WorldWideScience

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. 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.

  6. 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.

  7. 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

  8. 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)

  9. 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.

  10. 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

  11. 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...

  12. 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...

  13. 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...

  14. 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)

  15. 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...

  16. 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.

  17. 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...

  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. 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.)

  20. 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.

  1. 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.

  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. 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.

  4. 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)

  5. 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....

  6. 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...

  7. Bilateral agreements

    International Nuclear Information System (INIS)

    Anon.

    2004-01-01

    The bilateral agreements concern Brazil with United States relative to the co operation in nuclear energy, Germany with Russian Federation relative to the elimination and disposal of nuclear weapons; The multilateral agreements concerns the signature of the Protocols to amend the Paris and Brussels Conventions, the multilateral nuclear environmental programme in the Russian Federation, the status of Conventions in the field of nuclear energy. (N.C.)

  8. 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.

  9. 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)

  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. 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

  12. 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

  13. 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.

  14. 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.

  15. 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

  16. Preparation + consultation = better regulation

    International Nuclear Information System (INIS)

    Bines, W.

    2001-01-01

    This paper describes the recent experience of the Health and Safety Commission and its executive arm, the Health and Safety Executive (H.S.E.), in consulting over implementation of the bulk of the revised Basic Safety Standards Directive 96/29/EURATOM (the B.B.S.directive) and provides a personal assessment of the successful and challenges of this approach. (N.C.)

  17. Tutoring Mentoring Peer Consulting

    OpenAIRE

    Szczyrba, Birgit; Wildt, Johannes

    2006-01-01

    Consulting, Coaching und Supervision, Tutoring, Mentoring und kollegiale Beratung: Beratungsangebote verschiedenster Art werden wie selbstverständlich in den Berufen nachgefragt, die mit Beziehung und Interaktion, mit komplexen sozialen Organisationen und Systemen, mit hoher Verantwortlichkeit, aber unsicheren Handlungsbedingungen zu tun haben. Mittlerweile beginnt diese Nachfrage auch in den Hochschulen zu steigen. Eine solche Steigerung wird ausgelöst durch den Wandel in den Lehr-Lernkultur...

  18. 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...

  19. "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.

  20. 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.

  1. 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

  2. Consulting in Electronic Commerce

    Directory of Open Access Journals (Sweden)

    Florentina Loredana Tache

    2010-10-01

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

  3. 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...

  4. 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....

  5. 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

  6. 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.

  7. 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.

  8. 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.

  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. Agreement Workflow Tool (AWT)

    Data.gov (United States)

    Social Security Administration — The Agreement Workflow Tool (AWT) is a role-based Intranet application used for processing SSA's Reimbursable Agreements according to SSA's standards. AWT provides...

  11. 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

  12. 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...

  13. 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.

  14. Technology Partnership Agreements | NREL

    Science.gov (United States)

    Partnership Agreements Technology Partnership Agreements Looking for Funding? We do not fund any projects under a technology partnership agreement. The partner provides the necessary resources and, in using technology partnership agreements. See a summary of our Fiscal Year 2017 technology partnership

  15. 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.

  16. 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…

  17. 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.

  18. 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.

  19. 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)

  20. 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...

  1. 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.

  2. Nuclear cooperation agreements

    International Nuclear Information System (INIS)

    Nuclear cooperation agreements are reviewed in tabular form, especially agreements with developing countries. The reporting countries are the USA, the Federal Republic of Germany, Canada, Australia, Japan, and France. A separate EURATOM list is annexed

  3. Narrative and Structure in Consultation

    Science.gov (United States)

    Hadley, David

    2012-01-01

    This article explores the process of consultation to professional networks, teams, groups and individuals concerned with the mental health of children and young people in the care system, and those adopted. Frequently there are significant elements of early trauma suffered by the young people and disruption in the professional organisation. The…

  4. Consultancy on Strategic Information Planning.

    Science.gov (United States)

    Pejova, Zdravka, Ed.; Horton, Forest W., Ed.

    At the workshop, better management through strategic planning of information and consultancy was discussed as one way in which developing and Eastern European countries could tackle the complex information problems they are facing during the transition to a market economy. The sixteen papers in this volume are grouped into three basic categories:…

  5. Consultative Instructor Supervision and Evaluation

    Science.gov (United States)

    Lee, William W.

    2010-01-01

    Organizations vary greatly in how they monitor training instructors. The methods used in monitoring vary greatly. This article presents a systematic process for improving instructor skills that result in better teaching and better learning, which results in better-prepared employees for the workforce. The consultative supervision and evaluation…

  6. The Organizational Communication Consulting Spectrum.

    Science.gov (United States)

    Tubbs, Stewart L.

    Surveys of businesses and business managers indicate that developing communication skills within organizations is a priority. Communication consulting exists over a wide spectrum of activities that include guest speaking, conducting workshops, and conducting management training programs. These three processes can include a "canned program" that…

  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. Gamification in a Consulting Company

    NARCIS (Netherlands)

    Blaauw, Frank; Bazylevska, L.; Aiello, M.

    2014-01-01

    Gamification refers to the use of game-design elements in a non-gaming context. The consulting company Capgemini has set up a rudimentary Gamification platform to help motivating the people to do extra work for the company in their spare time. In order to re- ward people for this effort, they can

  9. Shareholders' agreements in Denmark

    DEFF Research Database (Denmark)

    Werlauff, Erik

    2010-01-01

    ’ agreements”) cannot bind the company within the sense of company law under the new state of law, and voting rights agreements, agreements on right of pre-emption etc. will therefore only apply at the level of contract law between the parties to the agreement. This article for European Business Law Review......The article warns that with effect from 1 March 2010, the new Danish Companies Act (on public and private limited companies) has seriously weakened the effect of shareholders’ agreements which have been entered into on Danish companies. These agreements (in the act’s new terminology: “owners...... analyses the consequences of this. Rights and duties in the owners’ agreements must now be reiterated to the greatest possible extent in the company’s articles of association so that the precepts become binding on the company and its management. Whether the parties to the owners’ agreement can be required...

  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. 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

  12. Consultancy

    NARCIS (Netherlands)

    Vorm, J.K.J. van der

    2014-01-01

    The success of managing Occupational Health and Safety (OHS) depends on an effective and efficient process of becoming aware of the potential for improvement, problem definition, diagnosis, designing possible improvements, decision making and implementing potential improvements. This process

  13. 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...

  14. Uruguay; 2011 Article IV Consultation

    OpenAIRE

    International Monetary Fund

    2011-01-01

    This 2011 Article IV Consultation highlights that the growth momentum in Uruguay has continued into 2011 but a slowdown is under way, led by weaker exports and slower public investment. Uruguay’s economic and financial vulnerabilities are modest, and the government has reduced debt vulnerabilities significantly and built important financial buffers. Executive Directors have commended authorities’ skillful macroeconomic management that has underpinned Uruguay’s excellent economic performance, ...

  15. Austria; 2013 Article IV Consultation

    OpenAIRE

    International Monetary Fund

    2013-01-01

    This paper presents details of Austria’s 2013 Article IV Consultation. Austria has been growing economically but is facing challenges in the financial sector. Full implementation of medium-term fiscal adjustment plans require specifying several measures and plans that need gradual strengthening to take expected further bank restructuring cost into account. It suggests that strong early bank intervention and resolution tools, a better designed deposit insurance system, and a bank-financed reso...

  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. 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 ...

  18. 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)

  19. 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.

  20. 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...

  1. 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…

  2. 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...

  3. 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…

  4. Financing petroleum agreements

    International Nuclear Information System (INIS)

    Robson, C.J.V.

    1994-01-01

    This chapter describes the typical type of financing agreements which are currently used to finance North Sea petroleum projects whether they are in the cause of development or have been developed and are producing. It deals with the agreements which are entered into to finance borrowings for petroleum projects on a non-resource or limited resource basis. (UK)

  5. Competition for Assistance Agreements

    Science.gov (United States)

    It is EPA policy to promote competition in the award of assistance agreements to the maximum extent practicable.When assistance agreements are awarded competitively, it is EPA policy that the competitive process be fair and open & that no applicant receive

  6. 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

  7. 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

  8. Job share a consultant post.

    OpenAIRE

    Thornicroft, G.; Strathdee, G.

    1992-01-01

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

  9. [Teenagers' drawings in transcultural consultations].

    Science.gov (United States)

    Simon, Amalini; Titia Rizzi, Alice

    The place of teenagers' drawings has been studied as part of a transcultural consultation, based on the creativity of the children of migrants. When speaking is difficult, drawings enable teenagers to show another dimension of their internal world. Aravin, a young Tamil boy, who lacked the necessary words, was able to express all the complexity of his thoughts through his drawings, finally being able to formulate in the group the difficult situations which he was drawing. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  10. 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...

  11. International Fisheries Agreements

    DEFF Research Database (Denmark)

    Pintassilgo, Pedro; Kronbak, Lone Grønbæk; Lindroos, Marko

    2015-01-01

    This paper surveys the application of game theory to the economic analysis of international fisheries agreements. The relevance of this study comes not only from the existence of a vast literature on the topic but especially from the specific features of these agreements. The emphasis of the survey...... is on coalition games, an approach that has become prominent in the fisheries economics literature over the last decade. It is shown that coalition games were first applied to international fisheries agreements in the late 1990s addressing cooperative issues under the framework of characteristic function games...... and stability of international fisheries agreements. A key message that emerges from this literature strand is that self-enforcing cooperative management of internationally shared fish stocks is generally difficult to achieve. Hence, the international legal framework and regulations play a decisive role...

  12. Trade Agreements PTI

    Data.gov (United States)

    Department of Homeland Security — The objective of the Trade Agreements PTI is to advance CBP’s mission by working with internal and external stakeholders to facilitate legitimate trade and address...

  13. Production sharing agreements

    International Nuclear Information System (INIS)

    1994-01-01

    This paper, which was presented at the Production Sharing Agreement seminar, discusses economic rent, negotiations, trends in fiscal system development, and concessionary systems. Production sharing contracts, risk service contracts, joint ventures and the global market are examined. (UK)

  14. Multilateral and bilateral agreements

    International Nuclear Information System (INIS)

    Koponen, H.

    1993-01-01

    Finland has made both multilateral and bilateral agreements on the exchange of information related to radiation safety. The first arrangements for international agreements and exchange of information were made after the Chernobyl accident. In 1987, Finland joined the convention on early notification of a nuclear power accident coordinated by International Atomic Energy Agency. The convention is applied to accidents that cause of may cause emissions of radioactive substances that might affect the radiation safety of another country. Besides the convention on early notification, some other individual agreements have also been made. These include the International Nuclear Event Scale (INES) system and power companies own information exchange systems. Finland has conducted bilateral agreements with the Nordic countries and the Soviet Union on the notification of accidents and exchange of nuclear power plant information. Today, Russia answers for the Soviet Union's contractual obligations. (orig.)

  15. 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.

  16. 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.

  17. 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)

  18. Consultative exercise on dose assessments.

    Science.gov (United States)

    Bridges, B A; Parker, T; Simmonds, J R; Sumner, D

    2001-06-01

    A summary is given of a meeting held at Sussex University, UK, in October 2000, which allowed the exchange of ideas on methods of assessment of dose to the public arising from potential authorised radioactive discharges from nuclear sites in the UK. Representatives of groups with an interest in dose assessments were invited, and hence the meeting was called the Consultative Exercise on Dose Assessments (CEDA). Although initiated and funded by the Food Standards Agency, its organisation, and the writing of the report, were overseen by an independent Chairman and Steering Group. The report contains recommendations for improvement in co-ordination between different agencies involved in assessments, on method development and on the presentation of data on assessments. These have been prepared by the Steering Group, and will be taken forward by the Food Standards Agency and other agencies in the UK. The recommendations are included in this memorandum.

  19. Canadian seismic agreement

    International Nuclear Information System (INIS)

    Wetmiller, R.J.; Lyons, J.A.; Shannon, W.E.; Munro, P.S.; Thomas, J.T.; Andrew, M.D.; Lamontagne, M.; Wong, C.; Anglin, F.M.; Plouffe, M.; Lapointe, S.P.; Adams, J.; Drysdale, J.A.

    1990-04-01

    This is the twenty-first progress report under the agreement entitled Canadian Seismic Agreement between the US Nuclear Regulatory Commission (NRC) and the Canadian Commercial Corporation. Activities undertaken by the Geophysics Division of the Geological Survey of Canada (GD/GSC) during the period from July 01, 1988 to June 30, 1989 and supported in part by the NRC agreement are described below under four headings; Eastern Canada Telemetred Network and local network developments, Datalab developments, strong motion network developments and earthquake activity. In this time period eastern Canada experienced its largest earthquake in over 50 years. This earthquake, which has been christened the Saguenay earthquake, has provided a wealth of new data pertinent to earthquake engineering studies in eastern North America and is the subject of many continuing studies, which are presently being carried out at GD and elsewhere. 41 refs., 21 figs., 7 tabs

  20. FFTF Authorization Agreement

    International Nuclear Information System (INIS)

    DAUTEL, W.A.

    2000-01-01

    The purpose of the Authorization Agreement is to serve as a mechanism whereby the U.S. Department of Energy, Richland Operations Office (RL) and Fluor Hanford (FH) jointly clarify and agree to key conditions for conducting work safely and efficiently in the Fast Flux Test Facility (FFTF). Work must be accomplished in a manner that achieves high levels of quality while protecting the environment and the safety and health of workers and the public, and complying with applicable contractual and regulatory requirements. It is the intent of this Agreement to address those items of significant importance in establishing and supporting the FFTF Authorization Envelope, but this Agreement in no way alters the terms and conditions of the Project Hanford Management Contract (PHMC), Contract Number DE-AC06-96RL13200

  1. 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.

  2. International environmental agreements

    NARCIS (Netherlands)

    de Zeeuw, Aart

    2015-01-01

    The regulation of environmental externalities at the global level requires international agreements between sovereign states. Game theory provides an appropriate theoretical tool for analysis. However, game theory can result in a wide range of outcomes, and therefore it is important to discuss the

  3. FFTF Authorization Agreement

    International Nuclear Information System (INIS)

    DAUTEL, W.A.

    2000-01-01

    The purpose of the Authorization Agreement is to serve as a mechanism whereby the U.S. Department of Energy, Richland Operations Office (RL) and Fluor Hanford (FH) jointly clarify and agree to key conditions for conducting work safely and efficiently

  4. 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.

  5. 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...

  6. 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...

  7. 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

  8. 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

  9. 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…

  10. 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.

  11. 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...

  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. 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.

  14. 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…

  15. 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 ...

  16. 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.

  17. 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

  18. 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…

  19. 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.…

  20. Consultant radiographer leadership - A discussion

    International Nuclear Information System (INIS)

    Hogg, Peter; Hogg, Dianne; Henwood, Suzanne

    2008-01-01

    Effective leadership can be defined in many ways and is an essential element of successful organisations; poor leadership can result in problems such as low staff morale, high staff turnover and reduced productivity. Effective leadership behaviours are well documented in the literature and various leadership models have been proposed that illustrate these behaviours. This discussion paper does not focus on any particular model. Instead it considers the 'Leadership Qualities Framework' which was developed specifically for use within the UK National Health Service. This framework draws upon a range of leadership models and as such it gives a broad indication of leadership behaviours. The framework comprises three components - 'personal qualities', 'setting direction' and 'delivering the service'. This paper commences with an argument as to why effective leadership is important in organisations generally, and specifically within healthcare organisations. Various examples of leadership are illustrated from within and outside the NHS in order to demonstrate effective leadership behaviours. The Leadership Qualities Framework is then examined, along with scenarios to illustrate effective leadership behaviours in context (i.e. within a healthcare organisation). Subsequent reflections on the scenarios aim to identify leadership behaviours that are explained within the framework. The final element of this paper draws on [limited] published evidence of where consultant radiographers have demonstrated effective leadership behaviours. In this section the published evidence is examined and reflected upon. At the end of the article we indicate additional reading for those who wish to further develop their theoretical and practical leadership skills

  1. 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/.

  2. 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.

  3. 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.

  4. 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.

  5. The Sicomines Agreement

    DEFF Research Database (Denmark)

    Jansson, Johanna

    of the global political economy have shifted, and that China’s position as a foreign policy actor is now consolidated. Continuity, since the 2009 amendment of the agreement, which came about partly as a result of China’s ambitions to take up an active role in the International Monetary Fund (IMF......), was to the benefit of the policy preferences of the IMF and the World Bank. This case thus indicates that since China’s own aspirations are changeable, its emergence as an alternative development partner may not bring about any substantive change of direction for the DRC’s international relations. Furthermore......The Sicomines multibillion minerals-for-infrastructure deal was struck in 2007 between the Democratic Republic of Congo (DRC) and China. The paper investigates the drivers behind the original conception of the agreement, outlines the structure of the contract, analyses the dynamics at play during...

  6. Agreements in Virtual Organizations

    Science.gov (United States)

    Pankowska, Malgorzata

    This chapter is an attempt to explain the important impact that contract theory delivers with respect to the concept of virtual organization. The author believes that not enough research has been conducted in order to transfer theoretical foundations for networking to the phenomena of virtual organizations and open autonomic computing environment to ensure the controllability and management of them. The main research problem of this chapter is to explain the significance of agreements for virtual organizations governance. The first part of this chapter comprises explanations of differences among virtual machines and virtual organizations for further descriptions of the significance of the first ones to the development of the second. Next, the virtual organization development tendencies are presented and problems of IT governance in highly distributed organizational environment are discussed. The last part of this chapter covers analysis of contracts and agreements management for governance in open computing environments.

  7. REAL ESTATE PURCHASE AGREEMENTS

    Directory of Open Access Journals (Sweden)

    Bujorel FLOREA

    2016-12-01

    Full Text Available The study presented herein represents a field with good present and future perspectives, especially because real estate property is not under the incidence of a single normative act regarding the sale-purchase agreement of such goods, and given the fact that there are specific legal provisions with respect to various real estate categories and the localization of such property. The article deals with the sale-purchase agreement of various real estate categories, such as fields, buildings, the correspondent lots, urban area, farm, and forests fields, focusing on some particularities. A special care is attributed to examining the applicable laws with regard to the purchase agreements of field lands, the special conditions to be taken into account, the persons that may act as buyers, including foreigners, those without citizenship, and legal persons of a nationality other than Romanian. Finally, a special concern is given to the formalities required for legally exerting the pre-emptive right and the applicable sanctions in that respect.

  8. 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.

  9. Consultant radiographer leadership - A discussion

    Energy Technology Data Exchange (ETDEWEB)

    Hogg, Peter [Directorate of Radiography, University of Salford, Allerton Building, Frederick Road, Salford, Greater Manchester M6 6PU (United Kingdom)], E-mail: p.hogg@salford.ac.uk; Hogg, Dianne [Henwood Associates (South East) Ltd, Company Number: 513796, Registered Office: 2 Lakeview Stables, Lower St Clere, Kemsing, Kent, TN15 6NL (United Kingdom); Henwood, Suzanne [East Lancashire Primary Care Trust, Linden Business Centre, Linden Road, Colne. BB8 9BA (United Kingdom)

    2008-12-15

    Effective leadership can be defined in many ways and is an essential element of successful organisations; poor leadership can result in problems such as low staff morale, high staff turnover and reduced productivity. Effective leadership behaviours are well documented in the literature and various leadership models have been proposed that illustrate these behaviours. This discussion paper does not focus on any particular model. Instead it considers the 'Leadership Qualities Framework' which was developed specifically for use within the UK National Health Service. This framework draws upon a range of leadership models and as such it gives a broad indication of leadership behaviours. The framework comprises three components - 'personal qualities', 'setting direction' and 'delivering the service'. This paper commences with an argument as to why effective leadership is important in organisations generally, and specifically within healthcare organisations. Various examples of leadership are illustrated from within and outside the NHS in order to demonstrate effective leadership behaviours. The Leadership Qualities Framework is then examined, along with scenarios to illustrate effective leadership behaviours in context (i.e. within a healthcare organisation). Subsequent reflections on the scenarios aim to identify leadership behaviours that are explained within the framework. The final element of this paper draws on [limited] published evidence of where consultant radiographers have demonstrated effective leadership behaviours. In this section the published evidence is examined and reflected upon. At the end of the article we indicate additional reading for those who wish to further develop their theoretical and practical leadership skills.

