 264.7 cells. In summary, our observations reveal finer details of the functional activity of HP0986 protein in relation to its behavior in a murine macrophage cell environment. These findings reconfirm the proinflammatory and apoptotic role of HP0986 signifying it to be an important trigger of innate responses. These observations form much needed baseline data entailing future in vivo studies of the functions of HP0986 in a murine model. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. BNFL Sellafield further public consultation

    International Nuclear Information System (INIS)

    1994-01-01

    The main issues raised during the further public consultation on the draft Sellafield authorisations for the discharge of radioactive wastes from the British Nuclear Fuel (BNFL) Sellafield site are outlined. An analysis of the categories and numbers of the 42,500 responses is made. The public consultation was based on five documents; a letter to consultees from the Department of the Environment and the Ministry of Agriculture, Fisheries and Food (MAFF); the report by Her Majesty's Inspectorate of Pollution and the Inspectorate of MAFF on their earlier consultation exercise; a paper by BNFL on the economic and commercial justification of the Thermal Oxide Reprocessing Plant (THORP); a statement of the Government's policy on reprocessing and THORP and a document prepared by BNFL on the environmental implication of THORP. (UK)

  7. Consulting by Business College Academics: Lessons for Business Communication Courses

    Science.gov (United States)

    Dave, Anish

    2009-01-01

    Business communication (BC) is a crucial aspect of management consulting. BC scholars have widely studied the relationship between BC and management consulting, including consulting by BC academics. A limited review of the studies of management consulting, including consulting done by business college academics, hereafter referred to simply as…

  8. A Collaborative Approach to Implement Positive Behavior Support Plans for Children with Problem Behaviors: A Comparison of Consultation versus Consultation and Feedback Approach

    Science.gov (United States)

    Erbas, Dilek

    2010-01-01

    The purpose of this study is to compare the effectiveness of consultation alone and consultation plus feedback on the proper use of positive behavior support strategies (PBS) on behaviors of three mothers with children with developmental disabilities. Results indicated that consultation plus feedback was more effective than consultation alone…

  9. [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.

  10. 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.

  11. 20 CFR 404.1616 - Medical or psychological consultants.

    Science.gov (United States)

    2010-04-01

    ..., psychological experts employed by or under contract with the State agencies must meet the qualification... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Medical or psychological consultants. 404... Determination Function § 404.1616 Medical or psychological consultants. (a) What is a medical consultant? A...

  12. Efficient Transmission of H.264 Video over Multirate IEEE 802.11e WLANs

    Directory of Open Access Journals (Sweden)

    Alnuweiri Hussein

    2008-01-01

    Full Text Available The H.264 video encoding technology, which has emerged as one of the most promising compression standards, offers many new delivery-aware features such as data partitioning. Efficient transmission of H.264 video over any communication medium requires a great deal of coordination between different communication network layers. This paper considers the increasingly popular and widespread 802.11 Wireless Local Area Networks (WLANs and studies different schemes for the delivery of the baseline and extended profiles of H.264 video over such networks. While the baseline profile produces data similar to conventional video technologies, the extended profile offers a partitioning feature that divides video data into three sets with different levels of importance. This allows for the use of service differentiation provided in the WLAN. This paper examines the video transmission performance of the existing contention-based solutions for 802.11e, and compares it to our proposed scheduled access mechanism. It is demonstrated that the scheduled access scheme outperforms contention-based prioritized services of the 802.11e standard. For partitioned video, it is shown that the overhead of partitioning is too high, and better results are achieved if some partitions are aggregated. The effect of link adaptation and multirate operation of the physical layer (PHY is also investigated in this paper.

  13. 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.

  14. Multiple Compensation Consultants and CEO Pay

    NARCIS (Netherlands)

    Kabir, Mohammed Rezaul; Minhat, Marizah

    The study examines the practice of employing multiple compensation consultants. Data for a sample of UK companies over the period 2003-2006 are analyzed using a variety of econometric methods. We find that CEOs receive higher equity-based pay when firms employ more than one compensation consultant.

  15. Consultants' Corner: System Performance. A Forum.

    Science.gov (United States)

    Drabenstott, John, Ed.

    1986-01-01

    Five library consultants address issues that affect online system performance: options in system design that relate to diverse library requirements; criteria that most affect performance; benchmark tests and sizing criteria; minimalizing the risks of miscalculation; and the roles and responsibilities of vendors, libraries, and consultants.…

  16. Trending Longitudinal Agreement between Parent and Child Perceptions of Quality of Life for Pediatric Palliative Care Patients

    Directory of Open Access Journals (Sweden)

    Meaghann S. Weaver

    2017-08-01

    Full Text Available Pediatric palliative care studies often rely on proxy-reported instead of direct child-reported quality of life metrics. The purpose of this study was to longitudinally evaluate quality of life for pediatric patients receiving palliative care consultations and to compare patient-reported quality of life with parent perception of the child’s quality of life across wellness domains. The 23-item PedsQL™ V4.0 Measurement Model was utilized for ten child and parent dyads at time of initial palliative care consultation, Month 6, and Month 12 to assess for physical, emotional, social, and cognitive dimensions of quality of life as reported independently by the child and by the parent for the child. Findings were analyzed using Bland–Altman plots to compare observed differences to limits of agreement. This study revealed overall consistency between parent- and child-reported quality of life across domains. Physical health was noted to be in closest agreement. At the time of initial palliative care consult, children collectively scored their social quality of life higher than parental perception of the child’s social quality of life; whereas, emotional and cognitive quality of life domains were scored lower by children than by the parental report. At the one year survey time point, the physical, emotional, and social domains trended toward more positive patient perception than proxy perception with congruence between quality of life scores for the cognitive domain. Findings reveal the importance of eliciting a child report in addition to a parent report when measuring and longitudinally trending perceptions on quality of life.

  17. 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.

  18. Therapists perspectives on the effective elements of consultation following training.

    Science.gov (United States)

    Beidas, Rinad S; Edmunds, Julie M; Cannuscio, Carolyn C; Gallagher, Mark; Downey, Margaret Mary; Kendall, Philip C

    2013-11-01

    Consultation is an effective implementation strategy to improve uptake of evidence-based practices for youth. However, little is known about what makes consultation effective. The present study used qualitative methods to explore therapists perspectives about consultation. We interviewed 50 therapists who had been trained 2 years prior in cognitive-behavioral therapy for child anxiety. Three themes emerged regarding effective elements of consultation: (1) connectedness with other therapists and the consultant, (2) authentic interactions around actual cases, and (3) the responsiveness of the consultant to the needs of individual therapists. Recommendations for the design of future consultation endeavors are offered.

  19. Therapists’ Perspectives on the Effective Elements of Consultation Following Training

    Science.gov (United States)

    Beidas, Rinad S.; Edmunds, Julie M.; Cannuscio, Carolyn C.; Gallagher, Mark; Downey, Margaret Mary; Kendall, Philip C.

    2013-01-01

    Consultation is an effective implementation strategy to improve uptake of evidence-based practices for youth. However, little is known about what makes consultation effective. The present study used qualitative methods to explore therapists’ perspectives about consultation. We interviewed 50 therapists who had been trained 2 years prior in cognitive-behavioral therapy for child anxiety. Three themes emerged regarding effective elements of consultation: (1) connectedness with other therapists and the consultant, (2) authentic interactions around actual cases, and (3) the responsiveness of the consultant to the needs of individual therapists. Recommendations for the design of future consultation endeavors are offered. PMID:23435832

  20. 77 FR 31348 - Boott Hydropower, Inc.; Notice of Consulting Parties and Agenda for Section 106 Consultation Meeting

    Science.gov (United States)

    2012-05-25

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Project No. 2790-055] Boott Hydropower, Inc.; Notice of Consulting Parties and Agenda for Section 106 Consultation Meeting On May 4, 2012, the... Hydropower, Inc. and the Eldred L. Field Hydroelectric Facility Trust (co-licensees for the Lowell...

  1. 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

  2. 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

  3. 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

  4. Entropy coders of the H.264/AVC standard

    CERN Document Server

    Tian, Xiaohua; Lian, Yong

    2010-01-01

    This book presents a collection of algorithms and VLSI architectures of entropy (or statistical) codecs of recent video compression standards, with focus on the H.264/AVC standard. For any visual data compression scheme, there exists a combination of two, or all of the following three stages: spatial, temporal, and statistical compression. General readers are first introduced with the various algorithms of the statistical coders. The VLSI implementations are also reviewed and discussed. Readers with limited hardware design background are also introduced with a design methodology starting from

  5. Telephone consultations on exposure to nuclear disaster radiation

    International Nuclear Information System (INIS)

    Yashima, Sachiko; Chida, Koichi

    2014-01-01

    The Fukushima nuclear disaster occurred on March 11, 2011. For about six weeks, I worked as a counselor for phone consultations regarding radiation risk. I analyzed the number of consultations, consultations by telephone, and their changing patterns with elapse of time, to assist with consultations about risk in the future. There were a large number of questions regarding the effects of radiation, particularly with regard to children. We believe that counseling and risk communication are the key to effectively informing the public about radiation risks. (author)

  6. Information giving and receiving in hematological malignancy consultations.

    Science.gov (United States)

    Alexander, Stewart C; Sullivan, Amy M; Back, Anthony L; Tulsky, James A; Goldman, Roberta E; Block, Susan D; Stewart, Susan K; Wilson-Genderson, Maureen; Lee, Stephanie J

    2012-03-01

    Little is known about communication with patients suffering from hematologic malignancies, many of whom are seen by subspecialists in consultation at tertiary-care centers. These subspecialized consultations might provide the best examples of optimal physician-patient communication behaviors, given that these consultations tend to be lengthy, to occur between individuals who have not met before and may have no intention of an ongoing relationship, and which have a goal of providing treatment recommendations. The aim of this paper is to describe and quantify the content of the subspecialty consultation in regards to exchanging information and identify patient and provider characteristics associated with discussion elements. Audio-recorded consultations between 236 patients and 40 hematologists were coded for recommended communication practices. Multilevel models for dichotomous outcomes were created to test associations between patient, physician and consultation characteristics and key discussion elements. Discussions about the purpose of the visit and patient's knowledge about their disease were common. Other elements such as patient's preference for his/her role in decision-making, preferences for information, or understanding of presented information were less common. Treatment recommendations were provided in 97% of the consultations and unambiguous presentations of prognosis occurred in 81% of the consultations. Unambiguous presentations of prognosis were associated with non-White patient race, lower educational status, greater number of questions asked, and specific physician provider. Although some communication behaviors occur in most consultations, others are much less common and could help tailor the amount and type of information discussed. Approximately half of the patients are told unambiguous prognostic estimates for mortality or cure. Copyright © 2011 John Wiley & Sons, Ltd.

  7. Activation of AMPA receptor promotes TNF-α release via the ROS-cSrc-NFκB signaling cascade in RAW264.7 macrophages

    Energy Technology Data Exchange (ETDEWEB)

    Cheng, Xiu-Li [Department of Physiology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing (China); Ding, Fan [Office of Scientific R& D, Tsinghua University, Beijing (China); Li, Hui; Tan, Xiao-Qiu [Department of Physiology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing (China); Liu, Xiao [Department of Pathophysiology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing (China); Cao, Ji-Min, E-mail: caojimin@126.com [Department of Physiology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing (China); Gao, Xue, E-mail: longlongnose@163.com [Department of Pathophysiology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing (China)

    2015-05-29

    The relationship between glutamate signaling and inflammation has not been well defined. This study aimed to investigate the role of AMPA receptor (AMPAR) in the expression and release of tumor necrosis factor-alpha (TNF-α) from macrophages and the underlying mechanisms. A series of approaches, including confocal microscopy, immunofluorescency, flow cytometry, ELISA and Western blotting, were used to estimate the expression of AMPAR and downstream signaling molecules, TNF-α release and reactive oxygen species (ROS) generation in the macrophage-like RAW264.7 cells. The results demonstrated that AMPAR was expressed in RAW264.7 cells. AMPA significantly enhanced TNF-α release from RAW264.7 cells, and this effect was abolished by CNQX (AMPAR antagonist). AMPA also induced elevation of ROS production, phosphorylation of c-Src and activation of nuclear factor (NF)-κB in RAW264.7 cells. Blocking c-Src by PP2, scavenging ROS by glutathione (GSH) or inhibiting NF-κB activation by pyrrolidine dithiocarbamate (PDTC) decreased TNF-α production from RAW264.7 cells. We concluded that AMPA promotes TNF-α release in RAW264.7 macrophages likely through the following signaling cascade: AMPAR activation → ROS generation → c-Src phosphorylation → NF-κB activation → TNF-α elevation. The study suggests that AMPAR may participate in macrophage activation and inflammation. - Highlights: • AMPAR is expressed in RAW264.7 macrophages and is upregulated by AMPA stimulation. • Activation of AMPAR stimulates TNF-α release in macrophages through the ROS-cSrc-NFκB signaling cascade. • Macrophage AMPAR signaling may play an important role in inflammation.

  8. Accurate determination of 41Ca concentrations in spent resins from the nuclear industry by Accelerator Mass Spectrometry

    International Nuclear Information System (INIS)

    Nottoli, Emmanuelle; Bourlès, Didier; Bienvenu, Philippe; Labet, Alexandre; Arnold, Maurice; Bertaux, Maité

    2013-01-01

    The radiological characterisation of nuclear waste is essential for managing storage sites. Determining the concentration of Long‐Lived RadioNuclides (LLRN) is fundamental for their long-term management. This paper focuses on the measurement of low 41 Ca concentrations in ions exchange resins used for primary fluid purification in Pressurised Water Reactors (PWR). 41 Ca concentrations were successfully measured by Accelerator Mass Spectrometry (AMS) after the acid digestion of resin samples, followed by radioactive decontamination and isobaric suppression through successive hydroxide, carbonate, nitrate and final CaF 2 precipitations. Measured 41 Ca concentrations ranged from 0.02 to 0.03 ng/g, i.e. from 0.06 to 0.09 Bq/g. The 41 Ca/ 60 Co activity ratios obtained were remarkably reproducible and in good agreement with the current ratio used for resins management. - Highlights: • In the context of radioactive waste management, this study aimed at measuring 41 Ca in spent resins using Accelerator Mass Spectrometry. • A chemical treatment procedure was developed to quantitatively recover calcium in solution and selectively extract it. • Developed firstly on synthetic matrices, the chemical treatment procedure was then successfully applied to real resin samples. • Accelerator mass spectrometry allowed measuring concentrations of 41 Ca in spent resins as low as 0.02 ng/g of dry resin. • Final results are in agreement with current data used for spent resins management

  9. 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.

  10. Consultation Barriers between Teachers and External Consultants: A Grounded Theory of Change Resistance in School Consultation

    Science.gov (United States)

    Thornberg, Robert

    2014-01-01

    The aim of this study, conducted in Sweden, was to investigate the cultural barriers between school personnel (teachers and principals) and nonschool personnel (a resource team), who were external to the school system, regarding consultation about challenging or difficult-to-teach students. Focus groups with teachers, principals, and the resource…

  11. Bladder Pain Syndrome International Consultation on Incontinence

    DEFF Research Database (Denmark)

    Hanno, P.; Lin, A.; Nordling, J.

    2010-01-01

    Aims of Study: The Bladder Pain Syndrome Committee of the International Consultation on Incontinence was assigned the task by the consultation of reviewing the syndrome, formerly known as interstitial cystitis, in a comprehensive fashion. This included the topics of definition, nomenclature......, taxonomy, epidemiology, etiology, pathology, diagnosis, symptom scales, outcome assessment, principles of management, specific therapies, and future directions in research. Study Design, Materials, Methods: The emphasis was on new information developed since the last consultation 4 years previously. Where...... possible, existing evidence was assessed and a level of recommendation was developed according to the Oxford system of classification. Results: The consultation decided to refer to the condition as "bladder pain syndrome" (BPS) because the designation is more descriptive of the clinical condition...

  12. 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

  13. Why Hire a Consultant if You Already Know What's Best?

    Science.gov (United States)

    Kaufman, Roger

    1996-01-01

    Discusses the client-consultant relationship from both sides. Argues that a consulting breakdown can be a chance for both the client and the consultant to grow through negotiation. Lists some basic guidelines for successful consulting relationships. (PEN)

  14. Comparative assessment of H.265/MPEG-HEVC, VP9, and H.264/MPEG-AVC encoders for low-delay video applications

    Science.gov (United States)

    Grois, Dan; Marpe, Detlev; Nguyen, Tung; Hadar, Ofer

    2014-09-01

    The popularity of low-delay video applications dramatically increased over the last years due to a rising demand for realtime video content (such as video conferencing or video surveillance), and also due to the increasing availability of relatively inexpensive heterogeneous devices (such as smartphones and tablets). To this end, this work presents a comparative assessment of the two latest video coding standards: H.265/MPEG-HEVC (High-Efficiency Video Coding), H.264/MPEG-AVC (Advanced Video Coding), and also of the VP9 proprietary video coding scheme. For evaluating H.264/MPEG-AVC, an open-source x264 encoder was selected, which has a multi-pass encoding mode, similarly to VP9. According to experimental results, which were obtained by using similar low-delay configurations for all three examined representative encoders, it was observed that H.265/MPEG-HEVC provides significant average bit-rate savings of 32.5%, and 40.8%, relative to VP9 and x264 for the 1-pass encoding, and average bit-rate savings of 32.6%, and 42.2% for the 2-pass encoding, respectively. On the other hand, compared to the x264 encoder, typical low-delay encoding times of the VP9 encoder, are about 2,000 times higher for the 1-pass encoding, and are about 400 times higher for the 2-pass encoding.

  15. Group Work in Schools: A Process Consultation Approach

    Science.gov (United States)

    Farouk, Shaalan

    2004-01-01

    This paper provides a description of how an educational psychologist can consult with groups of teachers mostly in relation to their work with pupils who display emotional behavioural difficulties. The paper includes a review of the work on group consultation in schools, followed by a description of process consultation (Schein, 1988 ) and how the…

  16. Agreements

    International Nuclear Information System (INIS)

    2001-01-01

    These columns summarize the different bilateral and multilateral agreements concluded recently between the different OECD countries and concerning the nuclear energy domain: Argentina - Australia: Agreement concerning Co-operation in the Peaceful Uses of Nuclear Energy (2001). Argentina - Brazil: Joint Declaration regarding the Creation of the Argentinean-Brazilian Agency for Nuclear Energy Applications (2001). Australia - Czech Republic / Australia - Hungary: Agreements on Co-operation in Peaceful Uses of Nuclear Energy and the Transfer of Nuclear Material (2001). Australia - Indonesia: Arrangement Concerning Co-operation on Nuclear Safeguards and Related Matters (2001). Austria - Switzerland: Agreement on the Early Exchange of Information in the Field of Nuclear Safety and Radiation. Brazil - United States: Extension of the Agreement concerning Research and Development in Nuclear Material Control, Accountancy, Verification, Physical Protection, and Advanced Containment and Surveillance Technologies for International Safeguards Applications (2001). Czech Republic - Republic of Korea: Agreement for Co-operation in the Peaceful Uses of Nuclear Energy (2001). European Union- Russian Federation: Agreements on Nuclear Safety and Controlled Nuclear Fusion (2001). France - United States: Agreement for Co-operation in Advanced Nuclear Reactor Science and Technology (2001). Japan - United Kingdom: Co-operation Agreement on Advanced Nuclear Fuel Cycle, Fast Breeder Reactor and Other Related Technologies (2001). Republic OF Korea - United States: Annex IV Joint Project on Cintichem Technology (2000). Morocco - United States: Protocol amending the Co-operation Agreement on the Peaceful Uses of Nuclear Energy (2001). Multilateral Agreements: Agreement for Information Exchange on Radiological Surveillance in Northern Europe (2001). Status of Conventions in the Field of Nuclear Energy. (author)

  17. THE IMPORTANCE OF CONSULTING IN CONTEMPORARY BUSINESS MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Svetlana Vukotić

    2017-07-01

    Full Text Available Modern business is characterized by risk and uncertainty, and such an environment is reflected in the decisions taken by managers. On the other hand, management consulting is one of the most important management techniques developed over the last fifty years. The secondary effect of this invention is the rapid development of new frameworks, tools, and techniques improving the operations in a number of companies. Exposure of consulting organizations to varying combinations of business circumstances and experiences of different companies have allowed for the accumulation of valuable knowledge and business experience. From this coupling, or interaction of knowledge and experience of consulting companies, on the one hand and the needs of management companies to recognize their role and hire consultants, on the other hand, developed the importance of financial consulting and auditing. Rational management processes cannot be imagined without reliable information provided by the audit, especially as the strategic management includes the control phase. The importance and relationship between consulting and management in companies that do business according to modern principles is a central topic of consideration in this paper.

  18. 76 FR 55678 - Tribal Consultation Policy

    Science.gov (United States)

    2011-09-08

    ... types of agency actions that will require tribal consultation in the future. ACF's response was that due... disparities of American Indians and Alaska Natives (AI/AN) and ensuring that access to critical health and... within ACF, many of which already consult with AI/ANs. 3. Background Since the formation of the Union...

  19. Chitosan Nanoparticles Attenuate Hydrogen Peroxide-Induced Stress Injury in Mouse Macrophage RAW264.7 Cells

    Directory of Open Access Journals (Sweden)

    Zi-Rong Xu

    2013-09-01

    Full Text Available This study was carried out to investigate the protective effects of chitosan nanoparticles (CNP against hydrogen peroxide (H2O2-induced oxidative damage in murine macrophages RAW264.7 cells. After 24 h pre-incubation with CNP (25–200 μg/mL and chitosan (CS (50–200 μg/mL, as controls, the viability loss in RAW264.7 cells induced by H2O2 (500 μM for 12 h was markedly restored in a concentration-dependent manner as measured by MTT assay (P < 0.05 and decreased in cellular LDH release (P < 0.05. Moreover, CNP also exerted preventive effects on suppressing the production of lipid peroxidation such as malondialdehyde (MDA (P < 0.05, restoring activities of endogenous antioxidant including superoxide dismutase (SOD, and glutathione peroxidase (GSH-Px (P < 0.05, along with increasing total antioxidant capacity (T-AOC (P < 0.05. In addition, pre-incubation of CNP with RAW264.7 cells for 24 h resulted in the increase of the gene expression level of endogenous antioxidant enzymes, such as MnSOD and GSH-Px (P < 0.05. At the same concentration, CNP significantly decreased LDH release and MDA (P < 0.05 as well as increased MnSOD, GSH-Px, and T-AOC activities (P < 0.05 as compared to CS. Taken together, our findings suggest that CNP can more effectively protect RAW264.7 cells against oxidative stress by H2O2 as compared to CS, which might be used as a potential natural compound-based antioxidant in the functional food and pharmaceutical industries.

