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Sample records for consultation dietetique est-elle

  1. Impact of nutrition management in patients with head and neck cancers treated with irradiation: is the nutritional intervention useful?; Interet de la prise en charge nutritionnelle des patients traites par irradiation des voies aerodigestives superieures: la consultation dietetique est-elle utile?

    Energy Technology Data Exchange (ETDEWEB)

    Garabige, V. [Institut Curie, Service de Dietetique, 75 - Paris (France); Giraud, P.; Jaulerry, C.; Brunin, F. [Institut Curie, Dept. d' Oncologie Radiotherapie, 75 - Paris (France); Rycke, Y. de [Institut Curie, Dept. de Biostatistiques, 75 - Paris (France); Girod, A.; Jouffroy, T.; Rodriguez, J. [Institut Curie, Service de Chirurgie ORL, 75 - Paris (France)

    2007-05-15

    Aims. The head and neck tumors are most often associated with a precarious nutritional status. Radiotherapy increases the risk of de-nutrition because of its secondary effects on the secretory and sensorial mucous membranes. The purpose of our retrospectively study was to evaluate the interest of a precocious and regular nutritional therapy on the ability to maintain the nutritional status of the patient during the radiotherapy. Patients and methods. The fifty-two patients included in the survey have been classified retrospectively in two different groups based on their observance to the nutritional therapy: group 1 'good observance', group 2 'bad observance'. Results. The 31 patients of group 1 have lost an average of 1.9 kg by the end of the irradiation, whereas the 21 patients of group 2 have lost an average of 6.1 kg (p < 0.001). The almost stability in weight of patients in group 1 was linked to a lower frequency of breaks in the radio-therapy (6 vs 33% p = 0.03) and in a decrease in grade of inflammatory, mucous membranes (10% of grade 3 in group 1 vs 52% in group 2, p = 0.006). The quantity of calories ingested in form of nutritional supplements was greater in group 1 and consequently enabled patients to stabilized their weight (1200 calories in group 1 versus 850 calories in group 2, p < 0.005). Conclusions. The given nutritional advice and the prescription of adapted nutritional supplements consequently allowed limiting efficiently the weight lost during the irradiation and the grade of mucositis. The systematization of a precocious nutritional therapy for patients irradiated for head and neck tumors seems absolutely essential. (authors)

  2. La metaphore est-elle la marque de l’insuffisance de l’esprit?

    Directory of Open Access Journals (Sweden)

    Isabelle Oliveira

    2010-01-01

    Full Text Available L’une des caractéristiques les plus communément reconnues à la discipline de la terminologie est sa conceptualité. Au contraire de l’opinion émise sur la métaphore, la terminologie s’efforce de travailler à partir de notions précises dont le sens doit être délimité et l’articulation à d’autres notions explicitée afin de bannir les ambiguïtés et les fausses évidences qu’elles véhiculent. Elle se distingue aussi du texte poétique caractérisé en particulier par la richesse des images et le jeu sur les signifiants. On comprend dès lors pourquoi la métaphore apparaît de prime abord comme une ennemie du champ de la terminologie qu’il faudrait bannir à tout prix. Cette figure de rhétorique consistant en un transport de sens risque à tout moment de rendre inopérant l’effort d’univocité et de rigueur du travail du terminologue. Mais la métaphore n’est pourtant pas absente des textes de spécialité. Il faut dès lors se demander si cette présence est « accidentelle”, contingente, ou si elle est incontournable et signifiante. Pour cela, il nous faudra étudier à la fois la place de la métaphore dans le texte de spécialité, et le discours des scientifiques portant sur elle. Mais une telle démarche nous laisse prisonnier de la dichotomie entre concept et métaphore et masque peutêtre une parenté inaperçue entre eux. Si le concept est habité par la métaphore, qu’en est-il du discours de spécialité? N’est-il pas réduit à n’être qu’un vaste poème qui ne s’avouerait pas comme tel? Est-elle seulement une figure de style ou aurait-elle un impact qui outrepasseraitsa modeste fonction discursive ? Il semble bien, même si le débat sur la métaphore et son usage est loin d’être clos. Notre théorie s’inscrit plutôt dans le sens d’une réévaluation du sens, d’une extension toujours plus grande de l’impact de ce trope qui, plus qu’une simple finalité esthétique, aurait une

  3. L’analyse économique est-elle intemporelle ? Is the Economic Analysis Timeless ?

    Directory of Open Access Journals (Sweden)

    Antoine Parent

    2009-06-01

    Full Text Available En réponse à la question « L’analyse économique est-elle intemporelle ? », nous soulignons la diversité et la complexité du rapport au temps de l’analyse économique : la représentation du temps futur est au coeur de l’analyse des anticipations. La modélisation dynamique dans un cadre d’équilibre général conduit, quant à elle, à une représentation du monde comme succession d’équilibres. Enfin, l’investigation du temps historique à partir des hypothèses de rationalité économique constitue le paradigme de la « New Economic History ». Il ressort de ce bref survol que l’analyse économique ne néglige aucun des aspects du rapport au temps : temps passé, temps présent, temps futur.To answer this question, we develop three issues : first, the assessment of the future is the core issue in studying expectations; second, dynamic economic modeling often leads to represent Time as a series of economic equilibriums; lastly, the «New Economic History» investigates History using the rational behavior hypothesis. In that way, the three dimensions of Time, past, present, and future are taken into account by Economic Analyses.

  4. Hammoudi Abdallah, Bauchard Denis, Leveau Rémy, (coord. Cahen Judith, La démocratie est-elle soluble dans l’islam ? , Paris, CNRS Éditions/IFRI, 2007, 280 p.

    Directory of Open Access Journals (Sweden)

    Suleiman-Gabryel Nasser

    2009-05-01

    Full Text Available La démocratie est elle soluble dans l’islam ? La question a le mérite d’être claire et sans ambigüité. Elle est suscitée par une histoire contemporaine marquée par la présence américaine dans le monde arabe de manière directe (Irak et indirecte (Maghreb, Moyen Orient. C’est dans ce cadre qu’un discours exogène sur la modernisation, avec son corollaire politique (démocratie, élections, censée entraîner l’extinction de l'hyperterrorisme se trouve doté d’une nouvelle légitimité. Ainsi, la mis...

  5. La grande vitesse est-elle toujours sur les rails ?

    OpenAIRE

    Libourel, Eloïse; Ruggeri, Charlotte; Schorung, Matthieu

    2016-01-01

    National audience; Depuis le milieu du XXème, la grande vitesse ferroviaire est considérée comme une innovation révolutionnaire pour le transport de voyageurs. Elle renvoie une image de modernité à tous les acteurs institutionnels et à la société civile, et elle permet également aux États d’afficher une image de puissance technique et industrielle. L’objectif est de capitaliser sur l’objet « grande vitesse » pour valoriser l’avancée technologique d’un pays, d’une région, et pour promouvoir de...

  6. La grande vitesse est-elle toujours sur les rails ?

    OpenAIRE

    Libourel, Eloïse; Ruggeri, Charlotte; Schorung, Matthieu

    2016-01-01

    National audience; Depuis le milieu du XXème, la grande vitesse ferroviaire est considérée comme une innovation révolutionnaire pour le transport de voyageurs. Elle renvoie une image de modernité à tous les acteurs institutionnels et à la société civile, et elle permet également aux États d’afficher une image de puissance technique et industrielle. L’objectif est de capitaliser sur l’objet « grande vitesse » pour valoriser l’avancée technologique d’un pays, d’une région, et pour promouvoir de...

  7. Situational Consultation

    Science.gov (United States)

    Rimehaug, Tormod; Helmersberg, Ingunn

    2010-01-01

    Situational Consultation (SC) is presented as a framework for flexible integration of several models and methodologies in consultation practice by choosing an approach adapted to the specific situation. In SC, models and their characteristic role positions are considered interchangeable tools with qualitative differences in strengths and…

  8. [Bioclimatic consultation].

    Science.gov (United States)

    Cordes, H; Reinke, R

    1975-01-23

    The climatological environment may effect the human state of health, disadvantageously or favourably. This knowledge, confirmed by empiric as well as scientific research can be used by e.g. changing the place of residence towards a healthy and benefical climate. For a professional climatological planning of such a project the "Deutscher Wetterdienst" renders bioclimatic consultations within the Federal Republic of Germany. For this purpose individual reactions as well as state health of the person in question have to be considered. A method will be shown how to combine medical diagnostic facts and bioclimatic consultation.

  9. Individual Consultations

    Directory of Open Access Journals (Sweden)

    Ian Walkinshaw

    2015-09-01

    Full Text Available Responding to calls for research into measurable English language outcomes from individual language support consultations at universities, this study investigated the effect of individual consultations (ICs on the academic writing skills and lexico-grammatical competence of students who speak English as an additional language (EAL. Attendance by 31 EAL students at ICs was recorded, and samples of their academic writing texts before and after a 9-month interval were compared. Participants’ academic writing skills were rated, and lexico-grammatical irregularities were quantified. No statistically significant positive shifts manifested, due to the relatively short research period and limited participant uptake, but there were encouraging predictors of future shifts given continued utilization of the service. First, although a Wilcoxon signed-rank test showed no association between attendance at ICs and shifts in academic writing ability, a Spearman’s rho calculation suggested a tentative relationship to positive pre–post shifts in three academic writing sub-skills: Task Fulfillment, Grammar, and Vocabulary. Second, instances of four common lexico-grammatical irregularities (subject/verb, wrong word, plural/singular, and punctuation declined at post-testing. Although only regular, sustained attendance would produce statistically significant shifts, there is a potential association between participants’ use of ICs and improved academic writing skills/lexico-grammatical competence.