  10. 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…

  11. 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

  12. 40 CFR Appendix C-1 to Subpart E... - Required Provisions-Consulting Engineering Agreements

    Science.gov (United States)

    2010-07-01

    ... equipment which are readily available through competitive procurement, or through standard or proven... entertainment, gifts, or otherwise), to any official, employee, or agent of the owner, of the State, or of EPA...

  13. 40 CFR Appendix D to Subpart E of... - EPA Transition Policy-Existing Consulting Engineering Agreements

    Science.gov (United States)

    2010-07-01

    ... access to Category A records. Also, where there is an indication that fraud, gross abuse, or corrupt... historical and advisory guidelines in general use and acceptable locally. These guidelines include those in ASCE manual 45 or other analyses or data which the contracting parties relied on or used in negotiation...

  14. 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.

  15. International nuclear agreements

    International Nuclear Information System (INIS)

    Miatello, A.; Severino, R.

    1988-01-01

    This multilingual glossary, in the laborious compilation of which the authors have been greatly assisted by a group of professional translators and experts, presents for the first time a substantial number of entries in four languages (English, French, German and Italian), whose terminology and phraseology, all bearing the appropriate normative reference, has been drawn from the official text of the most relevant international agreements on nuclear policy. It is complemented by a thorough critical study on the status of nonproliferation by Lawrence Scheinman and Josef Pilat. Librarians, translators and interpreters as well as scholars and researchers in international law will find this volume a reference tool of specific interest

  16. Agreement in Persian

    Directory of Open Access Journals (Sweden)

    Lofti, Ahmad R.

    2006-01-01

    Full Text Available This article investigates agreement as a number marking mechanism in Persian. The mechanism differs from number marking on nominals in that with an inanimate plural subject, the SG verbal ending signals a collective conceptualization of the experience where the members of the group are considered together as a single unit. The PL ending, on the other hand, signals a distributive conceptualization where the entities are individuated; hence, they are considered to be dispersed over space, or distinct in sort or time. Autonomy - whether the entity is conceived of as governing the course of events or not - seems to underlie the choice between SG and PL.

  17. License agreement, employee work

    OpenAIRE

    Poncová, Veronika

    2012-01-01

    The rigorous thesis is focused on license agreement and employee work. The aim of the thesis is not only an analysis of the use of a copyrighted work by a person different from the author of the work, but also an analysis of the performance of copyright by a person different from the author of the work. The thesis consists of five chapters. The opening chapter provides a summary of the notion of copyright, its sources at the national and international levels, but also the European Union legis...

  18. 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.

  19. 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.

  20. 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...

  1. 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.

  2. 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,

  3. 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.

  4. 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...

  5. 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...

  6. 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...

  7. 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

  8. 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...

  9. 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

  10. 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...

  11. 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.

  12. 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.

  13. 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 ...

  14. 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...

  15. VHA Data Sharing Agreement Repository

    Data.gov (United States)

    Department of Veterans Affairs — The VHA Data Sharing Agreement Repository serves as a centralized location to collect and report on agreements that share VHA data with entities outside of VA. It...

  16. 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

  17. 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

  18. Systems management of facilities agreements

    International Nuclear Information System (INIS)

    Blundell, A.

    1998-01-01

    The various types of facilities agreements, the historical obstacles to implementation of agreement management systems and the new opportunities emerging as industry is beginning to make an effort to overcome these obstacles, are reviewed. Barriers to computerized agreement management systems (lack of consistency, lack of standards, scarcity of appropriate computer software) are discussed. Characteristic features of a model facilities agreement management system and the forces driving the changing attitudes towards such systems (e.g. mergers) are also described

  19. Why are Trade Agreements Regional?

    OpenAIRE

    Zissimos, Ben

    2007-01-01

    This paper shows how distance may be used to coordinate on a unique equilibrium in which trade agreements are regional. Trade agreement formation is modeled as coalition formation. In a standard trade model with no distance between countries, a familiar problem of coordination failure arises giving rise to multiple equilibria; any one of many possible trade agreements can form. With distance between countries, and through strategic interaction in tariff setting, regional trade agreements gene...

  20. 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.

  1. 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.

  2. 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.

  3. Seismic contracts and agreements

    International Nuclear Information System (INIS)

    Cooper, N.M.; Krause, V.

    1999-01-01

    Some points to consider regarding management of seismic projects within the Canadian petroleum industry were reviewed. Seismic projects involve the integration of many services. This paper focused on user-provider relationships, the project planning process, competitive bid considerations, the types of agreement used for seismic and their implications, and the impact that certain points of control may have on a company: (1) initial estimate versus actual cost, (2) liability, (3) safety and operational performance, and (4) quality of deliverables. The objective is to drive home the point that in today's environment where companies are forming, merging, or collapsing on a weekly basis , chain of command and accountability are issues that can no longer be dealt with casually. Companies must form business relationships with service providers with a full knowledge of benefits and liabilities of the style of relationship they choose. Diligent and proactive management tends to optimize cost, safety and liability issues, all of which have a bearing on the points of control available to the company

  4. 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.

  5. 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.

  6. Predicting word sense annotation agreement

    DEFF Research Database (Denmark)

    Martinez Alonso, Hector; Johannsen, Anders Trærup; Lopez de Lacalle, Oier

    2015-01-01

    High agreement is a common objective when annotating data for word senses. However, a number of factors make perfect agreement impossible, e.g. the limitations of the sense inventories, the difficulty of the examples or the interpretation preferences of the annotations. Estimating potential...... agreement is thus a relevant task to supplement the evaluation of sense annotations. In this article we propose two methods to predict agreement on word-annotation instances. We experiment with a continuous representation and a three-way discretization of observed agreement. In spite of the difficulty...

  7. 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…

  8. 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…

  9. 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.

  10. 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...

  11. 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.

  12. 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.

  13. 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

  14. 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

  15. 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

  16. Standardization Versus Innovation In Management Consultancy

    Directory of Open Access Journals (Sweden)

    Ciumara Tudor

    2011-12-01

    Full Text Available This paper is supported by the Sectoral Operational Programme Human Resources Development (SOP HRD, financed from the European Social Fund and by the Romanian Government under the contract number SOP HRD/89/1.5/S/62988. In this paper we propose some perspectives on the relationship between standardization and innovation in the management consulting business. Most of the consulting services are situated somewhere between absolute standardization and absolute innovation. Approaching any of these poles brings some advantages and disadvantages, both to the service providers and to their customers. It is important to find a balance between innovation and standardization to maximize the results of all agents involved.

  17. Minimizing the legal risk with 'curbside' consultation.

    Science.gov (United States)

    Kreichelt, Ray; Hilbert, Mary Lou; Shinn, Deidre

    2008-01-01

    "Curbside consultations"--in which a physician obtains insights on a medical case from another physician who has not seen the patient or reviewed the record--can yield advantages to the requesting physician. However, shortcomings are inherent in this common type of exchange and pose legal risk to the curbside consultant. This article provides background and practical tips that might help avoid being caught up in a lawsuit by surprise, or if named as a party, avoid being held culpable when the only involvement was a brief conversation with a colleague.

  18. 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…

  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. 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.

  1. 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

  2. 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.

  3. What to listen for in the consultation

    DEFF Research Database (Denmark)

    Jensen, Christian Gaden; Elsass, Peter; Neustrup, Line

    2014-01-01

    OBJECTIVE: To analyze whether qualitative themes in breast cancer patients' self-presentations predicted symptoms of psychological distress and depression in order to improve the consultation process. METHODS: Ninety-seven breast cancer patients gave unstructured, 10-min self-presentations at the...

  4. Behavior Analytic Consultation for Academic Referral Concerns

    Science.gov (United States)

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

    2016-01-01

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

  5. 29 CFR 1908.4 - Offsite consultation.

    Science.gov (United States)

    2010-07-01

    ... on occupational safety and health issues by telephone and correspondence, and at locations other than... 29 Labor 5 2010-07-01 2010-07-01 false Offsite consultation. 1908.4 Section 1908.4 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR...

  6. Psychiatric consultations and the management of associated ...

    African Journals Online (AJOL)

    Psychiatric consultations and the management of associated comorbid medical conditions in a regional referral hospital. NSZ Tema, ABR Janse van Rensburg. Abstract. Background. Psychiatrists are often called upon to evaluate patients with a medical condition and psychiatric symptoms, either as a complication thereof or ...

  7. 77 FR 48159 - Tribal Consultation Meeting

    Science.gov (United States)

    2012-08-13

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

  8. 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.

  9. Using Communication Consultants to Rightsize Successfully.

    Science.gov (United States)

    Tudor, Thomas R.; Sleeth, Randall G.

    1997-01-01

    Argues that successful "rightsizing" requires that managers preserve the morale and productivity of the remaining employees. Finds a communication consultant can offer guidance on how to maintain employee morale, help employees perceive the layoffs as fair, take care of employees who have lost their jobs, assist management with layoff…

  10. 77 FR 23283 - Tribal Consultation Policy

    Science.gov (United States)

    2012-04-18

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

  11. An Employer's Guide to Child Care Consultants.

    Science.gov (United States)

    Eichman, Caroline

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

  12. Organizational design approaches in management consulting

    NARCIS (Netherlands)

    Visscher, Klaasjan; Visscher-Voerman, Irene

    2010-01-01

    Purpose: The purpose of this paper is to map the variety in organizational design approaches, to clarify their differences, and to find out what constitutes good designing in practice. - Design/methodology/approach: A series of in-depth interviews with experienced, high-reputation consultants is

  13. 40 CFR 93.105 - Consultation.

    Science.gov (United States)

    2010-07-01

    ... Implementation Plans of Transportation Plans, Programs, and Projects Developed, Funded or Approved Under Title 23... EPA with MPOs, State departments of transportation, and DOT in developing applicable implementation...) through (e) of this section. Public consultation procedures will be developed in accordance with the...

  14. 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.

  15. Arriving at the postmodern medical consultation.

    NARCIS (Netherlands)

    Elwyn, G.

    2004-01-01

    The analysis of the medical consultation is characterised by mainly prescriptive attempts to recommend 'best practice'. As the role of the individual in society has gained prominence, the power relationships in medical practice have had to change to reflect the increasing recognition of autonomy and

  16. Expectation Levels in Dictionary Consultation and Compilation*

    African Journals Online (AJOL)

    Abstract: Dictionary consultation and compilation is a two-way engagement between two par- ties, 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 con- sultation skills, their knowledge of ...

  17. 77 FR 13338 - Tribal Consultation Meetings

    Science.gov (United States)

    2012-03-06

    ..., Public Law 110-134, notice is hereby given of one-day Tribal Consultation Sessions to be held between the... American Indian and Alaska Native children and their families, taking into consideration funding... consideration funding allocations, distribution formulas, and other issues affecting the delivery of Head Start...

  18. 78 FR 11891 - Tribal Consultation Meeting

    Science.gov (United States)

    2013-02-20

    ... Law 110-134, notice is hereby given of two 1-day Tribal Consultation Sessions to be held between the... American Indian and Alaska Native children and their families, taking into consideration funding... families, taking into consideration funding allocations, distribution formulas, and other issues affecting...

  19. 77 FR 5027 - Tribal Consultation Meetings

    Science.gov (United States)

    2012-02-01

    ..., Public Law 110-134, notice is hereby given of a one-day Tribal Consultation Session to be held between... American Indian and Alaska Native children and their families, taking into consideration funding... the needs of American Indian and Alaska Native children and families, taking into consideration...

  20. 76 FR 48865 - Tribal Consultation Meetings

    Science.gov (United States)

    2011-08-09

    ..., Public Law 110-134, notice is hereby given of one-day Tribal Consultation Sessions to be held between the... American Indian and Alaska Native children and their families, taking into consideration funding... meeting the needs of American Indian and Alaska Native children and families, taking into consideration...

  1. 77 FR 19020 - Tribal Consultation Meeting

    Science.gov (United States)

    2012-03-29

    ... Law 110-134, notice is hereby given of a one-day Tribal Consultation Session to be held between the... needs of American Indian and Alaska Native children and their families, taking into consideration... children and families, taking into consideration funding allocations, distribution formulas, and other...

  2. Delivering an MBA Management Consulting Experience

    Science.gov (United States)

    LeMaire, Ryan; Fisher, Kirk; Watson, Edward F., III

    2017-01-01

    This article reports on an innovative MBA elective consulting course that attempts to address how to better prepare inexperienced MBA students for a competitive job market. This article is a best practice paper designed to provide insights and encouragement to educators.

  3. School Neuropsychology Consultation in Neurodevelopmental Disorders

    Science.gov (United States)

    Decker, Scott L.

    2008-01-01

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

  4. Process Consultation: Its Role in Organization Development.

    Science.gov (United States)

    Schein, Edgar H.

    This volume focuses on the process by which the consultant builds readiness for organizational development (OD) programs, actually conducts training, and works with the key individuals of an organization as part of an OD program. Part I describes in some detail the human processes in organizations--communication, functional roles of group members,…

  5. Developing Critical Thinking through Student Consulting Projects

    Science.gov (United States)

    Canziani, Bonnie; Tullar, William L.

    2017-01-01

    The authors present survey results from faculty at 44 universities on the role of student consulting projects in developing business students' critical thinking. They conclude that students can improve critical thinking by engaging in guided primary and secondary research to inform their business assumptions that underpin business planning and…

  6. 78 FR 57858 - Tribal Consultation Meeting

    Science.gov (United States)

    2013-09-20

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

  7. 78 FR 20658 - Tribal Consultation Meeting

    Science.gov (United States)

    2013-04-05

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

  8. 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)

  9. 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.

  10. Labor Agreement Information System (LAIRS)

    Data.gov (United States)

    Office of Personnel Management — The Labor Agreement Information Retrieval System (LAIRS) is a database containing historical information on labor-management relations in the Federal Government. It...

  11. Voluntary agreements in environmental policy

    International Nuclear Information System (INIS)

    Torvanger, Asbjoern

    2001-01-01

    A typically voluntary agreement is signed between the authorities and an industrial sector in order to reduce the emission of environmentally harmful substances. There are many different types of agreements. Voluntary agreements are not strictly voluntary, since in the background there is often some kind of ''threat'' about taxation or fees if the industry is unwilling to cooperate. This type of agreements has become popular in many OECD countries during the last decades. In Norway there are only a few agreements of this type. Experience with the use of voluntary agreements as well as research show that they are less cost-effective than market-based instruments such as taxes and quota systems. If there are great restrictions on the use of taxes and quota systems because of information- or measurement problems, or because these instruments are not politically acceptable, then voluntary agreements may be an interesting alternative. Thus, voluntary agreements are best used as a supplement to other instruments in some niche areas of the environmental policy. In some cases, voluntary agreements may be used between two countries or at a regional level, for example within the EU

  12. 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

  13. 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.

  14. 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.

  15. 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.

  16. [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.

  17. Nuclear fuel waste disposal. Canada's consultative approach

    Energy Technology Data Exchange (ETDEWEB)

    Hillier, J A.R.; Dixon, R S [AECL (Canada)

    1993-07-01

    Over the past two decades, society has increasingly demanded more public participation and public input into decision-making by governments. Development of the Canadian concept for deep geological disposal of used nuclear fuel has proceeded in a manner that has taken account of the requirements for social acceptability as well as technical excellence. As the agency responsible for development of the disposal concept, Atomic Energy of Canada Limited (AECL) has devoted considerable effort to consultation with the various publics that have an interest in the concept. This evolutionary interactive and consultative process, which has been underway for some 14 years, has attempted to keep the public informed of the technical development of the concept and to invite feedback. This paper describes the major elements of this evolutionary process, which will continue throughout the concept assessment and review process currently in progress. (author)

  18. Nuclear fuel waste disposal. Canada's consultative approach

    International Nuclear Information System (INIS)

    Hillier, J.A.R.; Dixon, R.S.

    1993-01-01

    Over the past two decades, society has increasingly demanded more public participation and public input into decision-making by governments. Development of the Canadian concept for deep geological disposal of used nuclear fuel has proceeded in a manner that has taken account of the requirements for social acceptability as well as technical excellence. As the agency responsible for development of the disposal concept, Atomic Energy of Canada Limited (AECL) has devoted considerable effort to consultation with the various publics that have an interest in the concept. This evolutionary interactive and consultative process, which has been underway for some 14 years, has attempted to keep the public informed of the technical development of the concept and to invite feedback. This paper describes the major elements of this evolutionary process, which will continue throughout the concept assessment and review process currently in progress. (author)

  19. 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

  20. 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

  1. United Arab Emirates; 2013 Article IV Consultation

    OpenAIRE

    International Monetary Fund

    2013-01-01

    This staff report on United Arab Emirates 2013 Article IV Consultation highlights economic policies and development. Against a backdrop of political stability, confidence has further increased, tourism has been firm, demand from expatriates from the broader region has increased, and capital inflows have strengthened amid high global liquidity. The real estate sector, which had been impaired since the 2009 crisis, has stabilized in Abu Dhabi and has started to recover in Dubai. Dubai aims to b...

  2. Users enlist consultants to calculate costs, savings

    Energy Technology Data Exchange (ETDEWEB)

    1982-05-24

    Consultants who calculate payback provide expertise and a second opinion to back up energy managers' proposals. They can lower the costs of an energy-management investment by making complex comparisons of systems and recommending the best system for a specific application. Examples of payback calculations include simple payback for a school system, a university, and a Disneyland hotel, as well as internal rate of return for a corporate office building and a chain of clothing stores. (DCK)

  3. Clinical ethics consultation's dilemma, and a solution.

    Science.gov (United States)

    Rasmussen, Lisa M

    2011-01-01

    Clinical ethics consultation is on the horns of a dilemma. One horn skewers the field for its lack of standards, while the other horn skewers it for proposing arbitrary or deeply contested foundations. I articulate the dilemma by discussing several critiques of the field and the challenge of formulating standards and suggest that the solution lies, at least until a robust consensus emerges, with establishing a list of proscriptive standards to guide the field.

  4. Federal Facility Agreement progress report

    Energy Technology Data Exchange (ETDEWEB)

    1993-10-01

    The (SRS) Federal Facility Agreement (FFA) was made effective by the US. Environmental Protection Agency Region IV (EPA) on August 16, 1993. To meet the reporting requirements in Section XXV of the Agreement, the FFA Progress Report was developed. The FFA Progress Report is the first of a series of quarterly progress reports to be prepared by the SRS. As such this report describes the information and action taken to September 30, 1993 on the SRS units identified for investigation and remediation in the Agreement. This includes; rubble pits, runoff basins, retention basin, seepage basin, burning pits, H-Area Tank 16, and spill areas.