  20. 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

  1. A novel frame-level constant-distortion bit allocation for smooth H.264/AVC video quality

    Science.gov (United States)

    Liu, Li; Zhuang, Xinhua

    2009-01-01

    It is known that quality fluctuation has a major negative effect on visual perception. In previous work, we introduced a constant-distortion bit allocation method [1] for H.263+ encoder. However, the method in [1] can not be adapted to the newest H.264/AVC encoder directly as the well-known chicken-egg dilemma resulted from the rate-distortion optimization (RDO) decision process. To solve this problem, we propose a new two stage constant-distortion bit allocation (CDBA) algorithm with enhanced rate control for H.264/AVC encoder. In stage-1, the algorithm performs RD optimization process with a constant quantization QP. Based on prediction residual signals from stage-1 and target distortion for smooth video quality purpose, the frame-level bit target is allocated by using a close-form approximations of ratedistortion relationship similar to [1], and a fast stage-2 encoding process is performed with enhanced basic unit rate control. Experimental results show that, compared with original rate control algorithm provided by H.264/AVC reference software JM12.1, the proposed constant-distortion frame-level bit allocation scheme reduces quality fluctuation and delivers much smoother PSNR on all testing sequences.

  2. Simulated consultations: a sociolinguistic perspective.

    Science.gov (United States)

    Atkins, Sarah; Roberts, Celia; Hawthorne, Kamila; Greenhalgh, Trisha

    2016-01-15

    Assessment of consulting skills using simulated patients is widespread in medical education. Most research into such assessment is sited in a statistical paradigm that focuses on psychometric properties or replicability of such tests. Equally important, but less researched, is the question of how far consultations with simulated patients reflect real clinical encounters--for which sociolinguistics, defined as the study of language in its socio-cultural context, provides a helpful analytic lens. In this debate article, we draw on a detailed empirical study of assessed role-plays, involving sociolinguistic analysis of talk in OSCE interactions. We consider critically the evidence for the simulated consultation (a) as a proxy for the real; (b) as performance; (c) as a context for assessing talk; and (d) as potentially disadvantaging candidates trained overseas. Talk is always a performance in context, especially in professional situations (such as the consultation) and institutional ones (the assessment of professional skills and competence). Candidates who can handle the social and linguistic complexities of the artificial context of assessed role-plays score highly--yet what is being assessed is not real professional communication, but the ability to voice a credible appearance of such communication. Fidelity may not be the primary objective of simulation for medical training, where it enables the practising of skills. However the linguistic problems and differences that arise from interacting in artificial settings are of considerable importance in assessment, where we must be sure that the exam construct adequately embodies the skills expected for real-life practice. The reproducibility of assessed simulations should not be confused with their validity. Sociolinguistic analysis of simulations in various professional contexts has identified evidence for the gap between real interactions and assessed role-plays. The contextual conditions of the simulated

  3. Wind power projects and Aboriginal consultation

    Energy Technology Data Exchange (ETDEWEB)

    Isaac, T. [McCarthy Tetrault LLP, Vancouver, BC (Canada)

    2006-07-01

    This presentation outlined some of the legal aspects related to Aboriginal involvement in wind power development consultation processes and disputes. Aboriginal rights are rights held by Aboriginal people that are an element of a practice, custom, or tradition integral to the culture of groups claiming such rights. Wind power developers should understand that Aboriginal rights claims may include fishing; whaling; transportation; and cultural and spiritual activities. Aboriginal title is a subcategory of Aboriginal rights, and is a right to land itself, and an encumbrance on the Crown's underlying title to land. Weak Aboriginal claims where potential infringement by energy developers is minor may only require notice and information. Strong prima facie cases for Aboriginal rights and title where the potential for infringement is of high significance may result in more extensive consultation involving interim solutions; formal Aboriginal participation in decision-making processes; and written responses demonstrating how Aboriginal concerns have been considered. There are a number of circumstances requiring a case-by-case approach, and the Crown may make decisions in the face of Aboriginal disagreement. However, energy developers should ensure that consultation processes are fair and reasonable. Conflicting interests can often be successfully resolved through consultation, and accommodation to Aboriginal rights may include mitigation, avoiding interference, and agreeing to as little infringement as possible. Aboriginal title may attach to private land but only to the Crown's underlying title. The Crown has no duty to consult respecting Aboriginal title on private land because title has already been infringed. In these cases, duty to consult and accommodate may be discharged through other regulatory processes such as environmental impact assessments. It was concluded that wind power project proponents should build a relationship with the Crown, as avoiding

  4. Environmental agreements in Canada : Aboriginal participation, EIA follow-up and environmental management of major projects

    Energy Technology Data Exchange (ETDEWEB)

    O' Faircheallaigh, C. [Griffith Univ., Brisbane (Australia). Dept. of Politics and Public Policy

    2006-05-15

    Attempts are now being made to address the historic marginalization of indigenous peoples from the management of resource projects located on their ancestral lands through the use of environmental agreements. However, the rapid pace of resource development in certain regions of Canada has meant that there is an increased need to ensure effective follow-up procedures for Environmental Impact Assessment (EIA) processes in order to achieve meaningful Aboriginal participation in the management of large-scale resource projects. Lack of effective follow-up has made it difficult for the relevant agencies to manage risks and uncertainties. This book discussed the use of new policy environmental agreements between industry, government, and Aboriginal peoples. Case studies where environmental agreements were used in the Northwest Territories, Alberta, and Newfoundland were presented in order to demonstrate their efficacy. It was concluded that structures and processes must be designed to encourage Aboriginal participation in consultation processes. refs., tabs.

  5. CORRELATION OF 48Ca, 50Ti, AND 138La HETEROGENEITY IN THE ALLENDE REFRACTORY INCLUSIONS

    International Nuclear Information System (INIS)

    Chen, Hsin-Wei; Lee, Typhoon; Lee, Der-Chuen; Chen, Jiang-Chang

    2015-01-01

    Precise determinations of 48 Ca anomalies in Allende calcium–aluminum-rich inclusions (CAIs) are reported in this work. There are endemic positive 48 Ca/ 44 Ca anomalies in all analyzed CAIs after normalization to 42 Ca/ 44 Ca, and it is clearly shown that there is no simple correlation between 48 Ca/ 44 Ca and 50 Ti/ 48 Ti anomalies, in agreement with Jungck et al. Compared to the 48 Ca/ 44 Ca versus 50 Ti/ 48 Ti correlation line defined by differentiated meteorites, reported by Chen et al., the CAIs plot to elevated 50 Ti/ 48 Ti. Assuming the 48 Ca/ 44 Ca anomalies of both CAIs and differentiated meteorites came from the same source, excess 50 Ti anomalies in CAIs can be calculated by subtracting the part associated with 48 Ca/ 44 Ca. These excesses show a linear correlation with 138 La anomalies, a neutrino-process nuclide. According to current stellar nucleosynthetic models, we therefore suggest that the solar system 48 Ca, 50 Ti, and 138 La isotopic variations are made of mixtures between grains condensed from ejecta of neutron-rich accretion-induced SNe Ia and the O/Ne–O/C zone of core-collapse SNe II

  6. 40 CFR Appendix V to Part 264 - Examples of Potentially Incompatible Waste

    Science.gov (United States)

    2010-07-01

    ... corrosive alkalies Lime wastewater Lime and water Spent caustic Group 1-B Acid sludge Acid and water Battery...Cl3 Other water-reactive waste Potential consequences: Fire, explosion, or heat generation; generation... Waste V Appendix V to Part 264 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED...

  7. Program Performance Assessment System (PPAS). External reviewers' report of the consultants' meeting on analytical quality control services

    International Nuclear Information System (INIS)

    2001-01-01

    In reviewing the recommendations of previous Consultants' Meetings concerning the AQCS program, it is apparent that there has been a clear and consistent agreement on what the objectives of the AQCS activities should be. The mission statement as given in the Agency's 'Blue Book 1997-1998' states 'To assist analytical laboratories in Member States in maintaining/improving the quality of their analytical measurements, to achieve internationally acceptable levels of quality assurance and to develop and supply appropriate reference standards to achieve these objectives'. In concert with this mission statement, the consultants have endorsed an elaboration of these objectives for both the Agency' s laboratories and Member State laboratories as outlined in the 1994 Consultants' Report (KONA, HI, USA) which includes: the improvement of the reliability of results for the intended purposes; the enhancement of the comparability of results from one measurement laboratory to another; the attainment of compatibility of results in physical and chemical sciences with specific coverage of international standards for food and agriculture, human health, environment, industry, earth sciences, radiation safety, and safeguards activities; the demonstration of quality measurement systems sufficient for laboratory/analyst accreditation or acceptance, and; the establishment of traceability of radioactivity measurements and chemical analyses to the international SI system of measurements

  8. Municipal consultation key to understanding haul road maintenance agreements for Saskatchewan rural municipalities

    International Nuclear Information System (INIS)

    Leibel, R.E.A.

    1998-01-01

    Current municipal perspectives regarding the oil and gas industry in Saskatchewan were described. Municipal jurisdiction and authority regarding road development and heavy haul road maintenance agreements were defined. Based on actual work experience, collaborative working relationships between the oil and gas industry and the municipal sector is well worth some industry time and effort since it will result in cost savings for the industry. In general, rural municipalities receive very limited tax benefits to recapture the costs of road reconstruction and maintenance caused by heavy industry traffic. Road servicing costs can be recaptured only if companies respect the weight limits, hauling regulations and road bans. On the whole, municipalities in Saskatchewan are favourably disposed towards the oil and gas industry, and have done well in the past to accommodate industry's needs. It is not unreasonable therefore to expect that industry show sensitivity to the impact of its activities on the local municipality, and does its level best to be on good terms with the municipalities through early two-way communication. Text of some relevant acts of the Legislature respecting the powers and authorities of rural municipalities are appended

  9. Consultant-based otolaryngology emergency service: a five-year experience.

    Science.gov (United States)

    Barnes, M L; Hussain, S S M

    2011-12-01

    To present our experience of running a consultant-based otolaryngology emergency care service for more than five years. In 2003, we developed a system of consultant-based emergency service: consultants spent a week on-call providing a dedicated emergency service, with routine commitments cancelled. Our new system had advantages over traditional working practices in terms of consultant involvement, trainee education, continuity and efficiency. It also reduced disruption to elective commitments for both consultants and registrars. This system was fundamental to the successful review of all urgent (and in future elective) cases within target periods. Only 31 per cent of new referrals to the consultant emergency clinics required a further appointment. Good teamwork and flexibility in working arrangements have been essential to the success of this service. Given that health service changes have reduced junior trainee working hours and numbers, and that patients increasingly expect to be treated by trained doctors, our new consultant-based emergency service has merit. Although implementation in other units may differ, we recommend this new service, for the above reasons.

  10. USING H.264/AVC-INTRA FOR DCT BASED SEGMENTATION DRIVEN COMPOUND IMAGE COMPRESSION

    Directory of Open Access Journals (Sweden)

    S. Ebenezer Juliet

    2011-08-01

    Full Text Available This paper presents a one pass block classification algorithm for efficient coding of compound images which consists of multimedia elements like text, graphics and natural images. The objective is to minimize the loss of visual quality of text during compression by separating text information which needs high special resolution than the pictures and background. It segments computer screen images into text/graphics and picture/background classes based on DCT energy in each 4x4 block, and then compresses both text/graphics pixels and picture/background blocks by H.264/AVC with variable quantization parameter. Experimental results show that the single H.264/AVC-INTRA coder with variable quantization outperforms single coders such as JPEG, JPEG-2000 for compound images. Also the proposed method improves the PSNR value significantly than standard JPEG, JPEG-2000 and while keeping competitive compression ratios.

  11. The guideline "consultation psychiatry" of the Netherlands Psychiatric Association

    NARCIS (Netherlands)

    Leentjens, A.F.G.; Boenink, A.D.; Sno, H.N.; Strack van Schijndel, R.J.M.; Croonenborg, van J.J.; Everdingen, van J.J.E.; Feltz - Cornelis, van der C.M.; Laan, van der S.; Marwijk, van H.W.J.; Os, T.W.D.P. Van

    2009-01-01

    Background: In 2008, the Netherlands Psychiatric Association authorized a guideline "consultation psychiatry." Aim: To set a standard for psychiatric consultations in nonpsychiatric settings. The main objective of the guideline is to answer three questions: Is psychiatric consultation effective and,

  12. 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)

  13. Public Consultation toward Ethiopia's Family Law Reform ...

    African Journals Online (AJOL)

    Mandefrot Belay

    A comprehensive and open public consultation was conducted during the revision ... in Ethiopia which are expected to guide any legal reform process so that the ... law, the way in which public consultation forums were organized, and the ...

  14. 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

  15. Feedback as a means to improve clinical competencies: Consultants ...

    African Journals Online (AJOL)

    Background. Effective supervision by consultants in postgraduate medical education involves the process of feedback. Giving feedback may be challenging for consultants who have no formal training in this process, which may be further compounded in heterogeneous diverse settings. Objective. To explore consultants' ...

  16. WhatsApp Messenger is useful and reproducible in the assessment of tibial plateau fractures: inter- and intra-observer agreement study.

    Science.gov (United States)

    Giordano, Vincenzo; Koch, Hilton Augusto; Mendes, Carlos Henrique; Bergamin, André; de Souza, Felipe Serrão; do Amaral, Ney Pecegueiro

    2015-02-01

    The aim of this study was to evaluate the inter- and intra-observer agreement in the initial diagnosis and classification by means of plain radiographs and CT scans of tibial plateau fractures photographed and sent via WhatsApp Messenger. The increasing popularity of smartphones has driven the development of technology for data transmission and imaging and generated a growing interest in the use of these devices as diagnostic tools. The emergence of WhatsApp Messenger technology, which is available for various platforms used by smartphones, has led to an improvement in the quality and resolution of images sent and received. The images (plain radiographs and CT scans) were obtained from 13 cases of tibial plateau fractures using the iPhone 5 (Apple Inc., Cupertino, CA, USA) and were sent to six observers via the WhatsApp Messenger application. The observers were asked to determine the standard deviation and type of injury, the classification according to the Schatzker and the Luo classifications schemes, and whether the CT scan changed the classification. The six observers independently assessed the images on two separate occasions, 15 days apart. The inter- and intra-observer agreement for both periods of the study ranged from excellent to perfect (0.75WhatsApp Messenger. The authors now propose the systematic use of the application to facilitate faster documentation and obtaining the opinion of an experienced consultant when not on call. Finally, we think the use of the WhatsApp Messenger as an adjuvant tool could be broadened to other clinical centres to assess its viability in other skeletal and non-skeletal trauma situations. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  17. Energy consultancy in the year 2000

    International Nuclear Information System (INIS)

    Loeve, M.J.

    1998-01-01

    Liberalisation of the energy markets, shifting emphasis from energy carriers to energy products, improving insights in the areas of saving energy and energy efficiency, changes in the company itself. These are the developments which will continue to influence the profession of energy consultant, according to the author. A brief impression is given of what the energy consultant can do in the year 2000

  18. Submillimeter and microwave residual losses in epitaxial films of Y-Ba-Cu-O and Tl-Ca-Ba-Cu-O

    International Nuclear Information System (INIS)

    Miller, D.; Richards, P.L.; Eom, C.B.; Geballe, T.H.; Etemad, S.; Inam, A.; Venkatesan, T.; Martens, J.S.; Lee, W.Y.

    1992-12-01

    We have used a novel bolometric technique and a resonant technique to obtain accurate submillimeter and microwave residual loss data for epitaxial thin films of YBa 2 Cu 3 O 7 , Tl 2 Ca 2 Ba 2 Cu 3 O 10 and Tl 2 CaBa 2 Cu 2 O 8 . For all films we obtain good agreement between the submillimeter and microwave data, with the residual losses in both the Y-Ba-Cu-O and Tl-Ca-Ba-Cu-O films scaling approximately as frequency squared below ∼ 1 THz. We are able to fit the losses in the Y-Ba-Cu-O films to a two fluid and a weakly coupled grain model for the a-b planeconductivity, in good agreement with results from a Kramers-Kronig analysis of the loss data

  19. Energy saving consulting in Hamburg

    Energy Technology Data Exchange (ETDEWEB)

    1982-10-01

    For anyone who wants to realise the dream of his own house, the terms of thermal insulation and saving heating plant should be central in planning this. One needs advice from experts for this. A survey of the many consultants offices available in Hamburg is provided. The list was compiled with the assistance of the Hamburg Chamber of Commerce and the Hamburg Trades Council and of professional associations. The information on the special fields of activity of the named consultants is based on their statements.

  20. 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...

  1. 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

  2. 14 CFR 413.5 - Pre-application consultation.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Pre-application consultation. 413.5 Section 413.5 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION LICENSING LICENSE APPLICATION PROCEDURES § 413.5 Pre-application consultation. A...

  3. 25 CFR 26.4 - Who administers the Job Placement and Training Program?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Who administers the Job Placement and Training Program... PLACEMENT AND TRAINING PROGRAM General Applicability § 26.4 Who administers the Job Placement and Training Program? The Job Placement and Training Program is administered by the Bureau of Indian Affairs or a...

  4. Economic Evaluation of Pediatric Telemedicine Consultations to Rural Emergency Departments.

    Science.gov (United States)

    Yang, Nikki H; Dharmar, Madan; Yoo, Byung-Kwang; Leigh, J Paul; Kuppermann, Nathan; Romano, Patrick S; Nesbitt, Thomas S; Marcin, James P

    2015-08-01

    Comprehensive economic evaluations have not been conducted on telemedicine consultations to children in rural emergency departments (EDs). We conducted an economic evaluation to estimate the cost, effectiveness, and return on investment (ROI) of telemedicine consultations provided to health care providers of acutely ill and injured children in rural EDs compared with telephone consultations from a health care payer prospective. We built a decision model with parameters from primary programmatic data, national data, and the literature. We performed a base-case cost-effectiveness analysis (CEA), a probabilistic CEA with Monte Carlo simulation, and ROI estimation when CEA suggested cost-saving. The CEA was based on program effectiveness, derived from transfer decisions following telemedicine and telephone consultations. The average cost for a telemedicine consultation was $3641 per child/ED/year in 2013 US dollars. Telemedicine consultations resulted in 31% fewer patient transfers compared with telephone consultations and a cost reduction of $4662 per child/ED/year. Our probabilistic CEA demonstrated telemedicine consultations were less costly than telephone consultations in 57% of simulation iterations. The ROI was calculated to be 1.28 ($4662/$3641) from the base-case analysis and estimated to be 1.96 from the probabilistic analysis, suggesting a $1.96 return for each dollar invested in telemedicine. Treating 10 acutely ill and injured children at each rural ED with telemedicine resulted in an annual cost-savings of $46,620 per ED. Telephone and telemedicine consultations were not randomly assigned, potentially resulting in biased results. From a health care payer perspective, telemedicine consultations to health care providers of acutely ill and injured children presenting to rural EDs are cost-saving (base-case and more than half of Monte Carlo simulation iterations) or cost-effective compared with telephone consultations. © The Author(s) 2015.

  5. Impact of a national specialty e-consultation implementation project on access.

    Science.gov (United States)

    Kirsh, Susan; Carey, Evan; Aron, Dacid C; Cardenas, Omar; Graham, Glenn; Jain, Rajiv; Au, David H; Tseng, Chin-Lin; Franklin, Heather; Ho, P Michael

    2015-12-01

    To assess the early impact of implementation of the electronic consults (e-consults) initiative by the Veterans Health Administration (VHA), designed to improve specialty care access. Observational cohort study exploiting a natural experiment begun in May 2011 at 12 VHA medical centers and expanded to 122 medical centers by December 2013. The following were assessed: 1) growth of e-consults by VHA regional networks, medical centers, and specialty; 2) location of patient's primary care provider (medical center vs community-based outpatient clinic [CBOC]); 3) potential patient miles needed to travel for a specialty care face-to-face consult in place of the observed e-consults using estimated geodesic distance; 4) use of specialty care subsequent to the e-consult. Of 11,270,638 consults completed in 13 clinics of interest, 217,014 were e-consults (adjusted rate, 1.93 e-consults per 100 consults). The e-consult rate was highest in endocrinology (5.0 per 100), hematology (3.0 per 100), and gastroenterology (3.0 per 100). The percentage of e-consult patients with CBOC-based primary care grew from 28.5% to 44.4% in the first year of implementation and to 45.6% at year 3. Of those e-consult patients from community clinics, the average potential miles needed to travel was 72.1 miles per patient (SD = 72.6; median = 54.6; interquartile range = 17.1-108), translating to a potential savings of 6,875,631 total miles and travel reimbursement costs of $2,853,387. E-consult volume increased significantly since inception within many medical and surgical specialties. For patients receiving primary care at one of more than 800 CBOCs, e-consults may decrease travel burden and direct travel costs for patients.