  10. Consulting in Collection Development.

    Science.gov (United States)

    Ash, Lee

    1980-01-01

    Considers the role of the consultant in the areas of library collection development and weeding, and offers suggestions on determining the need for a consultant, obtaining one, and what to do when the consultant arrives. (FM)

  11. 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...

  12. Campaign Consultants - Client Payments

    Data.gov (United States)

    City of San Francisco — Campaign Consultants are required to report ���economic consideration�۝ promised by or received from clients in exchange for campaign consulting services during the...

  13. Optimizing Consulting Delivery Systems.

    Science.gov (United States)

    Spottswood, Curran

    1980-01-01

    Summarizes a study of several types of consulting groups in the Bell System and describes characteristics which are associated with high-impact consulting. A strategy which is designed for internal consulting organizations to maximize the likelihood of both initial success and long-term survival of the group is proposed. (Author/MER)

  14. 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.

  15. Consulting on Academic Library Buildings.

    Science.gov (United States)

    Mason, Ellsworth

    1980-01-01

    Addresses the following aspects of consulting on library buildings: new trends, the need for a consultant, selecting a consultant, timeliness in hiring, expectations, following through, and the cost of consulting. (FM)

  16. Designing consultancy on energy

    Energy Technology Data Exchange (ETDEWEB)

    Nielsen, Lene [Danish Energy Authority, Copenhagen (Denmark)

    2005-07-01

    There is a wide tradition for using energy consultancy in all end-using sectors and in various models. A lot of aspects have to be taken into consideration when a consultant scheme is to be launched. This paper will contribute to the discussion of the role of the consultant in the different energy end-use sectors: Energy consultancy is defined. The process for energy consulting is related to the eight fundamental objectives for effective management consulting (Arthur N. Turner): responding to a client's request for information; providing solutions to specific problems; giving an in-depth, accurate diagnosis; presenting a program of recommended corrective actions; implementing changes; building consensus and commitment; facilitating client learning; and enhancing organizational effectiveness. The role of the consultant is divided into 4 categories (expert, diagnostician, sparring partner, process consultant) depending on the consultant's focus (process or cases) and methodology (analysis or dialogue). Designing energy consultancy should reflect the end-use sector (household, industry etc.)

  17. Making consultations run smoothly

    DEFF Research Database (Denmark)

    Jespersen, Astrid Pernille; Jensen, Torben Elgaard

    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 field of science and technology studies (STS), including notions of relationality, multiplicity and otherness. Through this lens, and based on extensive fieldwork, it describes the daily work of arranging time before, during and after consultations. In conclusion, it suggests that a STS...

  18. The Dream Consultant

    DEFF Research Database (Denmark)

    Muhr, Sara Louise; Kirkegaard, Line

    2013-01-01

    for work. We draw on Lacan's notion of desire as the Other's desire and analyze the consultants' desire as controlled by a need for recognition at work. We show how consultants need off-work fantasies to maintain the illusion of wholeness – of being more than work. Only with this illusion of wholeness can...

  19. 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...

  20. Family Practice Consultation.

    African Journals Online (AJOL)

    gauge the patients' opin:on on the family doctors' role regardirg prayer ... family practice consultation arc presented. ... patients' expectation of prayer and ..... New developments and frequently asked questions covering - high and low BMI, ...

  1. La maladie de Parkinson est-elle une maladie à prion ?

    OpenAIRE

    Brandel, Jean-Philippe; Corbillé, A.-G; Derkinderen, P.; Haïk, S

    2015-01-01

    National audience; The accumulation of a specific protein in aggregated form is a common phenomenon in human neurodegenerative diseases. In Parkinson's disease, this protein is α-synuclein which is a neuronal protein of 143 amino acids. With a monomeric conformation in solution, it also has a natural capacity to aggregate into amyloid structures (dimers, oligomers, fibrils and Lewy bodies or neurites). It therefore fulfils the characteristics of a prion protein (different conformations, seedi...

  2. Antimatière Est-elle la clé de l'Univers?

    CERN Multimedia

    Grousson, Mathieu

    2009-01-01

    "De quoi est fait l'Univers? De matière ordinaire et, selon la théorie actuelle, de matière noire et d'énergie noire... dont nul ne sait rien! Et s'il s'agissait plutôt d'antimatière? Car elle permet de réécrire l'histoire du cosmos sans déroger à ses lois et, cette fois, sans nulle zone d'ombre. Reste à vérifier qu'elle antigravite bien..." (14 pages)

  3. Une sociologie de l’existence est-elle possible ?

    Directory of Open Access Journals (Sweden)

    Danilo Martuccelli

    2011-10-01

    Full Text Available En partant du diagnostic d’une affirmation croissante des questions existentielles dans les sociétés contemporaines, l’article interroge les manières dont la sociologie peut les aborder. Il revient dans une première partie sur les grands principes de la philosophie de l’existence, mais surtout sur l’œuvre de Jean-Paul Sartre qui a, plus que tout autre, explicitement marqué les principaux essais d’une sociologie existentialiste et les impasses de ces tentatives. Dans la seconde partie, en s’appuyant sur les conclusions précédentes, l’article développe les raisons d’une montée des thèmes socio-existentiels dans la modernité et répond à la question de savoir pourquoi, et surtout comment, l’analyse sociologique peut et doit étudier les questions existentielles.Is a sociology of existence possible?Starting from the diagnosis of an increasing assertion of existential questions in contemporary societies, this article interrogates ways that sociology can address them. In the first part, it comes back to the great principles of existential philosophy particularly on Sartre’s work, that has, more than anyone else, explicitly marked the major essays of an existentialist sociology as well as the dead ends of these attempts. In the second part, relying on the previous conclusions, this article will develop the reasons of the rise of socio-existential themes in modernity, and it will answer the question of why, and especially how, sociological analysis can and must study existential questions.¿Es posible una sociología de la existencia?A partir del diagnóstico según el cual emergen en la sociedad actual cuestiones de índole existencial, en este artículo se expone como la sociología puede abordarlas. Parte en la primera parte de los grandes principios de la filosofía existencial, especialmente de Sartre que más que ningún otro ha introducido una aproximación sociológico-existencialista y ha subrayado sus límites. En la segunda parte, apoyándose en las conclusiones precedentes, el artículo explica las razones de este aumento del cuestionamiento socio-existencial en la modernidad y responde a la pregunta del porqué y del como el análisis sociológico puede y debe interesarse por la temática existencial.

  4. La préhistoire est-elle toujours une science humaine ?

    OpenAIRE

    Beaune, Sophie A. de

    2007-01-01

    This article goes beyond the major trends in the field – such as New Archaeology and Contextual Archaeology – in attempting to compare the evolution of two approaches: on the one hand, «cultural» events and, on the other, material data relating to technology and economy. The first approach – dealing with cultural events – is examined from the standpoint of artistic production and Neanderthal Man's linguistic capacity. This approach is seen to vacillate between the epistemological models of th...

  5. Une sagesse est-elle possible face à la mort ?

    OpenAIRE

    2012-01-01

    Dans la Lettre à Ménécée, le sage Épicure nous dit qu'il est urgent de philosopher : " Quand on est jeune il ne faut pas remettre à philosopher, et quand on est vieux il ne faut pas se lasser de philosopher. Car jamais il n'est trop tôt ou trop tard pour travailler à la santé de l'âme. "1 Cette urgence a pour cause essentielle le fait que nous soyons mortels et que la peur de la mort est la cause de tous nos maux, cette crainte est en effet à l'origine de toutes les illusions qui nous font de...

  6. 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.

  7. Sharing Expertise: Consulting

    Science.gov (United States)

    Graves, Bill

    2011-01-01

    A special breed of superintendents who have developed expertise in a particular area find ways of sharing it in other venues as outside consultants. They pull extra duty to put their special skills into practice, to give back to their communities, to stay current and grounded in the field, or to enhance their professional reputations. They teach…

  8. Mentoring for new consultants.

    Science.gov (United States)

    Ackroyd, R; Adamson, K A

    2015-01-01

    There is increasing evidence of the benefits of having a mentor during the early years as a consultant. Mentoring encourages and provides support to an individual in their professional development. Although there are different forms of mentoring there is recognition that developing a formal mentoring scheme can provide a consistent approach and support within a framework. The Royal College of Physicians of Edinburgh has introduced a mentoring scheme for new consultants that provides a forum for supporting them in their ongoing professional wellbeing. There is potential that the process of mentoring can improve an individual's development, and motivate and encourage them to develop the skills needed to achieve their goals, thus having an impact on ultimately improving their ability to deliver an effective patient-centred service.

  9. Health Consultation in China

    Institute of Scientific and Technical Information of China (English)

    1995-01-01

    ONE Sunday morning, I noticed some people gathered at a clearing outside a school in which my family had an apartment. Feeling curious, I joined them to find that some young dentists, wearing their white coats, were offering free consultations for people. They were selling toothbrushes and dental floss at the same time. One of my teeth was bothering me. It always felt odd when I bit something cold. I consulted with a young dentist, who was wearing a pair of glasses. He asked me many questions like when had it begun to hurt, if I felt the pain, how long it had been since I had it filled the previous time. He asked me to open my mouth and checked the tooth carefully. "You should have your

  10. The Process of Psychological Consultation

    Science.gov (United States)

    Nolan, Anna; Moreland, Neil

    2014-01-01

    Consultation is a key means of service delivery in many psychological services. However, the "process" of consultation is little explored in Educational Psychology literature, particularly in the United Kingdom (UK). This paper focuses on a small-scale qualitative research study of psychological consultation provided by educational…

  11. Management Consulting: Planning, Entry, Performance.

    Science.gov (United States)

    Cosier, Richard A.; Dalton, Dan R.