  5. Federal Facility Agreement progress report

    International Nuclear Information System (INIS)

    1993-10-01

    The (SRS) Federal Facility Agreement (FFA) was made effective by the US. Environmental Protection Agency Region IV (EPA) on August 16, 1993. To meet the reporting requirements in Section XXV of the Agreement, the FFA Progress Report was developed. The FFA Progress Report is the first of a series of quarterly progress reports to be prepared by the SRS. As such this report describes the information and action taken to September 30, 1993 on the SRS units identified for investigation and remediation in the Agreement. This includes; rubble pits, runoff basins, retention basin, seepage basin, burning pits, H-Area Tank 16, and spill areas

  6. A report on the green plan consultations

    International Nuclear Information System (INIS)

    1990-08-01

    This document is a summary of what Canadians who participated in the consultations had to say about environmental issues and concerns; the solutions, roles and responsibilities, and priorities for action. It is based on detailed reports from 41 information sessions and 17 consultation workshops held across Canada. It is based on some 3,000 pages of comments and suggestions, an analysis of 4,500 question response forms, and written submissions from more than 1,000 individuals and organizations. The report is organized into two sections: improving decision making; and, action on environmental issues. The first section deals with science, education, enforcement, decision-making processes and partnerships. The second section deals with specific environmental issues identified in the consultation document, such as global warming and toxic substances, and other publicly identified issues, including energy and land use. Suggestions for further consideration represent possible policy, program and legislative elements of 'The Green Plan'. They are intended as a basis for a more focused debate which will help in the establishment of priorities

  7. Windpower opposition : notify, consult, engage or partnership?

    Energy Technology Data Exchange (ETDEWEB)

    Prier, P.G. [Stantec Consulting, Guelph, ON (Canada)

    2010-07-01

    This PowerPoint presentation discussed some of the methods that can be used to understand and defuse opposition to wind power projects. The presentation discussed the actual empowerment of communities and citizens as opposed to the token gestures often used by large organizations to placate and manipulate stakeholders. Stakeholders were defined as regulatory authorities, directly and indirectly affected landowners, non-government organizations, First Nations groups, and anyone in or outside the study area with an interest in the prospective development. The consultation scope should reflect the significance of potential effects and be conducted early in the decision-making process. The design of the project and its implementation should be transparent, and operators should be responsive to all concerns and questions. A range of consultation techniques should be used to reflect the nature of different stakeholders. Community engagement should support mutual respect of values in order to create an authentic decision-making partnership. Communities should be notified when routine operational or maintenance activities are being conducted. Consultations are required for increases in nameplate capacity of less than 25 percent. Community engagement is required for the development of greenfield wind farms greater than 20 MW. tabs., figs.

  8. Virtual slides: application in pulmonary pathology consultations.

    Directory of Open Access Journals (Sweden)

    Michał Wojciechowski

    2008-02-01

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

  9. 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.

  10. 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.

  11. 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)

  12. 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)

  13. Teaching and assessing consultation skills: an evaluation of a South ...

    African Journals Online (AJOL)

    Teaching and assessing consultation skills: an evaluation of a South African workshop ... of this work is unsupervised consultations with patients suffering from new or ... Their attitudes to the LAP and the forms of teaching that its use promotes ...

  14. 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 ...

  15. Consultancy and knowledge management for radioactive waste disposal. Use of external knowledge of the Asse archive

    International Nuclear Information System (INIS)

    Driftmann, Christian; Josipovic, Neven

    2015-01-01

    The booklet on consultancy and knowledge management for radioactive waste disposal - use of external knowledge of the Asse archive covers the following topics: (i) Basic principles for consulting the government by external consultants: terminology, external consultancy in the legislative process, external consultancy in the administration. (ii) External consultancy in the frame of the final repository search: external consultancy profiles, legal appraisal.

  16. Pesticide Worker Safety Cooperative Agreements

    Science.gov (United States)

    The worker safety program cooperative agreements fund projects to educate pesticide applicators, handlers, and farmworkers on working safely with, and around, pesticides. Read about pesticide related grant opportunities and reports from previous grants.

  17. Corporate Integrity Agreement (CIA) documents

    Data.gov (United States)

    U.S. Department of Health & Human Services — OIG negotiates corporate integrity agreements (CIA) with health care providers and other entities as part of the settlement of Federal health care program...

  18. 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…

  19. 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...

  20. 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.

  1. 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...

  2. 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…

  3. 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)

  4. 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…

  5. 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' ...

  6. 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.

  7. Flexible climate agreements after 2012

    International Nuclear Information System (INIS)

    Vevatne, Jonas

    2004-01-01

    The Kyoto agreement is only a small step towards much stronger and broader commitments and new creativity is needed to further develop a really global climate policy. A flexible approach is necessary to obtain broad participation and substantial reduction of the emissions of greenhouse gases. Flexibility is also important to ease negotiations, to ensure cost-effectiveness and implement a global climate agreement. The US withdrawal from the Kyoto Protocol has rendered the agreement much less effective than the original goal of five per cent reduction of the emission from the industrialized countries. In addition the emissions are increasing much faster in countries that have not committed themselves to the agreement. The agreement runs out in 2012 and should be followed by a new agreement, the negotiations about which are to start up no later than 2005. Attempts by the European Union to begin a discussion about future commitments were very quickly wrecked by the G77 group with strong support from the U.S.A. To formulate a practical climate policy the general goal in the Climate Convention must be interpreted and specified. It may seem impossible to agree upon a long-term goal. But the clarity it provides will be very useful. It will be a guide for short-term goals and a reference for evaluation of success

  8. Rater agreement in lung scintigraphy

    International Nuclear Information System (INIS)

    Christiansen, F.; Andersson, T.; Rydman, H.; Qvarner, N.; Maare, K.

    1996-01-01

    Purpose: The PIOPED criteria in their original and revised forms are today's standards in the interpretation of ventilation-perfusion scintigraphy. When the PIOPED criteria are used by experienced raters with training in consensus interpretation, the agreement rates have been demonstrated to be excellent. Our purpose was to investigate the rates of agreement between 2 experienced raters from different hospitals who had no training in consensus interpretation. Material and Methods: The 2 raters investigated a population of 195 patients. This group included 72 patients from a previous study who had an intermediate probability of pulmonary embolism and who had also been examined by pulmonary angiography. Results: The results demonstrated moderate agreement rates with a kappa value of 0.54 (0.45-0.63 in a 95% confidence interval), which is similar to the kappa value of the PIOPED study but significantly lower than the kappa values of agreement rates among consensus-trained raters. There was a low consistency in the intermediate probability category, with a proportional agreement rate of 0.39 between the experienced raters. Conclusion: The moderate agreement rates between raters from different hospitals make it difficult to compare study populations of a certain scintigraphic category in different hospitals. Further investigations are mandatory for accurate diagnosis when the scintigrams are in the category of intermediate probability of pulmonary embolism. (orig.)

  9. 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.

  10. 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.

  11. 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.

  12. [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.

  13. 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.

  14. Response to government consultation paper dated December 23, 2002

    International Nuclear Information System (INIS)

    2003-01-01

    The principles that must be observed to achieve a properly functioning wholesale electricity market in Ontario were described according to the vision of the Association of Major Power Consumers in Ontario (AMPCO). According to AMPCO, the government should not offer any further 4.3 cent fixed prices other than those already described in the regulations to Bill 210. AMPCO would also object if the costs of maintaining fixed charges to some customers were added in any way to the stranded debt to be recovered from all customers. It also believes that the modified Market Power Mitigation Agreement (MPMA) rebate mechanism should be retained until real competition is achieved in the province. It is recommended that decontrol processes at Ontario Power Generation be refocused on the creation of real competition in Ontario instead of decontrolling megawatts. AMPCO suggests that all current contract agreements should be left in place and untouched, and that the Ontario government should make it perfectly clear that it is committed to developing a wholesale market over time. The paper comments on the fixed price option and responds to issues raised in the Consultation Paper, such as what steps should be taken to increase competition in Ontario and to encourage new energy suppliers to enter Ontario's market, and what measures should be taken to address the long-term supply of electrical generation. It is recommended that in the short term, the laid-up nuclear units should be brought back into service starting in 2003. With the return of nuclear units, there would be little need for additional new merchant generation until 2005 or 2006. It was also recommended that the Ontario government should continue to support local generation facilities to include cogeneration and other generation linked with industrial facilities. 1 tab

  15. 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...

  16. Search and nonsearch protocols for radiographic consultation

    International Nuclear Information System (INIS)

    Swensson, R.G.; Theodore, G.H.

    1989-01-01

    Six radiologists, acting as film reviewers, used two different consultation protocols to differentiate among 292 ambiguous findings on chest films: 120 simulated nodules and 172 normal findings (previous readers' false-positive reports of nodules). The non-search protocol identified each finding (by location), and reviewers rated its likelihood as a nodule. The search protocol, which asked reviewers to report and rate all locations regarded as possible nodules on each film, assigned a default negative rating to any unreported finding (nodule or normal). Receiver operator characteristic analyses demonstrated a significantly higher accuracy for each reviewer's search- protocol discriminations between these nodules and confusing normal findings

  17. New hospital consultant: surviving a difficult period.

    Science.gov (United States)

    Robinson, Geoffrey; Morreau, Johan; Leighton, Marion; Beasley, Richard

    2007-08-10

    The first years of consultant practice are amongst the most stressful in a medical specialist's career. Recognising the likely difficulties is essential if measures are to be put in place to lessen their impact. In this article, recommendations are made on how to balance clinical and non-clinical duties and to obtain the support required for professional development. Self-care of mental and physical health is vital and planning is necessary to ensure that both personal health and a work/life balance are maintained.

  18. A rock characterisation facility consultative document

    International Nuclear Information System (INIS)

    1992-10-01

    This U.K. Nirex Ltd., consultative document describes a proposed underground rock characterisation facility, east of Sellafield, for conducting geophysical surveys as a basis for refining long-term safety analysis of an underground repository for intermediate-level and low-level radioactive wastes. Planning application will be submitted in 1993. The construction of shafts and galleries is described and the site's geologic, topographical, climatic and archaeological features discussed. The effects to the local environment and on local populations and other socio-economic factors are discussed. (UK)

  19. The duty to consult and legal obligations

    Energy Technology Data Exchange (ETDEWEB)

    Carpenter, A.W. [Lawson Lundell Lawson and MacIntosh, Calgary, AB (Canada)

    2002-07-01

    Aboriginal law in Canada has been evolving and industry is beginning to engage in the change. This presentation describes the legal aspects regarding Aboriginal rights and the duty to consult First Nations regarding treaty rights. The implications for First Nations and industry are described. Aboriginal peoples of Canada include the Indian, Inuit and Metis populations. Aboriginal titles exist, therefore they are constitutionally protected. The paper describes recent decisions regarding the Mikisew Cree First Nation versus Canada, the Taku River Tlinget versus Ringstad, and the Haida Nation versus British Columbia and Weyerhaeuser.

  20. UK strategy for radioactive discharges 2001-2020. Consultation document

    International Nuclear Information System (INIS)

    2000-06-01

    This consultation draft of a strategy for radioactive discharges describes how the United Kingdom (UK) will implement the agreements reached at the 1998 Ministerial meeting of the OSPAR Commission, with regard to radioactive substances. It also provides a policy base for future reviews of discharge authorisations by the regulatory bodies and for strategic planning by the nuclear operators. The strategy sets a framework for radioactive discharges from UK installations over the next twenty years. Its aims are: progressive and substantial reductions in radioactive discharges from the UK as a whole and from each of the main sectors responsible for such discharges; progressive reduction of human exposure to ionising radiation resulting from radioactive discharges, so that no member of the general public in the UK will be exposed to a dose of more than 0.02 mSv a year, as a result of authorised radioactive discharges made from 2020 onwards; progressive reductions in concentrations of radionuclides in the marine environment resulting from radioactive discharges, such that by 2020 they add close to zero to historic levels. The scope of the UK strategy encompasses radioactive discharges from nuclear licensed sites, defence activities and other nuclear and non-nuclear sources of radioactive discharges. It covers both liquid and aerial discharges, although it is assumed that in general liquid discharges will have the largest and most measurable effects in the marine environment

  1. Acute surgical unit: The consultant experience

    Directory of Open Access Journals (Sweden)

    Patrick J Stokes

    2016-07-01

    Full Text Available Background Establishment of the Acute Surgical Unit (ASU has redefined the approach to emergency surgery in Australia with quantitative data showing improvement in patient outcomes. However, as qualitative data regarding the ASU remains scarce, we sought to determine the impact of the ASU on overall surgeon job satisfaction. Aims The aim of this paper was to specifically address the impact of the ASU on consultant surgeons overall job satisfaction. Methods We designed a 34 – item questionnaire with consultant general surgeons addressing important aspects of the ASU. Themes included on – call rostering and workload, academic pursuits, surgical training, work – life balance and overall job satisfaction. Results We received responses from 88 surgeons currently working on ASU units, responding correctly and in full to the survey. Overall, our surveyed cohort reported better on – call rostering, improved surgical training and higher levels of job satisfaction and overall work – life balance with ASU implementation. Conclusion Preliminary qualitative results indicate that the ASU may improve on – call rostering, work – life balance and overall job satisfaction.

  2. 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.

  3. 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.

  4. 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.

  5. MRMC analysis of agreement studies

    Science.gov (United States)

    Gallas, Brandon D.; Anam, Amrita; Chen, Weijie; Wunderlich, Adam; Zhang, Zhiwei

    2016-03-01

    The purpose of this work is to present and evaluate methods based on U-statistics to compare intra- or inter-reader agreement across different imaging modalities. We apply these methods to multi-reader multi-case (MRMC) studies. We measure reader-averaged agreement and estimate its variance accounting for the variability from readers and cases (an MRMC analysis). In our application, pathologists (readers) evaluate patient tissue mounted on glass slides (cases) in two ways. They evaluate the slides on a microscope (reference modality) and they evaluate digital scans of the slides on a computer display (new modality). In the current work, we consider concordance as the agreement measure, but many of the concepts outlined here apply to other agreement measures. Concordance is the probability that two readers rank two cases in the same order. Concordance can be estimated with a U-statistic and thus it has some nice properties: it is unbiased, asymptotically normal, and its variance is given by an explicit formula. Another property of a U-statistic is that it is symmetric in its inputs; it doesn't matter which reader is listed first or which case is listed first, the result is the same. Using this property and a few tricks while building the U-statistic kernel for concordance, we get a mathematically tractable problem and efficient software. Simulations show that our variance and covariance estimates are unbiased.

  6. Between voluntary agreement and legislation

    DEFF Research Database (Denmark)

    Gwozdz, Wencke; Hedegaard, Liselotte; Reisch, Lucia

    2009-01-01

    Voluntary agreements and self-imposed standards are broadly applied to restrict the influence food advertising exerts on children’s food choices – yet their effects are unknown. The current project will therefore investigate whether and, if yes, how the Danish Code for Responsible Food Marketing...

  7. Form 6 - gas balancing agreement

    International Nuclear Information System (INIS)

    Anon.

    1990-01-01

    In 1988, a special Committee of the Rocky Mountain Mineral Law Foundation undertook a project to draft a model from gas balancing agreement. This project was initiated at the request of a number of Foundation members who felt that a model form gas balancing agreement would facilitate the negotiation of operating agreement, since gas balancing issues had become sticking points in the process. The Committee was composed of attorneys representing a wide cross-section of the oil and gas industry including both major and independent oil companies, production companies with interstate pipeline affiliates, and private practitioners. The Committee attempted to address the more controversial issues in gas balancing with optional provisions in the Form. To facilitate the negotiation process, the number of optional provisions was minimized. This form may be used as an Appendix to the new A.A.P.L. Form 610-1989 Model Form Operating Agreement. This book includes provision of this Form which are: Ownership of gas production; Balancing of production accounts; Cash balancing upon depletion; Deliverability tests; Nominations; Statements; Payment of taxes; Operating expenses; Overproducing allowable; Payment of leasehold burdens; Operator's liability; Successors and assigns; Audits; Arbitration; and Operator's fees

  8. Psychoimmunology Consultation - A Study on Comorbidity

    Directory of Open Access Journals (Sweden)

    Mariana Marinho

    2017-03-01

    Full Text Available Introduction: In comparison to the general population, notified  HIV-positive patients have higher prevalence  rates for most mental disorders, with values reaching 30-60%. Objectives: To characterize the population that is referred to Psychiatry-Psychoimmunology consultation; to explore the possible relationship  between  psychiatric  diagnosis, antiretroviral treatment and HCV co-infection, with sociodemographic and clinical variables. Methods: We have selected HIV-positive patients referred for the first time to Psychiatry-Psychoimmunology consultation, between January 2012 and July 2015. Information was collected through the clinical process in electronic form. Statistical analy- sis was performed using the statistical analysis  program  Statistical  Package for Social Sciences, version 20. Results: The sample contained 209 patients, with a median age of 43 years, mostly men, with four years of schooling, single, professionally inactive, infected via heterosexual behavior. However, we found statistically significant differences between sexes for the last three variables. The majority was under antiretroviral treatment, with no significant differences between sexes. In the first consultation, 29.0% and 30.1% had, respectively, substance use and HCV co-infection, with a significant predominance in men. Depressive symptoms and adjustment disorder to the disease constituted, respectively, the referral reason and the most common psychiatric diagnosis, in both sexes. More than half had psychiatric history. HCV co-infection showed a statistical significant correlation between variables like sex, occupational status, infection transmission route,  psychiatric  history  and  use  of  alcohol and/or illicit drugs. The same was true between the psychiatric diagnosis and some variables like infection notification  time, alcohol and/or drugs and HCV co-infection. Conclusions: During the course of infection, these patients often face

  9. 76 FR 16420 - Notice of Agreements Filed

    Science.gov (United States)

    2011-03-23

    .... Title: Hanjin and WHS Transpacific Vessel Sharing and Slot Allocation Agreement. Parties: Hanjin... amendment would add COSCON as a party to the Agreement and revise the name of the Agreement to Hanjin/WHS...

  10. 78 FR 35270 - Notice of Agreements Filed

    Science.gov (United States)

    2013-06-12

    ... Russia from the geographic scope of the agreement. Agreement No.: 012210. Title: Siem Car Carrier Pacific AS/Eukor Car Carriers Inc. Space Charter Agreement. Parties: Siem Car Carrier Pacific AS and Eukor...

  11. 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.

  12. 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."

  13. Cap and trade offsets regulation - consultation paper

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-07-01

    Due to increasing concerns about the environment, British Columbia has committed to reducing its 2007 greenhouse gas emissions levels by 33% in 2020 and 80% in 2050. To reach those objectives, emissions trading and offset regulations are being developed by the Climate Action Secretariat. The aim of this document is to present a first draft of the regulations to the various stakeholders, including First Nations and the general public, together with the proposed offset eligibility criteria and related process, and to get their feedback. This document is itself part of the 5-phase process of developing the regulations. Following the 45 days during which comments on the proposed regulation were sought, the climate action secretariat will complete legal drafting of the regulations, drawing on help from this stakeholder input, and the regulation will subsequently be implemented. An accompanying response form was attached to this consultation paper.

  14. First joint environmental consultancy for China

    International Nuclear Information System (INIS)

    Hendry, S.

    1993-01-01

    China's first joint venture environmental consulting firm, Environomics, formed with $100,000 from Chinese and U.S. investors, will begin doing business next month, says general manager Husayn Anwar. Last December Beijing slated its environmental industry's output to triple to yuan 10 billion ($1.8 billion)/year by the year 2000 - a response to increased strains on the environment caused by China's economic boom. The chemical industry is the foremost source of emissions of toxic substances such as mercury, phenol, and chromium: it also emits one-third of all industrial wastewater in the country, according to a May 1992 Ministry of the Chemical Industry report. Demand for ozone-depleting chlorofluorocarbons, without any change in technology, is set to triple by 2000, the ministry says

  15. Animal Welfare: Data from an Online Consultation.

    Science.gov (United States)

    Sechi, Paola; Baldinelli, Chiara; Iulietto, Maria F; Goga, Beniamino T Cenci

    2015-11-02

    This paper analyses data obtained from an online survey related to animal welfare and religious slaughter topics. The questionnaire was conducted with the purpose of examining the purchase behaviour of a group of consumers (with different religious orientation) and their views on animal protection and ritual slaughter. The main results of the consultation were two. The first evidenced the respondents' great interest about the question on animal welfare, which is in accordance with the growing interest of European citizens concerning this issue. The second was the demand for a more transparent labelling of animal products, which would also reflect animal welfare and the slaughter method used. These results are in contrast with marketing analysis, which finds that consumers want to only receive positive information. Paradoxically, the more information is transmitted to reassure consumers, the higher is the risk to alarm them.

  16. Key Value Considerations for Consultant Pharmacists.

    Science.gov (United States)

    Meyer, Lee; Perry, Ronald G; Rhodus, Susan M; Stearns, Wendy

    2016-07-01

    Managing the efficiency and costs of residents' drug regimens outside the acute-care hospital and through transitions of care requires a toolbox filled with cost-control tools and careful collaboration among the pharmacy provider(s), facility staff, and the consultant/senior care pharmacist. This article will provide the reader with key long-term care business strategies that affect the profitability of the pharmacy provider in various care settings while, at the same time, ensuring optimal therapy for residents as they transition across levels of care. Readers can take away ideas on how to access critical information, what they can do with this information, and how they can improve the overall care process. Four experts in various aspects of pharmacy management share their insights on pharmacy practice issues including formulary management, performance metrics, short-cycle dispensing challenges/solutions, cost-control measures, facility surveys, billing practices, medication reconciliation, prospective medication reviews, and transitions of care.