  6. Capturing the competence of management consulting work

    NARCIS (Netherlands)

    Visscher, Klaasjan

    2006-01-01

    Purpose: The purpose of this article is to assess whether the effort of consulting firms and branch organizations to establish a shared and standardized methodology as a means to professionalize consulting and as a standard for training is possible and sensible. - Design/methodology/approach: A

  7. The preoperative cardiology consultation: indications and risk modification.

    Science.gov (United States)

    Groot, M W; Spronk, A; Hoeks, S E; Stolker, R J; van Lier, F

    2017-11-01

    The cardiologist is regularly consulted preoperatively by anaesthesiologists. However, insights into the efficiency and usefulness of these consultations are unclear. This is a retrospective study of 24,174 preoperatively screened patients ≥18 years scheduled for elective non-cardiac surgery, which resulted in 273 (1%) referrals to the cardiologist for further preoperative evaluation. Medical charts were reviewed for patient characteristics, main reason for referring, requested diagnostic tests, interventions, adjustment in medical therapy, 30-day mortality and major adverse cardiac events. The most common reason for consultation was the evaluation of a cardiac murmur (95 patients, 35%). In 167 (61%) patients, no change in therapy was initiated by the cardiologist. Six consultations (2%) led to invasive interventions (electrical cardioversion, percutaneous coronary intervention or coronary artery bypass surgery). On average, consultation delayed clearance for surgery by two weeks. In most patients referred to the cardiologist after being screened at an outpatient anaesthesiology clinic, echocardiography is performed for ruling out specific conditions and to be sure that no further improvement can be made in the patient's health. In the majority, no change in therapy was initiated by the cardiologist. A more careful consideration about the potential benefits of consulting must be made for every patient.

  8. Working with boundaries in systems psychodynamic consulting

    Directory of Open Access Journals (Sweden)

    Henk Struwig

    2012-03-01

    Research purpose: The purpose of the research was to produce a set of theoretical assumptions about organisational boundaries and boundary management in organisations and, from these, to develop a set of hypotheses as a thinking framework for practising consulting psychologists when they work with boundaries from a systems psychodynamic stance. Motivation for the study: The researcher used the belief that organisational boundaries reflect the essence of organisations. Consulting to boundary managers could facilitate a deep understanding of organisational dynamics. Research design, approach and method: The researcher followed a case study design. He used systems psychodynamic discourse analysis. It led to six working hypotheses. Main findings: The primary task of boundary management is to hold the polarities of integration and differentiation and not allow the system to become fragmented or overly integrated. Boundary management is a primary task and an ongoing activity of entire organisations. Practical/managerial implications: Organisations should work actively at effective boundary management and at balancing integration and differentiation. Leaders should become aware of how effective boundary management leads to good holding environments that, in turn, lead to containing difficult emotions in organisations. Contribution/value-add: The researcher provided a boundary-consulting framework in order to assist consultants to balance the conceptual with the practical when they consult.

  9. Identifying challenges in project consultants engagement practices

    Science.gov (United States)

    Shariffuddin, Nadia Alina Amir; Abidin, Nazirah Zainul

    2017-10-01

    Construction projects, green or conventional, involve multi-faceted disciplines engaged with the goal of delivering products i.e. building, infrastructure etc. at the best quality within stipulated budgets. For green projects, additional attention is added for environmental quality. Due to the various responsibilities and liabilities involved as well as the complexity of the construction process itself, formal engagement of multi-disciplinary professionals i.e. project consultants is required in any construction project. Poor selection of project consultants will lead to a multitude of complications resulting in delay, cost escalation, conflicts and poor quality. This paper explores the challenges that occur during the engagement of project consultants in a green project. As the engagement decision involves developers and architects, these two groups of respondents with green project backgrounds were approached qualitatively using interview technique. The challenges identified are limited experience and knowledge, consultants' fee vs. quality, green complexity, conflicts of interest, clients' extended expectation and less demand in green projects. The construction shifts to green project demands engagement of project consultants with added skills. It is expected that through the identification of challenges, better management and administration can be created which would give impact to the overall process of engagement in green projects.

  10. Impact of Diabetes E-Consults on Outpatient Clinic Workflow.

    Science.gov (United States)

    Zoll, Brian; Parikh, Pratik J; Gallimore, Jennie; Harrell, Stephen; Burke, Brian

    2015-08-01

    An e-consult is an electronic communication system between clinicians, usually a primary care physician (PCP) and a medical or surgical specialist, regarding general or patient-specific, low complexity questions that would not need an in-person consultation. The objectives of this study were to understand and quantify the impact of the e-consult initiative on outpatient clinic workflow and outcomes. We collected data from 5 different Veterans Affairs (VA) outpatient clinics and interviewed several physicians and staff members. We then developed a simulation model for a primary care team at an outpatient clinic. A detailed experimental study was conducted to determine the effects of factors, such as e-consult demand, view-alert notification arrivals, walk-in patient arrivals, and PCP unavailability, on e-consult cycle time. Statistical tests indicated that 4 factors related to outpatient clinic workflow were significant, and levels within each of the 4 significant factors resulted in statistically different e-consult cycle times. The arrival rate of electronic notifications, along with patient walk-ins, had a considerable effect on cycle time. Splitting the workload of an unavailable PCP among the other PCPs, instead of the current practice of allocating it to a single PCP, increases the system's ability to handle a much larger e-consult demand. The full potential of e-consults can only be realized if the workflow at the outpatient clinics is designed or modified to support this initiative. This study furthers our understanding of how e-consult systems can be analyzed and alternative workflows tested using statistical and simulation modeling to improve care delivery and outcomes. © The Author(s) 2014.

  11. SOME REFLECTIONS UPON MANAGEMENT CONSULTING AS PROFESSIONAL SERVICES

    OpenAIRE

    Tomescu Ada; Botezat Elena

    2008-01-01

    Management consulting helping organizations improve their performance, primarily through the thorough analysis of existing business problems and development of plans for improvement. There is probably no activity about which the opinions are so divided as management consulting. The purpose of this paper is to make some reflections upon what role play the consulting management services as professional service to the firms and how offering these services affects the offering and delivery of oth...

  12. 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...

  13. Suppression of the lipopolysaccharide-induced expression of MARCKS-related protein (MRP) affects transmigration in activated RAW264.7 cells.

    Science.gov (United States)

    Chun, Kwang-Rok; Bae, Eun Mi; Kim, Jae-Kwan; Suk, Kyoungho; Lee, Won-Ha

    2009-01-01

    The molecular action mechanism of MRP, one of the protein kinase C (PKC) substrates, has been under intense investigation, but reports on its role in macrophage function remain controversial. The treatment of macrophage cell lines with bacterial lipopolysaccharide (LPS) induced a high level of MRP expression suggesting that MRP plays a role in the function of activated macrophages. In order to investigate the role of MRP in activated RAW264.7 cells, we stably transfected MRP-specific shRNA expression constructs and tested for alterations in macrophage-related functions. The down-regulation of MRP expression resulted in a marked reduction in chemotaxis toward MCP-1 or extracellular matrix proteins. Furthermore, pharmacological inhibitors of PKC significantly inhibited the chemotaxis in RAW264.7 cells. These data reveals the pivotal role of MRP in the transmigration of activated RAW264.7 cells.

  14. Crisis Communication Consultation of the Federal Reserve Bank System

    Science.gov (United States)

    Chandler, Robert C.; Wallace, J. D.

    2008-01-01

    This article, designed for both consulting practitioners and academics, reveals what it is like to do a high-level and high-profile client consultancy. This consultancy was highly informed by and assumes a working knowledge of instructional communication theory, research, and methods as well as drawing upon contemporary communication scholarship…

  15. Effect of Egg White Combined with Chalcanthite on Lipopolysaccharide induced Inflammatory Cytokine Expression in RAW 264.7 cells

    Directory of Open Access Journals (Sweden)

    Choi Eun-A

    2012-03-01

    Full Text Available Historically, mineral compound herbal medicines have long been used in treatments of immune-related diseases in Korea, China and other Asian countries. In this study, we inv-estigated the anti-inflammatory effect of egg white combined with chalcanthite (IS4 on lipopolysaccharide (LPS-stimulated RAW 264.7 cells. RAW 264.7 cells cultured with LPS and various con-centrations of IS4 were analyzed to determine the production of pro-inflammatory cytokines and mediators by using enzyme-linked immune sorbent assays (ELISAs. IS4 concentration inhibited the production of interleukin-1beta (IL-1β, interleukin-6 (IL-6, and granulocyte-macrophage colony-stimulating factor (GM-CSF induced by LPS. IS4 at high concentrations (25 and 50`㎍/ml inhibited, in concentration-dependent manner, the expression of tumor necrosis factor-alpha (TNF–α stimulated by LPS. IS4 has shown an anti-inflammatory effect in RAW 264.7 cells.

  16. An evaluation of the effect of JPEG, JPEG2000, and H.264/AVC on CQR codes decoding process

    Science.gov (United States)

    Vizcarra Melgar, Max E.; Farias, Mylène C. Q.; Zaghetto, Alexandre

    2015-02-01

    This paper presents a binarymatrix code based on QR Code (Quick Response Code), denoted as CQR Code (Colored Quick Response Code), and evaluates the effect of JPEG, JPEG2000 and H.264/AVC compression on the decoding process. The proposed CQR Code has three additional colors (red, green and blue), what enables twice as much storage capacity when compared to the traditional black and white QR Code. Using the Reed-Solomon error-correcting code, the CQR Code model has a theoretical correction capability of 38.41%. The goal of this paper is to evaluate the effect that degradations inserted by common image compression algorithms have on the decoding process. Results show that a successful decoding process can be achieved for compression rates up to 0.3877 bits/pixel, 0.1093 bits/pixel and 0.3808 bits/pixel for JPEG, JPEG2000 and H.264/AVC formats, respectively. The algorithm that presents the best performance is the H.264/AVC, followed by the JPEG2000, and JPEG.

  17. 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.

  18. 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...

  19. Lessons Learned from a Consultation Process Overseas

    Science.gov (United States)

    Merino-Soto, César

    2014-01-01

    In this commentary I discuss three international school consultation experiences, highlighting aspects that serve as lessons for professional development and the implementation of effective and helpful strategies that meet the needs of children and youth in school systems. Relationships developed and maintained between the consulting teams and the…

  20. Therapists’ Perspectives on the Effective Elements of Consultation Following Training

    OpenAIRE

    Beidas, Rinad S.; Edmunds, Julie M.; Cannuscio, Carolyn C.; Gallagher, Mark; Downey, Margaret Mary; Kendall, Philip C.

    2013-01-01

    Consultation is an effective implementation strategy to improve uptake of evidence-based practices for youth. However, little is known about what makes consultation effective. The present study used qualitative methods to explore therapists’ perspectives about consultation. We interviewed 50 therapists who had been trained 2 years prior in cognitive-behavioral therapy for child anxiety. Three themes emerged regarding effective elements of consultation: (1) connectedness with other therapists ...

  1. Development of a Remote Consultation System Using Avatar Technology

    Science.gov (United States)

    Ohnishi, Tatsuya; Yajima, Hiroshi; Sawamoto, Jun

    The chance to use the Internet as a communications tool has been increasing, and the consultation businesses for customers at remote places are diversifying in their communication media and forms. In the remote consultation, the lack of non-verbal information is reported as one of the reasons for inefficiency and customer's dissatisfaction compared with the face-to-face consultation. The technique for supplementing non-verbal information with a TV telephone is proposed, and helps to confirm understanding degree or the utterance timing by watching the movement of the face. But the displayed face of the partner causes strong feeling of strain between strangers and the participants also care about background scene displayed on the monitor producing risks in the consultation tasks. In this paper, we propose a remote consultation method that uses avatar technology in the virtual space in order to provide non-verbal information and also avoiding the problem of TV telephone at the same time. The effectiveness of the proposed remote consultation method is confirmed by experiments.

  2. 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

  3. Consultation: Creating School-Based Interventions. Second Edition.

    Science.gov (United States)

    Dinkmeyer, Don, Jr.; Carlson, Jon

    Decades after consultation has become a mandated function of school counselors, consultants still seek effective ways to deliver this essential role. This book, geared towards mental health professionals, provides a set of skills for working with the school-based population. The ideas, based on Adlerian psychology, present a theory of consultation…

  4. 29 CFR 1903.10 - Consultation with employees.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 5 2010-07-01 2010-07-01 false Consultation with employees. 1903.10 Section 1903.10 Labor... INSPECTIONS, CITATIONS AND PROPOSED PENALTIES § 1903.10 Consultation with employees. Compliance Safety and... extent they deem necessary for the conduct of an effective and thorough inspection. During the course of...

  5. Expectation Levels in Dictionary Consultation and Compilation ...

    African Journals Online (AJOL)

    Dictionary consultation and compilation is a two-way engagement between two parties, namely a dictionary user and a lexicographer. How well users cope with looking up words in a Bantu language dictionary and to what extent their expectations are met, depends on their consultation skills, their knowledge of the structure ...

  6. 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.

  7. Mechanochemical synthesis of CaMoO{sub 4} nanoparticles. Kinetics and characterization

    Energy Technology Data Exchange (ETDEWEB)

    Hoseinpur, Arman [Ferdowsi University of Mashhad (Iran, Islamic Republic of). Energy Storage Dept.; Ferdowsi University of Mashhad (Iran, Islamic Republic of). Dept. of Materials Engineering; Bezanaj, Malihe Mohammadi; Khaki, Jalil Vahdati [Ferdowsi University of Mashhad (Iran, Islamic Republic of). Dept. of Materials Engineering

    2016-10-15

    This research introduces the mechanosynthesis process for CaMoO{sub 4} nanoparticles by using MoO{sub 3} and CaO as initial reactants. An empirical model was developed to describe the kinetics of the reaction. X-ray diffraction was used at each step of the milling to evaluate the developed model. The experimental data and the results from the model are in good agreement. The synthesized powders in this research were characterized using X-ray diffraction, electron microscopy, dynamic laser scattering, and photoluminescence spectroscopy techniques. Photoluminescence characterizations revealed that the synthesized CaMoO{sub 4} generated two photoluminescence emissions, at 377 nm (violet) and 515 nm (green). It was also observed that further milling of the synthesized powders changed the photoluminescence properties of the product. After 12 h of milling, the synthesized CaMoO{sub 4} generated a novel photoluminescence emission at 564 nm. The results of this research indicate that mechanical milling can be employed to control the photoluminescent properties of CaMoO{sub 4}.

  8. MED5/355: Using Web-technology for Asynchronous Telemedicine Consulting

    OpenAIRE

    Reviakin, Y; Sukhanov, A

    1999-01-01

    Introduction Common telemedicine consultations can be divided in two classes: real-time telemedicine consultations and asynchronous telemedicine consultations. The advantage of real-time consultations is obvious - this is a natural discussion between physicians, which may be realised on the basis of desktop videoconferences. But the problems are also obvious: the necessity of additional hardware and the elevated demands for channel bandwidth. Because of the latter, the use of asynchronous tel...

  9. Low-complexity transcoding algorithm from H.264/AVC to SVC using data mining

    Science.gov (United States)

    Garrido-Cantos, Rosario; De Cock, Jan; Martínez, Jose Luis; Van Leuven, Sebastian; Cuenca, Pedro; Garrido, Antonio

    2013-12-01

    Nowadays, networks and terminals with diverse characteristics of bandwidth and capabilities coexist. To ensure a good quality of experience, this diverse environment demands adaptability of the video stream. In general, video contents are compressed to save storage capacity and to reduce the bandwidth required for its transmission. Therefore, if these compressed video streams were compressed using scalable video coding schemes, they would be able to adapt to those heterogeneous networks and a wide range of terminals. Since the majority of the multimedia contents are compressed using H.264/AVC, they cannot benefit from that scalability. This paper proposes a low-complexity algorithm to convert an H.264/AVC bitstream without scalability to scalable bitstreams with temporal scalability in baseline and main profiles by accelerating the mode decision task of the scalable video coding encoding stage using machine learning tools. The results show that when our technique is applied, the complexity is reduced by 87% while maintaining coding efficiency.

  10. 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

  11. [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.

  12. An empirical study of multidimensional fidelity of COMPASS consultation.

    Science.gov (United States)

    Wong, Venus; Ruble, Lisa A; McGrew, John H; Yu, Yue

    2018-06-01

    Consultation is essential to the daily practice of school psychologists (National Association of School Psychologist, 2010). Successful consultation requires fidelity at both the consultant (implementation) and consultee (intervention) levels. We applied a multidimensional, multilevel conception of fidelity (Dunst, Trivette, & Raab, 2013) to a consultative intervention called the Collaborative Model for Promoting Competence and Success (COMPASS) for students with autism. The study provided 3 main findings. First, multidimensional, multilevel fidelity is a stable construct and increases over time with consultation support. Second, mediation analyses revealed that implementation-level fidelity components had distant, indirect effects on student Individualized Education Program (IEP) outcomes. Third, 3 fidelity components correlated with IEP outcomes: teacher coaching responsiveness at the implementation level, and teacher quality of delivery and student responsiveness at the intervention levels. Implications and future directions are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  13. An integrated occupational hygiene consultation model for the catering industry.

    Science.gov (United States)

    Lin, Yi-Kuei; Lee, Lien-Hsiung

    2010-07-01

    Vegetable oil used in food processing, during high-temperature exposure, will generate particulate matter (PM) and polycyclic aromatic hydrocarbons (PAHs), which are carcinogenic chemical compounds, with the potential to cause lung disease for restaurant kitchen staff. This study's design includes a three-stage consultation process with eight major consultation items, in order to build an integrated consultation model for occupational hygiene. This model combines inspection and consultation, targeting Chinese restaurants in the catering industry. Characteristics of the integrated consultation model include cooperation between different government departments and collaboration with nongovernmental, professional consulting organizations. An additional benefit of the model is the building of a good partnership relationship with the Catering Trade Association. The consultation model helps Chinese restaurants attain improvements in their work environments with minimal investment. Postconsultation, results show a 63.35% and 61.98% (P < 0.001) decrease in the mean time-weighted concentration of exposure to PM and PAHs, respectively. The overall regulation compliance rate of Chinese restaurants significantly increased from 34.3% to 89.6%. These results show that the integrated consultation model for occupational hygiene not only helps small and medium enterprises reduce exposure concentrations in the workplace but also has specific potential for successful implementation in Taiwan.

  14. [Motivations for a consultation before adoption: A multicenter study].

    Science.gov (United States)

    Thieblemont, M; Francois, P; Poirier, V; Bosdure, E; Munck, M-R; Borsa-Dorion, A; Hazart, I; Moukagni-Pelzer, M; Brunel, D; Peyron, F; de Monleon, J-V

    2016-01-01

    While the number of international adoptions in France is decreasing, adopted children are older and in poorer health than they used to be. This phenomenon has resulted in an increase in the demand for preadoption consultations over the past several years. This study analyses the reasons for these consultations. Prospective multicenter study conducted from 1 January to 31 December 2013. Ten centers contributed to the study, i.e., 196 preadoption consultations. Seeking medical advice was the reason for 88% of the consultations, whether the advice was based on the study of an identified child's medical file (32%) or a country's healthcare characteristics, whether the country was identified (34%) or not (23%). In 6% of cases, the motive for preadoption consultations was social and familial, and in the last 5% it was to obtain general information about adoption and its procedures. In more than 40% of the cases, whether the child or the country identified, Russia is the subject of the consultation because of the complexity of the files and because of the dreaded but rarely mentioned fetal alcohol syndrome. The deterioration of adopted children's health is an additional worry for future adoption applicants. To provide them with the best information possible without making choices for them, specialists should have substantial experience in adoption before going into these preadoption consultations. Copyright © 2015. Published by Elsevier SAS.

  15. Neglected ends: clinical ethics consultation and the prospects for closure.

    Science.gov (United States)

    Fiester, Autumn

    2015-01-01

    Clinical ethics consultations (CECs) are sometimes deemed complete at the moment when the consultants make a recommendation. In CECs that involve actual ethical conflict, this view of a consult's endpoint runs the risk of overemphasizing the conflict's resolution at the expense of the consult's process, which can have deleterious effects on the various parties in the conflict. This overly narrow focus on reaching a decision or recommendation in consults that involve profound moral disagreement can result in two types of adverse, lingering sequelae: moral distress or negative moral emotions. The problem, succinctly named, is that such consults have insufficient "closure" for patients, families, and providers. To promote closure, and avoid the ills of moral distress and the moral emotions, I argue that CECs need to prioritize assisted conversation between the different stakeholders in these conflicts, what is often referred to as "bioethics mediation."

  16. The Next Frontier in Family Business: Career Consulting.

    Science.gov (United States)

    Haid, Richard L.

    1995-01-01

    Offers guidelines for being a consultant to family businesses' chief executive officers (CEOs). The consultant can make it easier for these CEOs to step down and complete an often painful but unavoidable transition. (Author/JOW)

  17. Building Interpersonal Relationships as a Key to Effective Speaking Center Consultations

    Science.gov (United States)

    Ward, Kiya; Schwartzman, Roy

    2009-01-01

    Although much interest has been generated regarding the functions speaking centers serve and the effects consultations can have, minimal research has addressed the dynamics of consultations themselves. This study documents what speaking center clients and consultants identify as barriers in consultations and how they address them. Analysis of…

  18. A Review of Gerald Caplan's "Theory and Practice of Mental Health Consultation."

    Science.gov (United States)

    Mendoza, Danielle W.

    1993-01-01

    Reviews Caplan's "Theory and Practice of Mental Health Consultation" (1970), considered classic seminal work in field of consultation. Presents Caplan's general definition of consultation and general principles or procedures of consultation. Describes each of Caplan's four models of consultation and compares models in terms of professional role of…

  19. One-hole states in nuclei of 41K, 41Ca and 41Sc

    International Nuclear Information System (INIS)

    Kim, Moon Won

    1985-01-01

    The one-hole states in nuclei of 41 K, 41 Ca and 41 Sc have been calculated with a model space based on the (1f 7/2 ,2P 3/2 ) 2 (1d 3/2 , 2S 1/2 ) -1 configuration using the nuclear shell model. The two body effective interaction is assumed to be a surface-delta potential. 40 Ca is also assumed to be an inert core. Energy spectra and spectroscopic factors are obtained and compared with the experimental data. The calculate results in fair agreement with the observed values. (Author)

  20. Characterization of CYP264B1 and a terpene cyclase of a terpene biosynthesis gene cluster from the myxobacterium Sorangium cellulosum So ce56

    OpenAIRE

    Ly, Thuy Thi Bich

    2011-01-01

    In the work presented here, CYP264B1 and the terpene cyclase GeoA of Sorangium cellulosum So ce56 have been characterized. CYP264B1 is able to convert norisoprenoids (a-ionone and b-ionone) and diverse sesquiterpene compounds, including nootkatone. Three products, 3-hydroxy-a-ionone, 3-hydroxy-b-ionone and 13-hydroxy-nootkatone were characterized using HPLC and 1H and 13C NMR. CYP264B1 is the first enzyme reported to be capable to hydroxylate regioselectively both norisoprenoids at the positi...