    1993-01-01

    Contends that counseling has much in common with organizational consulting. Provides overview of consulting practices that counselors might find useful should they decide to investigate organizational consulting. Includes aspects of market research, gauging competition, and target markets. Considers promotion, networking, and elements of…

  12. 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.

  13. Epistemics in audiological consultations

    DEFF Research Database (Denmark)

    Egbert, Maria

    ' subjective descriptions of hearing experiences in different environments. In these consultations, the institutional conceptualization of hearing (and thus of hearing loss) is that of an objectively measurable functioning of the ear, categorized in an audiogram by decibels and hertz. In contrast, persons......, broad, and metaphorical. Compared to visual impairment, describing hearing seems to be more difficult, and frequently, persons with hearing impairment resort to visual metaphors. A CA examination of conversational order in the areas of turn-taking, sequence, repair, topic, multimodality, and linguistic...... at the micro-level of direct healthcare encounters to the macro-level and globel problems of the impact of untreated hearing loss. The social repercussions are stigmatization, miscommunication, loss of work, social isolation, depression, and suicide (Carmen 2001). The financial loss per person dropping out...

  14. Responsive Systems Consultation: A Model for Conjoint Consultation Preliminary Results.

    Science.gov (United States)

    Prasad-Gaur, Archna; And Others

    Responsive Systems Consultation (RSC) is an approach for enhancing children's developmental outcomes and involves a psychological or educational consultant working jointly with a child's parents and teachers. The impact of the RSC on parent and teacher consultees' attitudes toward home-school collaboration and their evaluation of the consultation…

  15. Educating Consultants for Multicultural Practice of Consultee-Centered Consultation

    Science.gov (United States)

    Ingraham, Colette L.

    2017-01-01

    Literature about educating consultants with knowledge, skills, and dispositions to work effectively within culturally and linguistically diverse schools is scarce. Research suggests that additional attention is needed on the preparation of consultants to practice with multicultural competence. This article reviews theories and research and…

  16. 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.

  17. 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....

  18. Simulated consultations: a sociolinguistic perspective

    National Research Council Canada - National Science Library

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

    2016-01-01

    .... 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...

  19. 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…

  20. Communication Consulting as Persuasion: Issues and Implications.

    Science.gov (United States)

    Ross, Roseanna G.

    Focusing on the issue of the training and preparation of the communication specialist in communication consulting, an investigation of the persuasive elements in the client-consulting relationship suggests that more direct focus on consulting as persuasion can lead to more responsible and effective enactment of the role of both consultant and…

  1. Comment la psychologie expérimentale française est-elle devenue cognitive ?

    OpenAIRE

    Plas, Régine

    2007-01-01

    How French Experimental Psychology Became Cognitive The French cognitive psychology derives from naturalistic branch of psychology, which defines itself at the end of XIXth century as physiological psychology and during the XXth century as experimental psychology. A brief historical reminder of institutionalization of psychology in France, of its different theoretical orientations and of the reattachment of the scientific psychology to the CNRS‘s life sciences department is followed by an eva...

  2. LA RéGLEMENTATION DES MARCHéS FINANCIERS EST-ELLE REMISE EN CAUSE PAR LA CRISE ACTUELLE ?

    Directory of Open Access Journals (Sweden)

    Mihut Marius

    2010-07-01

    Full Text Available One the most important things to reveal about each economic crisis that can occur is to understand the past and the present and then maybe to try to predict the future. Economic crisis are not new, sooner or later they have common economic phenomenon and common causes and results. What is it not common are not the solutions. If some crisis can be described as crisis of over production or even oil crisis, the current one sis more a consumption crisis. Is it possible to regulate the market? Is it worth? Will it be a solution? Maybe we can try but what we see is that all the countries that have tried a regulated national economy their increase was either small or none at all.

  3. La structure iconographique d’un art rupestre est-elle une clef pour son interprétation?

    Directory of Open Access Journals (Sweden)

    Georges SAUVET

    2009-12-01

    Full Text Available RÉSUMÉ: L’hypothèse émise par R. Layton selon laquelle la structure des arts rupestres diffère profondément, en termes de fréquence des motifs et de leur distribution entre les sites, en fonction de la religion et de l’organisation sociale des groupes humains est réexaminée dans ce travail collectif, à l’aide d’une documentation renouvelée et augmentée provenant d’Afrique et d’Australie, mais aussi d’une analyse approfondie de l’art pariétal paléolithique d’Europe occidentale. Il ressort de cette étude que l’hétérogénéité des sites (distribution géographique des motifs et la diversité de l’iconographie (fréquence des motifs sont des critères importants indubitablement liés à la structure sociale, aux croyances et à l’économie des sociétés, mais qu’ils ne permettent pas de trancher en faveur d’une organisation totémique ou de pratiques chamaniques.RESUMEN: La hipótesis de R. Layton según la cual la estructura de las artes rupestres difiere mucho en términos de frecuencia de los motivos y de su distribución entre los sitios, en función de la religión y de la organización social de los grupos humanos es examinada de nuevo en este trabajo colectivo, a la luz de una documentación nueva y aumentada procedente de África y Australia y de un análisis pormenorizado del arte parietal paleolítico de Europa occidental. Resulta de este estudio que la heterogeneidad de los sitios (distribución geográfica de los motivos y la diversidad de la iconografía (frecuencia de los motivos son criterios efectivamente ligados a la estructura social, a las creencias y a la economía de las sociedades, pero no permiten decidir a favor de una organización totémica o de prácticas chamánicas.

  4. Perceived incivility during emergency department phone consultations.

    Science.gov (United States)

    Shetty, Amith L; Vaghasiya, Milan; Boddy, Rachel; Byth, Karen; Unwin, Danielle

    2016-06-01

    Perceived incivility during ED medical phone consultations is poorly researched. We aimed to determine frequency and factors influencing perceived incivility during ED phone consultations. We conducted a prospective self-reported survey of 40 consecutive phone consultations for 21 ED volunteer doctors. Consultations were classified based on the aim of consultation and deemed as 'positive', 'neutral' or 'negative' based on the perceptions of the consulting doctor. Training levels, time bands and specialty data were collected for both consulting and consulted parties. Fifty-seven of 714 included consultations (7.98%, 95% CI 6.2-10.2%) were reported as negative by ED medical staff. Factors associated with significant incidence of negative grading of consultation involved requests for investigations (19.3% vs 5.3%, P  4 (9.1% vs 3.8%, P incivility during ED phone consultations. Perceived incivility occurs infrequently during ED phone consultations. ED female medical staff are at an increased risk of perceived incivility during phone consultations with non-ED medical professionals. Health organisations should actively pursue programmes to investigate the occurrence of incivility during healthcare consultations and implement programmes to mitigate the risk of developing a negative workplace culture. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  5. 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…

  6. 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 re

  7. [Remote medical consultations in gerontology].

    Science.gov (United States)

    Mathieu-Fritz, Alexandre; Esterle, Laurence; Espinoza, Pierre

    2012-01-01

    Experimental teleconsultations have been set up between a university hospital and a public geriatric hospital in Paris in order to facilitate elderly patients' access to specialist consultations. Caregivers have had to accept major changes to their professional practices (delegation of tasks, sharing of knowledge, etc.). This new telemedecine scheme represents huge progress in patient care.

  8. Tianjin Architects & Consulting Engineers

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Tianjin Architects& Consulting Engineers (TACE), established in 1952,is the largest integrated architectural design institutein Tianjian. TACE has five A-Class certificates issued by the Ministry of Construction in areas such as engineering design, and it is rated as one of the top 100 exploration and design companies in China.

  9. 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 re

  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. 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…

  12. [Teledermatology versus consultations--a comparative study of 120 consultations].

    Science.gov (United States)

    Herrmann, F E; Sönnichsen, K; Blum, A

    2005-10-01

    Dermatology fulfills the prerequisites for telemedicine. An important application of telemedicine might be the field of dermatologic consultations. In this comparative study images of skin disease were taken of 120 patients hospitalized in the University Hospitals of Tuebingen to answer the following questions: (1) are the preconditions in daily routine given for teledermatology, (2) is there adequate agreement between the diagnoses reached in dermatologic consultations and with teledermatology, and (3) can the images be utilized for teaching purposes. Patient acceptance was very good and the images captured with a digital camera were easily obtained. The results of intraobserver analysis for the two teledermatologists without any knowledge of the patients' history were 70.2% and 46.4%, respectively, and with knowledge of the history 76.6% and 64.3%. The results of interobserver analysis without any knowledge of the patients' history were 46.4% and 57.2% and with knowledge of the history 64.3% and 66%, respectively. With the reduction of the image quality, reduced reliability of the diagnoses was observed. Seven of ten images could be used for teaching purposes. It was demonstrated that in dermatology telemedicine is applicable in many, but not in all patients who are referred for dermatologic consultations.

  13. CURBSIDE CONSULTATION IN HIP ARTHROPLASTY

    OpenAIRE

    Sporer, Scott M.; Bernard R. Bach, Jr

    2009-01-01

    DESCRIPTION A user friendly reference for decision making in hip arthroplasty designed in a question formed clinical problem scenarios and answers format .The articles composed of the answers, containing current concepts and preferences of experts in primary and revision hip surgery are enhanced by several images, diagrams and references and written in the form of a curbside consultation by Scott M. Sporer, MD. and his collaborators. PURPOSE By this practical reference of hip arthroplasty, Sc...