  17. Financial security for women -- Fem Consult congress.

    Science.gov (United States)

    1996-01-01

    The nongovernmental organization "Fem Consult," which seeks to strengthen the socioeconomic position of women by applying a gender perspective to programs and projects in developing countries, celebrated its 10th anniversary in 1996 by holding a conference in the Netherlands on financial security for women in the developing world. During the conference, the President of the WWF (Working Women's Forum) described her agency's 17 years of experience in lending to impoverished rural and urban women in India. By extending microcredit assistance through a network of cooperatives, the WWF has been the catalyst for lasting improvements in the economic and social status of impoverished women. Representatives of the Grameen Bank, Women's World Banking, the Ecumenical Development Cooperative Society, and other organizations also addressed the conference.

  18. Structural analysis consultation using artificial intelligence

    Science.gov (United States)

    Melosh, R. J.; Marcal, P. V.; Berke, L.

    1978-01-01

    The primary goal of consultation is definition of the best strategy to deal with a structural engineering analysis objective. The knowledge base to meet the need is designed to identify the type of numerical analysis, the needed modeling detail, and specific analysis data required. Decisions are constructed on the basis of the data in the knowledge base - material behavior, relations between geometry and structural behavior, measures of the importance of time and temperature changes - and user supplied specifics characteristics of the spectrum of analysis types, the relation between accuracy and model detail on the structure, its mechanical loadings, and its temperature states. Existing software demonstrated the feasibility of the approach, encompassing the 36 analysis classes spanning nonlinear, temperature affected, incremental analyses which track the behavior of structural systems.

  19. Energy futures project : backgrounder for consultation sessions

    International Nuclear Information System (INIS)

    Bhargava, A.

    2006-05-01

    The National Energy Board periodically publishes a long-term energy and demand report as part of an ongoing monitoring program. The next report is planned for release in 2007. This background document provided background information to ensure that consultation participants have a common understanding of key issues to be addressed during the cross-country consultations that have been planned before the release of the final version of the report. An outline of the proposed analytical approach was presented, as well as details of major assumptions and scenario storylines. Scenario themes included: economic, energy and environmental sustainability; a security-focused world shaped by war and civil strife; and strong global economic growth fueled by the rapid growth of the Chinese and Indian economies. A methodology overview was provided as well as a reference case. Issues related to energy supply included oil; natural gas liquids; natural gas; and electricity. Issues related to energy demand included the residential sector; the commercial sector; the industrial sector; and the transportation sector. Historical trends and forecasts were outlined using the macroeconomic variable of interest. Supply, demand, and supporting infrastructure across all energy forms within a North American and global context were considered. The impact of environmental management strategies were reviewed, as well as the role of the government in shaping policies. It was concluded that the purpose of the final report is to serve as a standard of references for parties interested in Canadian energy issues and trends as well as to inform decision makers of key risks and uncertainties facing the energy future.9 tabs., 1 fig

  20. 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.

  1. 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.

  2. 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...

  3. 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...

  4. International agreements on nuclear weapons

    International Nuclear Information System (INIS)

    Dombey, N.

    1982-01-01

    The satellite detection of a nuclear explosion in the South Atlantic and Israel's destruction of a research reactor in Iraq make it essential to strengthen existing monitoring and enforcement programs to prevent proliferation. While there was no reliable evidence that either South Africa or Iraq was violating non-proliferation agreements, worst case scenarios can demonstrate to unfriendly countries that South Africa had diverted fuel to test a nuclear weapon and that Iraq is intending to produce weapons-grade plutonium 239. The situation can be improved by formulating better terms and conditions for internationalizing access to materials. Nuclear suppliers need to agree on terms that will assure their customers that contracts for civil programs will be honored. The International Atomic Energy Agency (IAEA), which includes both nuclear suppliers and customers, could achieve stronger agreements that take into account recent technological advances that will expand enrichment and reprocessing activities. 23 references, 1 figure

  5. 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.

  6. 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)

  7. 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.

  8. 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...

  9. 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.

  10. 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.

  11. 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'.

  12. Prognostic accuracy of antenatal neonatology consultation.

    Science.gov (United States)

    Kukora, S; Gollehon, N; Weiner, G; Laventhal, N

    2017-01-01

    Neonatologists provide antenatal counseling to support shared decision-making for complicated pregnancies. Poor or ambiguous prognostication can lead to inappropriate treatment and parental distress. We sought to evaluate the accuracy of antenatal prognosticaltion. A retrospective cohort was assembled from a prospectively populated database of all outpatient neonatology consultations. On the basis of the written consultation, fetuses were characterized by diagnosis groups (multiple anomalies or genetic disorders, single major anomaly and obstetric complications), assigned to five prognostic categories (I=survivable, IIA=uncertain but likely survivable, II=uncertain, IIB=uncertain but likely non-survivable, III non-survivable) and two final outcome categories (fetal demise/in-hospital neonatal death or survival to hospital discharge). When possible, status at last follow-up was recorded for those discharged from the hospital. Prognostic accuracy was assessed using unweighted, multi-level likelihood ratios (LRs). The final cohort included 143 fetuses/infants distributed nearly evenly among the three diagnosis groups. Over half (64%) were assigned an uncertain prognosis, but most of these could be divided into 'likely survivable' or 'likely non-survivable' subgroups. Overall survival for the entire cohort was 62% (89/143). All but one of the fetuses assigned a non-survivable prognosis suffered fetal demise or died before hospital discharge. The neonatologist's antenatal prognosis accurately predicted the probability of survival by prognosis group (LR I=4.56, LR IIA=10.53, LR II=4.71, LR IIB=0.099, LR III=0.040). The LRs clearly differentiated between fetuses with high and low probability of survival. Eleven fetuses (7.7%) had misalignment between the predicted prognosis and outcome. Five died before discharge despite being given category I or IIA prognoses, whereas six infants with category IIB or III prognoses survived to discharge, though some of these were

  13. 48 CFR 1642.7001 - Management agreement.

    Science.gov (United States)

    2010-10-01

    ... EMPLOYEES HEALTH BENEFITS ACQUISITION REGULATION CONTRACT MANAGEMENT CONTRACT ADMINISTRATION Management Agreement (in Lieu of Novation Agreement) 1642.7001 Management agreement. When it is in the best interest of... day-to-day performance of the contract. Examples of situations in which a Management Agreement may be...

  14. 76 FR 63618 - Notice of Agreements Filed

    Science.gov (United States)

    2011-10-13

    ...; Washington, DC 20036. Synopsis: The amendment removes Korea from the geographic scope of them agreement and... geographic scope of the Agreement to include Taiwan. The parties requested expedited review. Agreement No... and Korea, China, Taiwan, Thailand, Vietnam, and Singapore. Agreement No.: 012138. Title: CSAV/CCNI...

  15. 77 FR 42310 - Notice of Agreements Filed

    Science.gov (United States)

    2012-07-18

    ...; Washington, DC 20006-4007. Synopsis: The agreement would provide for delivery of data to the Port of Oakland... delivery. Agreement No.: 201217. Title: Port of Long Beach Data Services Agreement. Parties: Port of Long... 1100; Washington, DC 20006-4007. Synopsis: The agreement would provide for delivery of data to the Port...

  16. 76 FR 553 - Notice of Agreements Filed

    Science.gov (United States)

    2011-01-05

    ... obsolete language on the duration of Agreement, and changes the name and restates the Agreement. By Order... agreement's governing board and would update the corporate addresses of American President Lines, Ltd.; APL.... as a party to the agreement and updates the corporate addresses of American President Lines, Ltd...

  17. 48 CFR 2831.109 - Advance agreements.

    Science.gov (United States)

    2010-10-01

    ... proposed agreement. The approved determination will be placed in the contract file. (c) All advance... the agreements. Advance agreements will be signed by both the contractor and the contracting officer, and made a part of the contract file. Copies of executed advance agreements will be distributed to the...

  18. 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

  19. CEC/NRPB Association Agreement

    International Nuclear Information System (INIS)

    DeBeger, D.

    1993-01-01

    In January 1990 the National Radiological Protection Board signed an 'Agreement of Association' with the European Atomic Energy Community, represented by the Commission of the European Communities, to carry out research work in fields covered by the Radiation Protection Research Programme. Under the terms of the contract the Board assumed overall responsibility for the coordination of work involving a number of European organisations, 25 in total and covering 9 countries stretching from Greece to Sweden. The contract provided for funding of research work relating to the assessment of human exposure to natural, medical and occupational radiation and the associated risks. (Author)

  20. 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.

  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. 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

  3. Consulting-Research Froblems with German and American Multinational Firms.

    Science.gov (United States)

    Hildebrandt, Herbert W.

    International researchers need to be aware of international problems and multinational managerial codes when they work with worldwide organizations. This paper develops the premise that consulting with German multinational companies is more complex than consulting with or researching for American firms. Discussion focuses on the following three…

  4. 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...

  5. 76 FR 47089 - Regulatory Review Schedule; Cancellation of Consultation Meetings

    Science.gov (United States)

    2011-08-04

    ... Consultation-- Wild Horse Resort Casino, 1, 2, 3, 4, 5 Southwest. Scottsdale, AZ. September 19-20, 2011 NIGC Regional Training..... Sky Ute Casino Resort 3, 4, 5 Ignacio, CO. September 27-28, 2011 NIGC Consultation-- Turning Stone Casino, NY... 3, 5 Northeast. November 7-12, 2011 USET Annual Meeting........ Mississippi...

  6. 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…

  7. 36 CFR 1270.50 - Consultation with law enforcement agencies.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Consultation with law enforcement agencies. 1270.50 Section 1270.50 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION PRESIDENTIAL RECORDS PRESIDENTIAL RECORDS Presidential Records Compiled for Law Enforcement Purposes § 1270.50 Consultation with...

  8. Intellectual Humility and Morality as Consultee-Centered Consultation Epistemologies

    Science.gov (United States)

    Truscott, Stephen D.; Kearney, Moriah A.; Davis, Don E.; Roach, Andrew T.

    2017-01-01

    Little research examines how epistemological constructs affect the consultation process in schools. We consider how the epistemological constructs of (a) intellectual humility and (b) moral foundations may moderate the effectiveness of consultee-centered consultation. We define the constructs and provide examples of their potential influences on…

  9. 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…

  10. 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...

  11. 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...

  12. 10 CFR 19.15 - Consultation with workers during inspections.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Consultation with workers during inspections. 19.15...: INSPECTION AND INVESTIGATIONS § 19.15 Consultation with workers during inspections. (a) Commission inspectors... inspectors deem necessary for the conduct of an effective and thorough inspection. (b) During the course of...

  13. A Critical Review of Videoconferencing Software to Support School Consultation

    Science.gov (United States)

    Fischer, Aaron J.; Schultz, Brandon K.; Collier-Meek, Melissa A.; Zoder-Martell, Kimberly A.; Erchul, William P.

    2018-01-01

    With recent advances in technology, several viable options now exist for school consultants to communicate with teachers via synchronous online videoconferencing (VC) without the need for specialized equipment. Unfortunately, few studies have evaluated the effectiveness of school consultation through VC, so practitioners are provided little…

  14. 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...

  15. 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...

  16. International Consultation and Training on Group Work in South Asia

    Science.gov (United States)

    Ibrahim, Farah A.

    2015-01-01

    This article presents a consultation and training for faculty and graduate students in South Asia under the auspices of the United Nations' Transfer of Knowledge Through Expatriate Nationals (TOKTEN) Program. It describes the development of a consultation relationship and training on group work. Needs assessments focusing on both cultural…

  17. 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…

  18. Consultation and the TADS Experience. Occasional Paper Number 1.

    Science.gov (United States)

    Trohanis, Pascal L.; And Others

    During the past 10 years, the Technical Assistance Development System's (TADS) staff and advisory board members along with 500 other people have provided consultation services to model demonstration programs and state education agencies that help young handicapped children and their families. Consultants are usually located through a sponsor or…

  19. 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...

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

    Science.gov (United States)

    Kahnweiler, Jennifer B.; Pressman, Sue

    The Federal Government is America's largest employer and is expanding consulting opportunities for career development professionals. Increased Federal mandates for outsourcing have opened wide doors for the entrepreneurial-spirited career counselors and created new challenges for traditional methods of offering career services. As consultants who…

  1. Got Guilt? Consultant Guilt in the Writing Center Community

    Science.gov (United States)

    Nicklay, Jennifer

    2012-01-01

    During class discussions, the author's fellow consultants would often lament consultations that could have gone better if they had only known the "rules" of how to handle the situation. They perceived that there were acceptable and unacceptable ways to approach certain situations, rather than a range of flexible choices. The author began to…

  2. Analysis of international negotiations and trade agreements

    OpenAIRE

    Górriz Gonzalo, Verónica

    2014-01-01

    This study aims to analyze international trade agreements and negotiations. For that purpose, two agreements made by the United States are chosen to be analyzed. In the first place, the North America Free Trade Agreement (NAFTA) agreement, that was signed by the United States, Canada and Mexico in 1994 in order to create a free trade area. In addition, the Transatlantic Trade and Investment Partnership (TTIP) will be analyze, an agreement that is still being negotiated between the United Stat...

  3. Concertation or Consultation. That is the question.

    CERN Multimedia

    Staff Association

    2018-01-01

    In April 2017 (as reported in Echo No. 268), the Staff Association, when invited to an Enlarged Directorate meeting, stressed that “concertation requires a positive attitude and mutual trust. […] The Staff Association is firmly committed in this respect but does not consider that the concertation process is as effective as we should like”. The continued lack, for the Staff Association, of an effective concertation process led to a revisiting of the situation in June 2017 (Echo No. 271), in an article that stressed the importance of the concertation process at CERN since it was introduced in 1983, the year in which the Standing Concertation Committee (SCC) replaced the Standing Consultation Committee. The importance of concertation was also highlighted by Mr Bernard Dormy, Chair of TREF, in an interview he gave to the Staff Association at the end of January 2018 (Echo No. 284), when he retired from his position as the Chair of the Forum. “To sum it up, I would certainl...

  4. Concertation rather than Consultation or Negotiation!

    CERN Multimedia

    Staff Association

    2017-01-01

    At CERN, the Concertation between the Management and the Personnel has been in effect since 1983, the year in which the Standing Concertation Committee (SCC) came to replace the Standing Consultation Committee. Since then, the concertation process has been enshrined in the Staff Rules and Regulations, which define its scope of application: “Any proposed measures of a general nature regarding the conditions of employment or association of members of the personnel shall be the subject of discussion within the SCC” (S VII 1.08). More generally, all questions relating to the employment and working conditions of the members of personnel are discussed in the SCC, including in particular issues of remuneration, social protection (CHIS and Pension Fund), career evolution... In Article S VII 1.07 of the Staff Rules and Regulations it is also stated that: “Discussion shall mean a procedure whereby the Director-General and the Staff Association concert together to try to reach a common po...

  5. Gas priority users consultation : government response

    International Nuclear Information System (INIS)

    2007-01-01

    This consultation document presents the results of an updated analysis of gas priority users comments on the UK government's proposals for updating the current priority lists, amending the eligibility criteria for priority user status, and simplifying the administration of the scheme. The extension of Category C priority users to include sites where interruption of gas supplies would lead to damage exceeding fifty million pounds to a plant at another site is discussed. It is acknowledged that there is a preference for a reduction of gas demand as opposed to a cessation in the case of an emergency gas supply deficit and details are given of a Task Group set up to examine options for reducing demand rather than cessation for large industrial gas users. The role of the Network Emergency Co-ordinator, support for a more flexible approach, pre-agreed rota interruption, a long-duration emergency, demand reduction, and the establishment of a Government/Industry Gas/Electricity Task Group are discussed, and the raising of the load shedding threshold of 25,000 therms/yr is considered

  6. Spirituality and distress in palliative care consultation.

    Science.gov (United States)

    Hills, Judith; Paice, Judith A; Cameron, Jacqueline R; Shott, Susan

    2005-08-01

    One's spirituality or religious beliefs and practices may have a profound impact on how the individual copes with the suffering that so often accompanies advanced disease. Several previous studies suggest that negative religious coping can significantly affect health outcomes. The primary aim of this study was to explore the relationship between spirituality, religious coping, and symptoms of distress among a group of inpatients referred to the palliative care consult service. Pilot study. The study was conducted in a large academic medical center with a comprehensive Palliative Care and Home Hospice Program. (1) National Comprehensive Cancer Network Distress Management Assessment Tool; (2) Pargament Brief Religious Coping Scale (Brief RCOPE); (3) Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp); (4) Puchalski's FICA; and (5) Profile of Mood States-Short Form (POMS-SF). The 31 subjects surveyed experienced moderate distress (5.8 +/- 2.7), major physical and psychosocial symptom burden, along with reduced function and significant caregiving needs. The majority (87.2%) perceived themselves to be at least somewhat spiritual, with 77.4% admitting to being at least somewhat religious. Negative religious coping (i.e., statements regarding punishment or abandonment by God) was positively associated with distress, confusion, depression, and negatively associated with physical and emotional well-being, as well as quality of life. Palliative care clinicians should be alert to symptoms of spiritual distress and intervene accordingly. Future research is needed to identify optimal techniques to address negative religious coping.

  7. Department of Training and Consulting - Overview

    International Nuclear Information System (INIS)

    Dobrzynski, L.

    2007-01-01

    Department of Training and Consulting is regularly serving secondary schools' pupils and teachers, university students and the public. As usual we have been visited by about 7000 visitors, mainly students from secondary schools in Poland. The Department is constantly developing experiments which can be conducted by students of secondary schools and universities, as well as by professionals. At the moment there are about 20 experiments available for the guests of the Department. They cover measurements of the lifetimes, elements of radioprotection, absorption of radiation in various materials, excitation of fluorescence radiation, influence of magnetic field on beta radiation as well as electrons emitted from typical electron gun, Compton scattering and elements of gamma spectroscopy, search for radioactive pollutions etc. In addition the Department was very active during Science Picnic in May and Science Festival in September, when the Department proposed organisation of a '' Day with Radioactivity ''. '' The Day '' consisted of a number of public lectures and demonstrations. In addition two evenings were dedicated to a public debate on energy sources and energy demands and supply in next 50-100 years. One should also mention organisation and leading of the professional course for accelerators' operators, as well as starting a new university course on '' Nuclear Energy and Its Use '' (Cardinal Stefan Wyszynski University, Warsaw). The web side of the Department contains educational materials (part of it can be found on international platform http://www.nupex.org), quizzes and self-teaching materials. (author)

  8. [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.

  9. 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

  10. 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).

  11. 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

  12. 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...

  13. The Brazil agreement - quo vadis

    International Nuclear Information System (INIS)

    Hossner, R.

    1981-01-01

    After an analysis of the power requirements of Brazil as well as of the options for covering these requirements an important nuclear power program for peaceful uses was decided. It is performed on the basis of a bilateral agreement between Brazil and the Federal Republic of Germany of 1975 by co-operation between the German and the Brazilian industry. German firms make their know-how available as well as experts for a limited period of time, in order to establish during about 20 years an independent Brazilian infrastructure for nuclear power plants and their requirements, and to realize the transfer of technology which at the same time shall transmit impulses to the industrial development of the country. (orig.) [de

  14. Implementation of nuclear reduction agreements

    International Nuclear Information System (INIS)

    Scheinman, L.