  1. Ubiquitous consultation tool for decentral knowledge workers

    OpenAIRE

    Nazari Shirehjini, A.A.; Rühl, C.; Noll, S.

    2003-01-01

    The special issue of this initial study is to examine the current work situation of consulting companies, and to elaborate a concept for supporting decentralized working consultants. The concept addresses significant challenges of decentralized work processes by deploying the Peer-to-Peer methodology to decentralized expert and Knowledge Management, cooperation, and enterprise resource planning.

  2. Interventions before consultations for helping patients address their information needs.

    Science.gov (United States)

    Kinnersley, P; Edwards, A; Hood, K; Cadbury, N; Ryan, R; Prout, H; Owen, D; Macbeth, F; Butow, P; Butler, C

    2007-07-18

    Patients often do not get the information they require from doctors and nurses. To address this problem, interventions directed at patients to help them gather information in their healthcare consultations have been proposed and tested. To assess the effects on patients, clinicians and the healthcare system of interventions which are delivered before consultations, and which have been designed to help patients (and/or their representatives) address their information needs within consultations. We searched: the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library (issue 3 2006); MEDLINE (1966 to September 2006); EMBASE (1980 to September 2006); PsycINFO (1985 to September 2006); and other databases, with no language restriction. We also searched reference lists of articles and related reviews, and handsearched Patient Education and Counseling (1986 to September 2006). Randomised controlled trials of interventions before consultations designed to encourage question asking and information gathering by the patient. Two researchers assessed the search output independently to identify potentially-relevant studies, selected studies for inclusion, and extracted data. We conducted a narrative synthesis of the included trials, and meta-analyses of five outcomes. We identified 33 randomised controlled trials, from 6 countries and in a range of settings. A total of 8244 patients was randomised and entered into studies. The most common interventions were question checklists and patient coaching. Most interventions were delivered immediately before the consultations.Commonly-occurring outcomes were: question asking, patient participation, patient anxiety, knowledge, satisfaction and consultation length. A minority of studies showed positive effects for these outcomes. Meta-analyses, however, showed small and statistically significant increases for question asking (standardised mean difference (SMD) 0.27 (95% confidence interval (CI) 0.19 to 0.36)) and

  3. Low-magnitude high-frequency vibration inhibits RANKL-induced osteoclast differentiation of RAW264.7 cells.

    Science.gov (United States)

    Wu, Song-Hui; Zhong, Zhao-Ming; Chen, Jian-Ting

    2012-01-01

    Osteoclasts are the key participants in regulation of bone mass. Low-magnitude high-frequency vibration (LMHFV) has been found to be anabolic to bone in vivo. This study aimed to investigate the effect of LMHFV on osteoclast differentiation in vitro. Murine monocyte cell line RAW264.7 cells in the presence of receptor activator of nuclear factor-kappaB ligand (RANKL) were treated with or without LMHFV at 45 Hz (0.3 g) for 15 min day(-1). Tartrate resistant acid phosphatase (TRAP)-positive multinucleated cells (MNCs) and actin ring formation were evaluated. Expression of the osteoclast-specific genes, such as cathepsin K, matrix metallopeptidase-9 (MMP-9) and TRAP, were analyzed using real time-PCR. c-Fos, an osteoclast-specific transcription factor, was determined using Western blot. We found that LMHFV significantly decreased the number of RANKL-induced TRAP-positive MNCs (P<0.01), and inhibited the actin ring formation. The mRNA expression of the cathepsin K, MMP-9 and TRAP were down-regulated by LMHFV intervention (all P<0.001). Furthermore, LMHFV also inhibited the expression of c-Fos protein in the RANKL-treated RAW264.7 cells (P<0.05). Our results suggest that LMHFV can inhibit the RANKL-induced osteoclast differentiation of RAW264.7 cells, which give some new insight into the anabolic effects of LMHFV on bone.

  4. UPLC-MS/MS-Based Profiling of Eicosanoids in RAW264.7 Cells Treated with Lipopolysaccharide

    Directory of Open Access Journals (Sweden)

    Jae Won Lee

    2016-04-01

    Full Text Available While both the pro- and anti-inflammatory effects of several eicosanoids have been widely studied, the degree of inflammation in cells that results from various eicosanoids has yet to be comprehensively studied. The objective of this study was to assess the effect of lipopolysaccharide (LPS treatment on eicosanoid content in RAW264.7 cells. An Ultra performance liquid chromatography coupled to tandem mass spectrometry (UPLC-MS/MS-based profiling method was used to analyze the eicosanoid contents of RAW264.7 cells treated with different LPS concentrations. The profiling data were subjected to statistical analyses, such as principal component analysis (PCA and hierarchical clustering analysis. LPS treatment increased nitric oxide production and secretion of pro-inflammatory cytokines, such as tumor necrosis factor-α and interleukin-6, in a concentration-dependent manner. In total, 79 eicosanoids were identified in the cells. RAW264.7 cells treated with different LPS concentrations were well differentiated in the PCA score plot. A heatmap was used to identify the eicosanoids that were up- or down-regulated according to the degree of inflammation and LPS concentration. Thirty-nine eicosanoids were upregulated and seven were down-regulated by LPS treatment in a concentration-dependent manner. Our novel UPLC-MS/MS technique can profile eicosanoids, and can evaluate the correlations between inflammation and eicosanoid metabolism.

  5. The representations of adolescents about gynecological consultation

    Directory of Open Access Journals (Sweden)

    Vera Lúcia de Oliveira Gomes

    2014-06-01

    Full Text Available Objective: To analyze the social representation of adolescents about gynecological consultation and the influence of those in searching for consultations. Method: Qualitative descriptive study based on the Social Representations Theory, conducted with 50 adolescents in their last year of middle school. The data was collected between April and May of 2010 by Evocations and a Focal Group. The software EVOC and contextual analysis were used in the data treatment. Results: The elements fear and constraint, constant in the central nucleus, can justify the low frequency of adolescents in consultations. The term embarrassment in the peripheral system reinforce current sociocultural norms, while prevention, associated with learning about sex and clarifying doubts, allows to envision an educative function. Obtained testimonies in the focal groups exemplify and reinforce those findings. Conclusion: For an effective health education, professionals, including nurses, need to clarify the youth individually and collectively about their rights to privacy, secrecy, in addition to focus the gynecological consultation as a promotion measure to sexual and reproductive health.

  6. User Consultation Behaviour in Internet Dictionaries

    DEFF Research Database (Denmark)

    Simonsen, Henrik Køhler

    2011-01-01

    the participants looked, but also how they accessed lexicographic data. The paper presents a suitable method for using eye-tracking studies in Internet lexicography and advocates an increased use of this method to produce empirical data upon which additional theoretical considerations on the information and data......The purpose of this paper is to explore and discuss user consultation behaviour on the basis of eye-tracking data and interview data. To date the focus has been almost exclusively on the use of log files in Internet lexicography - an approach which is questioned in this article. The paper is based...... on empirical data from an exploratory eyetracking study of the user consultation behaviour of six participants and on interview data from a follow-up post-study interview of the participants. The paper elucidates and discusses the consultation behaviour in Internet lexicography and shows not only at what...

  7. Agreement between the Government of the Republic of Finland and the Government of Australia concerning the transfer of nuclear material between Finland and Australia

    International Nuclear Information System (INIS)

    1978-01-01

    This Agreement between two non-nuclear weapon States was signed on 20 July 1978 under the Non-proliferation Treaty. It lays down that nuclear material may only be transferred to a body duly authorised by the recipient Party's appropriate Governmental Authority; such material may not be used for nuclear weapons or diverted to military purposes and is subject to IAEA safeguards and physical protection measures. Provision is made for regular consultation between both Parties on effective implementation of the Agreement which will remain in force for 30 years. (NEA) [fr

  8. Mutual construction and reconstruction in client-consultant interaction

    DEFF Research Database (Denmark)

    Smith, Irene Skovgaard

    Based on preliminary interviews with client representatives and a pilot case study, the pa-per explores collaboration and mutual construction in client-consultant relationships. Both consultants and client actors take part in an active construction and reconstruction of knowledge that involve...... struggles over position, power and control. In the context of client-consultant interaction, it is thus not only ideas and solutions that are contested but also the power to define. Attention is paid to how ideas are brought into play and negotiated in the interaction between actors. The empirical material...... presented in the paper illustrates how consultancy projects evolve through processes of negotiation over whose interpretation should count and who should be in control. In the process, client actors with different posi-tions and interests play an active role in creating what become valid and what ideas...

  9. [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.

  10. 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...

  11. Business Communication Consulting and Research in Multinational Companies.

    Science.gov (United States)

    Hildebrandt, Herbert W.

    1978-01-01

    Describes three issues involved in communication research and consulting for multinational companies, particularly those in Germany: qualifications for doing international consulting and research, problems of American scholar-researchers in those firms, and suggestions for dealing with those issues. (JMF)

  12. 7 CFR 1951.264 - Action when borrower fails to cooperate, respond or graduate.

    Science.gov (United States)

    2010-01-01

    ... Analyzing Credit Needs and Graduation of Borrowers § 1951.264 Action when borrower fails to cooperate, respond or graduate. (a) When borrowers with other than FCP loans fail to: (1) Provide information... appeal the decision. (b) If an FCP borrower fails to cooperate after a lender expresses a willingness to...

  13. 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

    OpenAIRE

    Akobeng, Anthony K.; O'Leary, Neil; Vail, Andy; Brown, Nailah; Widiatmoko, Dono; Fagbemi, Andrew; Thomas, Adrian G.

    2015-01-01

    Background: Evidence for the use of telephone consultation in childhood inflammatory bowel disease (IBD) is lacking. We aimed to assess the effectiveness and cost consequences of telephone consultation compared with the usual out-patient face-to-face consultation for young people with IBD. Methods: We conducted a randomised-controlled trial in Manchester, UK, between July 12, 2010 and June 30, 2013. Young people (aged 8–16 years) with IBD were randomized to receive telephone consultation o...

  14. 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

  15. 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.

  16. The preoperative cardiology consultation: Indications and risk modification

    NARCIS (Netherlands)

    M.W. de Groot (Mark); A. Spronk (Angela); S.E. Hoeks (Sanne); R.J. Stolker (Robert); F. van Lier (Felix)

    2017-01-01

    textabstractBackground The cardiologist is regularly consulted preop-eratively by anaesthesiologists. However, insights into the efficiency and usefulness of these consultations are unclear. Methods This is a retrospective study of 24,174 preoperatively screened patients ≥18 years scheduled for

  17. A Novel Steganography Technique for SDTV-H.264/AVC Encoded Video

    Directory of Open Access Journals (Sweden)

    Christian Di Laura

    2016-01-01

    Full Text Available Today, eavesdropping is becoming a common issue in the rapidly growing digital network and has foreseen the need for secret communication channels embedded in digital media. In this paper, a novel steganography technique designed for Standard Definition Digital Television (SDTV H.264/AVC encoded video sequences is presented. The algorithm introduced here makes use of the compression properties of the Context Adaptive Variable Length Coding (CAVLC entropy encoder to achieve a low complexity and real-time inserting method. The chosen scheme hides the private message directly in the H.264/AVC bit stream by modifying the AC frequency quantized residual luminance coefficients of intrapredicted I-frames. In order to avoid error propagation in adjacent blocks, an interlaced embedding strategy is applied. Likewise, the steganography technique proposed allows self-detection of the hidden message at the target destination. The code source was implemented by mixing MATLAB 2010 b and Java development environments. Finally, experimental results have been assessed through objective and subjective quality measures and reveal that less visible artifacts are produced with the technique proposed by reaching PSNR values above 40.0 dB and an embedding bit rate average per secret communication channel of 425 bits/sec. This exemplifies that steganography is affordable in digital television.

  18. Video coding standards AVS China, H.264/MPEG-4 PART 10, HEVC, VP6, DIRAC and VC-1

    CERN Document Server

    Rao, K R; Hwang, Jae Jeong

    2014-01-01

    Review by Ashraf A. Kassim, Professor, Department of Electrical & Computer Engineering, and Associate Dean, School of Engineering, National University of Singapore.     The book consists of eight chapters of which the first two provide an overview of various video & image coding standards, and video formats. The next four chapters present in detail the Audio & video standard (AVS) of China, the H.264/MPEG-4 Advanced video coding (AVC) standard, High efficiency video coding (HEVC) standard and the VP6 video coding standard (now VP10) respectively. The performance of the wavelet based Dirac video codec is compared with H.264/MPEG-4 AVC in chapter 7. Finally in chapter 8, the VC-1 video coding standard is presented together with VC-2 which is based on the intra frame coding of Dirac and an outline of a H.264/AVC to VC-1 transcoder.   The authors also present and discuss relevant research literature such as those which document improved methods & techniques, and also point to other related reso...

  19. Fast mode decision algorithm in MPEG-2 to H.264/AVC transcoding including group of picture structure conversion

    Science.gov (United States)

    Lee, Kangjun; Jeon, Gwanggil; Jeong, Jechang

    2009-05-01

    The H.264/AVC baseline profile is used in many applications, including digital multimedia broadcasting, Internet protocol television, and storage devices, while the MPEG-2 main profile is widely used in applications, such as high-definition television and digital versatile disks. The MPEG-2 main profile supports B pictures for bidirectional motion prediction. Therefore, transcoding the MPEG-2 main profile to the H.264/AVC baseline is necessary for universal multimedia access. In the cascaded pixel domain transcoder architecture, the calculation of the rate distortion cost as part of the mode decision process in the H.264/AVC encoder requires extremely complex computations. To reduce the complexity inherent in the implementation of a real-time transcoder, we propose a fast mode decision algorithm based on complexity information from the reference region that is used for motion compensation. In this study, an adaptive mode decision process was used based on the modes assigned to the reference regions. Simulation results indicated that a significant reduction in complexity was achieved without significant degradation of video quality.

  20. Introducing Farouk's Process Consultation Group Approach in Irish Primary Schools

    Science.gov (United States)

    Hayes, Marie; Stringer, Phil

    2016-01-01

    Research has shown that teacher consultation groups increase teachers' behaviour management skills through discussion and collaborative problem-solving. Unlike the United Kingdom, at the time of this research consultation groups were not widely used in Irish schools. This research introduced Farouk's process consultation approach in three Irish…

  1. 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 ...

  2. Consulting Whom? Lessons from the Toronto Urban Aboriginal Strategy

    Directory of Open Access Journals (Sweden)

    Mai T. Nguyen

    2014-04-01

    Full Text Available The research conducted here looks at the current Urban Aboriginal Strategy (UAS in Toronto. The purpose of this Strategy is to provide long-term investments to support Aboriginal communities in urban settings by focusing on three priority areas: improving life skills; promoting job training, skills, and entrepreneurship; and supporting Aboriginal women, children, and families. This article seeks to answer the following question: Does the UAS provide Aboriginal participants with the ability to effectively participant in the consultation process? It argues that the UAS process of consulting with the urban Aboriginal community does not allow for the effective participation of Aboriginal peoples because of problematics related to consulting in an urban setting and despite the language of partnership, the federal government still reserves the right to make final decisions. These problems diminish the ability to build renewed Aboriginal-State relations based on mutual respect and trust, which has been absent within the Aboriginal-State apparatus and resulted in the political exclusion of Aboriginals in Canada. Though consultation can be a vehicle for empowering participants with decision-making authority, this is not the case in Toronto. The lack of a common vision, political buy-in, and the aura of secrecy leads to a political relationship built on mistrust. Mistrust between members and government renders the consultation process ineffective. This article combines the literature on public consultations with official government documents to identify critical components that must be evident for consultations to be fruitful and participation effective. These criteria are the benchmarks upon which to measure effectiveness. Based on interviews with the Steering Committee, this article finds that the UAS process of consulting with the Toronto Aboriginal community does not enable Aboriginal participants to effectively participate in the democratic process.

  3. 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.

  4. Addressing Cultural Responsiveness in Consultation: An Empirical Demonstration

    Science.gov (United States)

    McKenney, Elizabeth L. W.; Mann, Kacee A.; Brown, Danice L.; Jewell, Jeremy D.

    2017-01-01

    This study explored whether and to what extent consultation practices specifically focused on culturally responsive instruction provided additive benefit, after establishing strong classroom management. Three teachers leading culturally diverse classrooms participated in two phases of consultation. The first was a traditional, classroom-management…

  5. 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...

  6. Participation in Written Government Consultations in Denmark and the UK

    DEFF Research Database (Denmark)

    Rasmussen, Anne

    2015-01-01

    Despite the proliferation of instruments of public consultation in liberal democracies, little is known of how the design and use of these instruments affect stakeholder participation in practice. The article examines participation in written government consultations in an analysis of approximately...... 5,000 responses to consultations in Denmark and the UK in the first half of 2008. It shows that participation is highly conditional upon system-and actor-level characteristics in practice. Our findings indicate that, even if liberal democracies have adopted similar procedures for actor consultation...

  7. Exploring dialectical behaviour therapy clinicians' experiences of team consultation meetings.

    Science.gov (United States)

    Walsh, Cian; Ryan, Patrick; Flynn, Daniel

    2018-01-01

    This article presents a detailed idiographic analysis of Dialectical Behaviour Therapy (DBT) clinicians' experiences of team consultation meetings. DBT is an evidence-based psychological intervention with a demonstrated efficacy in the treatment of borderline personality disorder (BPD). Team consultation meetings encompass one of the primary components involved in this treatment model; where DBT clinicians regularly meet to discuss client work and enhance further learning. The present study's aim was to assess what are DBT clinicians' experiences of the consultation meeting component and whether it is useful or not. Semi-structured interviews were completed with 11 DBT clinicians (nine females, two males) from three different consultation teams. The research project utilised an interpretative phenomenological analysis (IPA) framework. Audio-recorded interview data was analysed using this framework. Four superordinate themes emerged from the interview data, which included ten subordinate themes. The superordinate themes focused on: (1) the acquisition of DBT technical knowledge and other MDT related expertise (2) participants' emotional experiences of DBT and consultation meetings, and how this can evolve over time (3) the underlying processes that occur in the consultation team including the development of a team bond and the impact of membership changes and (4) the largely consistent and reliable nature of consultation meetings and how they help maintain clinician motivation. Team consultation meetings were found to be supportive; playing an important role in maintaining clinician motivation through the availability of team support, opportunities to reflect and learn, and assistance in regulating emotions. Challenges arose in relation to team membership changes and acclimatisation to the type of feedback utilised in team consultation. The study's implications for practise are considered.

  8. Active listening in medical consultations: development of the Active Listening Observation Scale (ALOS-global).

    Science.gov (United States)

    Fassaert, Thijs; van Dulmen, Sandra; Schellevis, François; Bensing, Jozien

    2007-11-01

    Active listening is a prerequisite for a successful healthcare encounter, bearing potential therapeutic value especially in clinical situations that require no specific medical intervention. Although generally acknowledged as such, active listening has not been studied in depth. This paper describes the development of the Active Listening Observation Scale (ALOS-global), an observation instrument measuring active listening and its validation in a sample of general practice consultations for minor ailments. Five hundred and twenty-four videotaped general practice consultations involving minor ailments were observed with the ALOS-global. Hypotheses were tested to determine validity, incorporating patients' perception of GPs' affective performance, GPs' verbal attention, patients' self-reported anxiety level and gender differences. The final 7-item ALOS-global had acceptable inter- and intra-observer agreement. Factor analysis revealed one homogeneous dimension. The scalescore was positively related to verbal attention measured by RIAS, to patients' perception of GPs' performance and to their pre-visit anxiety level. Female GPs received higher active listening scores. The results of this study are promising concerning the psychometric properties of the ALOS-global. More research is needed to confirm these preliminary findings. After establishing how active listening differentiates between health professionals, the ALOS-global may become a valuable tool in feedback and training aimed at increasing listening skills.

  9. Relativistic calculations of the fine-structure intervals of the ns2np2P terms and the ionization energies of the Ca-, Sr-and Ba- ions

    International Nuclear Information System (INIS)

    Wijesundera, W.P.; Vosko, S.H.; Parpia, F.A.

    1996-01-01

    We report new calculations of the energy differences between the ns 1/2 2 np 1/2 and ns 1/2 2 np 3/2 levels of the Ca - , Sr - and Ba - ions; here n 4, 5 and 6 for Ca - , Sr - and Ba - , respectively. The electron affinities of Ca, Ba and Sr have also been calculated. All estimates were obtained by performing a series of multiconfiguration Dirac-Fock calculations for the neutral atoms and their anions. Correlations among valence electrons in both the ground and excited states were included in these calculations. Our estimate of the fine structure of the ground state of Sr - is in good agreement with recent measurements. Our estimates of the electron affinities of Ca, Sr and Ba are in reasonable agreement with experiment. (author)

  10. The Role of the Consultant: Content Expert or Process Facilitator?

    Science.gov (United States)

    Schein, Edgar H.