  14. 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…

  15. Core Competencies for Training Effective School Consultants

    Science.gov (United States)

    Burkhouse, Katie Lynn Sutton

    2012-01-01

    The purpose of this research was to develop and validate a set of core competencies of effective school-based consultants for preservice school psychology consultation training. With recent changes in service delivery models, psychologists are challenged to engage in more indirect, preventative practices (Reschly, 2008). Consultation emerges as…

  16. Special Education Teacher Consultant: Idealism versus Realism.

    Science.gov (United States)

    Haight, Sherrel Lee

    1984-01-01

    A review of literature on topics of teacher consultant roles, cross-categorical services, approval criteria, and caseloads suggests the position of teacher consultant as it is being implemented may be untenable. There is a critical lack of role definition at state and local levels and a dearth of professional preparation in consultation skills.…

  17. Observed Consultation: Confidence and Accuracy of Assessors

    Science.gov (United States)

    Tweed, Mike; Ingham, Christopher

    2010-01-01

    Judgments made by the assessors observing consultations are widely used in the assessment of medical students. The aim of this research was to study judgment accuracy and confidence and the relationship between these. Assessors watched recordings of consultations, scoring the students on: a checklist of items; attributes of consultation; a…

  18. Observed Consultation: Confidence and Accuracy of Assessors

    Science.gov (United States)

    Tweed, Mike; Ingham, Christopher

    2010-01-01

    Judgments made by the assessors observing consultations are widely used in the assessment of medical students. The aim of this research was to study judgment accuracy and confidence and the relationship between these. Assessors watched recordings of consultations, scoring the students on: a checklist of items; attributes of consultation; a…

  19. Tips for telephone and electronic medical consultation.

    Science.gov (United States)

    Gupta, Sailesh G

    2013-11-01

    The world is gradually shrinking in terms of time, and communications, while expanding in terms of population and distances. Patients demand and expect telephone and e-mail consultations and medical professionals are only too happy to oblige. However, a telephone consult is never so satisfying for the patients and well as the doctor as a face consult. Besides much essential information, cues and clues to diagnosis may be missed only with an audio input from patients. A telephone consult should be offered only to know the patient, and only after a prior face consult. It should be ensured that the patient can definitely understand, and follow the directions, and manage the disorder at home. While a telephone consultation may be considered convenient and short, there may be several disadvantages of such consultation, a wrong diagnosis and an inappropriate prescription being just two of them. Telephone etiquette should be followed by the staff and the physician. A triage system may be set up to filter calls that need to be necessarily answered by the physician himself. Telephone consults should be charged, and should be followed by a face consult as soon as possible. E-mail consultations are governed essentially by the same principles that govern telephone consultations. There is a slight advantage of e-mail consultation in that reports can be submitted online, including radiological reports. However, confidentiality is an important and uncertain issue in cyber space. A memorandum of understanding maybe signed between the patient and the physician. The information provided on e-mail should be of a general nature and a face consult should precede e-mail consultation. Patients may be referred to web resources for information. Telemedicine is a useful tool to obtain a medical diagnosis and to provide medical advice, and is likely to be used vastly in the near future.

  20. CURBSIDE CONSULTATION IN HIP ARTHROPLASTY

    Directory of Open Access Journals (Sweden)

    Scott M. Sporer

    2009-03-01

    Full Text Available DESCRIPTION A user friendly reference for decision making in hip arthroplasty designed in a question formed clinical problem scenarios and answers format .The articles composed of the answers, containing current concepts and preferences of experts in primary and revision hip surgery are enhanced by several images, diagrams and references and written in the form of a curbside consultation by Scott M. Sporer, MD. and his collaborators. PURPOSE By this practical reference of hip arthroplasty, Scott M. Sporer, MD. and the contributors have aimed providing the reader practical and clinically relevant information, evidence-based advices, their preferences and opinions containing current concepts for difficult and controversial clinical situations in total hip replacement surgery which are often not addressed clearly in traditional references. FEATURES The book is composed of 9 sections and 49 articles each written by a different expert designed in a question and answers format including several images and diagrams and also essential references at the end of each article. In the first section preoperative questions is subjected. Second section is about preoperative acetabulum questions. Third section is about preoperative femur questions. Fourth section is about intraoperative questions. Intraoperative acetabulum question is subjected in the fifth section and the intraoperative femur questions in the sixth section. The seventh section is about postoperative questions. Eighth and ninth sections are about general questions about failure and failure of acetabulum in turn. AUDIENCE Mainly practicing orthopedic surgeons, fellows and residents who are interested in hip arthroplasty have been targeted but several carefully designed scenarios of controversial and difficult situations surrounding total hip replacement surgery and the current information will also be welcomed by experienced clinicians practicing in hip arthroplasty. ASSESSMENT Scott M. Sporer

  1. Integrating corpus consultation in language studies

    OpenAIRE

    Angela Chambers

    2005-01-01

    peer-reviewed Alongside developments in language research, the potential of corpora as a resource in language learning and teaching has been evident to researchers and teachers since the late 1960s. Despite publications which emphasise the benefits of corpus consultation for language learners (Bernardini, 2002; Kennedy & Miceli, 2001), there is little evidence to suggest that direct corpus consultation is coming to be seen as a complement or alternative to consultation of a dictionary, cou...

  2. Consulting--Part 2. The art and science of using consultants.

    Science.gov (United States)

    Lister, E D; Pirrotta, S

    1996-11-01

    Part I of this series described a research project--a survey of more than 300 physician executives. Asked to share their personal experiences of unsuccessful consultations, our correspondents painted a clear picture of what can go wrong when organizational consultants enter health care systems, and described the lasting destructive sequelae to failed consultations. The two issues responsible for most failed consultations were the intrusion of internal politics into the process and the failure to clearly establish and maintain consensual goals. In Part 2, the consultation process is explored from a very different perspective. What are the issues that often trigger requests for consultation services, as well as the dynamics that can foreshadow success or failure before consultants are even engaged? What are the pitfalls and pointers for the successful use of consultation services?

  3. The effect of parallel consulting on the quality of consultations in regional general practice.

    Science.gov (United States)

    Tran, Peter Duy; Laurence, Jerome Martin; Weston, Kathryn M; McLennan, Peter L

    2012-05-01

    The sustainability of community-based medical education relies on maintaining consultation quality as perceived by patients. This study aims to investigate the effect of an alternative model (parallel consultation) of teaching on patients' views of consultation quality as compared to the conventional consultation model in a general practice setting. A cross-sectional questionnaire study. Patients attending a regional general practice in the Southern Highlands of New South Wales between February and May 2010, who consented to student involvement in their consultation. Instruments to measure 'empathy' (CARE score) and 'enablement' (PEI score) as markers for consultation quality were administered after patient consultations. There was no difference in consultation length between the two groups. There was a small increase in the level of empathy experienced by patients attending parallel consultations compared to conventional consultations (Pconsultation group (Pconsultation quality, as experienced by the patient, when using the parallel consulting model. Parallel consulting does not change the length of time a patient spends with their doctor, and patients have a positive perception of the students involved in this model of clinical teaching.

  4. Competency-Based Behavior Consultation Training: An Evaluation of Consultant Outcomes, Treatment Effects, and Consumer Satisfaction

    Science.gov (United States)

    Lepage, Kathy; Kratochwill, Thomas R.; Elliott, Stephen N.

    2004-01-01

    Assessments of consultants, clients, and consumer satisfaction were used to examine the effects of a competency-based consultation training program conducted over 4 years. Using a multiple-baseline framework to assess training effects on consultants and single-case study designs to evaluate changes in client behavior, a number of significant…

  5. Teaching CONSULT: Consultation with Novel methods & Simulation for UME Longitudinal Training.

    Directory of Open Access Journals (Sweden)

    Keme Carter

    2015-10-01

    Full Text Available Introduction: An important area of communication in healthcare is the consultation. Existing literature suggests that formal training in consultation communication is lacking. We aimed to conduct a targeted needs assessment of third-year students on their experience calling consultations, and based on these results, develop, pilot, and evaluate the effectiveness of a consultation curriculum for different learner levels that can be implemented as a longitudinal curriculum. Methods: Baseline needs assessment data were gathered using a survey completed by third-year students at the conclusion of the clinical clerkships. The survey assessed students’ knowledge of the standardized consultation, experience and comfort calling consultations, and previous instruction received on consultation communication. Implementation of the consultation curriculum began the following academic year. Second-year students were introduced to Kessler’s 5 Cs consultation model through a didactic session consisting of a lecture, viewing of “trigger” videos illustrating standardized and informal consults, followed by reflection and discussion. Curriculum effectiveness was assessed through pre- and post- curriculum surveys that assessed knowledge of and comfort with the consultation process. Fourth-year students participated in a consultation curriculum that provided instruction on the 5 Cs model and allowed for continued practice of consultation skills through simulation during the Emergency Medicine clerkship. Proficiency in consult communication in this cohort was assessed using two assessment tools, the Global Rating Scale and the 5 Cs Checklist. Results: The targeted needs assessment of third-year students indicated that 93% of students have called a consultation during their clerkships, but only 24% received feedback. Post-curriculum, second-year students identified more components of the 5 Cs model (4.04 vs. 4.81, p<0.001 and reported greater comfort with the

  6. Linking Knowledge and Action: PRI's Community Consultant.

    Science.gov (United States)

    Spencer, Gregory P.