    1994-01-01

    The collapse of the Soviet Union not only created a new political environment conductive to arms control and disarmament. It also raised unique and unprecedent non-proliferation problems which bear on the implementation of Start I and even on the Non-proliferation treaty insofar as a failure to rein in Ukraine would create a case of instant proliferation and raise questions about whether somehow Russia as a successor of the Soviet Union failed to meet its Non-proliferation Treaty obligation not to 'assist' any other state in acquiring nuclear weapons. The significance of implementing the agreements concerned with non-proliferation, production of highly enriched uranium outside IAEA safeguards, transparency relevance to the international arena, particularly to nuclear issues are discussed as crucial to progress towards a more stable and secure world order. The importance of the Non-proliferation Treaty extension Conference is underlined

  15. Department of Training and Consulting - Overview

    International Nuclear Information System (INIS)

    Dobrzynski, L.

    2010-01-01

    Full text: The Department of Training and Consulting concentrates on the dissemination of knowledge on radiation phenomena: the origins, applications and health effects of ionizing radiation in particular. Its activity is open to the public. However, the main recipients are students of secondary schools and teachers. During about 12 years of such activity the number of visitors has exceeded 60 000 persons, while during last few years the average number of our visitors varies between 6 000 and 7 000 per year, which shows how much this kind of activity is needed. It should be noted that the term 'visitor' is not the most appropriate, because what the 'visitor' actually experiences in the Department is a series of lectures with demonstrations, visits to the MARIA reactor or regular experimenting in a specially designed Laboratory of Atomic and Nuclear Physics for schools, teachers and university students. The Department organized two permanent exhibitions. One is connected with the nuclear waste treatment and storage, another one displays a large model. 4x4x4 m. of a nuclear reactor of the WWER-type which was about to be installed at Zarnowiec about 20 years ago. The Department is equally active during annual Picnics and Festivals of Science in Warsaw and other Polish towns. Our staff is often asked to deliver lectures outside the Institute for Nuclear Studies, and participates in discussions on problems of teaching, in addition, the Department leads, together with the Institute of Physics of the Polish Academy of Sciences, Warsaw, the annual competition, named '' Physical Paths '', for high-school students. The competition is arranged in three categories: research, demonstration of physical phenomena, and essays on physics and its relation to civilization. This competition particularly stimulates small educational centers in Poland. This year, 2010, the competition was organized for the fifth time. The Department of Training and Consulting arranges regular courses

  16. History Making: The Historian as Consultant

    Directory of Open Access Journals (Sweden)

    Jorma Kalela

    2013-11-01

    Full Text Available History is not just a genre of knowledge but also a basic feature of human life. Accounting for the past, or creating histories, to quote David Thelen, is ‘as natural a part of life as eating or breathing’. Casual references to what has taken place make up the vast majority of these accounts. But there are also a great number of deliberately created expositions of the past. They are produced in every field of society and by a wide variety of actors, from private persons to, for example, politicians and various media. The totality of them can be called everyday history. These accounts of the past serve present purposes – histories have innumerable functions and are of countless types. Divergent accounts also influence each other, and my suggestion is that their interaction be called the never-ending social process of history-making. History making, in other words, is not the preserve of academically-trained historians. They are experts but not outside observers. Scholarly historians are inescapably involved in the social process of history making. Their work goes beyond prevailing histories: they seek interpretations that make better sense of the past than the existing ones. Embedded in this effort is another constructivist function: they demonstrate ways to think about the past and how to use it. When demonstrating ‘that’s not how it was’, historians at the same display ‘how the presentation should have been constructed’. Even if they don’t think of themselves as consultants on history making they act in this capacity.

  17. Consultation on AIDS and the workplace.

    Science.gov (United States)

    1988-12-01

    The 1988 Consultation on Acquired Immunodeficiency Syndrome (AIDS) and the Workplace, organized by the World Health Organization (WHO), addressed 3 issues: 1) risk factors associated with human immunodeficiency virus (HIV) infection in the workplace, 2) the response of businesses and workers to the AIDS epidemic, and 3) use of the workplace for AIDS education. There is no evidence to suggest that HIV can be transmitted by casual, person-to-person contact in the workplace. The central policy issue for businesses concerns protection of the human rights of workers with HIV infection. Most workers with HIV/AIDS want to continue working as long as they are able to, and they should be enabled to contribute their creativity and productivity in a supportive occupational setting. Consistent policies and procedures should be developed at national and enterprise levels before HIV-related questions arise in the workplace. Such policies should be communicated to all concerned, continually reviewed in the light of scientific and epidemiologic evidence, monitored for their successful implementation, and evaluated for their effectiveness. Pre-employment HIV/AIDS screening, whether for assessment of fitness to work or for insurance purposes, should not be required and raises serious concerns about discrimination. Moreover, there should be no obligation on the worker's part to inform his or her employer if HIV infection develops. Information and educational activities at the workplace are essential to create the climate of collective responsibility and mutual understanding required to protect individuals with HIV or AIDS from stigmatization and discrimination by co-workers, employers or clients, and unions.

  18. 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.

  19. 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…

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

    Science.gov (United States)

    Sibarani, Roza Marsaulina

    2014-01-01

    This paper reports the process of informal learning in the pre-consulting phase in management-consulting firms in Indonesia. As the consulting industry significantly grows in Indonesia, more organisations use consultant services to improve their business. Pre-consulting is an important phase to define the right solutions, which involves a lot of…

  1. 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

  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. [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.

  4. 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.

  5. 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…

  6. 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.

  7. 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.

  8. [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.

  9. 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.

  10. 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.

  11. 48 CFR 225.403 - World Trade Organization Government Procurement Agreement and Free Trade Agreements.

    Science.gov (United States)

    2010-10-01

    ... Government Procurement Agreement and Free Trade Agreements. 225.403 Section 225.403 Federal Acquisition... FOREIGN ACQUISITION Trade Agreements 225.403 World Trade Organization Government Procurement Agreement and... Government Procurement Agreement, acquire only U.S.-made, qualifying country, or designated country end...

  12. 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...

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

    Science.gov (United States)

    Reiter-Theil, Stella

    2008-07-01

    Broad evidence exists that health care professionals are facing ethical difficulties in patient care demanding a spectrum of useful ethics support services. Clinical ethics consultation is one of these forms of ethics support being effective in the acute setting. An authentic case is presented as an illustration. We introduce an integrative model covering the activities being characteristic for ethics consultation and going beyond "school"-specific approaches. Finally, we formulate some do's and don'ts of ethics consultation that are considered to be key issues for successful practice.

  14. 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...

  15. 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....

  16. Exploring accountability of clinical ethics consultants: practice and training implications.

    Science.gov (United States)

    Weise, Kathryn L; Daly, Barbara J

    2014-01-01

    Clinical ethics consultants represent a multidisciplinary group of scholars and practitioners with varied training backgrounds, who are integrated into a medical environment to assist in the provision of ethically supportable care. Little has been written about the degree to which such consultants are accountable for the patient care outcome of the advice given. We propose a model for examining degrees of internally motivated accountability that range from restricted to unbounded accountability, and support balanced accountability as a goal for practice. Finally, we explore implications of this model for training of clinical ethics consultants from diverse academic backgrounds, including those disciplines that do not have a formal code of ethics relating to clinical practice.

  17. [Remote Slit Lamp Microscope Consultation System Based on Web].

    Science.gov (United States)

    Chen, Junfa; Zhuo, Yong; Liu, Zuguo; Chen, Yanping

    2015-11-01

    To realize the remote operation of the slit lamp microscope for department of ophthalmology consultation, and visual display the real-time status of remote slit lamp microscope, a remote slit lamp microscope consultation system based on B/S structure is designed and implemented. Through framing the slit lamp microscope on the website system, the realtime acquisition and transmission of remote control and image data is realized. The three dimensional model of the slit lamp microscope is established and rendered on the web by using WebGL technology. The practical application results can well show the real-time interactive of the remote consultation system.

  18. 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

  19. 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...

  20. Sport psychology group consultation using social networking web sites.

    Science.gov (United States)

    Dietrich, Frederick; Shipherd, Amber M; Gershgoren, Lael; Filho, Edson Medeiros; Basevitch, Itay

    2012-08-01

    A social networking Web site, Facebook, was used to deliver long-term sport psychology consultation services to student-athletes (i.e., soccer players) in 30- to 60-min weekly sessions. Additional short-term team building, group cohesion, communication, anger management, injury rehabilitation, mental toughness, commitment, and leadership workshops were provided. Cohesion and overall relationships between both the student-athletes and the sport psychology consultants benefited from this process. Social networking Web sites offer a practical way of providing sport psychology consulting services that does not require use of major resources. (c) 2012 APA, all rights reserved.

  1. 23 CFR 635.115 - Agreement estimate.

    Science.gov (United States)

    2010-04-01

    ... CONSTRUCTION AND MAINTENANCE Contract Procedures § 635.115 Agreement estimate. (a) Following the award of contract, an agreement estimate based on the contract unit prices and estimated quantities shall be...

  2. 48 CFR 1542.1203 - Processing agreements.

    Science.gov (United States)

    2010-10-01

    ... MANAGEMENT CONTRACT ADMINISTRATION Novation and Change of Name Agreements 1542.1203 Processing agreements. (a... required documentary evidence. (2) Verify the accuracy of the list of contracts through the Contract...

  3. 76 FR 72408 - Notice of Agreements Filed

    Science.gov (United States)

    2011-11-23

    .... Synopsis: The amendment adds Korea to the geographic scope of the agreement and removes some historical... agreement authorizes the parties to exchange space in the trade between China, Singapore, Vietnam and the U...

  4. 75 FR 42445 - Notice of Agreement Filed

    Science.gov (United States)

    2010-07-21

    ...)-523-5793 or [email protected] . Agreement No.: 012105. Title: SCM Lines Transportes/CCNI Agreement. Parties: Compania Chilena de Navegacion Interoceanica S.A. and SCM Lines Transportes Maritimos Sociedade...

  5. 27 CFR 70.485 - Closing agreements.

    Science.gov (United States)

    2010-04-01

    ... Relating to Alcohol, Tobacco, Firearms, and Explosives Administrative Remedies § 70.485 Closing agreements... disadvantage through consummation of such an agreement. (b) Scope of closing agreement—(1) In general. A...

  6. 78 FR 6325 - Notice of Agreements Filed

    Science.gov (United States)

    2013-01-30

    ... Enterprises LLC. Agreement No.: 012193-000. Title: Siem Car Carrier Pacific AS/Compania Sud Americana de Vapores S.A. Space Charter Agreement. Parties: Siem Car Carrier Pacific AS and Compania Sud Americana de...

  7. 77 FR 71001 - Notice of Agreements Filed

    Science.gov (United States)

    2012-11-28

    .... Agreement No.: 012187-000. Title: Siem Car Carrier Pacific AS/Hoegh Autoliners, Inc. Space Charter Agreement. Parties: Siem Car Carrier Pacific AS and Hoegh Autoliners, Inc. Filing Party: Ashley W. Craig Esq...

  8. 77 FR 16838 - Notice of Agreements Filed

    Science.gov (United States)

    2012-03-22

    ... the U.S. Pacific Coast and the Middle East and Asia. Agreement No.: 012161. Title: Siem Car Carrier Pacific AS/Hyundai Glovis Co., Ltd. Space Charter Agreement. Parties: Siem Car Carrier Pacific AS; Hyundai...

  9. Department of Training and Consulting - Overview

    International Nuclear Information System (INIS)

    Dobrzynski, L.

    2008-01-01

    Full text: The Department of Training and Consulting is regularly serving secondary schools' pupils and teachers, university students and the public. As usual, we have been visited by over 5000 visitors, mainly students from secondary schools in Poland. In this contest, it is worth to mention the organization of the two 3-days Workshops '' On the nuclear energy from the very basics '', aimed to offer the teachers of secondary schools general understanding of the problems connected with nuclear energy. The Workshops were organized in collaboration with the International Atomic Energy Agency and Polish Atomic Agency. Also two other one-day courses on the nuclear radiation were organized for teachers from rather remote parts of Poland. In the teachers' opinion all these events were very successful. The Department is constantly developing experiments that can be conducted by students of secondary schools and universities, as well as by professionals. At the moment there are about 20 experiments available for the guests of the Department. They cover the measurements of lifetimes, essential elements of radioprotection, absorption of radiation in various materials, excitation of fluorescence radiation, influence of magnetic field on beta radiation as well as on electrons emitted from a typical electron gun, Compton scattering and elements of gamma spectroscopy, search for radioactive pollutions etc. A new task of preparing some experiments to be driven through the internet was put forward. It is hoped that this project will end within 2008. For the second time the Department has organized (together with the Institute of Physics of the Polish Academy of Sciences, Warsaw) '' The Physical Pathways '' competition for the students of secondary schools. The students could choose one of three possibilities (even all of them): either to submit a scientific paper, or to present demonstration of a physical phenomena, or to write an essay on the connection between physics and the

  10. Department of Training and Consulting - Overview

    International Nuclear Information System (INIS)

    Dobrzynski, L.

    2009-01-01

    Full text: The Department of Training and Consulting regularly serves secondary schools pupils and teachers, university students and the public. Almost 6600 visitors, mainly students from secondary schools in Poland, visited the Department. In addition to regular lectures, demonstrations, visits to the reactor MARIA and two current exhibitions (on nuclear waste and the WWER reactor model), several laboratory experiments have been organized for secondary schools. A one-day summer workshop on '' Basics of nuclear radiation, its properties and use in science, technology and medicine '' offered secondary school teachers a general understanding of the problems connected with radioactivity. The Department is constantly developing experiments that can be conducted by students of secondary schools and universities, as well as by professionals. At the moment, there are about 25 experiments available for the guests of the Department. They cover the measurement of lifetimes, essential elements of radioprotection, absorption of radiation in various materials, excitation of fluorescence radiation, influence of magnetic fields on beta radiation as well as on electrons emitted from a typical electron gun, Compton scattering and elements of gamma spectroscopy, search for radioactive pollutions etc. Three experiments were modernized to enable them to be conducted over the Internet. This project is a bit delayed but should be finished by the end of April 2009. For the third time the Department organized (together with the Institute of Physics of the Polish Academy of Sciences, Warsaw) '' The Physical Pathways '' competition for secondary school students. The students could choose one of three possibilities (even all of them): either to submit a scientific paper, to present a demonstration of a physical phenomenon, or to write an essay on the connection between physics and the development of civilization. They could also submit work prepared by a team of up to three persons. The

  11. Department of Training and Consulting - Overview

    International Nuclear Information System (INIS)

    Dobrzynski, L.

    2010-01-01

    Full text: The Department of Training and Consulting regularly serves secondary schools pupils and teachers, university students and the public. As usual we have been visited by over 6400 visitors, mainly students from secondary schools in Poland. In the opinion of the teachers the outcome of all visits was very positive. In addition, special courses on radioactivity and nuclear energy dedicated to teachers were organized. Many lectures have been delivered outside of the Department, in schools, universities and institutes. The Department is constantly developing experiments that can be conducted by students of secondary schools and universities, as well as by professionals. At the moment there are about 28 experiments available for the guests of the Department. The list of experiments and their descriptions can be found on our home page http://dsid.ipj.gov.pl. They cover the measurement of lifetimes, essential elements of radioprotection, absorption of radiation in various materials, excitation of fluorescence radiation, influence of magnetic fields on beta radiation as well as on electrons emitted from a typical electron gun, Compton scattering and elements of gamma spectroscopy, the search for radioactive pollution, the basics of the wave-particle dualism of matter, and the recently added Frank-Hertz experiment and radioactive decay of thoron. For the fifth time the Department has organized (together with the Institute of Physics of the Polish Academy of Sciences, Warsaw) '' The Physical Pathways '' competition for students of secondary schools. The students could choose one of three possibilities (even all of them): either to submit a scientific paper, to present a demonstration of a physical phenomena, or to write an essay on the connection between physics and the development of civilization. They could also submit work prepared by a team of up to 3 persons. The level of the competition turned out to be very high. The competition apparently attracts more and

  12. Department of Training And Consulting - Overview

    International Nuclear Information System (INIS)

    Dobrzynski, L.

    2005-01-01

    Full text: The Department of Training and Consulting is regularly serving secondary school pupils and teachers, university students and the public. As usual we have been visited by more than 5000 visitors, mainly students from secondary schools. Since January 2003, the Department participated in an European program called NUPEX (from Nuclear Physics Experience) that aimed at creating an internet platform of educational material from nuclear physics and its applications. The platform was finally prepared in eight languages (English, French, German, Italian, Flemish, Greek, Hungarian and Polish) and is dedicated to pupils from secondary schools and to science teachers. The whole material can be found at http://www.nupex.org. The Polish part is displayed additionally at http://ipj.gov.pl/pl/szkolenia/nupex. It is worth mentioning that the Polish group played an important role in the whole project. Seven modules were fully prepared by us; we also were active in helping the other Project's participants to understand technicalities connected with preparation of the material for internet. New educational posters have been designed by the Department. The titles of these posters are: Energy and its transformations; typical electric power plants; Nuclear Power Plants; Nuclear Power Plants in Europe and in the World. The posters are offered to visiting schools. The number of possible experiments at our Laboratory of Atomic Physics is still increasing. Recently a computer simulation of the process of start-up of the nuclear reactor was prepared. Although it can be considered as a game, in fact the animation reflects the reality of the process and can be used for training of nuclear reactor's operators. For the first time one, of the leading secondary schools in Warsaw, the Stefan Batory School, participated in a Summer School of Physics organized at our Department, which lasted 10 days. Most of the educational program was filled with the basics of nuclear physics with emphasis

  13. TRIPs Agreement, Important Multilateral WTO Treaty

    Directory of Open Access Journals (Sweden)

    Oana-Maria Florescu

    2006-08-01

    Full Text Available This article aims at presenting the content and the frame of the TRIPs. Agreement. It starts by introducing the reader to the terms that defined the world economical climate by the time of the Agreement negociation. Also, it explains the need of having an Agreement on intellectual property rights with impact on the business world. Moreover, the article reviews the main provisions of the Agreement and the most important intellectual property rights.

  14. 7 CFR 900.109 - Mediation agreement.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Mediation agreement. 900.109 Section 900.109 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing... Mediation agreement. An agreement arrived at by mediation shall not become effective until approved by the...

  15. 25 CFR 502.5 - Collateral agreement.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Collateral agreement. 502.5 Section 502.5 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE INTERIOR GENERAL PROVISIONS DEFINITIONS OF THIS CHAPTER § 502.5 Collateral agreement. Collateral agreement means any contract, whether or not in writing...

  16. 40 CFR 35.3010 - Delegation agreement.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Delegation agreement. 35.3010 Section... STATE AND LOCAL ASSISTANCE Construction Grants Program Delegation to States § 35.3010 Delegation agreement. (a) Before execution of the delegation agreement, the Regional Administrator must determine that...

  17. 23 CFR 140.606 - Project agreements.

    Science.gov (United States)

    2010-04-01

    ... Reimbursement for Bond Issue Projects § 140.606 Project agreements. Project Agreements, Form PR-2, shall be... 23 Highways 1 2010-04-01 2010-04-01 false Project agreements. 140.606 Section 140.606 Highways... projects. 1 The text of FHWA Form PR-2 is found in 23 CFR part 630, subpart C, appendix A. ...

  18. 75 FR 78245 - Notice of Agreements Filed

    Science.gov (United States)

    2010-12-15

    ... Mexico, Panama, Jamaica, Colombia, and the Far East, including China, Hong Kong, and Korea. Agreement No.../CSAV Slot Swap Agreement. Parties: China Shipping Container Lines Co. Ltd., China Shipping Container... trade between United States ports and ports in China and Vietnam. Agreement No.: 201208-001. Title...

  19. 76 FR 67440 - Market Access Agreement

    Science.gov (United States)

    2011-11-01

    ... FARM CREDIT ADMINISTRATION Market Access Agreement AGENCY: Farm Credit Administration. ACTION: Notice of Draft Second Amended and Restated Market Access Agreement; request for comments. SUMMARY: The... Market Access Agreement (the ``Restated MAA'') is entered into among AgFirst Farm Credit Bank, AgriBank...