    1978-01-01

    This triad of consulting models identifies the assumption upon which each rests. The consultant with adequate knowledge and self-insight will understand which model is appropriate to a given situation. The three models include: (1) purchase of expertise; (2) doctor-patient role; and (3) consultation process for problem solving. (Author/MFD)

  11. Curbside consultation re-imagined: Borrowing from the conflict management toolkit.

    Science.gov (United States)

    Edelstein, Lauren M; Lynch, John J; Mokwunye, Nneka O; DeRenzo, Evan G

    2010-03-01

    Curbside ethics consultations occur when an ethics consultant provides guidance to a party who seeks assistance over ethical concerns in a case, without the consultant involving other stakeholders, conducting his or her own comprehensive review of the case, or writing a chart note. Some have argued that curbside consultation is problematic because the consultant, in focusing on a single narrative offered by the party seeking advice, necessarily fails to account for the full range of moral perspectives. Their concern is that any guidance offered by the ethics consultant will privilege and empower one party's viewpoint over-and to the exclusion of-other stakeholders. This could lead to serious harms, such as the ethicist being reduced to a means to an end for a clinician seeking to achieve his or her own preferred outcome, the ethicist denying the broader array of stakeholders input in the process, or the ethicist providing wrongheaded or biased advice, posing dangers to the ethical quality of decision-making. Although these concerns are important and must be addressed, we suggest that they are manageable. This paper proposes using conflict coaching, a practice developed within the discipline of conflict management, to mitigate the risks posed by curbside consultation, and thereby create new "spaces" for moral discourse in the care of patients. Thinking of curbside consultations as an opportunity for "clinical ethics conflict coaching" can more fully integrate ethics committee members into the daily ethics of patient care and reduce the frequency of ethically harmful outcomes.

  12. Service Learning In Physics: The Consultant Model

    Science.gov (United States)

    Guerra, David

    2005-04-01

    Each year thousands of students across the country and across the academic disciplines participate in service learning. Unfortunately, with no clear model for integrating community service into the physics curriculum, there are very few physics students engaged in service learning. To overcome this shortfall, a consultant based service-learning program has been developed and successfully implemented at Saint Anselm College (SAC). As consultants, students in upper level physics courses apply their problem solving skills in the service of others. Most recently, SAC students provided technical and managerial support to a group from Girl's Inc., a national empowerment program for girls in high-risk, underserved areas, who were participating in the national FIRST Lego League Robotics competition. In their role as consultants the SAC students provided technical information through brainstorming sessions and helped the girls stay on task with project management techniques, like milestone charting. This consultant model of service-learning, provides technical support to groups that may not have a great deal of resources and gives physics students a way to improve their interpersonal skills, test their technical expertise, and better define the marketable skill set they are developing through the physics curriculum.

  13. 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...

  14. Malpractice and the Communication Consultant: A Proactive Approach.

    Science.gov (United States)

    Montgomery, Daniel J.; And Others

    1995-01-01

    Provides communication practitioners with an overview of legal and ethical issues facing individuals who market themselves as professional communication consultants. Discusses the tort of negligence. Outlines court-supported practices that professional consultants might use to help protect clients and themselves. Argues that an understanding of…

  15. Subjective Quality Assessment of H.264/AVC Video Streaming with Packet Losses

    Directory of Open Access Journals (Sweden)

    Naccari Matteo

    2011-01-01

    Full Text Available Research in the field of video quality assessment relies on the availability of subjective scores, collected by means of experiments in which groups of people are asked to rate the quality of video sequences. The availability of subjective scores is fundamental to enable validation and comparative benchmarking of the objective algorithms that try to predict human perception of video quality by automatically analyzing the video sequences, in a way to support reproducible and reliable research results. In this paper, a publicly available database of subjective quality scores and corrupted video sequences is described. The scores refer to 156 sequences at CIF and 4CIF spatial resolutions, encoded with H.264/AVC and corrupted by simulating the transmission over an error-prone network. The subjective evaluation has been performed by 40 subjects at the premises of two academic institutions, in standard-compliant controlled environments. In order to support reproducible research in the field of full-reference, reduced-reference, and no-reference video quality assessment algorithms, both the uncompressed files and the H.264/AVC bitstreams, as well as the packet loss patterns, have been made available to the research community.

  16. 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.

  17. Anti-inflammatory effect of transduced PEP-1-heme oxygenase-1 in Raw 264.7 cells and a mouse edema model

    International Nuclear Information System (INIS)

    Kwon, Soon Won; Sohn, Eun Jeong; Kim, Dae Won; Jeong, Hoon Jae; Kim, Mi Jin; Ahn, Eun Hee; Kim, Young Nam; Dutta, Suman; Kim, Duk-Soo; Park, Jinseu; Eum, Won Sik; Hwang, Hyun Sook; Choi, Soo Young

    2011-01-01

    Highlights: → Recombinant PEP-1 heme oxygenase-1 expression vector was constructed and overexpressed. → We investigated transduction efficiency of PEP-1-HO-1 protein in Raw 264.7 cells. → PEP-1-HO-1 was efficiently transduced into Raw 264.7 cells in a dose and time dependent manner. → PEP-1-HO-1 exerted anti-inflammatory activity in Raw 264.7 cells and in a mice edema model. → PEP-1-HO-1 could be used as a therapeutic drug against inflammatory diseases. -- Abstract: Heme oxygenase-1 (HO-1), which catalyzes the degradation of free heme to biliverdin, carbon monoxide (CO), and free iron (Fe 2+ ), is up-regulated by several cellular stress and cell injuries, including inflammation, ischemia and hypoxia. In this study, we examined whether fusion of HO-1 with PEP-1, a protein transduction domain that is able to deliver exogenous molecules to living cells or tissues, would facilitate HO-1 delivery to target cells and tissues, and thereby effectively exert a therapeutically useful response against inflammation. Western blot analysis demonstrated that PEP-1-HO-1 fusion proteins were transduced into Raw 264.7 cells in time- and dose-dependent manners, and were stably maintained in the cells for about 60 h. In addition, fluorescence analysis revealed that only PEP-1-HO-1 fusion proteins were significantly transduced into the cytoplasm of cells, while HO-1 proteins failed to be transduced. In lipopolysaccharide (LPS)-stimulated Raw 264.7 cells and 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced mouse edema model, transduced PEP-1-HO-1 fusion proteins effectively inhibited the overexpression of pro-inflammatory mediators and cytokines. Also, histological analysis demonstrated that PEP-1-HO-1 remarkably suppressed ear edema. The results suggest that the PEP-1-HO-1 fusion protein can be used as a therapeutic molecule against reactive oxygen species-related inflammatory diseases.

  18. Exploring rater agreement: configurations of agreement and disagreement

    Directory of Open Access Journals (Sweden)

    ALEXANDER VON EYE

    2006-03-01

    Full Text Available At the level of manifest categorical variables, a large number of coefficients and models for the examination of rater agreement has been proposed and used for descriptive and explanatory purposes. This article focuses on exploring rater agreement. Configural Frequency Analysis (CFA is proposed as a method of exploration of cross-classifications of raters’ judgements. CFA allows researchers to (1 examine individual cells and sets of cells in agreement tables; (2 examine cells that indicate disagreement; and (3 explore agreement and disagreement among three or more raters. Four CFA base models are discussed. The first is the model of rater agreement that is also used for Cohen’s (1960  (kappa. This model proposes independence of raters’ judgements. Deviations from this model suggest agreement or disagreement beyond chance. The second CFA model is based on a log-linear null model. This model is also used for Brennan and Prediger’s (1981 n. It proposes a uniform distribution of ratings. The third model is that of Tanner and Young (1985. This model proposes equal weights for agreement cases and independence otherwise. The fourth model is the quasi-independence model. This model allows one to blank out agreement cells and thus to focus solely on patterns of disagreement. Examples use data from applicant selection.

  19. A Devil in the Details: Matrix-Dependent 40Ca42Ca++/42Ca+ and Its Effects on Estimates of the Initial 41Ca/40Ca in the Solar System

    Science.gov (United States)

    McKeegan, K. D.; Liu, M.-C.

    2015-07-01

    Ian Hutcheon established that the molecular ion interference 40Ca42Ca++/42Ca+ on 41K+ is strongly dependent on the mineral analyzed. Correction for this "matrix effect" led to a downward revision of the initial 41Ca/40Ca of the solar system.

  20. Brief Report: Healing Touch Consults at a Tertiary Care Children's Hospital.

    Science.gov (United States)

    Schlefman, Amanda; Rappaport, David I; Adams-Gerdts, Walle; Stubblefield, Samuel C

    2016-02-01

    Components of complementary and alternative medicine are increasingly being implemented at academic medical centers. These approaches include therapeutic touch or healing touch (HT), an energy-based therapy using light touch on or near the body. Limited data exist regarding complementary and alternative medicine use at children's hospitals. The aim of this study was to evaluate patterns and clinical characteristics of HT consultations among children hospitalized at Nemours/A.I. duPont Hospital for Children. We conducted a retrospective chart review of all patients hospitalized from January 2012 through December 2013, comparing patients who received HT consultations with those who did not. There were 25,396 admissions during the study period; 882 (4%) of these, representing 593 individual patients, received an HT consultation. As compared with those without an HT consultation, patients receiving HT were older (median 12 years vs 5 years, P<.001), female (58% vs 46%, P<.001), and more likely to be admitted to the hematology/oncology or blood/bone marrow transplant units (P<.001). Patients with HT consultations had longer hospitalizations (median 121 hours vs 38 hours, P<.001) and more medical problems (median 12 vs 4, P<.001). Six attending physicians were responsible for placing the majority of HT consultations. Of the 593 patients receiving an HT consultation, 21% received ≥2 consultations during the study period. Certain patients, such as those with longer hospitalizations and more medical problems, were more likely to receive HT consultations. Many patients received multiple consultations, suggesting that HT may be an important aspect of ongoing care for hospitalized children.

  1. 20 CFR 416.1016 - Medical or psychological consultants.

    Science.gov (United States)

    2010-04-01

    ..., psychological experts employed by or under contract with the State agencies must meet the qualification... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Medical or psychological consultants. 416... Disability Determination Function § 416.1016 Medical or psychological consultants. (a) What is a medical...

  2. 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.

  3. How lead consultants approach educational change in postgraduate medical education.

    Science.gov (United States)

    Fokkema, Joanne P I; Westerman, Michiel; Teunissen, Pim W; van der Lee, Nadine; Scherpbier, Albert J J A; van der Vleuten, Cees P M; Dörr, P Joep; Scheele, Fedde

    2012-04-01

      Consultants in charge of postgraduate medical education (PGME) in hospital departments ('lead consultants') are responsible for the implementation of educational change. Although difficulties in innovating in medical education are described in the literature, little is known about how lead consultants approach educational change.   This study was conducted to explore lead consultants' approaches to educational change in specialty training and factors influencing these approaches.   From an interpretative constructivist perspective, we conducted a qualitative exploratory study using semi-structured interviews with a purposive sample of 16 lead consultants in the Netherlands between August 2010 and February 2011. The study design was based on the research questions and notions from corporate business and social psychology about the roles of change managers. Interview transcripts were analysed thematically using template analysis.   The lead consultants described change processes with different stages, including cause, development of content, and the execution and evaluation of change, and used individual change strategies consisting of elements such as ideas, intentions and behaviour. Communication is necessary to the forming of a strategy and the implementation of change, but the nature of communication is influenced by the strategy in use. Lead consultants differed in their degree of awareness of the strategies they used. Factors influencing approaches to change were: knowledge, ideas and beliefs about change; level of reflection; task interpretation; personal style, and department culture.   Most lead consultants showed limited awareness of their own approaches to change. This can lead them to adopt a rigid approach, whereas the ability to adapt strategies to circumstances is considered important to effective change management. Interventions and research should be aimed at enhancing the awareness of lead consultants of approaches to change in PGME.

  4. Study of neutron shell structure of even-even 40-56Ca isotopes by the dispersive optical model

    International Nuclear Information System (INIS)

    Bespalova, O.V.; Boboshin, I.N.; Varlamov, V.V.; Ermakova, T.A.; Ishkhanov, B.S.; Romanovskij, E.A.; Spasskaya, T.I.; Timokhina, T.P.

    2005-01-01

    The single-particle energies and occupation probabilities of the bound neutron states in 40,42,44,46,48 Ca isotopes were obtained by the joint evaluation of the stripping and pick-up reaction data. The results were analyzed by the dispersive optical model and a good agreement was achieved. The dispersive optical potential was extrapolated to unstable 50,52,54,56 Ca nuclei. The calculated single-particle energies of the bound neutron states in unstable Ca isotopes were compared with the nuclear shell-model calculations, which predicted new magic number N = 34 for nuclei with Z = 20 [ru

  5. Disruptive Innovation: Implementation of Electronic Consultations in a Veterans Affairs Health Care System.

    Science.gov (United States)

    Gupte, Gouri; Vimalananda, Varsha; Simon, Steven R; DeVito, Katerina; Clark, Justice; Orlander, Jay D

    2016-02-12

    Electronic consultations (e-consults) offer rapid access to specialist input without the need for a patient visit. E-consult implementation began in 2011 at VA Boston Healthcare System (VABHS). By early 2013, e-consults were available for all clinical services. In this implementation, the requesting clinician selects the desired consultation within the electronic health record (EHR) ordering menu, which creates an electronic form that is pre-populated with patient demographic information and allows free-text entry of the reason for consult. This triggers a message to the requesting clinician and requested specialty, thereby enabling bidirectional clinician-clinician communication. The aim of this study is to examine the utilization of e-consults in a large Veterans Affairs (VA) health care system. Data from the electronic health record was used to measure frequency of e-consult use by provider type (physician or nurse practitioner (NP) and/or physician assistant), and by the requesting and responding specialty from January 2012 to December 2013. We conducted chart reviews for a purposive sample of e-consults and semi-structured interviews with a purposive sample of clinicians and hospital leaders to better characterize the process, challenges, and usability of e-consults. A total of 7097 e-consults were identified, 1998 from 2012 and 5099 from 2013. More than one quarter (27.56%, 1956/7097) of the e-consult requests originated from VA facilities in New England other than VABHS and were excluded from subsequent analysis. Within the VABHS e-consults (72.44%, 5141/7097), variability in frequency and use of e-consults across provider types and specialties was found. A total of 64 NPs requested 2407 e-consults (median 12.5, range 1-415). In contrast, 448 physicians (including residents and fellows) requested 2349 e-consults (median 2, range 1-116). More than one third (37.35%, 1920/5141) of e-consults were sent from primary care to specialists. While most e-consults

  6. Hydrolysis of molten CaCl2-CaF2 with additions of CaO

    Directory of Open Access Journals (Sweden)

    Espen Olsen

    2017-10-01

    Full Text Available Calcium halide based molten salts have recently attracted interest for a number of applications such as direct reduction of oxides for metal production and as liquefying agent in cyclic sorption processes for CO2 by CaO from dilute flue gases (Ca-looping. A fundamental aspect of these melts is the possible hydrolysis reaction upon exposure to gaseous H2O forming corrosive and poisonous hydrogen halides. In this work experiments have been performed investigating the formation of HCl and HF from a molten salt consisting of a 13.8 wt% CaF2 in CaCl2 eutectic exposed to a flowing gas consisting of 10 vol% H2O in N2. Hydrolysis has been investigated as function of content of CaO and temperature. HCl and HF are shown to be formed at elevated temperatures; HCl forms to a substantially larger extent than HF. Addition of CaO has a marked, limiting effect on the hydrolysis. Thermodynamic modeling of the reaction indicates activity coefficients for CaO above unity in the system. For cyclic CO2-capture based on thermal swing, it is advisable to keep the temperature in the carbonation (absorption reactor well below 850 ℃ while maintaining a high CaO content if molten CaCl2 is employed. Similar conclusions can be drawn with regards to CaF2.

  7. Assessing communication quality of consultations in primary care: initial reliability of the Global Consultation Rating Scale, based on the Calgary-Cambridge Guide to the Medical Interview.

    Science.gov (United States)

    Burt, Jenni; Abel, Gary; Elmore, Natasha; Campbell, John; Roland, Martin; Benson, John; Silverman, Jonathan

    2014-03-06

    To investigate initial reliability of the Global Consultation Rating Scale (GCRS: an instrument to assess the effectiveness of communication across an entire doctor-patient consultation, based on the Calgary-Cambridge guide to the medical interview), in simulated patient consultations. Multiple ratings of simulated general practitioner (GP)-patient consultations by trained GP evaluators. UK primary care. 21 GPs and six trained GP evaluators. GCRS score. 6 GP raters used GCRS to rate randomly assigned video recordings of GP consultations with simulated patients. Each of the 42 consultations was rated separately by four raters. We considered whether a fixed difference between scores had the same meaning at all levels of performance. We then examined the reliability of GCRS using mixed linear regression models. We augmented our regression model to also examine whether there were systematic biases between the scores given by different raters and to look for possible order effects. Assessing the communication quality of individual consultations, GCRS achieved a reliability of 0.73 (95% CI 0.44 to 0.79) for two raters, 0.80 (0.54 to 0.85) for three and 0.85 (0.61 to 0.88) for four. We found an average difference of 1.65 (on a 0-10 scale) in the scores given by the least and most generous raters: adjusting for this evaluator bias increased reliability to 0.78 (0.53 to 0.83) for two raters; 0.85 (0.63 to 0.88) for three and 0.88 (0.69 to 0.91) for four. There were considerable order effects, with later consultations (after 15-20 ratings) receiving, on average, scores more than one point higher on a 0-10 scale. GCRS shows good reliability with three raters assessing each consultation. We are currently developing the scale further by assessing a large sample of real-world consultations.

  8. Bilateral agreements

    International Nuclear Information System (INIS)

    1998-01-01

    Ten bilateral agreements are presented. These are: 1) Co-operation agreement relating to the peaceful uses of nuclear energy between Argentina and EURATOM (1996); 2) Agreement on co-operation in the peaceful uses of nuclear energy between Argentina and Greece (1997); 3) Implementing arrangement for technical exchange and co-operation in the area of peaceful uses of nuclear energy between Argentina and the United States (1997); 4) Agreement concerning co-operation in nuclear science and technology between Australia and Indonesia (1997); 5) Implementation of the 1985 Agreement for co-operation concerning the peaceful uses of nuclear energy between the People's Republic of China and the United States (1998); 6) Protocol of co-operation between France and Lithuania (1997); 7) Agreement on co-operation in energy research, science and technology, and development between Germany and the United States (1998); 8) Agreement on early notification of a nuclear accident and exchange of information on nuclear facilities between Greece and Romania (1997); 9) Agreement on early notification of nuclear accidents and co-operation in the field of nuclear safety between Hungary and the Ukraine (1997); 10) Agreement in the field of radioactive waste management between Switzerland and the United States (1997). (K.A.)

  9. Anti-Inflammatory Effects of Angelica sinensis (Oliv. Diels Water Extract on RAW 264.7 Induced with Lipopolysaccharide

    Directory of Open Access Journals (Sweden)

    Young-Jin Kim

    2018-05-01

    Full Text Available The dry root of Angelica sinensis (Oliv. Diels, also known as “female ginseng”, is a popular herbal drug amongst women, used to treat a variety of health issues and cardiovascular diseases. The aim of this study is to evaluate the detailed molecular mechanism for anti-inflammatory effects of Angelica sinensis root water extract (ASW. The anti-inflammatory effect of ASW on lipopolysaccharide (LPS-induced RAW 264.7 mouse macrophages was evaluated by the tetrazolium-based colorimetric assay (MTT, Griess reagent assay, multiplex cytokine assay, real time reverse transcription polymerase chain reaction (RT-PCR, and Fluo-4 calcium assay. ASW restored cell viability in RAW 264.7 at concentrations of up to 200 µg/mL. ASW showed notable anti-inflammatory effects. ASW exhibited IC50 = 954.3, 387.3, 191.7, 317.8, 1267.0, 347.0, 110.1, 573.6, 1171.0, 732.6, 980.8, 125.0, and 257.0 µg/mL for interleukin (IL-6, tumor necrosis factor (TNF-α, monocyte chemotactic activating factor (MCP-1, regulated on activation, normal T cell expressed and secreted (RANTES, granulocyte colony-stimulating factor (G-CSF, granulocyte macrophage colony-stimulating factor (GM-CSF, vascular endothelial growth factor (VEGF, lipopolysaccharide-induced CXC chemokine (LIX, macrophage inflammatory protein (MIP-1α, MIP-1β, MIP-2, IL-10, and intracellular calcium, respectively. Additionally, ASW inhibited the LPS-induced production of nitric oxide and the LPS-induced mRNA expression of CHOP (GADD153, Janus kinase 2 (JAK2, signal transducers and activators of transcription 1 (STAT1, first apoptosis signal receptor (FAS, and c-Fos, NOS2, and PTGS2 (COX2 in RAW 264.7 significantly (p < 0.05. Data suggest that ASW exerts an anti-inflammatory effect on LPS-induced RAW 264.7 via NO-bursting/calcium-mediated JAK-STAT pathway.

  10. A fast inter mode decision algorithm in H.264/AVC for IPTV broadcasting services

    Science.gov (United States)

    Kim, Geun-Yong; Yoon, Bin-Yeong; Ho, Yo-Sung

    2007-01-01

    The new video coding standard H.264/AVC employs the rate-distortion optimization (RDO) method for choosing the best coding mode. However, since it increases the encoder complexity tremendously, it is not suitable for real-time applications, such as IPTV broadcasting services. Therefore we need a fast mode decision algorithm to reduce its encoding time. In this paper, we propose a fast mode decision algorithm considering quantization parameter (QP) because we have noticed that the frequency of best modes depends on QP. In order to consider these characteristics, we use the coded block pattern (CBP) that has "0" value when all quantized discrete cosine transform (DCT) coefficients are zero. We also use both the early SKIP mode and early 16x16 mode decisions. Experimental results show that the proposed algorithm reduces the encoding time by 74.6% for the baseline profile and 72.8% for the main profile, compared to the H.264/AVC reference software.

  11. Uniqueness of family therapists as family business systems consultants: a cross-disciplinary investigation.

    Science.gov (United States)

    Lee, Jinhee; Danes, Sharon M

    2012-06-01

    The purpose of this study is to address how the consulting approaches of family therapists working with family businesses differ from those of business consultants. The logic of analytic induction was used to analyze qualitative data from family business consultants with and without training in family therapy. Consultants were asked to respond to two vignettes: one emphasized primarily family system problems, whereas the other emphasized business problems with influencing issues at the family/business intersection. Both similarities and differences were found in reference to problem assessment, consulting goal orientation, intervention strategy focus, consultant role and function, and consulting setting preference between consultants with and without family therapy training. Results indicate that consultants of each discipline provide a unique perspective and expertise that allow them to successfully address the spectrum of issues that family firms face. Further, findings highlight the unique contribution of family therapists to an interdisciplinary consulting team. © 2012 American Association for Marriage and Family Therapy.