    Within the Partnership for Rural Improvement (PRI), community consultants operate within three complex sets of relationships: client groups, the organizational structure of PRI, and the local operational base. Community consultants are responsible for developing and facilitating rural development and for providing assistance in community and…

  7. Consulting Careers: A Profile of Three Occupations

    Science.gov (United States)

    Mullins, John

    2011-01-01

    Choosing an industry in which to work is often as important as choosing an occupation. And over the next several years, the best advice for some workers may be to choose an industry that sells advice: consulting. The management, scientific, and technical consulting services industry comprises businesses that offer specialized advice to other…

  8. The Consulting Challenge: A Case Competition

    Science.gov (United States)

    Sachau, Daniel A.; Naas, Patricia A.

    2010-01-01

    The Consulting Challenge is a yearly case competition in which teams of graduate students respond to a request for proposals (RFP) for consulting services. The case and RFP are based on a problem that a host organization has experienced. Over 3 days, students meet with representatives of the host organization, analyze data, prepare a proposal for…

  9. Capturing the Competence of Management Consulting Work

    Science.gov (United States)

    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 survey was conducted among Dutch management…

  10. Linking Knowledge and Action: PRI's Community Consultant.

    Science.gov (United States)

    Spencer, Gregory P.

    Within the Partnership for Rural Improvement (PRI), community consultants operate within three complex sets of relationships: client groups, the organizational structure of PRI, and the local operational base. Community consultants are responsible for developing and facilitating rural development and for providing assistance in community and…

  11. How to Hire a Search Consultant.

    Science.gov (United States)

    Lester, Virginia L.

    1993-01-01

    Increasingly, colleges and universities are using consultants to help search committees find the right president for the institution. Search consultants bring experience, historical and national perspectives, objectivity, personal knowledge of candidates, and a professional approach. Energy, enthusiasm, and style are important consultant…

  12. Patient expectations from consultation with family physician.

    NARCIS (Netherlands)

    Tähepöld, H.; Brink-Muinen, A. van den; Maaroos, H.I.

    2006-01-01

    Aim: To assess patient expectations from a consultation with a family physician and determine the level and area of patient involvement in the communication process. Method: We videotaped 403 consecutive patient-physician consultations in the offices of 27 Estonian family physicians. All videotaped

  13. 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…

  14. 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 su

  15. Timer: a new objective measure of consultation content and its application to computer assisted consultations.

    Science.gov (United States)

    Pringle, M; Robins, S; Brown, G

    1986-01-01

    As part of the research into the effect in the consultation of the use of a computer to prompt opportunistic preventive care a valid, objective, and practical measure of the consultation process was required. After a review of the alternative methods the Time Interval Medical Event Recorder (Timer) was developed, its reliability tested, and applied to 93 control consultations and 49 computer assisted consultations. Timer records, every five seconds, four consultation events: the problems being dealt with, the physical activity, the verbal activity, and the secondary tasks being attempted. Timer showed that control consultations lasted an average of 6 minutes 58 seconds. The doctors spent 35% of their time on administration, and patients and doctors were both conversational for just 33% of the consultation. Giving information was the most common verbal activity (48% of the duration of the consultation) with silence accounting for 21% of the time. When the computer was used the average consultation was longer, at 7 minutes and 46 seconds. The doctor's contribution to the consultation appeared to have increased. Patient centred speech fell from 36% in controls to 28% of the duration of the consultation when the computer was used, while doctor centred speech rose from 30% to 34.5%. Secondary tasks (exploring patient concepts, education, management sharing, and prevention) were attempted during 28% of the control consultations and 40% of the computer consultations. This was accounted for by the increase in prevention (p less than 0.001). Timer is a reliable and practical tool for researching the consultation, and though it has shown validity in detecting differences between consultations that use a computer and those that do not, further applications are required to establish its full value. PMID:3089391

  16. 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…

  17. 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…

  18. CONSULTATION ON UPDATED METHODOLOGY FOR ...

    Science.gov (United States)

    The National Academy of Sciences (NAS) expects to publish the Biological Effects of Ionizing Radiation (BEIR) committee's report (BEIR VII) on risks from ionizing radiation exposures in calendar year 2005. The committee is expected to have analyzed the most recent epidemiology from the important exposed cohorts and to have factored in any changes resulting from the updated analysis of dosimetry for the Japanese atomic bomb survivors. To the extent practical, the Committee will also consider any relevant radiobiological data, including those from the Department of Energy's low dose effects research program. Based on their evaluation of relevant information, the Committee is then expected to propose a set of models for estimating risks from low-dose ionizing radiation. ORIA will review the BEIR VII report and consider revisions to the Agency's methodology for estimating cancer risks from exposure to ionizing radiation in light of this report and other relevant information. This will be the subject of the Consultation. This project supports a major risk management initiative to improve the basis on which radiation risk decisions are made. This project, funded by several Federal Agencies, reflects an attempt to characterize risks where there are substantial uncertainties. The outcome will improve our ability to assess risks well into the future and will strengthen EPAs overall capability for assessing and managing radiation risks. the BEIR VII report is funde

  19. The Consultation of the Puericulture.

    Directory of Open Access Journals (Sweden)

    Rotardo Rafael Navarro Ruíz

    2010-06-01

    Full Text Available He/she was carried out a bibliographical revision related with the topic Puericulture with the objective of deepening in the knowledge related with the topic, keeping in mind that it is the consultation, par excellence, of the Primary Attention that takes charge of the care and the minor cultivation from a lot before the conception. The visit of the children and young to their doctor, without problems of health mediate they allow to evaluate the integral operation of these and to guide the parents on as acting before possible situations that are presented we Also insist in the different subespecialitys that compose the Puericulture like they are: Puericulture Preconcepcional, Intra-uterine Puericulture and or Prenatal, Puericulture Neonatal, Puericulture of the Infant, Puericulture of the Naive one, Puericulture of the Scholar, the adolescent's Puericulture and that of the boy handicapped. We stand out that this realized activity with quality guarantees the full health of the children, through the clinical exam and other observations we can identify and to diagnose some situation of health that can arise precociously and to diminish future problems.

  20. 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.

  1. Practical guidance for charting ethics consultations.

    Science.gov (United States)

    Bruce, Courtenay R; Smith, Martin L; Tawose, Olubukunola Mary; Sharp, Richard R

    2014-03-01

    It is generally accepted that appropriate documentation of activities and recommendations of ethics consultants in patients' medical records is critical. Despite this acceptance, the bioethics literature is largely devoid of guidance on key elements of an ethics chart note, the degree of specificity that it should contain, and its stylistic tenor. We aim to provide guidance for a variety of persons engaged in clinical ethics consultation: new and seasoned ethics committee members who are new to ethics consultation, students and trainees in clinical ethics, and those who have significant experience with ethics consultation so that they can reflect on their practice. Toward the goal of promoting quality charting practices in ethics consultations, we propose recommendations on a broad array of questions concerning clinical ethics consultation chart notes, including whether and when to write a chart note, and practical considerations for the tenor, purpose, and content of a chart note. Our broader aim is to promote discussion about good charting practices in clinical ethics, with the hope of contributing to clear standards of excellence in clinical ethics consultation.

  2. INTEGRATING CORPUS CONSULTATION IN LANGUAGE STUDIES

    Directory of Open Access Journals (Sweden)

    Angela Chambers

    2005-05-01

    Full Text Available Alongside developments in language research, the potential of corpora as a resource in language learning and teaching has been evident to researchers and teachers since the late 1960s. Despite publications which emphasise the benefits of corpus consultation for language learners (Bernardini, 2002; Kennedy & Miceli, 2001, there is little evidence to suggest that direct corpus consultation is coming to be seen as a complement or alternative to consultation of a dictionary, course book, or grammar by the majority of learners. There is thus a need for research to underpin the integration of corpora and concordancing in the language-learning environment.This study begins with an account of published research relating to course design and structure in the area of corpus consultation by language learners. The focus then narrows to the initial training of learners in corpus consultation, using as an example a course involving undergraduate students on several language degree programmes. The results of the students' consultation of the corpora are examined, including choice of search word(s, analytical skills, the problems encountered, and their evaluation of the activity. The results reveal how corpus consultation can complement traditional language-learning resources, while also raising questions concerning its integration in the language-learning environment.

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

    Science.gov (United States)

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

    2016-03-01

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

  4. Postpartum consultation: Occurrence, requirements and expectations

    Directory of Open Access Journals (Sweden)

    Carlgren Ingrid

    2008-07-01

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

  5. [Structured electronic consultation letter for shoulder disorders].

    Science.gov (United States)

    Paloneva, Juha; Oikari, Marjo; Ylinen, Jari; Ingalsuo, Minna; Ilkka, Kunnamo; Ilkka, Kiviranta

    2012-01-01

    Referral to a specialist has a significant influence on management of the patient and costs associated with the treatments. However, development and research of the process by which patients are referred has been almost neglected. Expectations considering the purpose, contents, and timing of the referral of the consulting physician and the consultant do not always meet. A structured, electronic consultation letter was developed to respond this need. Functionality and interactivity are the key elements of the referral, including (1) an electronic referral letter to a specialist, (2) interactive education in clinical examination and management of shoulder disorders, and (3) an instrument of clinical examination and documentation of shoulder disorders.

  6. 24 CFR 91.100 - Consultation; local governments.