  20. 75 FR 76729 - Market Access Agreement

    Science.gov (United States)

    2010-12-09

    ... FARM CREDIT ADMINISTRATION Market Access Agreement AGENCY: Farm Credit Administration. ACTION: Notice of approval of the draft amendment to the amended and restated market access agreement. SUMMARY... Credit Bank of Wichita and the Western Farm Credit Bank under Section 7.12 of the Market Access Agreement...

  1. 50 CFR 81.3 - Cooperative Agreement.

    Science.gov (United States)

    2010-10-01

    ...) FINANCIAL ASSISTANCE-WILDLIFE SPORT FISH RESTORATION PROGRAM CONSERVATION OF ENDANGERED AND THREATENED SPECIES OF FISH, WILDLIFE, AND PLANTS-COOPERATION WITH THE STATES § 81.3 Cooperative Agreement. Upon... Project Agreement can be approved for endangered or threatened species projects. A cooperative agreement...

  2. 43 CFR 24.5 - International agreements.

    Science.gov (United States)

    2010-10-01

    ... WILDLIFE POLICY: STATE-FEDERAL RELATIONSHIPS § 24.5 International agreements. (a) International conventions... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false International agreements. 24.5 Section 24... shall be to recommend that the United States negotiate and accede to only those international agreements...

  3. 75 FR 14159 - Notice of Agreements Filed

    Science.gov (United States)

    2010-03-24

    ... parties to exchange slots in the trade between U.S. East Coast ports and ports in Turkey. Agreement No.: 201048-005. Title: Lease and Operating Agreement between Philadelphia Regional Port Authority and... FEDERAL MARITIME COMMISSION Notice of Agreements Filed The Commission hereby gives notice of the...

  4. 22 CFR 120.23 - Distribution agreement.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Distribution agreement. 120.23 Section 120.23... § 120.23 Distribution agreement. An agreement (e.g., a contract) to establish a warehouse or distribution point abroad for defense articles exported from the United States for subsequent distribution to...

  5. 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.

  6. Inpatient consultations to an orthopaedic service: the hidden workload.

    LENUS (Irish Health Repository)

    O'Malley, N T

    2011-12-01

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

  7. 24 CFR 200.191 - Placement of 203(k) consultant.

    Science.gov (United States)

    2010-04-01

    ... HUD has developed such an exam. (c) Delayed effective date of examination requirement for consultants... date to pass the comprehensive exam. Failure to pass the examination by the deadline date constitutes...

  8. 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.

  9. Role of Laryngological Consultation in the Intervention of Dysphonia

    Science.gov (United States)

    Stone, Ed.; And Others

    1978-01-01

    Described and provided is a laryngology consult form that has been found useful by speech therapists in obtaining information important to the diagnosis and management of children with voice disorders. (CL)

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

    CERN Multimedia

    Ignacio Reguero, IT Department

    2016-01-01

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

  11. 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...

  12. Patients Consulting Traditional Health Practioners In The Context Of ...

    African Journals Online (AJOL)

    reported reasons for consulting the THP included a complex of supernatural or psychosocial problems, chronic conditions, acute conditions, generalized pain, HIV and other STIs. ... African Journal of Trad, Comp and Alternative Medicine Vol.

  13. Inconsistency of residents' communication performance in challenging consultations

    NARCIS (Netherlands)

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

    2013-01-01

    Objective: Communication performance inaonsistency 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

  14. The effect of a preanaesthesia clinic consultation on adult patient ...

    African Journals Online (AJOL)

    reduce anxiety however current studies on anxiety and the preanaesthesia clinic have not quantified this reduction. Objective: ... Disadvantages of the preoperative clinic may include ad- ditional consultation costs and longer hospital waiting.

  15. 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.

  16. OHS consultants as facilitators of learning processes in client enterprises

    DEFF Research Database (Denmark)

    Broberg, Ole

    2004-01-01

    emphasis on initiating learning processes in the client enter-prise in a way that will develop the OHS management capabilities of that enterprise. This presentation is based on a research program focussing on how OHS consultants go about when they are involved in consultancy on technological change...... processes in client enter-prises. Specifically the learning perspective will be touched upon. The research programme included four cases in different client enterprises: 1) New tech-nology in a logistic department of a brewery, 2) new pharmaceutical process facility, 3) design of a new catering centre...... in another institution than pre-sent the users to blueprints and then ask them to put forward technical suggestions to im-prove the workplace design. In conclusion, the study pointed out that the OHS consultants had different work practices on learning aspects of their consultancy. Several constraining...

  17. Patient satisfaction with TB care clinical consultations in Kampala: a ...

    African Journals Online (AJOL)

    ... on treatment outcome. Keywords: Patient satisfaction, TB care clinical consultations, cross sectional study. ... Background: Tuberculosis (TB) remains a major global ... Measurement of outcome: Variables considered were; how long the ... Key: ART= Antiretroviral Therapy. Characteristic. Parameter n (%). Sex. Female.

  18. 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...

  19. Financial implications for built environment consultants working at ...

    African Journals Online (AJOL)

    Therefore, economists expected .... deferral of the consultant's fee (or a portion thereof), which the .... In this study a quantitative approach was followed with the aim of ..... such as attorneys, accountants or doctors will invoice clients for their.

  20. Haudenosaunee Territory for Consultation Purposes (EPA.TRIBCONSULTBND_R2)

    Data.gov (United States)

    U.S. Environmental Protection Agency — Layer for displaying areas in New York State that are of interest to Region 2 Haudenosaunee tribes for consultation on environmental issues. The boundaries are based...

  1. Industry consultation on grid connection of small PV systems

    Energy Technology Data Exchange (ETDEWEB)

    Knight, J.; Thorneycroft, J.; Cotterell, M.; Gambro, S.

    2000-07-01

    This report presents the results of consultation within the PV industry and the electricity supply industry concerning guidelines for the connection of small PV systems to the electricity network. (author)

  2. Consulting: a new area of business for energy supply utilities; Consulting - ein neues Geschaeftsfeld fuer Energieversorgungsunternehmen

    Energy Technology Data Exchange (ETDEWEB)

    Busse, H.; Oswald, H. [MVV-Energie AG im Internationalen Gasconsulting, Duggendorf (Germany)

    2000-03-01

    The radical changes in national and international markets in recent years will have a long-term effect on the future development of industry and of energy supply utilities. The dynamics and complexity of these processes are producing new challenges. These are leading to a departure from rigid structures in the supply enterprises, towards functional, process-oriented organizational structures. In addition, a whole series of new business activities is arising. One of these new strategic areas of business is consulting. In Germany, a range of regional and municipal supply utilities now offer consulting services for third parties on an intensified basis around the world. Since about 1990, larger municipal technical service organizations and regional energy supply utilities have been working on numerous projects both within Germany and abroad. It has become apparent that it is necessary to take a long breath (one to four years) from the time of obtaining the sale until the award of contract, particularly in the case of foreign projects. In addition to the demand for technical know-how, BOT (Build, Operate, Transfer) projects and assistance with financing and matters regarding structure, setting-up and organization of possible new projects are of particular interest. (orig.) [German] Die umfassenden Veraenderungen der nationalen und internationalen Maerkte in den letzten Jahren wirken nachhaltig auf die zukuenftige Entwicklung der Industrie und der Energieversorgungsunternehmen. Aus der Dynamik und Komplexitaet der Prozesse resultieren neue Herausforderungen. Diese fuehren zur Abkehr von starren Strukturen in den Versorgungsunternehmen hin zu funktionalen am Prozess orientierten Organisationsstrukturen. Zusaetzlich leiten sich daraus eine Reihe neuer Geschaeftsfelder ab. Eines dieser neuen strategischen Geschaeftsfelder ist Consulting. In Deutschland bieten verschiedene regional und kommunal taetige Versorgungsunternehmen verstaerkt Beratungsleistung fuer Dritte weltweit

  3. Co-constructive consulting : a pragmatic, relational constructionist approach

    OpenAIRE

    Hicks, Jeff

    2010-01-01

    Management consulting is a $300 billion industry, about 70% of which is accounted for by organizational change work. These numbers aren’t especially remarkable, unless you consider that a similar percentage of change initiatives—about 70%, according to numerous studies—fail to meet their stated objectives. It’s not too difficult, in other words, to make a case for fundamental change in management and business consulting. In this dissertation, we develop an alternative approach we refer to as ...

  4. 'HAs fail to consult Irish people in UK'.

    Science.gov (United States)

    1992-11-10

    Health authorities are failing to consult local people on their health needs, a conference on the mental health of Irish people living in the UK heard last week. Consulting Irish people was often only 'symbolic', despite the requirements of the NHS and Community Care Act, conference Chair Padraic Kenna, Director of Innisfree Housing Association, told delegates. 'The Irish caught the boat in the 1950s only to miss the boat ever since,' he said.

  5. Consultancy services and the urban hierarchy in Western Europe

    OpenAIRE

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

    1992-01-01

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

  6. Organization of diagnostic and therapy consulting practice in the US

    International Nuclear Information System (INIS)

    Kowalski, M.

    2003-01-01

    Full text: Following topics will be discussed. Role of the Medical Physicist in diagnostic/therapy. Difference in educational background of currently practicing medical physicists. QA programs. Calibrations of beams, dosemeters, chambers. Standard labs. Importance of professional organizations. Importance of professional certifications. Setting up a private consulting practice in the US. Importance of paperwork, is a 'bureaucracy'a problem? Comparing advantages and disadvantage of working as physicist for a consulting group and for health care institution

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

    OpenAIRE

    Wiertelak, Eric P.

    2012-01-01

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

  8. THE IMPORTANCE OF CONSULTING IN CONTEMPORARY BUSINESS MANAGEMENT

    OpenAIRE

    Svetlana Vukotić; Jugoslav Aničić; Radovan Vukotić

    2017-01-01

    Modern business is characterized by risk and uncertainty, and such an environment is reflected in the decisions taken by managers. On the other hand, management consulting is one of the most important management techniques developed over the last fifty years. The secondary effect of this invention is the rapid development of new frameworks, tools, and techniques improving the operations in a number of companies. Exposure of consulting organizations to varying combin...

  9. 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.

  10. Ten common mistakes to avoid as an independent consultant.

    Science.gov (United States)

    Hau, M L

    1997-01-01

    1. Enthusiasm, dedication, and hard work will not guarantee success as an independent consultant. 2. Careful market research, selecting a venture that promises clients and profit, should be the basis for deciding to start a consultant business, not just enthusiasm and emotional drive. 3. Business management practices of developing a business plan, careful price setting, and managing cash flow are essential for business survival. 4. Legal considerations, including the form of the business, contracts, and essential recordkeeping, must not be overlooked.

  11. 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.

  12. 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.

  13. 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.

  14. The role of culture in the general practice consultation process.

    Science.gov (United States)

    Ali, Nasreen; Atkin, Karl; Neal, Richard

    2006-11-01

    In this paper, we will examine the importance of culture and ethnicity in the general practice consultation process. Good communication is associated with positive health outcomes. We will, by presenting qualitative material from an empirical study, examine the way in which communication within the context of a general practitioner (GP) consultation may be affected by ethnicity and cultural factors. The aim of the study was to provide a detailed understanding of the ways in which white and South Asian patients communicate with white GPs and to explore any similarities and differences in communication. This paper reports on South Asian and white patients' explanations of recent videotaped consultations with their GP. We specifically focus on the ways in which issues of ethnic identity impacted upon the GP consultation process, by exploring how our sample of predominantly white GPs interacted with their South Asian patients and the extent to which the GP listened to the patients' needs, gave patients information, engaged in social conversation and showed friendliness. We then go on to examine patients' suggestions on improvements (if any) to the consultation. We conclude, by showing how a non-essentialist understanding of culture helps to comprehend the consultation process when the patients are from Great Britain's ethnicised communities. Our findings, however, raise generic issues of relevance to all multi-racial and multi-ethnic societies.

  15. 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.

  16. 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.

  17. 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.

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

    DEFF Research Database (Denmark)

    Larsen, Jan-Helge; Risør, Ole

    1997-01-01

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

  19. The purpose of the general practice consultation from the patients perspective - theoretical aspects

    DEFF Research Database (Denmark)

    Thorsen, Hanne; Witt, Klaus; Malterud, Kirsti

    2001-01-01

    Consultation purposes, general practice, patients´expectations, patients satosfaction, patientcenteredness......Consultation purposes, general practice, patients´expectations, patients satosfaction, patientcenteredness...

  20. Department of Training and Consulting: Overview

    International Nuclear Information System (INIS)

    Dobrzynski, L.

    2004-01-01

    Full text: The department of Training and Consulting is regularly serving secondary schools' pupils and teachers, university students and the public. The year 2003 set up a new record: the Department accepted a bout 7000 visitors, about 2000 more than during 2002. A truly great event was the opening of the permanent exhibition displaying the model of nuclear power plant originally planned to be built in Zarnowiec near Gdansk. The opening was combined with a short symposium on the ''Nuclear Physics and Technology - Today and Tomorrow's Social Education in European Union''. The opening was visited by many prominent guests from Polish Atomic Agency, local governments, universities and institutes. In addition, the Department participated in the organization of a symposium dedicated to the 100 th Anniversary of the first Nobel Prize awarded to Marie Curie-Sklodowska. This was also an occasion for a small exhibition based on photographs and exhibits borrowed from the Maria Curie-Sklodowska Museum in Warsaw, which was co-organiser of the symposium. The main organizer and proposer of the symposium was a social organization, the Interschool Committee of Promotion of the Educational Undertakings ''Europe 2000'', which promotes educational initiatives for the youth from Otwock, a town near to Swierk. It was our pleasure that our Department was chosen as the place for the organization of this symposium in which the best pupils, local authorities from Otwock, and sponsors of the activity of the aforementioned group were present. On the 15 th of October we celebrated the 5 th anniversary of our educational activity that started with the opening of the exhibition on ''Nuclear wastes: problems, solutions''. The exhibition is still displayed and attracts attention. It is a real pleasure to see how much the interest in our activity has grown through all those years. On the other hand, the educational efforts of the Department turned out to be worth our labor: in the all

  1. Information and consulting center in plasma technologies

    International Nuclear Information System (INIS)

    Vizireanu, S.; Aldea, E.; Mitu, B.; Dinescu, G.

    2001-01-01

    Plasma technologies are clean, non-expensive, and easy to adapt to small-scale production. They are largely used in various modern sectors of research, industry, medicine, biology and environmental protection. At the present time a pressure to transfer the knowledge from education and research sectors toward the industrial ones was established by the financing policies at national and European levels. Nevertheless, mainly in the last decade, an informational gap sets up in Romania between the suppliers of know-how in the plasma technologies and their beneficiaries. The newly appearing companies have little knowledge about the possibilities of our research and education. In turn, the research and education sectors do not know what companies are using nowadays plasma technologies, what kinds of technologies are needed and what aspects should be stressed in educational activity. The Information and Consulting Center in Plasma Technologies is an infrastructure project aiming at gathering information and expertise in plasma technologies with emphasizing on the Romanian capabilities. The information is accessible via Internet at the address http://www.alpha2.infim.ro. By accessing the center web page one enters into the main menu or it is possible to navigate by choosing key words, as for instance: objectives, plasma diagnostics, plasma technologies, which are listed in a dedicated search box. The information is organized in databases. In the database frame there are three main categories, which lead to detailed information about: - Users of plasma technologies, the technology type, the address; - Suppliers of plasma technologies, including the main research institutes with links to the relating Internet sites; - Education and training centers including the universities and their departments dedicated to plasma physics. The expertise is organized in three categories. They are instrumentation and equipment, plasma diagnostics and plasma technologies. In the

  2. Department of Training and Consulting: Overview

    International Nuclear Information System (INIS)

    Dobrzynski, L.

    2003-01-01

    Full text: The Department of Training and Consulting is a training centre for high-school students and their teachers, for students of physics and natural sciences in general, last but not least for society broadly understood, including professionals dealing with nuclear radiation. In 2002 the Department was visited by about 5000 high-school students who could listen to the lectures, and take part in experimental demonstrations on ionising radiation, its role in everyday life, technical and medical applications. In addition, the Department led the radiation protection course for the accelerators' operators employed by the Institute for Nuclear Studies. One-day courses on physics of radiation were also arranged for teachers. The Laboratory of Atomic and Nuclear Physics for Schools is still developing. The Laboratory permits high-school students to make simple experiments of qualitative and quantitative character. Its main purpose is to teach the elements of experimental work. In addition, university students of physics can conduct quite complicated experiments. Indeed, the Laboratory is also used for this purpose. The actual list of experiments available to students includes: the behaviour of charged particles in electric and magnetic fields, excitation and properties of photoluminescence, production and properties of X-rays, wave-particle duality, properties of alpha, beta and gamma radiation, elements of gamma spectroscopy including identification of elements by means of induced X-ray fluorescence. The first experience gathered recently is positive although there is still some work to do in order to make the Laboratory more educational. In particular, one of the conclusions drawn from our meetings at the instruments is that although high-school students can follow instructions and understand briefly the physical processes, they are not prepared for reporting the results of the observations or experiments. It is clear that we have to help them in overcoming this

  3. Unwrapping Court-Connected Mediation Agreements

    DEFF Research Database (Denmark)

    Adrian, Lin; Mykland, Solfrid

    2018-01-01

    Court-connected mediated agreements seem to both fulfil and fail the ideal of self-determination in mediation theory. In a study of 134 agreements from court-connected mediation, we found that the majority of agreements contain creative elements and display great variation in the provisions...... and understand them. The judicial language is well known for the drafters of the agreement but not the parties. Thus, court-connected mediation seems to fail aspects of self-determination when it comes to drafting agreements. We draw on new-institutional theory when we explore and explain this apparent...... they contain. These results indicate that the parties play an important role in crafting the substance of their agreements. However, we also found that the wording of the agreements is characterised by legal and bureaucratic language to the extent that people without legal training find it difficult to read...

  4. 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

  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. 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. 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

  8. 48 CFR 25.403 - World Trade Organization Government Procurement Agreement and Free Trade Agreements.

    Science.gov (United States)

    2010-10-01

    ... Government Procurement Agreement and Free Trade Agreements. 25.403 Section 25.403 Federal Acquisition... 25.403 World Trade Organization Government Procurement Agreement and Free Trade Agreements. (a... in 25.402(a)(1). The WTO GPA and FTAs specify procurement procedures designed to ensure fairness (see...

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

    Science.gov (United States)

    Geppert, Cynthia M.A.; Shelton, Wayne N.

    2012-01-01

    Despite the emergence of clinical ethics consultation as a clinical service in recent years, little is known about how clinical ethics consultation differs from, or is the same as, other medical consultations. A critical assessment of the similarities and differences between these 2 types of consultations is important to help the medical community appreciate ethics consultation as a vital service in today's health care setting. Therefore, this Special Article presents a comparison of medical and clinical ethics consultations in terms of fundamental goals of consultation, roles of consultants, and methodologic approaches to consultation, concluding with reflections on important lessons about the physician-patient relationship and medical education that may benefit practicing internists. Our aim is to examine ethics consultation as a clinical service integral to the medical care of patients. Studies for this analysis were obtained through the PubMed database using the keywords ethics consultation, medical consultation, ethics consults, medical consults, ethics consultants, and medical consultants. All English-language articles published from 1970 through August 2011 that pertained to the structure and process of medical and ethics consultation were reviewed. PMID:22469350

  10. Why Are There So Few Ethics Consults in Children's Hospitals?

    Science.gov (United States)

    Carter, Brian; Brockman, Manuel; Garrett, Jeremy; Knackstedt, Angie; Lantos, John

    2017-10-03

    In most children's hospitals, there are very few ethics consultations, even though there are many ethically complex cases. We hypothesize that the reason for this may be that hospitals develop different mechanisms to address ethical issues and that many of these mechanisms are closer in spirit to the goals of the pioneers of clinical ethics than is the mechanism of a formal ethics consultation. To show how this is true, we first review the history of collaboration between philosophers and physicians about clinical dilemmas. Then, as a case-study, we describe the different venues that have developed at one children's hospital to address ethical issues. At our hospital, there are nine different venues in which ethical issues are regularly and explicitly addressed. They are (1) ethics committee meetings, (2) Nursing Ethics Forum, (3) ethics Brown Bag workshops, (4) PICU ethics rounds, (5) Grand Rounds, (6) NICU Comprehensive Care Rounds, (7) Palliative Care Team (PaCT) case conferences, (8) multidisciplinary consults in Fetal Health Center, and (9) ethics consultations. In our hospital, ethics consults account for only a tiny percentage of ethics discussions. We suspect that most hospitals have multiple and varied venues for ethics discussions. We hope this case study will stimulate research in other hospitals analyzing the various ways in which ethicists and ethics committees can build an ethical environment in hospitals. Such research might suggest that ethicists need to develop a different set of "core competencies" than the ones that are needed to do ethics consultations. Instead, they should focus on their skills in creating multiple "moral spaces" in which regular and ongoing discussion of ethical issues would take place. A successful ethicist would empower everyone in the hospital to speak up about the values that they believe are central to respectful, collaborative practice and patient care. Such a role is closer to what the first hospital philosophers set

  11. [Effectiveness of support for asbestos health consultation in health centers].