  12. What if we shifted the basis of consulting from knowledge to knowing?

    NARCIS (Netherlands)

    Hicks, Jeff; Nair, P.; Wilderom, Celeste P.M.

    2009-01-01

    In this article, we argue that a focus on the debunking of consulting knowledge has led to a disconnect between the research and the practice of management consulting. A renewed focus on consulting practice, that is, the doing of consultancy itself, affords an opportunity for bringing clients,

  13. 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.

  14. 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.

  15. [Inhibitory effects of pseudolaric acid B on inflammatory response and M1 phenotype polarization in RAW264.7 macrophages induced by lipopolysaccharide].

    Science.gov (United States)

    Li, Yuxiu; Li, Tan; Ji, Wenjie; Li, Xiao; Ma, Yongqiang; Zhao, Jihong; Zhou, Xin; Li, Yuming

    2016-05-01

    To investigate the effects of pseudolaric acid B (PLAB) on the inflammatory response and M1 phenotype polarization in RAW264.7 cells induced by lipopolysaccharide (LPS) and the related mechanisms. The inflammatory model in vitro was made using RAW264.7 cells stimulated by LPS, and then was treated with 0.5 μmol/L PLAB and 1 μmol/L GW9662, a peroxisome proliferators-activated receptor γ (PPARγ) antagonist. The cell cycle was tested by flow cytometry. The mRNA expressions of PPARγ and M1 phenotype markers interleukin 1β (IL-1β), tumor necrosis factor α (TNF-α) were measured by real-time PCR. The expression levels of signal molecules involved in nuclear factor-κB (NF-κB) signal pathway were detected by Western blotting. PLAB markedly decreased the expressions of IL-1β and TNF-α mRNAs induced by LPS and increased PPARγ mRNA level. Moreover, the expressions of NF-κB p65, pNF-κB p65, IKKα, IKKβ, pIKKα/β, IκBα and pIκBα decreased in PLAB-treated cells. Meanwhile, RAW264.7 cells were arrested in G0 and G2 phase after the treatment with PLAB. However, the effects of PLAB on RAW264.7 cells could be reversed by GW9662 obviously. PLAB could inhibit the inflammatory response and M1 phenotype polarization in RAW264.7 cells induced by LPS via modulating cell cycle and NF-κB/PPARγ signal pathway.

  16. Complexity Control of Fast Motion Estimation in H.264/MPEG-4 AVC with Rate-Distortion-Complexity optimization

    DEFF Research Database (Denmark)

    Wu, Mo; Forchhammer, Søren; Aghito, Shankar Manuel

    2007-01-01

    A complexity control algorithm for H.264 advanced video coding is proposed. The algorithm can control the complexity of integer inter motion estimation for a given target complexity. The Rate-Distortion-Complexity performance is improved by a complexity prediction model, simple analysis of the pa...... statistics and a control scheme. The algorithm also works well for scene change condition. Test results for coding interlaced video (720x576 PAL) are reported.......A complexity control algorithm for H.264 advanced video coding is proposed. The algorithm can control the complexity of integer inter motion estimation for a given target complexity. The Rate-Distortion-Complexity performance is improved by a complexity prediction model, simple analysis of the past...

  17. The pattern and impact of infectious diseases consultation on antimicrobial prescription

    Directory of Open Access Journals (Sweden)

    Jaffar A Al-Tawfiq

    2013-01-01

    Full Text Available Objectives: Inclusion of infectious disease (ID physicians in the care of patients with possible infection can favorably affect antibiotic usage. The aim of this study was to evaluate the role of the ID consultations in reducing inappropriate antibiotic usage. Materials and Methods: This is a prospective study evaluating all adult ID consultations from January 2006 to December 2009. A total of 1444 consultation requests were recorded during the 4-year period. Results: The most frequent consultations were from cardiology (23.1%, orthopedics (8.2%, general medicine (7.8%, hematology-oncology (7.8%, gastroenterology (7.3%, and pulmonary/critical care (7.1%. The main reason for consultation was for the choice of antibiotics (75%. The commonest diagnoses prior to consultation were fever (14.7%, bacteremia (9.1%, and urinary tract infection (8.4%. Bacteremia was documented in 21.4% of cases and 12.9% were found to have no identifiable focus of infection. Antimicrobial therapy was changed in 58.7% and antimicrobials were discontinued in 14.7% of cases. The number of antimicrobial therapy was one (49.7% and 49.9% and two (24% and 17.6%, P = 0.0001 before and after the consultation, respectively. In addition, 17.3% and 26.9% ( P = 0.0001 received no antimicrobial agents before and after ID consultation. Conclusion: ID consultation is important to reduce inappropriate antimicrobial therapy and to limit the number of dual therapy.

  18. Temperature dependence of intracellular Ca2+ homeostasis in rat meiotic and postmeiotic spermatogenic cells.

    Science.gov (United States)

    Herrera, E; Salas, K; Lagos, N; Benos, D J; Reyes, J G

    2001-10-01

    The hypothesis that intracellular [Ca2+] is a cell parameter responsive to extreme temperatures in rat meiotic and postmeiotic spermatogenic cells was tested using intracellular fluorescent probes for Ca2+ and pH. In agreement with this hypothesis, extreme temperatures induced a rapid increase of cytosolic [Ca2+] in rat pachytene spermatocytes and round spermatids. Oscillatory changes in temperature can induce oscillations in cytosolic [Ca2+] in these cells. Intracellular [Ca2+] homeostasis in round spermatids was more sensitive to high temperatures compared with pachytene spermatocytes. The calculated activation energies for SERCA ATPase-mediated fluxes in pachytene spermatocytes and round spermatids were 62 and 75 kJ mol(-1), respectively. The activation energies for leak fluxes from intracellular Ca2+ stores were 55 and 68 kJ mol(-1) for pachytene spermatocytes and round spermatids, respectively. Together with changes in cytosolic [Ca2+], round spermatids undergo a decrease in pH(i) at high temperatures. This temperature-induced decrease in pH(i) appears to be partially responsible for the increase in cytosolic [Ca2+] of round spermatids induced by high temperatures. This characteristic of rat meiotic and postmeiotic spermatogenic cells to undergo an increment in cytosolic Ca2+ at temperatures > 33 degrees C can be related to the induction of programmed cell death by high temperatures in these cells.

  19. Selenium Pretreatment Alleviated LPS-Induced Immunological Stress Via Upregulation of Several Selenoprotein Encoding Genes in Murine RAW264.7 Cells.

    Science.gov (United States)

    Wang, Longqiong; Jing, Jinzhong; Yan, Hui; Tang, Jiayong; Jia, Gang; Liu, Guangmang; Chen, Xiaoling; Tian, Gang; Cai, Jingyi; Shang, Haiying; Zhao, Hua

    2018-04-18

    This study was conducted to profile selenoprotein encoding genes in mouse RAW264.7 cells upon lipopolysaccharide (LPS) challenge and integrate their roles into immunological regulation in response to selenium (Se) pretreatment. LPS was used to develop immunological stress in macrophages. Cells were pretreated with different levels of Se (0, 0.5, 1.0, 1.5, 2.0 μmol Se/L) for 2 h, followed by LPS (100 ng/mL) stimulation for another 3 h. The mRNA expression of 24 selenoprotein encoding genes and 9 inflammation-related genes were investigated. The results showed that LPS (100 ng/mL) effectively induced immunological stress in RAW264.7 cells with induced inflammation cytokines, IL-6 and TNF-α, mRNA expression, and cellular secretion. LPS increased (P immunological stress in RAW264.7 cells accompanied with the global downregulation of selenoprotein encoding genes and Se pretreatment alleviated immunological stress via upregulation of a subset of selenoprotein encoding genes.

  20. [Gallic acid inhibits inflammatory response of RAW264.7 macrophages by blocking the activation of TLR4/NF-κB induced by LPS].

    Science.gov (United States)

    Huang, Lihua; Hou, Lin; Xue, Hainan; Wang, Chunjie

    2016-12-01

    Objective To observe the influence of gallic acid on Toll-like receptor 4/nuclear factor-κB (TLR4/NF-κB) pathway in the RAW264.7 macrophages stimulated by lipopolysaccharide (LPS). Methods RAW264.7 macrophages were divided into the following groups: control group, LPS group, LPS combined with gallic acid group, LPS combined with pyrrolidine dithiocarbamate (PDTC) group and LPS combined with dexamethasone (DM) group. RAW264.7 cells were cultured for 24 hours after corresponding treatments. The levels of tumor necrosis factor α (TNF-α), interleukin-1 (IL-1) and IL-6 were detected by ELISA. The levels of TLR4 and NF-κB mRNAs were tested by real-time PCR. The levels of p-IκBα, p65, p-p65 and TLR4 proteins were examined by Western blotting. Results The expression levels of TNF-α, IL-1 and IL-6 were up-regulated in the RAW264.7 macrophages after stimulated by LPS. Gallic acid could reduce the elevated expression levels of TNF-α, IL-1 and IL-6 induced by LPS. The expression of TLR4 significantly increased after stimulated by LPS and NF-κB was activated. Gallic acid could reverse the above changes and prevent the activation of NF-κB. Conclusion Gallic acid could inhibit LPS-induced inflammatory response in RAW264.7 macrophages via TLR4/NF-κB pathway.

  1. 10 CFR 51.40 - Consultation with NRC staff.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Consultation with NRC staff. 51.40 Section 51.40 Energy....40 Consultation with NRC staff. (a) A prospective applicant or petitioner for rulemaking is encouraged to confer with NRC staff as early as possible in its planning process before submitting...

  2. Institutional policy learning and public consultation: the Canadian xenotransplantation experience.

    Science.gov (United States)

    Jones, Mavis; Einsiedel, Edna

    2011-09-01

    Attempts to evaluate public consultations, participatory technology assessment, and deliberative democracy have typically considered impacts on either policy or participants. The determination of impacts on policy institutions has been limited due to the challenges of tracing effects through the policy process, or penetrating bureaucratic walls. This paper presents findings from a retrospective study exploring the institutional lessons learned from a 2001 Canadian national public consultation on xenotransplantation. The consultation was conducted through an arm's-length process and involved the use of citizen juries in six regional sites. We conducted in-depth interviews of regulatory and policy actors who were engaged in early policy discussions and the consultation process. We reviewed evaluations of this process, both internal and external, which gave us richer insights into what institutional actors saw as the impacts of this consultative experience on their policy environment. Participants in our research identified a broader shift toward openness in policy culture which they linked specifically to the innovative consultation process employed for xenotransplantation. We argue that beyond input into policy decisions, a consultation may have an impact in terms of its contribution to overall shifts in institutional culture (related to institutional learning), such as an "opening" of technological decision processes to a broader range of actors, knowledge, and values. Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. 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.

  4. 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.

  5. 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...

  6. 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

  7. The immune-enhancing activity of Cervus nippon mantchuricus extract (NGE) in RAW264.7 macrophage cells and immunosuppressed mice.

    Science.gov (United States)

    Hong, Se Hyang; Ku, Jin Mo; In Kim, Hyo; Ahn, Chang-Won; Park, Soo-Hyun; Seo, Hye Sook; Shin, Yong Cheol; Ko, Seong-Gyu

    2017-09-01

    Chemotherapeutics are often used to inhibit the proliferation of cancer cells. However, they can also harm healthy cells and cause side effects such as immunosuppression. Especially traditional oriental medicines long used in Asia, may be beneficial candidates for the alleviation of immune diseases. Cervus nippon mantchuricus extract (NGE) is currently sold in the market as coffee and health drinks. However, NGE was not widely investigated and efficacy remain unclear and essentially nothing is known about their potential immune-regulatory properties. As a result, NGE induced the differentiation of RAW264.7 macrophage cells. NGE-stimulated RAW264.7 macrophage cells elevated cytokines levels and NO production. NGE-stimulated RAW264.7 macrophage cells activated MAPKs and NF-κB signaling pathways. NGE encouraged the immuno-enhancing effects in immunosuppressed short-term treated with NGE mice model. NGE or Red ginseng encouraged the immuno-enhancing effects in immunosuppressed long-term treated with NGE mice model. Our data clearly show that NGE contains immune-enhancing activity and can be used to treat immunodeficiency. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  8. Water-bearing, high-pressure Ca-silicates

    Science.gov (United States)

    Németh, Péter; Leinenweber, Kurt; Ohfuji, Hiroaki; Groy, Thomas; Domanik, Kenneth J.; Kovács, István J.; Kovács, Judit S.; Buseck, Peter R.

    2017-07-01

    Water-bearing minerals provide fundamental knowledge regarding the water budget of the mantle and are geophysically significant through their influence on the rheological and seismic properties of Earth's interior. Here we investigate the CaO-SiO2-H2O system at 17 GPa and 1773 K, corresponding to mantle transition-zone condition, report new high-pressure (HP) water-bearing Ca-silicates and reveal the structural complexity of these phases. We document the HP polymorph of hartrurite (Ca3SiO5), post-hartrurite, which is tetragonal with space group P4/ncc, a = 6.820 (5), c = 10.243 (8) Å, V = 476.4 (8) Å3, and Z = 4, and is isostructural with Sr3SiO5. Post-hartrurite occurs in hydrous and anhydrous forms and coexists with larnite (Ca2SiO4), which we find also has a hydrous counterpart. Si is 4-coordinated in both post-hartrurite and larnite. In their hydrous forms, H substitutes for Si (4H for each Si; hydrogrossular substitution). Fourier transform infrared (FTIR) spectroscopy shows broad hydroxyl absorption bands at ∼3550 cm-1 and at 3500-3550 cm-1 for hydrous post-hartrurite and hydrous larnite, respectively. Hydrous post-hartrurite has a defect composition of Ca2.663Si0.826O5H1.370 (5.84 weight % H2O) according to electron-probe microanalysis (EPMA), and the Si deficiency relative to Ca is also observed in the single-crystal data. Hydrous larnite has average composition of Ca1.924Si0.851O4H0.748 (4.06 weight % H2O) according to EPMA, and it is in agreement with the Si occupancy obtained using X-ray data collected on a single crystal. Superlattice reflections occur in electron-diffraction patterns of the hydrous larnite and could indicate crystallographic ordering of the hydroxyl groups and their associated cation defects. Although textural and EPMA-based compositional evidence suggests that hydrous perovskite may occur in high-Ca-containing (or low silica-activity) systems, the FTIR measurement does not show a well-defined hydroxyl absorption band for this

  9. Magnetic phase diagram of the Ca1-xMnxO systems

    International Nuclear Information System (INIS)

    Masrour, R.; Hamedoun, M.

    2008-01-01

    The magnetic properties of the Ca 1-x Mn x O systems in the range 0≤x≤1 have been studied by mean field theory and high-temperature series expansions (HTSEs). By using the first theory, we have evaluated the nearest neighbour and the next-neighbour super-exchange interaction J 1 (x) and J 2 (x) respectively, in the range 0.45≤x≤1. The corresponding classical exchange energy for magnetic structure is obtained for the Ca 1-x Mn x O systems. The HTSEs combined with the Pade approximants (PA) method is applied to the Ca 1-x Mn x O systems; we have obtained the magnetic phase diagrams (T N or T SG versus dilution x) in the range 0≤x≤1. The obtained theoretical results are in agreement with experimental ones obtained by magnetic measurements. The critical exponents associated with the magnetic susceptibility (γ) and the correlation lengths (ν) are deduced in the range 0≤x≤1

  10. Consultation Report. Consultation under the Environmental Act sixth chapter 4 paragraph for interim storage, encapsulation and disposal of spent nuclear fuel

    International Nuclear Information System (INIS)

    2010-09-01

    This consultation report is an appendix to the Environmental Impact Assessment (EIA) which in turn is an appendix to SKB's application under the Environmental Code for the continued operation of CLAB (Central interim storage for spent Nuclear Fuel, located on the Simpevarp Peninsula in Oskarshamn municipality), to build the encapsulation plant and operate it integrated with CLAB and to construct and operate the disposal facility in Soederviken at Forsmark in Oesthammar municipality, and SKB's application for a license under the Nuclear Activities Act to construct and operate the disposal facility at Forsmark. The aim of the consultation report is to give an overall picture of the consultations

  11. Consultation and IBA negotiations in wind projects

    Energy Technology Data Exchange (ETDEWEB)

    Merle, Alexander [Bull Housser and Tupper LLP (Canada)

    2011-07-01

    This presentation aimed at providing more information on consultation and IBA negotiations in wind energy projects, it was given by a law firm Bull, Housser and Tupper LLP. The subjects tackled by this paper are: the duty to consult, what First Nations are expecting from IBAs, if IBAs will differ from one wind project to another, if templates assist in achieving equity, who should be responsible for financing IBAs, and whether benefits or payments of money can achieve equity. The presentation emphasised that it is important to cooperate and share information in determining what the role of the Crown should be. In addition, the authors believe that an innovative resolution table should be established and that legal certainty should be obtained. This presentation provided First Nations with useful information on consultation and IBA negotiations in wind energy projects.

  12. 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.

  13. Management consulting : does the 'advice business' qualify as an ethical profession?

    OpenAIRE

    2012-01-01

    M.Comm. The objective of this research could broadly be stated as an initial investigation into the field of management consulting — with regard to the ethical standards and the requirements for professions, as well as the consultant's required skill set. More detailed objectives are the following: To define the requirements necessary to view management consulting as an ethical profession based on the guidelines set for management and management consulting as a profession. To investigate t...

  14. 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.

  15. Use of Nondisclosure Agreements in Medical Malpractice Settlements by a Large Academic Health Care System.

    Science.gov (United States)

    Sage, William M; Jablonski, Joseph S; Thomas, Eric J

    2015-07-01

    Honesty and transparency are essential aspects of health care, including in physicians' and hospitals' responses to medical error. Biases and habits associated with medical malpractice litigation, however, may work at cross-purposes with compassion in clinical care and with efforts to improve patient safety. To determine the frequency of nondisclosure agreements in medical malpractice settlements and the extent to which the restrictions in these agreements seem incompatible with good patient care. We performed a retrospective review of medical malpractice claim files, including settlement agreements, for claims closed before (fiscal year 2001-2002), during (fiscal year 2006-2007), and after (fiscal years 2009-2012) the implementation of tort reform in Texas. We studied The University of Texas System, which self-insures malpractice claims that involve 6000 physicians at 6 medical campuses in 5 cities. Nondisclosure provisions in medical malpractice settlements. During the 5 study years, The University of Texas System closed 715 malpractice claims and made 150 settlement payments. For the 124 cases that met our selection criteria, the median compensation paid by the university was $100,000 (range, $500-$1.25 million), and the mean compensation was $185,372. A total of 110 settlement agreements (88.7%) included nondisclosure provisions. All the nondisclosure clauses prohibited disclosure of the settlement terms and amount, 61 (55.5%) prohibited disclosure that the settlement had been reached, 51 (46.4%) prohibited disclosure of the facts of the claim, 29 (26.4%) prohibited reporting to regulatory agencies, and 10 (9.1%) prohibited disclosure by the settling physicians and hospitals, not only by the claimant. Three agreements (2.7%) included specific language that prohibited the claimant from disparaging the physicians or hospitals. The 50 settlement agreements signed after tort reform took full effect in Texas (2009-2012) had stricter nondisclosure provisions than the

  16. Optimal Pricing Strategy in Marketing Research Consulting.

    OpenAIRE

    Chang, Chun-Hao; Lee, Chi-Wen Jevons

    1994-01-01

    This paper studies the optimal pricing scheme for a monopolistic marketing research consultant who sells high-cost proprietary marketing information to her oligopolistic clients in the manufacturing industry. In designing an optimal pricing strategy, the consultant needs to fully consider the behavior of her clients, the behavior of the existing and potential competitors to her clients, and the behavior of her clients' customers. The authors show how the environment uncertainty, the capabilit...

  17. Kaon scattering from C and Ca at 800 MeV/c

    International Nuclear Information System (INIS)

    Marlow, D.; Barnes, P.D.; Colella, N.J.; Dytman, S.A.; Eisenstein, R.A.; Grace, R.; Takeutchi, F.; Wharton, W.R.; Bart, S.; Hancock, D.; Hackenberg, R.; Hungerford, E.; Mayes, W.; Pinsky, L.; Williams, T.; Chrien, R.; Palevsky, H.; Sutter, R.

    1982-01-01

    Results from K +- elastic and inelastic scattering from 12 C and 40 Ca are reported. The data were all taken at an incident momentum of 800 MeV/c over an angular range from 2 to 38 0 . The elastic data are compared to first-order optical model calculations in coordinate and momentum space; good qualitative agreement is obtained. The inelastic data (from 12 C only) are compared to distorted-wave Born approximation calculations, and good agreement is found if ''realistic'' inelastic transition densities are used. Although a first-order optical potential description does not describe the data fully, there are strong indications of the increased penetrability of K + over K - in this energy range

  18. Digital audio recordings improve the outcomes of patient consultations

    DEFF Research Database (Denmark)

    Wolderslund, Maiken; Kofoed, Poul-Erik; Holst, René

    2017-01-01

    OBJECTIVES: To investigate the effects on patients' outcome of the consultations when provided with: a Digital Audio Recording (DAR) of the consultation and a Question Prompt List (QPL). METHODS: This is a three-armed randomised controlled cluster trial. One group of patients received standard care......, while the other two groups received either the QPL in combination with a recording of their consultation or only the recording. Patients from four outpatient clinics participated: Paediatric, Orthopaedic, Internal Medicine, and Urology. The effects were evaluated by patient-administered questionnaires...

  19. 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...

  20. Can audio recording of outpatient consultations improve patient outcome?

    DEFF Research Database (Denmark)

    Wolderslund, Maiken; Kofoed, Poul-Erik; Axboe, Mette

    different departments: Orthopedics, Urology, Internal Medicine and Pediatrics. A total of 5,460 patients will be included from the outpatient clinics. All patients randomized to an intervention group are offered audio recording of their consultation. An Interactive Voice Response platform enables an audio....... The intervention will be evaluated using a questionnaire measuring different aspect of patients recall and understanding of the information given, patients need for additional information subsequent to the consultation and their overall satisfaction with the consultation. Results The study will be conducted from...