    Science.gov (United States)

    2010-04-01

    ... Urban Development CONSOLIDATED SUBMISSIONS FOR COMMUNITY PLANNING AND DEVELOPMENT PROGRAMS Citizen Participation and Consultation § 91.100 Consultation; local governments. (a) General. (1) When preparing...

  7. Bladder Pain Syndrome International Consultation on Incontinence

    DEFF Research Database (Denmark)

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

    2010-01-01

    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......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...

  8. Consulting Informs Best Practice in Academia

    Directory of Open Access Journals (Sweden)

    Risa Blair

    2015-10-01

    Full Text Available The Conversational Plenary Session began with a clear agenda of describing the process and challenge of developing eLearning and eTraining. After a brief discussion of the benefits and challenges of the modality, the conversation quickly segued to a highly spirited conversation related to consulting and the negative implications when one calls oneself a consultant. In fact, this became an integral theme of multiple discussions throughout the rest of the conference. This author strives to identify a selection of literature which supports the viewpoint that consulting does indeed inform best practices in academia. Those professors with up-to-the-minute consultancies in their fields offer an enriched experience for their students.

  9. Three Obstacles to Improving Academic Consultation.

    Science.gov (United States)

    Kremer, John F.

    1980-01-01

    Notes three obstacles to improving academic consultation to students: (1) lack of knowledge of techniques to improve student performance; (2) reduction of barriers between students and professors; and (3) needed reinforcements for professors. Suggests strategies for overcoming those problems. (CK)

  10. [A nurse consultation in victimology for minors].

    Science.gov (United States)

    Soudan, Corinne

    2014-10-01

    The nurse consultation is an integral part of the treatment of children and adolescents experiencing psychological distress following traumatic events. Specific support is therefore offered to young patients, in particular through the intervention of a clinical nurse specialist.

  11. Ethics consultation: a dangerous, antidemocratic charlatanry?

    Science.gov (United States)

    Lilje, Christian

    1993-01-01

    Giles Scofield's argument indicates ethics consultants may need to better clarify what in fact they are and what they are not doing, claiming, and striving for. But we must not step back too far. We must neither engage in putting in envious professional claims for exclusive rights in the area of difficult and momentous decisions in healthcare nor get stuck in discussing normative ethics at the level of metaphysics, ontology, and dogmatics (as has happened in Germany for decades). We must not do so especially in view of the achievements of ethics consultation and the growing demand for it by all parties involved, conceded even by sceptics. Ethics consultation, according to Scofield, appears to be dangerous....Let us look more closely at the logic of the argument by discussing the presumed "antidemocratic" nature. The "new tyranny" of thoughts, and the "proper" role of bioethics consultation. Some considerations about the possibility of ethics expertise shall be left for the end.

  12. 265 Statistical Consulting and the African Universities

    African Journals Online (AJOL)

    User

    2011-07-21

    Jul 21, 2011 ... Indexed African Journals Online. An International Multidisciplinary Journal, Ethiopia ... engineering, medicine, public health, psychology, marketing, ..... method and the role of statistics; Statistical Consulting Environments (Life ... intelligible reports, makes presentations using PowerPoint and persuasive.

  13. ACF 2012 Reponse to Tribal Consultation Testimony

    Data.gov (United States)

    U.S. Department of Health & Human Services — On March 5 and 6, 2012, the Administration for Children and Families (ACF) held its annual tribal consultation session in Washington, D.C. This session marked the...

  14. Bladder Pain Syndrome International Consultation on Incontinence

    DEFF Research Database (Denmark)

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

    2010-01-01

    cytology and cystoscopy are recommended if clinically indicated. Treatment progresses from conservative management through various oral and intravesical therapies, with most surgical therapies reserved for unresponsive cases. Pain management is critical throughout the treatment process. The consultation...

  15. Supporting Group Communication Among UX Consultants

    OpenAIRE

    Feldt, Tommy

    2015-01-01

    Professional User Experience (UX) practitioners have an inherent need for effective group communication practices. If they work as external consultants, the need is arguably even greater. Enterprise Social Media (ESM) technologies have affordances that make them seem promising for this domain. The aim of this thesis is thus to identify the domain-specific communicative needs of UX consultants, and discuss how these might be supported using ESM. A case study was conducted, examining how the ES...

  16. Using Language Consultants in Communicative Language Teaching

    OpenAIRE

    Hiroki, Yamamoto; Makoto, Izumisawa; Graduate School, Meiji University

    2016-01-01

    The purpose of the present study is to introduce a teaching technique using language consultants in communicative language teaching. Language consultant is a role in which a student pays attention to a group member's language use during activities, and provides him/her with corrective and positive feedback after the activities, referring to dictionaries. Its effectiveness in terms of second language (L2) learning and motivation was investigated by using it with 42 English learners at a Japane...

  17. Nurse consultants: organizational influences on role achievement.

    Science.gov (United States)

    Woodward, Valerie A; Webb, Christine; Prowse, Morag

    2006-03-01

    This paper reports on organizational influences on nurse consultant post holders. The influence of individual characteristics has been the subject of another paper. Nurse consultant posts were set up in the United Kingdom from the late 1990s onwards and, therefore, there has been little opportunity to report on evaluations of these innovative initiatives. A cross-sectional design, using a convenience sample, was adopted. Ten nurse consultants working in a variety of settings and specialties participated in in-depth, tape-recorded interviews. The data were analysed using the Framework approach. Support systems were important influences on nurse consultants' role achievement levels. These took the form of internal trust networks, nurse consultant forums and links with higher education institutions. Post holders both gave and received support and acted to empower other nurses. Thus, relationships were vital to successful role integration. The culture and structures of the National Health System were also a powerful influence in terms of local and national modernization policies, and participants had to be careful in their choice of strategies to deal with the traditional medically dominated culture. The new nurse consultant role is challenging and innovative, but a major area of contention is how much post holders are expected to take on work previously done by doctors rather than developing their nursing role. Organizational support and commitment are needed if nurse consultants are to maximize the benefits of this innovation. The findings show that new nursing roles are not always easily accepted in multidisciplinary settings and that holders of such post need to have the appropriate previous knowledge, skills and personal characteristics, as well as the ability to negotiate their way through organizational influences.

  18. An Exploration of Consultation Approaches and Implementation in Heterogeneous Classrooms.

    Science.gov (United States)

    Burdette, Paula J.; Crockett, Jean B.

    1999-01-01

    This review of the literature on consultation in heterogeneous classrooms provides first, an overview of consultation; second, a description of school-based consultation; third, a research synthesis of exemplary studies of school-based consultation; and, finally, suggestions for future research and implications for practice. (Author/DB)

  19. 41 CFR 102-78.30 - Who are consulting parties?

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Who are consulting... Preservation § 102-78.30 Who are consulting parties? As more particularly described in 36 CFR 800.2(c), consulting parties are those parties having consultative roles in the Section 106 process (i.e., Section 106...

  20. Improving consultations in oncology: the development of a novel consultation aid

    Science.gov (United States)

    Furber, L; Murtagh, G M; Bonas, S A; Bankart, J G; Thomas, A L

    2014-01-01

    Background: The way in which patients receive bad news in a consultation can have a profound effect in terms of anxiety, depression and subsequent adjustment. Despite investment in well-researched communication skills training and availability of decision-making aids, communication problems in oncology continue to be encountered. Methods: We conducted a mixed-methods study in a large UK Cancer Centre to develop a novel consultation aid that could be used jointly by patients and doctors. Consultations were audio-recorded and both the doctors and the patients were interviewed. We used conversation analysis to analyse the consultation encounter and interpretative phenomenological analysis to analyse the interviews. Key themes were generated to inform the design of the aid. Results: A total of 16 doctors were recruited into the study along with 77 patients. Detailed analysis from 36 consultations identified key themes (including preparation, information exchange, question-asking and decision making), which were subsequently addressed in the design of the paper-based aid. Conclusions: Using detailed analysis and observation of oncology consultations, we have designed a novel consultation aid that can be used jointly by doctors and patients. It is not tumour-site specific and can potentially be utilised by new and follow-up consultations. PMID:24548856

  1. 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…

  2. Consulting as a Strategy for Knowledge Transfer

    Science.gov (United States)

    Jacobson, Nora; Butterill, Dale; Goering, Paula

    2005-01-01

    Academic researchers who work on health policy and health services are expected to transfer knowledge to decision makers. Decision makers often do not, however, regard academics’ traditional ways of doing research and disseminating their findings as relevant or useful. This article argues that consulting can be a strategy for transferring knowledge between researchers and decision makers and is effective at promoting the “enlightenment” and “interactive” models of knowledge use. Based on three case studies, it develops a model of knowledge transfer–focused consulting that consists of six stages and four types of work. Finally, the article explores how knowledge is generated in consulting and identifies several classes of factors facilitating its use by decision makers. PMID:15960773

  3. Wind power projects and Aboriginal consultation

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-07-01

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

  4. Moral mediation in interpreted health care consultations.

    Science.gov (United States)

    Seale, Clive; Rivas, Carol; Al-Sarraj, Hela; Webb, Sarah; Kelly, Moira

    2013-12-01

    This paper reports on the moral work done in routine diabetes review consultations in primary care with nurses. Consultations with fluent English speakers are compared with consultations where an interpreter was present, largely involving patients of Bangladeshi origin. The study setting was Tower Hamlets in London, where type 2 diabetes is particularly common. Existing research has shown some dissatisfaction with diabetes care amongst Bangladeshi patients, and studies of care providers in other locations suggest that they at times experience the care of this group as particularly challenging. Through analysis of video-recorded consultations recorded in 2010-2011 we shed light on possible reasons for these difficulties. The 12 non-English speakers often experienced difficulties in raising issues that concerned them, particularly if their interpreter did not translate their utterance because it was deemed to be unrelated to diabetes. These difficulties were not shared by the 24 fluent English speakers, who also found it easier to convey a positive moral reputation and to excuse behaviour that deviated from recommended self-management practices. Interpreters at times also acted as moral mediators. For example, where a participant in the consultation made statements that appeared to convey a negative moral judgement of an other participant, these would often go untranslated. Probably, neither health care providers nor patients are fully aware of the nature of their communication difficulties. Given this, interpreters possess considerable power to influence matters. Understanding the moral work of consultations is important in explaining the findings of other studies showing difficulties in the provision of diabetes care to people with limited English language skills.