    Science.gov (United States)

    Nagamatsu, Yasuko

    2011-09-01

    In this research, we aimed to evaluate the support for asbestos health consultation in health centers. In this exploratory descriptive study, a self-administered original questionnaire was developed and used. Among all 517 health centers, valid responses were returned from 323 (62.5%) consenting centers. Consultations in the previous year ranged from 0-108 cases, with a facility median of 3.0 cases. Among staff members, 86.4% did not receive training and 35.4% had never used the manual. Workplaces that use asbestos within their jurisdiction were recognized by 39.2% of staff members, and 16.7% of these members always supported consultants psychologically. The staff members were not confident about asbestos health consultation: 71.2% for general questions, 76.2% for questions about asbestos-related diseases, and 76.4% for questions about risk of asbestos-related diseases; 51.4% were not confident about the Asbestos-Related Health Damage Relief System. Health center staff members who were significantly more confident were those who had more staff to work with; dealt with many consultations in the previous year; recognized the workplaces using asbestos within their jurisdiction; often used the manual and often psychologically supported consultants. According to the covariance structure analysis model, the 'use of support systems' consisting of 'the use of manual', 'training attendance' and 'recognition of workplaces that use asbestos' positively affected the frequency of psychological support (peffective in building the confidence of health center staff in relation to asbestos health consultation, although the use of these support systems was low.

  12. The 'hidden work' of a hospital neurologist: 1000 consults later.

    LENUS (Irish Health Repository)

    Ali, E

    2012-02-01

    BACKGROUND: A new Web-based, internal neurology referral service was introduced in our department to expedite inpatient review for other departments and to allow assessment of the impact of neurology consults on patient care throughout the hospital, especially in the emergency department (ED). The results of the analysis of the first 1000 referrals using the new system are presented. Methods: An intranet referral system was designed by the consultant neurologists. The previous method of referral was by handwritten letter. The electronic template included \\'drop-down\\' menus and mandatory fields to help guide referring teams. An outcome section is completed by the neurology team. Results: An average of 17 referrals was seen weekly. Seventy-seven per cent were seen within 24 h of referral. A consultant neurologist saw 87% of the referrals directly; 13% were first seen by a registrar and later discussed with a consultant. Forty per cent were seen in the ED of which a one-third of the patients were discharged following assessment. The most common reason for referral was seizure(s) or an episode of collapse (28%). Patients presenting with stroke\\/transient ischaemic attack represented 13.5%, and 12.5% presented with headaches. The management of 79% of referred cases was deemed to have been significantly changed after neurology review. Discussion: The introduction of a neurology consultant-designed and consultant-led intranet referral service has greatly enhanced the delivery of the consult service to patients in our hospital. This referral system contributes significantly to hospital efficiency and to access for patients to specialist assessment.

  13. Electronic consultation system demonstrates educational benefit for primary care providers.

    Science.gov (United States)

    Kwok, Jonas; Olayiwola, J Nwando; Knox, Margae; Murphy, Elizabeth J; Tuot, Delphine S

    2017-01-01

    Background Electronic consultation systems allow primary care providers to receive timely speciality expertise via iterative electronic communication. The use of such systems is expanding across the USA with well-documented high levels of user satisfaction. We characterise the educational impact for primary care providers of a long-standing integrated electronic consultation and referral system. Methods Primary care providers' perceptions of the educational value inherent to electronic consultation system communication and the impact on their ability to manage common speciality clinical conditions and questions were examined by electronic survey using five-point Likert scales. Differences in primary care providers' perceptions were examined overall and by primary care providers' speciality, provider type and years of experience. Results Among 221 primary care provider participants (35% response rate), 83.9% agreed or strongly agreed that the integrated electronic consultation and referral system provided educational value. There were no significant differences in educational value reported by provider type (attending physician, mid-level provider, or trainee physician), primary care providers' speciality, or years of experience. Perceived benefit of the electronic consultation and referral system in clinical management appeared stronger for laboratory-based conditions (i.e. subclinical hypothyroidism) than more diffuse conditions (i.e. abdominal pain). Nurse practitioners/physician assistants and trainee physicians were more likely to report improved abilities to manage specific clinical conditions when using the electronic consultation and/or referral system than were attending physicians, as were primary care providers with ≤10 years experience, versus those with >20 years of experience. Conclusions Primary care providers report overwhelmingly positive perceptions of the educational value of an integrated electronic consultation and referral system. Nurse

  14. 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

  15. 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

  16. 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.

  17. 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 ...

  18. Analyzing rater agreement manifest variable methods

    CERN Document Server

    von Eye, Alexander

    2014-01-01

    Agreement among raters is of great importance in many domains. For example, in medicine, diagnoses are often provided by more than one doctor to make sure the proposed treatment is optimal. In criminal trials, sentencing depends, among other things, on the complete agreement among the jurors. In observational studies, researchers increase reliability by examining discrepant ratings. This book is intended to help researchers statistically examine rater agreement by reviewing four different approaches to the technique.The first approach introduces readers to calculating coefficients that allow one to summarize agreements in a single score. The second approach involves estimating log-linear models that allow one to test specific hypotheses about the structure of a cross-classification of two or more raters'' judgments. The third approach explores cross-classifications or raters'' agreement for indicators of agreement or disagreement, and for indicators of such characteristics as trends. The fourth approach compa...

  19. Safeguards agreements - Their legal and conceptual basis

    International Nuclear Information System (INIS)

    Sanders, B.; Rainer, R.H.

    1977-01-01

    The application of Agency safeguards requires treaty arrangements (Safeguards Agreements) between the State or States concerned and the Agency. The authority for the Agency to conclude such agreements and to implement them is provided for in the Agency's Statute. On the basis of the statutory provisions safeguards principles and procedures have been elaborated. These have been laid down in: The Agency's Safeguards System 1965, extended in 1966 and 1968; and the basis for negotiating safeguards agreements with NNWS pursuant to NPT. The verification of the undertaking by the State concerned not to use items subject to safeguards for purposes contrary to the terms of the agreement is ensured through the application of various safeguards measures. Containment and surveillance measures are expected to play an increasingly important role. One of the specific features of NPT Safeguards Agreements is the establishment of national systems of accounting and control of nuclear material. The majority of the agreements concluded under the non-NPT safeguards agreements implement obligations undertaken under co-operation agreements between States for peaceful uses of nuclear energy. These agreements naturally reflect approaches adopted by the parties, in particular regarding the circumstances under which safeguards should be applied. Thus, the concepts used in the non-NPT safeguards agreements and the Safeguards System document, which is incorporated in these agreements by reference, are in continuous evolution. The Agency's Safeguards System document (INFCIRC/66/Rev.2) continues to be supplemented in practical application and through explicit decision by the Board. The non-NPT safeguards agreements contain, besides technical safeguards provisions from this document, and further provision for notification, inventories and financial matters, legal and political provisions such as sanctions in the case of non-compliance, and privileges and immunities. The paper discusses the

  20. 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

  1. 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

  2. [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.

  3. Patients' reports of barriers to expressing concerns during cancer consultations.

    Science.gov (United States)

    Brandes, Kim; Linn, Annemiek J; Smit, Edith G; van Weert, Julia C M

    2015-03-01

    To identify cancer patients' most influential barriers to expressing concerns during cancer consultations in a new manner by examining patients' reports of perceived barriers and perceived occurrence of barriers in consultations. Two online focus groups (N=16) and an online survey (N=236) were conducted among cancer patients and cancer survivors. The online focus groups and survey were used to examine two elements of patients' barriers, i.e., patients' reports of perceived barriers and perceived occurrence of barriers in consultations. Composite scores of these two elements were calculated to determine influential barriers. Results showed that the most influential barriers were related to providers' behavior (e.g., providers do not explicitly invite patients to express concerns) and the environment where the consultation takes place (e.g., perceived lack of time). The results of this study indicate that influential barriers to expressing concerns are barriers that patients cannot overcome themselves (i.e., they are related to providers' behavior or the environment of the consultation). A collaborative approach between researchers, providers and policy makers is needed to overcome these barriers. The results of this study can be used to develop strategies to overcome barriers to patients expressing concerns. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  4. Perceived Educational Needs of the Integrated Care Psychiatric Consultant.

    Science.gov (United States)

    Ratzliff, Anna; Norfleet, Kathryn; Chan, Ya-Fen; Raney, Lori; Unützer, Jurgen

    2015-08-01

    With the increased implementation of models that integrate behavioral health with other medical care, there is a need for a workforce of integrated care providers, including psychiatrists, who are trained to deliver mental health care in new ways and meet the needs of a primary care population. However, little is known about the educational needs of psychiatrists in practice delivering integrated care to inform the development of integrated care training experiences. The educational needs of the integrated care team were assessed by surveying psychiatric consultants who work in integrated care. A convenience sample of 52 psychiatrists working in integrated care responded to the survey. The majority of the topics included in the survey were considered educational priorities (>50% of the psychiatrists rated them as essential) for the psychiatric consultant role. Psychiatrists' perspectives on educational priorities for behavioral health providers (BHPs) and primary care providers (PCPs) were also identified. Almost all psychiatrists reported that they provide educational support for PCPs and BHPs (for PCP 92%; for BHP 96%). The information provided in this report suggests likely educational needs of the integrated care psychiatric consultant and provides insight into the learning needs of other integrated care team members. Defining clear priorities related to the three roles of the integrated care psychiatric consultant (clinical consultant, clinical educator, and clinical team leader) will be helpful to inform residency training programs to prepare psychiatrists for work in this emerging field of psychiatry.

  5. Keeping experience at the bedside: the emergency consultant nurse role.

    Science.gov (United States)

    Currie, Jane

    The consultant nurse concept has not yet been transferred to the military setting. The motivation for developing the role in the NHS was to improve the quality of patient care by strengthening professional leadership and extending the clinical career ladder. The consultant nurse may be defined as an expert in their clinical field, possessing expert leadership and visionary skills. The role is based on four domains: expert practice, professional leadership, education and research. Typically, the emergency consultant nurse spends 50% of their time working clinically, thereby providing senior clinical expertise and adding value to the clinical role. In a military context the consultant nurse role could be perceived as the coming together of the senior command and administrative role and the clinical role. The military has the opportunity to develop a senior clinical emergency nurse role encompassing elements of the civilian consultant nurse model, which may strengthen leadership, provide a central resource of expertise and raise the profile of military nursing. This has the added potential to provide inspiration for junior nurses and retain experienced emergency nurses in the clinical arena.

  6. A framework for nuclear agreement and verification

    International Nuclear Information System (INIS)

    Ali, A.

    1991-01-01

    This chapter assesses the prospects for a nuclear agreement between India and Pakistan. The chapter opens with a review of past and present political environments of the two countries. The discussion proceeds to describe the linkage of global arms control agreements, prospects for verification of a Comprehensive Test Ban Treaty, the role of nuclear power in any agreements, the intrusiveness of verification, and possible post-proliferation agreements. Various monitoring and verification technologies are described (mainly satellite oriented). The chapter concludes with an analysis of the likelihood of persuading India and Pakistan to agree to a nonproliferation arrangement

  7. Agreements on emission of greenhouse gases

    International Nuclear Information System (INIS)

    Aulstad, Johan Greger

    2001-01-01

    Agreements on emission of greenhouse gases is one of the instruments used by Norwegian authorities to meet their obligations with respect to the Climate Convention and the Kyoto Protocol. This book discusses the legal issues raised by these agreements. A main topic is how the industrial emissions conform to the Pollution Act. Does the Pollution Act apply to these emissions? What is the impact of the sanction rules in this act on the emissions? The book also deals with the following general questions that arise in connection with the application of public authority: (1) Can the administration grant concessions and permits in the form of agreements? (2) What commitments can be imposed on a private party by the administration by agreement? (3) Should the procedures set down in the Pollution Act and in the Public Administration Act be followed fully when the pollution authorities make agreements? Is the opportunity of the administration to reverse more restricted when they make agreements than when they make one-sided decisions? Although this discussion primarily deals with the emission of greenhouse gases, the reasoning and conclusions are relevant in many other types of agreements in which the public administration is one of the parties. The agreement that regulates the emissions of greenhouse gases from the Norwegian aluminium industry is described in a special section. The book also gives a brief account of how agreements are used in the Danish climate policy

  8. 75 FR 24702 - Notice of Agreements Filed

    Science.gov (United States)

    2010-05-05

    ... Bay International Terminals, Inc. Operating Agreement. Parties: Tampa Bay International Terminals, Inc. and Tampa Port Authority. Filing Parties: Greg Lovelace, Director Cargo & Cruise Marketing; Tampa Port...

  9. 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.

  10. 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…

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

    Science.gov (United States)

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

    2013-01-01

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

  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. 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.

  14. Focusing on relationships, not information, respects autonomy during antenatal consultations.

    Science.gov (United States)

    Gaucher, Nathalie; Payot, Antoine

    2017-01-01

    Policy statements regarding antenatal consultations for preterm labour are guided by physicians' concerns for upholding the legal doctrine of informed consent, through the provision of standardised homogeneous medical information. This approach, led by classical in-control conceptions of patient autonomy, conceives moral agents as rational, independent, self-sufficient decision-makers. Recent studies on these antenatal consultations have explored patients' perspectives, and these differ from guidelines' suggestions. Relational autonomy - which understands moral agents as rational, emotional, creative and interdependent - resonates impressively with these new data. A model for antenatal consultations is proposed. This approach encourages clinicians to explore individual patients' lived experiences and engage in trusting empowering relationships. Moreover, it calls on physicians to enhance patients' relational autonomy by becoming advocates for their patients within healthcare institutions and professional organisations, while calling for broadscale policy changes to encourage further funding and support in investigations of the patient's voice. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  15. Teaching medical students consultation skills using e-learning

    DEFF Research Database (Denmark)

    Jørgensen, Merete; Witt, Klaus; Fridorff-Jens, Peter Kindt

    2015-01-01

    of a student includes a test-video of a consultation with the student in the doctor role, seeing a real patient, and the student´s skills in the subsequent analysis of the communication process according to its patientcentredness. The aim of the study is to measure the effect of adding access to 16 video cases......Teaching consultation skills to medical students using e-learning. Introduction: We have been teaching Family Medicine at the University of Copenhagen for more than twenty years. We wish to develop a method to evaluate the current teaching of consultation skills and the effect of new interventions...... of the ten items. The students were able to identify more elements in the test-video, related to patient function, to inform the patient properly, the use of summarizing and safety-netting Conclusion On-line video cases used interactively in the classroom sessions increase the students’ skills in analysing...

  16. Consultation expectations among patients with respiratory tract infection symptoms

    DEFF Research Database (Denmark)

    Lauridsen, Gitte Bruun; Sørensen, Mette Sejr; Hansen, Malene Plejdrup

    2017-01-01

    INTRODUCTION: Antibiotic resistance is a growing threat to public health, and antibiotic prescribing increases. About 90% of antibiotics are prescribed in general practice, mostly for acute respiratory tract infections. It is well known that patient expectations and general practitioners......' misinterpretation of patients' expectations are associated with antibiotic overuse. The aim of this study was to explore Danish patients' expectations when consulting a general practitioner with symptoms of acute respiratory tract infection, and to determine predictors for these expectations. METHODS......: A questionnaire survey was conducted in Danish primary care during 2014. Patients aged ≥ 18 years were asked about their expectations to the consultation when consulting with symptoms of acute respiratory tract infections. Associations between socio-demographic characteristics, self-reported antibiotic...

  17. Consultation expectations among patients with respiratory tract infection symptoms

    DEFF Research Database (Denmark)

    Bruun Lauridsen, Gitte; Sejr Sørensen, Mette; Hansen, Malene Plejdrup

    2017-01-01

    Introduction: Antibiotic resistance is a growing threat to public health, and antibiotic prescribing increases. About 90% of antibiotics are prescribed in general practice, mostly for acute respiratory tract infections. It is well known that patient expectations and general practitioners’ misinter......­pretation of patients’ expectations are associated with antibiotic overuse. The aim of this study was to explore Danish patients’ expectations when consulting a general prac­titioner with symptoms of acute respiratory tract infection, and to determine predictors for these expectations. Methods: A questionnaire survey...... was conducted in Danish primary care during 2014. Patients aged ≥ 18 years were asked about their expectations to the consultation when consulting with symptoms of acute respiratory tract infections. Associations between socio-demographic characteristics, self-reported antibiotic prescription and patients...

  18. 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.

  19. Observations of sexually transmitted disease consultations in India.

    Science.gov (United States)

    Mertens, T E; Smith, G D; Kantharaj, K; Mugrditchian, D; Radhakrishnan, K M

    1998-03-01

    To assess the quality of sexually transmitted disease (STD) case management provided in public and private health facilities in selected areas of Madras, Tamil Nadu, India, in order to make recommendations for improving the quality of care and promote the syndromic approach to STD treatment. Structured observations of consultations for STDs in health care facilities. Scoring of the observations according to standards for history taking, examination, treatment and provision of basic health promotion advice allows evaluation of STD case management. With STD treatment adequacy scored against Indian national guidelines (which recommend aetiologic treatment), history taking, examination and treatment were satisfactory in 76 out of 108 (70%) of observed consultations. However, if STD treatment adequacy is scored with respect to the syndrome approach towards selected STD (male urethritis and non herpetic genital ulcer for both sexes), only 8 out of 81 (10%) of the patients were satisfactory managed. During 32 out of 108 (30%) of the consultations, advice on the use of condoms in order to prevent STD or HIV/AIDS was given. Instructions regarding how to use condoms were offered to seven (6%) patients and condoms were only provided to one patient (1%). Patients were urged to refer their partner(s) for treatment during 29 (27%) of consultations. A criterion of adequate use of the STD consultation for health promotion, requiring both promotion of condoms and encouragement to refer partner(s) for treatment, was met during 13 (12%) of consultations. Monitoring and improving the standards of care at facilities at which STDs are treated have become key roles of STD/HIV/AIDS programmes. The present report suggests that in Madras the activities of medical practitioners who treat STD patients are far from ideal at present. Improvements would involve simplifying existing treatment guidelines by promoting the syndromic approach to STD management, continuing education programmes for

  20. 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.