  1. The role of marketing in the modern local consulting

    Directory of Open Access Journals (Sweden)

    Bezpalova Anna

    2016-02-01

    Full Text Available Modern market conditions are so complex and unstable that the marketing activity of the local consulting companies becomes virtually unpredictable, difficult to plan and control. Most consulting firms previously hold claims against their marketing and the current state of the market actually triggered the rejection and the transition to spontaneous economic activity. In the framework of the article the role of the of marketing in the current activity of local consulting companies is identified and its potential perspectives for the target audience are proved

  2. Consulting communities: a renewable energy toolkit

    Energy Technology Data Exchange (ETDEWEB)

    Hinshelwood, E.; McCallum, D.

    2001-07-01

    Renewable Energy (RE) projects in the UK have always involved a degree of consultation. In many cases, however, it is limited to statutory consultees and key individuals in the locality of a proposed site. But as sustainable development moves up the agenda, and as the UK generation of RE is falling behind its European counterparts, the views of communities are becoming more of an issues. If priority is to be placed on sensitive and successful RE development, then it is vital to recognise local people as key stakeholders. They need to be acknowledged as potential catalysts for change, rather than as obstacles or sources of resistance to new technologies. A greater emphasis on community involvement (at all levels in RE development) represents a strategic move. It is both ethically important, and cost-effective in the long run. While there are a variety of aspects of community involvement, this guide deals specifically with community consultation, and acts as a support to organisations and companies planning the development of a Renewable Energy project. The guide is not intended as a 'tactic to get around' communities or to somehow 'win them over'. The premise behind consultation is to ensure that local people have access to relevant information and that the channels of communication exist whereby local people can contribute to project development. In a successful consultation, residents are seen as partners in the overall process of sustainable development. Local people are vital if we are to move forward. (Author)

  3. Cost and consultation patterns of abdominal pain in Uruguayan children.

    Science.gov (United States)

    Saps, Miguel; Bolioli, Pablo; Espana, Magali; Marshall, Beth M; Di Lorenzo, Carlo

    2008-02-01

    Children with abdominal pain (AP) have worse quality of life and poorer social functioning and school attendance than their healthy peers. This is the first investigation of consultation patterns and costs of AP in South American children. All data were collected from Unidad Coronaria Movil in Montevideo, Uruguay. Diagnoses of all house calls during a 4-year period (January 2002 through December 2005) were analyzed. Variances in consultation patterns based on sex and age were investigated. Supply and personnel costs were analyzed and prorated to obtain an accurate estimate of the cost per house call and outpatient visit. A total of 125,945 in-home visits and 1588 outpatient consultations were analyzed. Consultation rates for AP peaked among patients 7 to 9 years of age. Female subjects 9 to 14 years of age consulted significantly more frequently for AP than male subjects in the same age group. The average AP consultation accounted for approximately 3.8% of the per capita health care spending in Uruguay in 2005. AP is a global health problem that is present across ethnicities, nationalities, and geographic locations and is associated with significant health care expenditure.

  4. 40 CFR 264.555 - Disposal of CAMU-eligible wastes in permitted hazardous waste landfills.

    Science.gov (United States)

    2010-07-01

    ... this section are met: (1) The waste meets the definition of CAMU-eligible waste in § 264.552(a)(1) and... remediation. (d) Applicable hazardous waste management requirements in this part, including recordkeeping... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Disposal of CAMU-eligible wastes in...

  5. Beyond the 'dyad': a qualitative re-evaluation of the changing clinical consultation.

    Science.gov (United States)

    Swinglehurst, Deborah; Roberts, Celia; Li, Shuangyu; Weber, Orest; Singy, Pascal

    2014-09-29

    To identify characteristics of consultations that do not conform to the traditionally understood communication 'dyad', in order to highlight implications for medical education and develop a reflective 'toolkit' for use by medical practitioners and educators in the analysis of consultations. A series of interdisciplinary research workshops spanning 12 months explored the social impact of globalisation and computerisation on the clinical consultation, focusing specifically on contemporary challenges to the clinician-patient dyad. Researchers presented detailed case studies of consultations, taken from their recent research projects. Drawing on concepts from applied sociolinguistics, further analysis of selected case studies prompted the identification of key emergent themes. University departments in the UK and Switzerland. Six researchers with backgrounds in medicine, applied linguistics, sociolinguistics and medical education. One workshop was also attended by PhD students conducting research on healthcare interactions. The contemporary consultation is characterised by a multiplicity of voices. Incorporation of additional voices in the consultation creates new forms of order (and disorder) in the interaction. The roles 'clinician' and 'patient' are blurred as they become increasingly distributed between different participants. These new consultation arrangements make new demands on clinicians, which lie beyond the scope of most educational programmes for clinical communication. The consultation is changing. Traditional consultation models that assume a 'dyadic' consultation do not adequately incorporate the realities of many contemporary consultations. A paradox emerges between the need to manage consultations in a 'super-diverse' multilingual society, while also attending to increasing requirements for standardised protocol-driven approaches to care prompted by computer use. The tension between standardisation and flexibility requires addressing in educational

  6. Clinical Ethics Consultation After God: Implications for Advocacy and Neutrality.

    Science.gov (United States)

    Parker, J Clint

    2018-06-01

    In After God: Morality and Bioethics in a Secular Age, H. Tristram Engelhardt, Jr. explores the broad implications for moral reasoning once a culture has lost a God's-eye perspective. In this paper, I focus on the implications of Engelhardt's views for clinical ethics consultation. I begin by examining the question of whether clinical ethics consultants (CECs) should advocate a particular viewpoint and/or process during consultations or adopt a neutral stance. I then examine the implications of Engelhardt's views for this question. Finally, I discuss some of Engelhardt's foundational ontological, metaphysical, meta-ethical, and epistemological commitments and how these commitments connect to his views on clinical ethics consultation.

  7. Immunostimulatory Activity of Opuntia ficus-indica var. Saboten Cladodes Fermented by Lactobacillus plantarum and Bacillus subtilis in RAW 264.7 Macrophages.

    Science.gov (United States)

    Hwang, Joon-Ho; Lim, Sang-Bin

    2017-02-01

    To increase the functionality of Opuntia ficus-indica var. saboten cladodes, it was fermented by Lactobacillus plantarum and Bacillus subtilis. Eighty percent methanol extracts were investigated for their effects on nitric oxide (NO) production, cytokine secretion, nuclear factor-κB (NF-κB) activity, and mitogen-activated protein kinase (MAPK) phosphorylation in RAW 264.7 cells. Methanol extracts of L. plantarum culture medium (LPCME) and B. subtilis culture medium (BSCME) did not affect lipopolysaccharide (LPS)-induced NO production but, at 500 μg/mL, increased interferon (IFN)-γ-induced NO production by 55.2 and 66.5 μM, respectively, in RAW 264.7 cells. In RAW 264.7 cells not treated with LPS and IFN-γ, LPCME did not affect NO production, but BSCME increased NO production significantly in a dose-dependent manner. In addition, BSCME induced the expression of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) in RAW 264.7 cells in a dose-dependent manner. BSCME at 500 μg/mL increased TNF-α and IL-1β mRNA levels by 83.8% and 82.2%, respectively. BSCME increased NF-κB-dependent luciferase activity in a dose-dependent manner; 500 μg/mL BSCME increased activity 9.1-fold compared with the control. BSCME induced the phosphorylation of p38, c-JUN NH 2 -terminal protein kinase (JNK), and extracellular signal-regulated kinase (ERK) in a dose-dependent manner, but did not affect total ERK levels. In conclusion, BSCME exerted immunostimulatory effects, which were mediated by MAPK phosphorylation and NF-κB activation, resulting in increased TNF-α and IL-1β gene expression in RAW 264.7 macrophages. Therefore, BSCM shows promise for use as an immunostimulatory therapeutic.

  8. Value of Combined Detection of Serum CEA, CA72-4, CA19-9, CA15-3 and CA12-5 in the Diagnosis of Gastric Cancer.

    Science.gov (United States)

    Chen, Changguo; Chen, Qiuyuan; Zhao, Qiangyuan; Liu, Min; Guo, Jianwei

    2017-05-01

    To examine whether the combined detection of serum tumor markers (CEA, CA72-4, CA19-9, CA15-3 and CA12-5) improves the sensitivity and accuracy in the diagnosis of gastric cancer (GC). An automatic chemiluminescence immune analyzer with matched kits was used to determine the levels of serum CEA, CA72-4, CA19-9, CA15-3, and CA12-5 in 87 patients with gastric cancer (GC group), 60 patients with gastric benign diseases (GBD group) who were hospitalized during the same period, and 40 healthy subjects undergoing a physical examination. The values of these 5 tumor markers in the diagnosis of gastric cancer were analyzed. The levels of serum CEA, CA72-4, CA19-9, and CA12-5 were higher in the GC group than in the GBD group and healthy subjects, and these differences were significant ( P 0.05). The combined detection of CEA, CA72-4, CA19-9, and CA12-5 had a higher diagnostic value for gastric cancer than did single detection, and the positive detection rate of the combined detection of the four tumor markers was 60.9%. The diagnostic power when using the combined detection of CA72-4, CEA, CA19-9, and CA12-5 was the best. The combined detection of serum CA72-4, CEA, CA19-9 and CA12-5 increases the sensitivity and accuracy in the diagnosis of GC and can thus be considered an important tool for early diagnosis. © 2017 by the Association of Clinical Scientists, Inc.

  9. An exploration of pharmacist-patient communication in clinic-style consultations

    OpenAIRE

    Greenhill, Nicola H.

    2010-01-01

    The importance of communication skills for pharmacists has been widely acknowledged. Research has shown that the use of good communication skills can improve patient health outcomes but little research has focussed on communication within new consultation based roles of pharmacists. This study aimed to explore the communication between pharmacists and patients in clinic style consultations and to investigate participant perceptions of communication and consultations. Eleven pharmacists ...

  10. Why the "widespread agreement" is wrong: contesting the non-harm arguments for the prohibition of full commercial surrogacy.

    Science.gov (United States)

    Gaffney, Peter

    2009-10-01

    Entering a commercial surrogacy agreement is an offence in almost all Australian jurisdictions. A 2009 Consultation Paper produced by the Standing Committee of Attorneys-General suggested that there was "widespread agreement" that commercial surrogacy should remain prohibited. The arguments most commonly raised against legalising commercial surrogacy are not harm-based; that is, they do not purport to show that any party involved is tangibly, objectively and non-consensually worse off as a result of the transaction. This would be very difficult to show. Rather, the arguments against commercial surrogacy tend to focus on non-harm considerations, including principally concerns about the commodification of life and exploitation. This article argues that there are no sound non-harm reasons for banning one form of commercial surrogacy namely full commercial surrogacy.

  11. 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.

  12. Inside the fitness for work consultation: a qualitative study.

    Science.gov (United States)

    Cohen, D A; Aylward, M; Rollnick, S

    2009-08-01

    Evidence now suggests that work is generally good for physical and mental health and well-being. Worklessness for whatever reason can lead to poorer physical and mental health. The role of the general practitioner (GP) in the management of fitness for work is pivotal. To understand the interaction between GP and patient in the fitness for work consultation. This study forms part of a larger research project to develop a learning programme for GPs around the fitness for work consultation based on behaviour change methodology. A qualitative study set in South Wales. Structured discussion groups with seven GPs. Two sessions each lasting 3 h were conducted to explore the GP and patient interaction around the fitness for work consultation. Multiple methods were used to enhance engagement. Thematic analysis was used to analyse the data. Four major themes emerged from the meetings: role legitimacy, negotiation, managing the patient and managing the systems. Within these, subthemes emerged around role legitimacy. 'It's not my job', 'It's not what I trained for' and the 'shifting agenda' Negotiation was likened to 'A polite tug of war' and subthemes around decision making, managing the agenda and dealing with uncertainty emerged. This study starts to unravel the complexity of the fitness for work consultation. It illustrates how GPs struggle with the 'importance' of their role and 'confidence' in managing the fitness for work consultation. It addresses the skillful negotiation that is required to manage the consultation effectively.

  13. EQClinic: a platform for learning communication skills in clinical consultations.

    Science.gov (United States)

    Liu, Chunfeng; Scott, Karen M; Lim, Renee L; Taylor, Silas; Calvo, Rafael A

    2016-01-01

    Doctors' verbal and non-verbal communication skills have an impact on patients' health outcomes, so it is important for medical students to develop these skills. Traditional, non-verbal communication skills training can involve a tutor manually annotating a student's non-verbal behaviour during patient-doctor consultations, but this is very time-consuming. Tele-conference systems have been used in verbal communication skills training. We describe EQClinic, a system that enables verbal and non-verbal communication skills training during tele-consultations with simulated patients (SPs), with evaluation exercises promoting reflection. Students and SPs can have tele-consultations through the tele-consultation component. In this component, SPs can provide feedback to students through a thumbs-up/ thumbs-down tool and a comments box. EQClinic automatically analyses communication features in the recorded consultations, such as facial expressions, and provides graphical representations. Our 2015 pilot study investigated whether EQClinic helped students be aware of their non-verbal behaviour and improve their communication skills, and evaluated the usability of the platform. Students received automated feedback, and SP and tutor evaluations, and then completed self-assessment and reflection questionnaires. Eight medical students and three SPs conducted 13 tele-consultations using EQClinic. More students paid attention to their non-verbal communication and students who were engaged in two consultations felt more confident in their second consultation. Students rated the system positively, felt comfortable using it (5.9/7), and reported that the structure (5.4/7) and information (5.8/7) were clear. This pilot provides evidence that EQClinic helps, and positively influences, medical students practise their communication skills with SPs using a tele-conference platform. It is not easy to improve non-verbal communication skills in a short time period. Further evaluation of

  14. EQClinic: a platform for learning communication skills in clinical consultations

    Directory of Open Access Journals (Sweden)

    Chunfeng Liu

    2016-07-01

    Full Text Available Background: Doctors’ verbal and non-verbal communication skills have an impact on patients’ health outcomes, so it is important for medical students to develop these skills. Traditional, non-verbal communication skills training can involve a tutor manually annotating a student's non-verbal behaviour during patient–doctor consultations, but this is very time-consuming. Tele-conference systems have been used in verbal communication skills training. Methods: We describe EQClinic, a system that enables verbal and non-verbal communication skills training during tele-consultations with simulated patients (SPs, with evaluation exercises promoting reflection. Students and SPs can have tele-consultations through the tele-consultation component. In this component, SPs can provide feedback to students through a thumbs-up/ thumbs-down tool and a comments box. EQClinic automatically analyses communication features in the recorded consultations, such as facial expressions, and provides graphical representations. Our 2015 pilot study investigated whether EQClinic helped students be aware of their non-verbal behaviour and improve their communication skills, and evaluated the usability of the platform. Students received automated feedback, and SP and tutor evaluations, and then completed self-assessment and reflection questionnaires. Results: Eight medical students and three SPs conducted 13 tele-consultations using EQClinic. More students paid attention to their non-verbal communication and students who were engaged in two consultations felt more confident in their second consultation. Students rated the system positively, felt comfortable using it (5.9/7, and reported that the structure (5.4/7 and information (5.8/7 were clear. This pilot provides evidence that EQClinic helps, and positively influences, medical students practise their communication skills with SPs using a tele-conference platform. Discussion: It is not easy to improve non

  15. Assessing communication quality of consultations in primary care: initial reliability of the Global Consultation Rating Scale, based on the Calgary-Cambridge Guide to the Medical Interview

    Science.gov (United States)

    Burt, Jenni; Abel, Gary; Elmore, Natasha; Campbell, John; Roland, Martin; Benson, John; Silverman, Jonathan

    2014-01-01

    Objectives To investigate initial reliability of the Global Consultation Rating Scale (GCRS: an instrument to assess the effectiveness of communication across an entire doctor–patient consultation, based on the Calgary-Cambridge guide to the medical interview), in simulated patient consultations. Design Multiple ratings of simulated general practitioner (GP)–patient consultations by trained GP evaluators. Setting UK primary care. Participants 21 GPs and six trained GP evaluators. Outcome measures GCRS score. Methods 6 GP raters used GCRS to rate randomly assigned video recordings of GP consultations with simulated patients. Each of the 42 consultations was rated separately by four raters. We considered whether a fixed difference between scores had the same meaning at all levels of performance. We then examined the reliability of GCRS using mixed linear regression models. We augmented our regression model to also examine whether there were systematic biases between the scores given by different raters and to look for possible order effects. Results Assessing the communication quality of individual consultations, GCRS achieved a reliability of 0.73 (95% CI 0.44 to 0.79) for two raters, 0.80 (0.54 to 0.85) for three and 0.85 (0.61 to 0.88) for four. We found an average difference of 1.65 (on a 0–10 scale) in the scores given by the least and most generous raters: adjusting for this evaluator bias increased reliability to 0.78 (0.53 to 0.83) for two raters; 0.85 (0.63 to 0.88) for three and 0.88 (0.69 to 0.91) for four. There were considerable order effects, with later consultations (after 15–20 ratings) receiving, on average, scores more than one point higher on a 0–10 scale. Conclusions GCRS shows good reliability with three raters assessing each consultation. We are currently developing the scale further by assessing a large sample of real-world consultations. PMID:24604483

  16. Establishing the potential of Ca isotopes as proxy for consumption of dairy products

    International Nuclear Information System (INIS)

    Chu, N.-C.; Henderson, Gideon M.; Belshaw, Nick S.; Hedges, Robert E.M.

    2006-01-01

    A procedure has been developed which allows precise determination of Ca isotope ratios in natural and organic samples such as bones, milk and other biological materials. In this study the procedure is used to determine Ca isotope ratios in modern dietary systems and to establish the potential of Ca isotopes as a paleodiet tracer by analysis of bones. Multi-sampling across a 5 cm portion of a red deer jawbone shows invariant Ca isotope ratios and suggests negligible isotopic effect during bone remodelling. The difference between Ca isotopes in red deer diet and bones from one location was 0.65 per mille , in agreement with a previous study of diet/bone offsets. Similar values for modern deer-bone δ 44/42 Ca from four geographically diverse populations demonstrate that geological/environmental conditions do not cause large variability and suggest that diet is the major cause for variations in bone δ 44/42 Ca. δ 44/42 Ca of herbivore milk is found to be ∼0.5 to 0.6 higher than the corresponding diet. Modern human milk has a δ 44/42 Ca of -1.15 (n = 4) and is isotopically the lightest material reported in this study. This suggests that, for these samples, a significant portion of Ca intake was from dairy sources, and that human milk has Ca which is, again, ∼0.6 per mille isotopically lighter than dietary Ca intake. Finally, Ca isotope ratios are presented from a variety of samples formed during fermentation processes (e.g., curds, whey, etc.) which indicate that these processes do not fractionate Ca isotopes significantly. Together, the data in this paper indicate that, because milk is an important dietary source of Ca with a distinctive signature, Ca isotope ratios should provide a tracer for past dairy consumption. A simplified model is outlined to demonstrate the ability to quantify dairy consumption by the analysis of Ca isotopes in bones

  17. The role of assessment packages for diagnostic consultations

    DEFF Research Database (Denmark)

    Rossen, Camilla B; Buus, Niels; Stenager, Egon

    2015-01-01

    and content. Assessment packages are widely used in an increasing number of medical specialities; however, there is a lack of knowledge about how packaged assessment influences the interaction between doctor and patient. In this study, we investigate the final consultation in assessment packages, which...... whose goal was to leave the consultation with clarification in the form of a definite diagnosis, but who were not offered such clarification. These patients negotiated the outcome of the consultation by applying implicit and explicit pressure, which induced the doctors to disregard the boundaries...... of the package and offer the patient more tests. The study highlights some of the problems related to introducing narrow, specialized package assessment....

  18. A resident's rotation in consultation psychiatry. A maturational experience.

    Science.gov (United States)

    Granet, R B; Perry, S W; Talbott, J A

    1980-12-01

    The authors emphasize the importance of a consultation psychiatry experience in the maturation of the young psychiatrist by examining some of the processes operational in both community and hospital consultation work, performed by the senior author during his fourth year of residency. Such experiences can provide opportunities for developing psychiatric skills not emphasized elsewhere, including the adoption of an active therapeutic stance, the application of the psychodynamic theory to the consultation system itself, and teaching without the use of jargon. In addition the experience as consultant facilitates the transition from residency to the outside world, not only through attitudinal changes achieved by exposure to less structured settings, a change in the supervisory model, and a solidification of identity as a physician and psychiatrist, but also by providing the resident the opportunity to begin de-cathecting from the training program.

  19. Mother-infant consultation during drug treatment: Research and innovative clinical practice

    Directory of Open Access Journals (Sweden)

    Lester Barry M

    2008-02-01

    Full Text Available Abstract Background This paper details a model for consulting with mothers and infants, and drug treatment staff used in a residential drug treatment program and relevant to other treatment settings. The role of parent-infant consultation based on the Neonatal Network Neurobehavioral Scale (NNNS was evaluated. Methods A sequential cohort model was used to assign participants to 1. NNNS consultation versus 2. standard care. The effects of NNNS consultation were evaluated using the Parenting Stress Index and NNNS summary scores. Results Participants in the NNNS consultation condition had significantly less stress overall, and less stress related to infant behavior than participants in standard care. There were no differences in infant behavior on the NNNS Summary scores. Conclusion The implications for NNNS consultation in drug treatment programs is outlined. The importance of prevention/intervention to establish satisfactory mother-infant interaction in recovery programs which include a central parenting component is indicated.

  20. 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.