  5. IT Consultants in Acquisition IT Integration

    DEFF Research Database (Denmark)

    Henningsson, Stefan; Øhrgaard, Christian

    2016-01-01

    ’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...... model, depicting the use of external consultants in acquisition IT integration, contributes to the literature on acquisition IT integration by providing an explanation for IT-based value creation in acquisition that is rooted in the external of the acquirer. In addition to adding to the limited...

  6. 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.

  7. Framing the consultation: the role of the referral in surgeon-patient consultations.

    Science.gov (United States)

    White, Sarah J; Stubbe, Maria H; Macdonald, Lindsay M; Dowell, Anthony C; Dew, Kevin P; Gardner, Rod

    2014-01-01

    This study describes and analyzes the impact of the referral process on communication at the beginning of surgeon-patient consultations. We used conversation analysis to analyze the opening interactional activities of surgeon-patient consultations in New Zealand. This study focuses on 20 video-recorded consultations recorded between 2004 and 2006. Participants in surgeon-patient consultations began referred consultations by discussing the referral letter in what we have termed "referral recognition sequences." These sequences are coconstructed activities that can be implicit or explicit and address the minimized epistemic distance between surgeons and patients that is caused by the referral process. These sequences can be simple or complex, and this complexity may be determined by the quality of the referral letter received. Acknowledgment of the referral letter assists in achieving alignment between surgeon, patient, and referring doctor regarding the presenting problem. If this alignment is not achieved, progressivity of the consultation is affected, as there is disagreement as to why the patient is seeing the surgeon. This research shows that to assist in the progressivity of surgeon-patient consultations, referral letters should be clear and patients made aware of the reason for referral. Surgeons should also overtly address the minimized epistemic distance caused by the referral letter to ensure patients present their problems in full.

  8. Principles of effective consultation: an update for the 21st-century consultant.

    Science.gov (United States)

    Salerno, Stephen M; Hurst, Frank P; Halvorson, Stephanie; Mercado, Donna L

    2007-02-12

    Little information in the literature exists to guide consult interactions between different medical specialties. A total of 323 general internists, family medicine physicians, general surgeons, orthopedic surgeons, and obstetricians/gynecologists (OB/GYNs) from 3 academic medical centers completed a survey addressing their ideal relationship with consultants. Differences between surgeons and nonsurgeons were calculated using logistic regression, adjusting for location and trainee status. Differences between different specialties of surgeons were calculated using analysis of variance with Scheffe post hoc analysis There was a 72% response rate. About half of respondents were surgeons and the rest were general internists and family medicine physicians. More nonsurgeons (69%) desired the consultant to focus on a narrow question than did surgeons (41%). Over half (59%) of family medicine physicians and internists preferred to retain order-writing authority on their patients compared with 37% of surgeons (Pinternal medicine input, preferring to consult medicine subspecialists directly. Specialty-dependent differences exist in consult preferences of physicians. These differences vary from the extremes of orthopedic surgeons desiring a comprehensive co-management approach with the consultant to general internists and family medicine physicians desiring to retain control over order writing and have a more focused consultant approach.

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

    Directory of Open Access Journals (Sweden)

    Eduard-Gabriel Ceptureanu

    2017-02-01

    Full Text Available The present paper addresses quality management from the specific perspective of project management consulting service providers, in the framework of large infrastructure projects. Because of their supposed superiority in knowledge and experience, project management consultants have an ultimate responsibility for the proper implementing of the project. Therefore, quality management in consulting organizations should focus on critical success factors. As there is no consensus yet regarding the most important aspects of the consulting activity on which depend the achievement of the project aims, there is scope for further investigating this subject. Here, the case of a project management consulting organization involved in large infrastructure projects in Romania, Bulgaria, Moldova, Ukraine and Serbia is analyzed. Data collected through a questionnaire-based survey among international consultants and support personnel suggest that factors related to leadership style and communication skills are more closely tied to the success of the project than more technical aspects. The results constitute an empirical evidence of main success factors for specialized consulting services in project management and can be useful in improving business and project performance and achieving business excellence.

  10. Negotiating the Dance: Consulting with Adoptive Systems.

    Science.gov (United States)

    Becker, Kent W.; Carson, David K.; Seto, Atsuko; Becker, Carol A.

    2002-01-01

    For marriage and family therapists and educators who train future marriage and family therapists, families formed by means of adoption offer an abundance of learning opportunities in both the areas of assessment and intervention. The following consultation case represents a composite family designed to highlight the unique features of adoptive…

  11. 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.

  12. 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…

  13. Science Consultants, Fictional Films, and Scientific Practice.

    Science.gov (United States)

    Kirby, David A.

    2003-01-01

    Proposes films to be successful communicative devices within the scientific community by showing that other scientists respond to depictions in films and how they respond. Demonstrates that science consultants use fictional films as promotional devices for their research fields. (Author/NB)

  14. Individualizing Language Strategies Using CONSULT-I.

    Science.gov (United States)

    Newman, Anabel P.; Metz, Elizabeth

    This handbook offers suggestions for implementing actions (termed variously in other settings as treatments, interventions, methods, techniques, strategies or activities) recommended for individual learners by CONSULT-I (R), a computer program created by James Fattu and Edward Patrick. Application of the program described in the handbook was under…

  15. 76 FR 55678 - Tribal Consultation Policy

    Science.gov (United States)

    2011-09-08

    ... proposal, new rule adoption, and other policy changes) that cause ACF to consult with the tribes. ACF's..., including native americans, persons with developmental disabilities, refugees, and legal immigrants, to help... budget (OLAB). Office of planning, research and evaluation (opre). Office of refugee resettlement (ORR...

  16. The Writing Consultation: Developing Academic Writing Practices

    Science.gov (United States)

    Murray, Rowena; Thow, Morag; Moore, Sarah; Murphy, Maura

    2008-01-01

    This article describes and analyses a specific mechanism, the writing consultation, designed to help academics to prioritise, reconceptualise and improve their writing practices. It makes the case for its potential to stimulate consideration of writing practices and motivations, a possible precondition for creating time for writing in academic…

  17. IT Consultants in Acquisition IT Integration

    DEFF Research Database (Denmark)

    Henningsson, Stefan; Øhrgaard, Christian

    2016-01-01

    model, depicting the use of external consultants in acquisition IT integration, contributes to the literature on acquisition IT integration by providing an explanation for IT-based value creation in acquisition that is rooted in the external of the acquirer. In addition to adding to the limited...

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

    African Journals Online (AJOL)

    as delirium, dementia, psychotic disorders due to general medical ... comorbid medical conditions in a regional referral hospital ... (10.0% of cases consulted) were admitted to either the medical or psychiatric wards with a confirmed diagnosis of delirium, .... and Emergency Services (535; 89); Internal Medicine including.

  19. 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.

  20. 77 FR 19020 - Tribal Consultation Meeting

    Science.gov (United States)

    2012-03-29

    ... Act of 2007, Public Law 110-134, notice is hereby given of a one-day Tribal Consultation Session to be... into consideration funding allocations, distribution formulas, and other issues affecting the delivery... children and families, taking into consideration funding allocations, distribution formulas, and...

  1. 29 CFR 1691.12 - Interagency consultation.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 4 2010-07-01 2010-07-01 false Interagency consultation. 1691.12 Section 1691.12 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR COMPLAINTS OF...) Prior to the initiation of any legal action against a recipient of Federal financial assistance alleging...

  2. Teacher Utilization of Instructional Consultation Teams

    Science.gov (United States)

    Berger, Jill; Yiu, Ho Lam; Nelson, Deborah; Vaganek, Megan; Rosenfield, Sylvia; Gravois, Todd; Gottfredson, Gary; Vu, Phuong; Shanahan, Kate; Hong, Vanessa

    2014-01-01

    Data regarding intervention utilization among the target population are critical to interpret evidence from efficacy trials for school-based interventions. When use of the intervention is voluntary, intervention diffusion becomes a particularly critical variable. We examined the use of Instructional Consultation Teams (IC Teams), a voluntary…

  3. 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.

  4. The Role of the Organisational Development Consultant

    Science.gov (United States)

    Simmons, Mike

    1972-01-01

    The consultant's concern is to increase an organization's capacity to initiate and manage change through an integrated approach to the company's social, economic, technical, and organizational systems, and to improve the performance and value of its human resources, using measurable criteria whenever possible. (Author/JB)

  5. Viburnum “terugloopziekte” : Consultancy onderzoek

    NARCIS (Netherlands)

    Ludeking, D.J.W.; Kromwijk, J.A.M.; Boer-Tersteeg, de P.M.; Bosch, C.