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

    Science.gov (United States)

    Olive, Philippa

    2017-08-01

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

  2. Management Consulting for Technological Modernization and Industry of the Future

    Directory of Open Access Journals (Sweden)

    Leonid Davidovich Gitelman

    2017-03-01

    Full Text Available The article presents the results of the authors’ study based on the hypothesis that aaddressing the multidimensional highly complex tasks of technological modernization and new industry against the background of a wave of breakthrough innovations is only possible within the framework of proactive management. Its methodological, instrumental and competence basis results from «smart» partnership of regional science, education, and business. In this case, the management сconsulting of a new type, being fundamentally different from the traditional one, plays the role of the partnership coordinator. These differences are expressed in specific intellectual logistics and organizational architecture of consulting projects, close connection to universities, innovation centres and various research structures of the region as well as the high specialization, which is reached by the involvement of the virtual teams of cross-disciplinary experts in the developments, the flexible products designed on the basis of the modular principle. In this regard, the study presents a number of new scientific results proving the hypothesis. The paper substantiates the approach to the organization and methodology of consulting activities for complex, rapidly developing systems which requires expanding the range of competencies and scope of the interaction of various actors — carriers of interdisciplinary knowledge. In accordance with this approach, the authors introduce the concept of integratory consulting for advanced development that offers a package of intellectual services for addressing challenges of the future. We have developed the methodology of the integrated system of research, consultations, training and transforming action that makes it possible to generate pre-emptive actions amid crisis, risk and threats. The article has proposed and tested an organizational mechanism of cooperation between parties (science, education, business involved in smart

  3. Do the majority of South Africans regularly consult traditional healers?

    Directory of Open Access Journals (Sweden)

    Gabriel Louw

    2016-12-01

    Full Text Available Background The statutory recognition of traditional healers as healthcare practitioners in South Africa in terms of the Traditional Health Practitioners Act 22 of 2007 is based on various assumptions, opinions and generalizations. One of the prominent views is that the majority of South Africans regularly consult traditional healers. It even has been alleged that this number can be as high as 80 per cent of the South African population. For medical doctors and other health practitioners registered with the Health Professions Council of South Africa (HPCSA, this new statutory status of traditional health practitioners, means the required presence of not only a healthcare competitor that can overstock the healthcare market with service lending, medical claims and healthcare costs, but also a competitor prone to malpractice. Aims The study aimed to determine if the majority of South Africans regularly consult traditional healers. Methods This is an exploratory and descriptive study following the modern historical approach of investigation and literature review. The emphasis is on using current documentation like articles, books and newspapers, as primary sources to determine if the majority of South Africans regularly consult traditional healers. The findings are offered in narrative form. Results It is clear that there is no trustworthy statistics on the percentages of South Africans using traditional healers. A scientific survey is needed to determine the extent to which traditional healers are consulted. This will only be possible after the Traditional Health Practitioners Act No 22 has been fully enacted and traditional health practitioners have become fully active in the healthcare sector. Conclusion In poorer, rural areas no more than 11.2 per cent of the South African population regularly consult traditional healers, while the figure for the total population seems to be no more than 1.4 per cent. The argument that the majority of South

  4. 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...

  5. Cooperative monitoring of regional security agreements

    Energy Technology Data Exchange (ETDEWEB)

    Pregenzer, A.L.; Vannoni, M.; Biringer, K.L. [Sandia National Labs., Albuquerque, NM (United States). Nonproliferation and Arms Control Analysis Dept.

    1996-11-01

    This paper argues that cooperative monitoring plays a critical role in the implementation of regional security agreements and confidence building measures. A framework for developing cooperative monitoring options is proposed and several possibilities for relating bilateral and regional monitoring systems to international monitoring systems are discussed. Three bilateral or regional agreements are analyzed briefly to illustrate different possibilities. These examples illustrate that the relationship of regional or bilateral arms control or security agreements to international agreements depends on a number of factors: the overlap of provisions between regional and international agreements; the degree of interest in a regional agreement among the international community; efficiency in implementing the agreement; and numerous political considerations. Given the importance of regional security to the international community, regions should be encouraged to develop their own infrastructure for implementing regional arms control and other security agreements. A regional infrastructure need not preclude participation in an international regime. On the contrary, establishing regional institutions for arms control and nonproliferation could result in more proactive participation of regional parties in developing solutions for regional and international problems, thereby strengthening existing and future international regimes. Possible first steps for strengthening regional infrastructures are identified and potential technical requirements are discussed.

  6. 7 CFR 1424.5 - Agreement process.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Agreement process. 1424.5 Section 1424.5 Agriculture Regulations of the Department of Agriculture (Continued) COMMODITY CREDIT CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS BIOENERGY PROGRAM § 1424.5 Agreement process. (a) To...

  7. Rater Agreement Indexes for Performance Assessment.

    Science.gov (United States)

    Burry-Stock, Judith A.; And Others

    1996-01-01

    It is argued that interrater agreement is a psychometric property which is theoretically different from classic reliability. Formulas are presented to illustrate a set of algebraically equivalent rater agreement indices that are intended to provide educational and psychological researchers with a practical way to establish a measure of rater…

  8. 7 CFR 3021.620 - Cooperative agreement.

    Science.gov (United States)

    2010-01-01

    ... Agriculture Regulations of the Department of Agriculture (Continued) OFFICE OF THE CHIEF FINANCIAL OFFICER, DEPARTMENT OF AGRICULTURE GOVERNMENTWIDE REQUIREMENTS FOR DRUG-FREE WORKPLACE (FINANCIAL ASSISTANCE) Definitions § 3021.620 Cooperative agreement. Cooperative agreement means an award of financial assistance...

  9. 8 CFR 217.6 - Carrier agreements.

    Science.gov (United States)

    2010-01-01

    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Carrier agreements. 217.6 Section 217.6 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS VISA WAIVER PROGRAM § 217... may notify a carrier of the existence of a basis for termination of a carrier agreement under this...

  10. 48 CFR 16.702 - Basic agreements.

    Science.gov (United States)

    2010-10-01

    ... attachment the required and applicable clauses agreed upon in the basic agreement. A basic agreement is not a... Government to place future contracts or orders with the contractor; or (3) Be used in any manner to restrict... (including reference to each amendment) or by attachment. (2) The contracting officer shall include clauses...

  11. 75 FR 40837 - Notice of Agreements Filed

    Science.gov (United States)

    2010-07-14

    ... filing of the following agreements under the Shipping Act of 1984. Interested parties may submit comments... & Construction Co., Ltd. and Discovery Sun Partnership Space Agreement. Parties: Discovery Sun Partnership and... Discovery Sun Partnership to provide space to Tropical Shipping & Construction Co., Ltd. in the trade...

  12. 77 FR 35680 - Notice of Agreement Filed

    Science.gov (United States)

    2012-06-14

    ... or [email protected] . Agreement No.: 201215. Title: Port of Los Angeles Data Delivery Agreement. Parties: Port of Los Angeles; PierPass Inc.; APM Terminals Pacific; California United Terminals, Inc... data to the Port of Los Angeles by the participating marine terminal operators and PierPass Inc., and...

  13. 76 FR 77998 - Market Access Agreement

    Science.gov (United States)

    2011-12-15

    ... FARM CREDIT ADMINISTRATION Market Access Agreement AGENCY: Farm Credit Administration. ACTION: Notice of approval of the Draft Second Amended and Restated Market Access Agreement. SUMMARY: The Farm Credit Administration (FCA) announces that it has approved the Draft Second Amended and Restated Market...

  14. 7 CFR 1290.8 - Grant agreements.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Grant agreements. 1290.8 Section 1290.8 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... minimum the following: (1) The projects in the approved State plan. (2) Total amount of Federal financial...

  15. 7 CFR 1291.8 - Grant agreements.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Grant agreements. 1291.8 Section 1291.8 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... minimum the following: (1) The projects in the approved State plan. (2) Total amount of Federal financial...

  16. Agreement Attraction in Comprehension: Representations and Processes

    Science.gov (United States)

    Wagers, Matthew W.; Lau, Ellen F.; Phillips, Colin

    2009-01-01

    Much work has demonstrated so-called attraction errors in the production of subject-verb agreement (e.g., "The key to the cabinets are on the table", [Bock, J. K., & Miller, C. A. (1991). "Broken agreement." "Cognitive Psychology, 23", 45-93]), in which a verb erroneously agrees with an intervening noun. Six self-paced reading experiments examined…

  17. 75 FR 69079 - Notice of Agreements Filed

    Science.gov (United States)

    2010-11-10

    ... World Liner Data Agreement. Parties: A.P. Moller-Maersk A/S; CMA CGM S.A.; Compania Chilena de... from ports in Mexico to the U.S. Atlantic ports. Agreement No.: 012110. Title: Trailer Bridge/HLUSA...

  18. 23 CFR 710.307 - Project agreement.

    Science.gov (United States)

    2010-04-01

    ... 23 Highways 1 2010-04-01 2010-04-01 false Project agreement. 710.307 Section 710.307 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RIGHT-OF-WAY AND ENVIRONMENT RIGHT-OF-WAY AND REAL ESTATE Project Development § 710.307 Project agreement. As a condition of Federal-aid, the STD...

  19. 5 CFR 1655.12 - Loan agreement.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Loan agreement. 1655.12 Section 1655.12 Administrative Personnel FEDERAL RETIREMENT THRIFT INVESTMENT BOARD LOAN PROGRAM § 1655.12 Loan agreement. (a) Upon determining that a loan application meets the requirements of this part, the TSP record keeper...

  20. 47 CFR 73.1650 - International agreements.

    Science.gov (United States)

    2010-10-01

    ... Agreements for the Broadcasting Service in Region 2: (i) MF Broadcasting 535-1605 kHz, Rio de Janeiro, 1981. (ii) MF Broadcasting 1605-1705 kHz, Rio de Janeiro, 1988. (3) Bi-lateral Agreements between the United...

  1. 48 CFR 18.118 - Trade agreements.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Trade agreements. 18.118 Section 18.118 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES EMERGENCY ACQUISITIONS Available Acquisition Flexibilities 18.118 Trade agreements...

  2. 48 CFR 2131.109 - Advance agreements.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Advance agreements. 2131... PRINCIPLES AND PROCEDURES Applicability 2131.109 Advance agreements. FAR 31.109 is applicable to FEGLI Program contracts, except that precontract costs and nonrecurring costs that exceed $100,000 will not be...

  3. Opening the Black Box of Trade Agreements

    NARCIS (Netherlands)

    Kohl, Tristan; De Lombaerde, Philippe; Saucedo Accosta, Edgar J.

    2017-01-01

    In this chapter the author presents a coding methodology to capture the heterogeneity of trade agreements and to facilitate quantitative analysis departing from qualitative legal differences in trade agreements. The coding is based on whether the provisions of the World Trade Organization (WTO) are

  4. Hubs and spokes in Regional Trade Agreements

    NARCIS (Netherlands)

    Vaal, A. de

    2017-01-01

    In the plethora of Regional Trade Agreements (RTAs) some countries are involved in much more RTAs than others. Furthermore, some countries take in a position as a hub: they have trade agreements with many other countries, while their partner countries are much less involved in RTA relations. Even

  5. Development of a radiation protection competency framework, a consultancies perspective

    International Nuclear Information System (INIS)

    Bryant, P A

    2016-01-01

    The UK nuclear industry is suffering heightened concerns of a skills gap. This has led to companies, and in particular consultancies recruiting increasing numbers of graduates and less experienced staff. The following paper provides an overview of an approach to developing a radiation protection based competency framework within a consultancy with the aim of supporting the identification of the required initiatives to support the development of staff, their careers, and the profession. It is hoped this will provide useful guidance for organisations that are embarking on establishing a training and development programme. (paper)

  6. Mergers and acquisitions: director and consultant liability exposure.

    Science.gov (United States)

    Waxman, J M

    1995-02-01

    Corporate directors and their consultants must make decisions in an uncertain and changing health care environment. The losses each may face as a result of an incomplete analysis of the true value of the entities involved in mergers or acquisitions may extend beyond the failure of the transaction to the creation of personal liability as well. Accordingly, objective, careful, detailed, and fair decision-making based upon adequate information is more critical than ever for directors if they are to be able to take advantage of the business judgment rule, and also for consultants to avoid their own liability when transactions fail to deliver the values they have estimated.

  7. Can audio recording improve patients' recall of outpatient consultations?

    DEFF Research Database (Denmark)

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

    Introduction In order to give patients possibility to listen to their consultation again, we have designed a system which gives the patients access to digital audio recordings of their consultations. An Interactive Voice Response platform enables the audio recording and gives the patients access...... and those who have not (control).The audio recordings and the interviews are coded according to six themes: Test results, Treatment, Risks, Future tests, Advice and Plan. Afterwards the extent of patients recall is assessed by comparing the accuracy of the patient’s statements (interview...

  8. 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

  9. Sports chronobiology consultation: from the lab to the arena.

    Science.gov (United States)

    Postolache, Teodor T; Hung, Tsung-Min; Rosenthal, Richard N; Soriano, Joseph J; Montes, Fernando; Stiller, John W

    2005-04-01

    This final article, coauthored by a chronobiology consultant, a sports psychologist who applied a chronobiology-based program to an Olympic national team, a clinical neurologist, a performance data analyst, a training-conditioning coach from a major league baseball team who applied chronobiology principles to major league pitchers, and a substance abuse expert, discusses practical aspects of a sports chronobiology consultation, including the goals and current arsenal of available interventions. Short vignettes of actual cases are presented for edification, and references are made to appropriate reviews found elsewhere in this issue.

  10. Nuclear arbitration: Interpreting non-proliferation agreements

    International Nuclear Information System (INIS)

    Tzeng, Peter

    2015-01-01

    At the core of the nuclear non-proliferation regime lie international agreements. These agreements include, inter alia, the Nuclear Non-proliferation Treaty, nuclear co-operation agreements and nuclear export control agreements.1 States, however, do not always comply with their obligations under these agreements. In response, commentators have proposed various enforcement mechanisms to promote compliance. The inconvenient truth, however, is that states are generally unwilling to consent to enforcement mechanisms concerning issues as critical to national security as nuclear non-proliferation.3 This article suggests an alternative solution to the non-compliance problem: interpretation mechanisms. Although an interpretation mechanism does not have the teeth of an enforcement mechanism, it can induce compliance by providing an authoritative interpretation of a legal obligation. Interpretation mechanisms would help solve the non-compliance problem because, as this article shows, in many cases of alleged non-compliance with a non-proliferation agreement, the fundamental problem has been the lack of an authoritative interpretation of the agreement, not the lack of an enforcement mechanism. Specifically, this article proposes arbitration as the proper interpretation mechanism for non-proliferation agreements. It advocates the establishment of a 'Nuclear Arbitration Centre' as an independent branch of the International Atomic Energy Agency (IAEA), and recommends the gradual introduction of arbitration clauses into the texts of non-proliferation agreements. Section I begins with a discussion of international agreements in general and the importance of interpretation and enforcement mechanisms. Section II then discusses nuclear non-proliferation agreements and their lack of interpretation and enforcement mechanisms. Section III examines seven case studies of alleged non-compliance with non-proliferation agreements in order to show that the main problem in many cases

  11. Letting the people speak: the public consultation process for nuclear power in Alberta and Saskatchewan

    International Nuclear Information System (INIS)

    Bratt, D.

    2010-01-01

    This paper compares the Alberta and Saskatchewan governments' public consultation process for the introduction of nuclear power in their provinces. While the goal was the same - to gauge public reaction on a continuous policy issue - the design of their respective consultation process was quite different. The paper analyzes the techniques of public consultation in the nuclear sector, especially the use of public hearings and multiple consultative tools. Finally, it assesses the impact that public consultation has on government decision-making. (author)

  12. New Danish Company Act on Shareholders' Agreements

    DEFF Research Database (Denmark)

    Werlauff, Erik

    2011-01-01

    ) organizational rights, (2) financial rights, and (3) rights of disposal, or in plainer words, the corporate (1) power, (2) money, and (3) exit. If a shareholders’ agreement is thoroughly kept and respected by all parties, both in the way they vote at general assemblies and in the way they act when wishing....... The substantial elements in many agreements are clauses on (1) voting for board candidates, (2) voting for dividends of certain proportions, and (3) first refusal rights, respectively, call options for shares in the company. Such clauses are at the very roots of corporate law, dealing with the shareholders’ (1......Section 82 of the Danish Company Act, in force from 1 March 2010, provides that ‘Shareholders’ agreements are neither binding on the company nor on decisions taken by the general assembly’. This has far-reaching consequences for shareholders’ agreements, also for already existing agreements...

  13. [Innovative medicines and market access agreements].

    Science.gov (United States)

    Toumi, M; Zard, J; Duvillard, R; Jommi, C

    2013-09-01

    Market Access Agreements (MAA) for drugs have emerged in response to the need to control health expenditures, as well as to the uncertainty about the true benefit of a drug. It is possible to group MAA in two types of agreements: financial agreements and outcome-based agreements. MAA is a growing trend and is shifting towards conditional access. However, the willingness to use these contracts and their implementation differ across countries, and some are still resistant to put them in place. The MAA challenges to overcome encompass the complexity of the schemes, the administrative burden and the difficulty of evaluating MAA. It is likely that these agreements might experience further evolution in the future to become a faster pathway for therapeutic innovations, at a fair price. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  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. Cooperative monitoring of regional security agreements

    Energy Technology Data Exchange (ETDEWEB)

    Pregenzer, A.L.; Vannoni, M.; Biringer, K.L.

    1995-08-01

    This paper argues that cooperative monitoring plays a critical role in the implementation of regional security agreements and confidence building measures. A framework for developing cooperative monitoring options is proposed and several possibilities for relating bilateral and regional monitoring systems to international monitoring systems are discussed. Three bilateral or regional agreements are analyzed briefly to illustrate different possibilities: (1) the demilitarization of the Sinai region between Israel and Egypt in the 1970s; (2) the 1991 quadripartite agreement for monitoring nuclear facilities among Brazil, Argentina, The Argentine-Brazilian Agency for Accounting and Control of Nuclear Materials and the International Atomic Energy Agency; and (3) a bilateral Open Skies agreement between Hungary and Romania in 1991. These examples illustrate that the relationship of regional or bilateral arms control or security agreements to international agreements depends on a number of factors: the overlap of provisions between regional and international agreements; the degree of interest in a regional agreement among the international community; efficiency in implementing the agreement; and numerous political considerations.Given the importance of regional security to the international community, regions should be encouraged to develop their own infrastructure for implementing regional arms control and other security agreements. A regional infrastructure need not preclude participation in an international regime. On the contrary, establishing regional institutions for arms control and nonproliferation could result in more proactive participation of regional parties in developing solutions for regional and international problems, thereby strengthening existing and future international regimes. Possible first steps for strengthening regional infrastructures are identified and potential technical requirements are discussed.

  16. 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.

  17. Safeguards agreements - their legal and conceptual basis

    International Nuclear Information System (INIS)

    Sanders, B.; Rainer, R.

    1977-01-01

    The application of Agency safeguards requires treaty arrangements (''Safeguards Agreements'') between the State or States concerned and the Agency. The authority for the Agency to conclude such agreements and to implement them is provided for in the Agency's Statute (Articles II, III A.5 and XII). On the basis of the statutory provisions safeguards principles and procedures have been elaborated. These have been laid down in: (a) The Agency's Safeguards System 1965, extended in 1966 and 1968 (INFCIRC/66/Rev.2); and (b) The basis for negotiating safeguards agreements with NNWS pursuant to NPT (INFCIRC/153). The verification of the undertaking by the State concerned not to use items subject to safeguards for purposes contrary to the terms of the agreement is verified through the application of various safeguards measures (design review, records, reports and inspection). Containment and surveillance measures are expected to play an increasingly important role. NPT Safeguards Agreements foresee as one of their specific features the establishment of national systems of accounting and control of nuclear material. The majority of the agreements concluded under document INFCIRC/66/Rev.2 - i.e. the non-NPT safeguards agreements - implement obligations undertaken under co-operation agreements between States for peaceful uses of nuclear energy. These agreements naturally reflect approaches adopted by the parties, in particular as to the circumstances under which safeguards should be applied. Thus, the concepts used in the non-NPT safeguards agreements and the safeguards system of document INFCIRC/66/Rev.2 which is incorporated in these agreements by reference are in continuous evolution. Document INFCIRC/66/Rev.2 continues to be supplemented in practical application and through explicit decision by the Board. The non-NPT safeguards agreements contain, besides technical safeguards provisions from document INFCIRC/66/Rev.2, and further provision for notification, inventories

  18. 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

  19. 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.

  20. A prospective analysis of gastroenterology out-patient consultations ...

    African Journals Online (AJOL)

    Introduction: The pattern and relative occurrence of gastrointestinal and liver disorders in Nigeria is unclear. The aim of this study was to assess the pattern of gastroenterology referral and consultations as seen in the outpatient department of the Lagos University Teaching Hospital, Lagos, Nigeria. Methods: This was a ...