  1. Multiple C-terminal tail Ca(2+)/CaMs regulate Ca(V)1.2 function but do not mediate channel dimerization.

    Science.gov (United States)

    Kim, Eun Young; Rumpf, Christine H; Van Petegem, Filip; Arant, Ryan J; Findeisen, Felix; Cooley, Elizabeth S; Isacoff, Ehud Y; Minor, Daniel L

    2010-12-01

    Interactions between voltage-gated calcium channels (Ca(V)s) and calmodulin (CaM) modulate Ca(V) function. In this study, we report the structure of a Ca(2+)/CaM Ca(V)1.2 C-terminal tail complex that contains two PreIQ helices bridged by two Ca(2+)/CaMs and two Ca(2+)/CaM-IQ domain complexes. Sedimentation equilibrium experiments establish that the complex has a 2:1 Ca(2+)/CaM:C-terminal tail stoichiometry and does not form higher order assemblies. Moreover, subunit-counting experiments demonstrate that in live cell membranes Ca(V)1.2s are monomers. Thus, contrary to previous proposals, the crystallographic dimer lacks physiological relevance. Isothermal titration calorimetry and biochemical experiments show that the two Ca(2+)/CaMs in the complex have different properties. Ca(2+)/CaM bound to the PreIQ C-region is labile, whereas Ca(2+)/CaM bound to the IQ domain is not. Furthermore, neither of lobes of apo-CaM interacts strongly with the PreIQ domain. Electrophysiological studies indicate that the PreIQ C-region has a role in calcium-dependent facilitation. Together, the data show that two Ca(2+)/CaMs can bind the Ca(V)1.2 tail simultaneously and indicate a functional role for Ca(2+)/CaM at the C-region site.

  2. The site of net absorption of Ca from the intestinal tract of growing pigs and effect of phytic acid, Ca level and Ca source on Ca digestibility.

    Science.gov (United States)

    González-Vega, J Caroline; Walk, Carrie L; Liu, Yanhong; Stein, Hans H

    2014-01-01

    An experiment was conducted to test the hypothesis that the standardised digestibility of Ca in calcium carbonate and Lithothamnium calcareum Ca is not different regardless of the level of dietary Ca, and that phytic acid affects the digestibility of Ca in these two ingredients to the same degree. The objectives were to determine where in the intestinal tract Ca absorption takes place and if there are measurable quantities of basal endogenous Ca fluxes in the stomach, small intestine or large intestine. Diets contained calcium carbonate or L. calcareum Ca as the sole source of Ca, 0% or 1% phytic acid and 0.4% or 0.8% Ca. A Ca-free diet was also formulated and used to measure endogenous fluxes and losses of Ca. Nine growing pigs (initial body weight 23.8 ± 1.3 kg) were cannulated in the duodenum and in the distal ileum, and faecal, ileal and duodenal samples were collected. Duodenal endogenous fluxes of Ca were greater (p calcareum Ca diets, but that was not the case if calcium carbonate was the source of Ca (interaction, p calcareum Ca was greater (p calcareum Ca. In conclusion, under the conditions of this experiment, standardised digestibility of Ca is not affected by the level of phytic acid, but may be affected by dietary Ca level depending on the Ca source. Calcium from calcium carbonate is mostly absorbed before the duodenum, but Ca from L. calcareum Ca is mostly absorbed in the jejunum and ileum.

  3. Evaluation of H.264/AVC over IEEE 802.11p vehicular networks

    Science.gov (United States)

    Rozas-Ramallal, Ismael; Fernández-Caramés, Tiago M.; Dapena, Adriana; García-Naya, José Antonio

    2013-12-01

    The capacity of vehicular networks to offer non-safety services, like infotainment applications or the exchange of multimedia information between vehicles, have attracted a great deal of attention to the field of Intelligent Transport Systems (ITS). In particular, in this article we focus our attention on IEEE 802.11p which defines enhancements to IEEE 802.11 required to support ITS applications. We present an FPGA-based testbed developed to evaluate H.264/AVC (Advanced Video Coding) video transmission over vehicular networks. The testbed covers some of the most common situations in vehicle-to-vehicle and roadside-to-vehicle communications and it is highly flexible, allowing the performance evaluation of different vehicular standard configurations. We also show several experimental results to illustrate the quality obtained when H.264/AVC encoded video is transmitted over IEEE 802.11p networks. The quality is measured considering two important parameters: the percentage of recovered group of pictures and the frame quality. In order to improve performance, we propose to substitute the convolutional channel encoder used in IEEE 802.11p for a low-density parity-check code encoder. In addition, we suggest a simple strategy to decide the optimum number of iterations needed to decode each packet received.

  4. Low-Power Bitstream-Residual Decoder for H.264/AVC Baseline Profile Decoding

    Directory of Open Access Journals (Sweden)

    Xu Ke

    2009-01-01

    Full Text Available Abstract We present the design and VLSI implementation of a novel low-power bitstream-residual decoder for H.264/AVC baseline profile. It comprises a syntax parser, a parameter decoder, and an Inverse Quantization Inverse Transform (IQIT decoder. The syntax parser detects and decodes each incoming codeword in the bitstream under the control of a hierarchical Finite State Machine (FSM; the IQIT decoder performs inverse transform and quantization with pipelining and parallelism. Various power reduction techniques, such as data-driven based on statistic results, nonuniform partition, precomputation, guarded evaluation, hierarchical FSM decomposition, TAG method, zero-block skipping, and clock gating , are adopted and integrated throughout the bitstream-residual decoder. With innovative architecture, the proposed design is able to decode QCIF video sequences of 30 fps at a clock rate as low as 1.5 MHz. A prototype H.264/AVC baseline decoding chip utilizing the proposed decoder is fabricated in UMC 0.18  m 1P6M CMOS technology. The proposed design is measured under 1 V 1.8 V supply with 0.1 V step. It dissipates 76  W at 1 V and 253  W at 1.8 V.

  5. [The presence of a companion in the primary care consultation].

    Science.gov (United States)

    Turabián, J L; Pérez Franco, B

    2015-01-01

    The presence of an adult accompanying the patient in the consulting room is a significant fact that deserves the attention of the physician. Some types of companions and their presence in the consultation have been described and may improve communication, patient management, and participatory decision making, achieving greater patient satisfaction. Consultations with companion are generally longer, and patients accompanied are often elderly, women, less educated, and with poorer physical and mental health. But it is not known exactly what is the significance of a consultation with a companion. It may be a semiological fact to keep in mind for the family diagnosis, or it may be the risks of their presence, the influence of medication, or the importance of the doctors themselves that are the cause of the presence of a companion. Different communication skills must be achieved during the interview with the companion in the consultation, rather than with the patient alone. Copyright © 2014. Publicado por Elsevier España, S.L.U.

  6. 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

  7. Low-lying dipole response in the stable 40,48Ca nuclei within the second random-phase approximation

    International Nuclear Information System (INIS)

    Gambacurta, D.; Grasso, M.; Catara, F.

    2012-01-01

    The low-lying dipole strength distributions of 40 CaCa and 48 Ca, in the energy region between 5 and 10 MeV, are studied within the second random phase approximation (RPA) with Skyrme interaction. Standard RPA models do not usually predict any presence of strength in this energy region, while experimentally a significant amount of strength is found. The inclusion of the 2 particle −2 hole configurations allows to obtain a description in a rather good agreement with the experimental data. The properties of the most collective state are analyzed in terms of its 1 particle −1 hole nature and its transition densities.

  8. Low-lying dipole response in the stable 40,48Ca nuclei within the second random-phase approximation

    Science.gov (United States)

    Gambacurta, D.; Grasso, M.; Catara, F.

    2012-10-01

    The low-lying dipole strength distributions of 40CaCa and 48Ca, in the energy region between 5 and 10 MeV, are studied within the second random phase approximation (RPA) with Skyrme interaction. Standard RPA models do not usually predict any presence of strength in this energy region, while experimentally a significant amount of strength is found. The inclusion of the 2 particle -2 hole configurations allows to obtain a description in a rather good agreement with the experimental data. The properties of the most collective state are analyzed in terms of its 1 particle -1 hole nature and its transition densities.

  9. The uptake of tocopherols by RAW 264.7 macrophages

    Directory of Open Access Journals (Sweden)

    Papas Andreas M

    2002-10-01

    Full Text Available Abstract Background Alpha-Tocopherol and gamma-tocopherol are the two major forms of vitamin E in human plasma and the primary lipid soluble antioxidants. The dietary intake of gamma-tocopherol is generally higher than that of alpha-tocopherol. However, alpha-tocopherol plasma levels are about four fold higher than those of gamma-tocopherol. Among other factors, a preferential cellular uptake of gamma-tocopherol over alpha-tocopherol could contribute to the observed higher plasma alpha-tocopherol levels. In this investigation, we studied the uptake and depletion of both alpha-tocopherol and gamma-tocopherol (separately and together in cultured RAW 264.7 macrophages. Similar studies were performed with alpha-tocopheryl quinone and gamma-tocopheryl quinone, which are oxidation products of tocopherols. Results RAW 264.7 macrophages showed a greater uptake of gamma-tocopherol compared to alpha-tocopherol (with uptake being defined as the net difference between tocopherol transported into the cells and loss due to catabolism and/or in vitro oxidation. Surprisingly, we also found that the presence of gamma-tocopherol promoted the cellular uptake of alpha-tocopherol. Mass balance considerations suggest that products other than quinone were formed during the incubation of tocopherols with macrophages. Conclusion Our data suggests that gamma-tocopherol could play a significant role in modulating intracellular antioxidant defence mechanisms. Moreover, we found the presence of gamma-tocopherol dramatically influenced the cellular accumulation of alpha-tocopherol, i.e., gamma-tocopherol promoted the accumulation of alpha-tocopherol. If these results could be extrapolated to in vivo conditions they suggest that gamma-tocopherol is selectively taken up by cells and removed from plasma more rapidly than alpha-tocopherol. This could, in part, contribute to the selective maintenance of alpha-tocopherol in plasma compared to gamma-tocopherol.

  10. Telemedicine Consultations in Oral and Maxillofacial Surgery: A Follow-Up Study.

    Science.gov (United States)

    Wood, Eric W; Strauss, Robert A; Janus, Charles; Carrico, Caroline K

    2016-02-01

    The purpose of this study was to follow up on the previous study in evaluating the efficiency and reliability of telemedicine consultations for preoperative assessment of patients. A retrospective study of 335 patients over a 6-year period was performed to evaluate success rates of telemedicine consultations in adequately assessing patients for surgical treatment under anesthesia. Success or failure of the telemedicine consultation was measured by the ability to triage patients appropriately for the hospital operating room versus the clinic, to provide an accurate diagnosis and treatment plan, and to provide a sufficient medical and physical assessment for planned anesthesia. Data gathered from the average distance traveled and data from a previous telemedicine study performed by the National Institute of Justice were used to estimate the cost savings of using telemedicine consultations over the 6-year period. Practitioners performing the consultation were successful 92.2% of the time in using the data collected to make a diagnosis and treatment plan. Patients were triaged correctly 99.6% of the time for the clinic or hospital operating room. Most patients (98.0%) were given sufficient medical and physical assessment and were able to undergo surgery with anesthesia as planned at the clinic appointment immediately after telemedicine consultation. Most patients (95.9%) were given an accurate diagnosis and treatment plan. The estimated amount saved by providing consultation by telemedicine and eliminating in-office consultation was substantial at $134,640. This study confirms the findings from previous studies that telemedicine consultations are as reliable as those performed by traditional methods. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  11. Evaluation of the Effect of Consultant Characteristics on Telemedicine Diagnosis and Treatment

    Directory of Open Access Journals (Sweden)

    Ann B. Bynum

    2011-01-01

    Full Text Available This study examined teleconsultants' specialty, practice setting, type of employment, years and training in telemedicine to evaluate the effect of these characteristics on diagnoses and treatment. A postuse survey was conducted during 1998–2003 (n=454 consultations in the University of Arkansas for Medical Sciences' Rural Hospital, Telehealth Project. There were 61 consultants who conducted the teleconsultations. The teleconsultants established a diagnosis in 121 consultations and reported a change in diagnoses in 29 consultations. The consultants established a treatment plan in 219 consultations and reported a change in the treatment plan in 100 consultations. Dermatologists were significantly more likely to establish (P<.01 and change (P=.005 the diagnosis and to establish a treatment plan (P=.03, when compared to all other specialties. Teleconsultants who were self-employed were significantly more likely to change the treatment plan (P=.012. The findings suggest that teleconsultants' characteristics can affect diagnoses and treatment in telemedicine.

  12. Vacancy induced metallicity at the CaHfO3/SrTiO3 interface

    KAUST Repository

    Nazir, Safdar

    2011-03-31

    Density functional theory is used to study the electronic properties of the oxide heterointerfaceCaHfO3/SrTiO3. Structural relaxation is carried out with and without O vacancies. As compared to related interfaces, strongly reduced octahedral distortions are found. Stoichiometric interfaces between the wide band gap insulatorsCaHfO3 and SrTiO3 turn out to exhibit an insulating state. However, interface metallicity is introduced by O vacancies, in agreement with experiment. The reduced octahedral distortions and necessity of O deficiency indicate a less complicated mechanism for the creation of the interfacial electron gas.

  13. Vacancy induced metallicity at the CaHfO3/SrTiO3 interface

    KAUST Repository

    Nazir, Safdar; Pulikkotil, J. J.; Schwingenschlö gl, Udo; Singh, Nirpendra

    2011-01-01

    Density functional theory is used to study the electronic properties of the oxide heterointerfaceCaHfO3/SrTiO3. Structural relaxation is carried out with and without O vacancies. As compared to related interfaces, strongly reduced octahedral distortions are found. Stoichiometric interfaces between the wide band gap insulatorsCaHfO3 and SrTiO3 turn out to exhibit an insulating state. However, interface metallicity is introduced by O vacancies, in agreement with experiment. The reduced octahedral distortions and necessity of O deficiency indicate a less complicated mechanism for the creation of the interfacial electron gas.

  14. An Analysis of WhatsApp Usage for Communication Between Consulting and Emergency Physicians.

    Science.gov (United States)

    Gulacti, Umut; Lok, Ugur; Hatipoglu, Sinan; Polat, Haci

    2016-06-01

    The aim of this study was to evaluate WhatsApp messenger usage for communication between consulting and emergency physicians. A retrospective, observational study was conducted in the emergency department (ED) of a tertiary care university hospital between January 2014 and June 2014. A total of 614 consultations requested by using the WhatsApp application were evaluated, and 519 eligible consultations were included in the study. The WhatsApp messages that were transferred to consultant physicians consisted of 510 (98.3%) photographic images, 517 (99.6%) text messages, 59 (11.3%) videos, and 10 (1.9%) voice messages. Consultation was most frequently requested from the orthopedics clinic (n = 160, 30.8%). The majority of requested consultations were terminated only by evaluation via WhatsApp messages. (n = 311, 59.9%). Most of the consulting physicians were outside of the hospital or were mobile at the time of the consultation (n = 292, 56.3%). The outside consultation request rate was significantly higher for night shifts than for day shifts (p = .004), and the majority of outside consultation request were concluded by only WhatsApp application (p WhatsApp is useful a communication tool between physicians, especially for ED consultants who are outside the hospital, because of the ability to transfer large amounts of clinical and radiological data during a short period of time.

  15. Flavonoids Identified from Korean Scutellaria baicalensis Georgi Inhibit Inflammatory Signaling by Suppressing Activation of NF-κB and MAPK in RAW 264.7 Cells

    Directory of Open Access Journals (Sweden)

    Gyeong-Eun Hong

    2013-01-01

    Full Text Available Scutellaria baicalensis Georgi has been used as traditional medicine for treating inflammatory diseases, hepatitis, tumors, and diarrhea in Asia. Hence, we investigated the anti-inflammatory effect and determined the molecular mechanism of action of flavonoids isolated from Korean S. baicalensis G. in lipopolysaccharide- (LPS- stimulated RAW 264.7 macrophages. A 3-(4,5-dimethylthiazol-2-yl-2,5-diphenyltetrazolium bromide assay was performed to examine cytotoxicity of the flavonoids at various concentrations of 10, 40, 70, and 100 µg/mL. No cytotoxicity was observed in RAW 264.7 cells at these concentrations. Furthermore, the flavonoids decreased production of inflammatory mediators such as inducible nitric oxide synthase, cyclooxygenase-2, interleukin-6, and tumor necrosis factor-alpha and inhibited phosphorylation of nuclear factor-kappa B (NF-κB and mitogen-activated protein kinases (MAPKs in LPS-induced RAW 264.7 cells. Moreover, to identify the differentially expressed proteins in RAW 264.7 cells of the control, LPS-treated, and flavonoid-treated groups, two-dimensional gel electrophoresis and mass spectrometry were conducted. The identified proteins were involved in the inflammatory response and included PRKA anchor protein and heat shock protein 70 kD. These findings suggest that the flavonoids isolated from S. baicalensis G. might have anti-inflammatory effects that regulate the expression of inflammatory mediators by inhibiting the NF-κB signaling pathway via the MAPK signaling pathway in RAW 264.7 cells.

  16. Ca2+/cation antiporters (CaCA: Identification, characterization and expression profiling in bread wheat (Triticum aestivum L.

    Directory of Open Access Journals (Sweden)

    Mehak Taneja

    2016-11-01

    Full Text Available The Ca2+/cation antiporters (CaCA superfamily proteins play vital function in Ca2+ ion homeostasis, which is an important event during development and defense response. Molecular characterization of these proteins has been performed in certain plants, but they are still not characterized in Triticum aestivum (bread wheat. Herein, we identified thirty four TaCaCA superfamily proteins, which were classified into TaCAX, TaCCX, TaNCL and TaMHX protein families based on their structural organization and evolutionary relation with earlier reported proteins. Since the T. aestivum comprises an allohexaploid genome, TaCaCA genes were derived from each A, B and D subgenome and homeologous chromosome (HC, except chromosome-group 1. Majority of genes were derived from more than one HCs in each family that were considered as homeologous genes (HGs due to their high similarity with each other. These HGs showed comparable gene and protein structures in terms of exon/intron organization and domain architecture. Majority of TaCaCA proteins comprised two Na_Ca_ex domains. However, TaNCLs consisted of an additional EF-hand domain with calcium binding motifs. Each TaCaCA protein family consisted of about ten transmembrane and two α-repeat regions with specifically conserved signature motifs except TaNCL, which had single α-repeat. Variable expression of most of the TaCaCA genes during various developmental stages suggested their specified role in development. However, constitutively high expression of a few genes like TaCAX1-A and TaNCL1-B indicated their role throughout the plant growth and development. The modulated expression of certain genes during biotic (fungal infections and abiotic stresses (heat, drought, salt suggested their role in stress response. Majority of TaCCX and TaNCL family genes were found highly affected during various abiotic stresses. However the role of individual gene needs to be established. The present study unfolded the opportunity

  17. Ca2+/Cation Antiporters (CaCA): Identification, Characterization and Expression Profiling in Bread Wheat (Triticum aestivum L.).

    Science.gov (United States)

    Taneja, Mehak; Tyagi, Shivi; Sharma, Shailesh; Upadhyay, Santosh Kumar

    2016-01-01

    The Ca 2+ /cation antiporters (CaCA) superfamily proteins play vital function in Ca 2+ ion homeostasis, which is an important event during development and defense response. Molecular characterization of these proteins has been performed in certain plants, but they are still not characterized in Triticum aestivum (bread wheat). Herein, we identified 34 TaCaCA superfamily proteins, which were classified into TaCAX, TaCCX, TaNCL, and TaMHX protein families based on their structural organization and evolutionary relation with earlier reported proteins. Since the T. aestivum comprises an allohexaploid genome, TaCaCA genes were derived from each A, B, and D subgenome and homeologous chromosome (HC), except chromosome-group 1. Majority of genes were derived from more than one HCs in each family that were considered as homeologous genes (HGs) due to their high similarity with each other. These HGs showed comparable gene and protein structures in terms of exon/intron organization and domain architecture. Majority of TaCaCA proteins comprised two Na_Ca_ex domains. However, TaNCLs consisted of an additional EF-hand domain with calcium binding motifs. Each TaCaCA protein family consisted of about 10 transmembrane and two α-repeat regions with specifically conserved signature motifs except TaNCL, which had single α-repeat. Variable expression of most of the TaCaCA genes during various developmental stages suggested their specified role in development. However, constitutively high expression of a few genes like TaCAX1-A and TaNCL1-B indicated their role throughout the plant growth and development. The modulated expression of certain genes during biotic (fungal infections) and abiotic stresses (heat, drought, salt) suggested their role in stress response. Majority of TaCCX and TaNCL family genes were found highly affected during various abiotic stresses. However, the role of individual gene needs to be established. The present study unfolded the opportunity for detail

  18. 76 FR 28446 - Policy on Consultation With Indian Tribes

    Science.gov (United States)

    2011-05-17

    .... Consultation promotes an enhanced form of communication that emphasizes trust, respect, and shared... consultation process, ensure continuity, and demonstrate commitment to the process. Communication will be open... access to traditional areas of cultural or religious importance on Federally managed lands; 2. The...

  19. 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.

  20. A molecular dynamics study of the atomic structure of (CaO)x(SiO2)1-x glasses.

    Science.gov (United States)

    Mead, Robert N; Mountjoy, Gavin

    2006-07-27

    The local atomic environment of Ca in (CaO)x(SiO2)1-x glasses is of interest because of the role of Ca in soda-lime glass, the application of calcium silicate glasses as biomaterials, and the previous experimental measurement of the Ca-Ca correlation in CaSiO(3) glass. Molecular dynamics has been used to obtain models of (CaO)x(SiO2)1-x glasses with x = 0, 0.1, 0.2, 0.3, 0.4, and 0.5, and with approximately 1000 atoms and size approximately 25 A. As expected, the models contain a tetrahedral silica network, the connectivity of which decreases as x increases. In the glass-forming region, i.e., x = 0.4 and 0.5, Ca has a mixture of 6- and 7-fold coordination. Bridging oxygen makes an important contribution to the coordination of Ca, with most bridging oxygens coordinated to 2 Si plus 1 Ca. The x = 0.5 model is in reasonable agreement with previous experimental studies, and does not substantiate the previous theory of cation ordering, which predicted Ca arranged in sheets. In the phase-separated region, i.e., x = 0.1 and 0.2, there is marked clustering of Ca.

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