    2012-01-01

    DUTCH Bij de teelt van Viburnum opulus komt het soms voor dat de groei pleksgewijs langzaam terugloopt. Het gewas lijkt niet ziek, maar het blad wordt stug en donker en de taklengte en bladgrootte worden elk jaar kleiner. In dit consultancy onderzoek is onderzocht wat de oorzaak is van deze

  6. The Writing Consultation: Developing Academic Writing Practices

    Science.gov (United States)

    Murray, Rowena; Thow, Morag; Moore, Sarah; Murphy, Maura

    2008-01-01

    This article describes and analyses a specific mechanism, the writing consultation, designed to help academics to prioritise, reconceptualise and improve their writing practices. It makes the case for its potential to stimulate consideration of writing practices and motivations, a possible precondition for creating time for writing in academic…

  7. 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…

  8. Psychiatric consultation of patients with hyperemesis gravidarum.

    Science.gov (United States)

    Kim, Deborah R; Connolly, K R; Cristancho, Pilar; Zappone, Mark; Weinrieb, Robert M

    2009-04-01

    The request for a psychiatric examination of patients with hyperemesis gravidarum (HG) is a unique challenge for the psychiatric consultant. Unfortunately, there are little data in the psychosomatic medicine literature to guide diagnostic evaluations and treatment of patients with HG. In this article, we summarize the existing literature and propose a practical approach to such patients based on the literature and our clinical experience.

  9. 34 CFR 200.63 - Consultation.

    Science.gov (United States)

    2010-07-01

    ... children from low-income families residing in participating public school attendance areas, including... to teachers and families of participating private school children. (c)(1) Consultation by the LEA... Programs Operated by Local Educational Agencies Participation of Eligible Children in Private Schools §...

  10. Factors affecting consultation length in a Japanese diabetes practice.

    Science.gov (United States)

    Kabeya, Yusuke; Uchida, Junko; Toyoda, Masao; Katsuki, Takeshi; Oikawa, Yoichi; Kato, Kiyoe; Kawai, Toshihide; Shimada, Akira; Atsumi, Yoshihito; Higaki, Megumu

    2017-04-01

    Sufficient consultation time is important for establishing good doctor-patient relationship. We examined the factors that affect consultation length in Japanese diabetes practice. This was a cross-sectional study performed at a diabetes clinic in central Tokyo, Japan. Regular diabetes consultations of 1197 patients with 22 physicians were analyzed. Consultation time and clinical characteristics were obtained from the electronic records. A negative binomial model, which included patient and physician characteristics, was constructed to examine the association of the variables with consultation length. Of the 1197 patients (mean age, 66; women, 25%; type 1 diabetes, 10%), the mean consultation time was 10.1min. In the multivariate model, longer consultation time was recorded in patients with type 1 diabetes, higher glycated hemoglobin (HbA1c), use of insulin injections, and use of hypnotics/anxiolytics. The consultation time was longer in patients with HbA1c of ⩾7.0 to consultation. Older and female physicians provided longer consultation. Clinical consultation length in diabetes practice was associated with certain patient and physician characteristics. The findings can be used for making diabetes consultation more efficacious, which could eventually lead to the provision of the most appropriate consultation time for individual patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Audit of the consultation process on general internal medicine services.

    Science.gov (United States)

    Conley, J; Jordan, M; Ghali, W A

    2009-02-01

    To determine the proportion of consultations requested by general internal medicine services that communicate key components of the consultation process to medical subspecialists. Retrospective chart review by two researchers, using a standardised chart abstraction instrument (93.1% agreement, kappa 0.85). Calgary, Alberta, Canada. A random sample of medical consultations was selected from those generated on two medical teaching units (MTUs) from 2003 to 2004. The primary measure of interest was whether a "clear clinical question" was posed to the subspecialist, a binary variable. Two hundred consultations were sampled from the 2885 subspecialty consultations. Of the selected consultations, 94.0% (188/200) were available for review. A clear clinical question was posed in 69.7% (131/188) of consultations (CI 0.63 to 0.74). In a secondary analysis involving a larger sample permitting comparison across subspecialties, 95.1% (368/387) of the consultations, representative of the subspecialties, were available for review. An MTU member contacted the subspecialist for 74.2% of consultations. If a consultation was urgent, a member of the MTU contacted the subspecialist in 81.0% of consultations. Of these urgent consultations, 63.3% had a clear clinical question. More than one in four consultations does not contain a clear clinical question, illustrating suboptimal communication between physicians. Innovative strategies that provide a sustainable solution for overcoming barriers to communication could have a significant impact on quality of care.

  12. 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...... to replay their consultation. The intervention is evaluated in a randomised controlled trial with 5.460 patients in order to determine whether providing patients with digital audio recording of the consultation affects the patients overall perception of their consultation. In addition to this primary...... objective we want to investigate if replay of the consultations improves the patients’ recall of the information given. Methods Interviews are carried out with 40 patients whose consultations have been audio recorded. Patients are divided into two groups, those who have listened to their consultation...

  13. Consultants and organization concepts; tracing routes of reception

    NARCIS (Netherlands)

    Heusinkveld, Stefan; Benders, Jos

    2001-01-01

    The aim of this paper is to explore how organization concepts evolve within consulting organizations. These companies are characterized by specific historical backgrounds, organization forms, particular services and include consultants with their own professional interests and competencies. As a con

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

    NARCIS (Netherlands)

    Fokkema, J.P.; Westerman, M.; Teunissen, P.W.; Lee, N.; Scherpbier, A.J.J.A.; Vleuten, C.P.M. van der; Dorr, P.J.; Scheele, F.

    2012-01-01

    CONTEXT: 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

  15. 75 FR 72838 - Notice of Tribal Consultations; Schedule Update

    Science.gov (United States)

    2010-11-26

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF THE INTERIOR National Indian Gaming Commission Notice of Tribal Consultations; Schedule Update AGENCY: National Indian Gaming Commission, Department of Interior. ACTION: Notice of tribal consultations; schedule...

  16. Exploring employment in consultation reports of patients with neuromuscular diseases

    NARCIS (Netherlands)

    Heerkens, Yvonne; Kuyk-Minis, Marie Antoinette van; Cup, Edith; Engels, Josephine; Engelen, Baziel van; Oostendorp, Rob

    2012-01-01

    To explore consultation reports for patient and employment characteristics and recommendations on employment regarding patients with neuromuscular diseases (NMDs). Eighty percent of the included consultation reports contained information on employment. Less than half the patients with NMD were emplo

  17. The Role of Design Consultants in Innovation Strategy Decisionmaking

    NARCIS (Netherlands)

    Calabretta, G.; Gemser, G.; Wijnberg, N.M.; Hekkert, P.P.M.

    2013-01-01

    To contain risks and increase the profitability of innovation efforts, firms frequently engage in joint innovation activities with external sources of knowledge, like design consultancies. Innovation literature has given limited consideration to the strategic role that design consultancies can play

  18. Exploring employment in consultation reports of patients with neuromuscular diseases

    NARCIS (Netherlands)

    Minis, M.A.H; Cup, E.H.C.; Heerkens, Y.F.; Engels, J.A.; Engelen, B.G. van; Oostendorp, R.A.B.

    2012-01-01

    Minis MA, Cup EH, Heerkens YF, Engels JA, van Engelen BG, Oostendorp RA. Exploring employment in consultation reports of patients with neuromuscular diseases. OBJECTIVES: To explore consultation reports for patient and employment characteristics and recommendations on employment regarding patients

  19. The Application of Cognitive Dissonance Theory to Consultation.

    Science.gov (United States)

    Hughes, Jan N.

    1983-01-01

    Summarizes aspects of cognitive dissonance theory (theory that predicts when a particular persuasive attempt will be successful) that are most relevant to consultation. Reviews the corresponding experimental support and suggests practical applications of dissonance research and theory to consultation. (LLL)

  20. Trend of newspaper consultation by students of federal University of ...

    African Journals Online (AJOL)

    Trend of newspaper consultation by students of federal University of Technology, Owerri. ... Data was obtained from the University Library's Records of users' statistics for Newspaper consultation for ten years, 2004-2013. ... Article Metrics.

  1. 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)

  2. L'écologie politique est-elle réactionnaire? L'enjeu des choix technologiques chez John Bellamy Foster

    OpenAIRE

    Flipo, Fabrice

    2010-01-01

    International audience; marxists authors are usually attributing the ecological destruction to capitalism and they see ecological movements at best as " petty bourgeois ", more often " reactionary ". But ecological issues are slowly coming on marxism's agenda. John Bellamy Foster is one leading author here. Through a careful reading of his writings we demonstrate that this eco-marxist synthesis isn't convincing as it doesn't define an ecologist praxis. The failure comes from diverging relatio...

  3. Is acidification still a major air pollution concern?; L`acidification est-elle encore un probleme majeur de pollution atmospherique

    Energy Technology Data Exchange (ETDEWEB)

    Le Bellac, C. [INES, 75 - Paris (France)

    1997-12-31

    The issue of acid emissions from district space heating systems, which burn heavy fuels and coal, is discussed: it is shown that nitrogen oxide emissions are relatively low; for sulfur dioxide, three solutions are possible: switching to natural gas, but peak periods would require stored fuels; reducing the sulfur content in fuels, but its prices are too erratic; and de-sulfurizing the combustion smokes, but it does not appears as economically sustainable, as the prices for quality fuels and difficult fuels are close and low. It is reminded that district space heating is more especially aimed at council buildings

  4. Is acidification still a major air pollution concern?; L`acidification est-elle encore un probleme majeur de pollution atmospherique?

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-12-31

    Although other forms of long-range air pollution are gaining attention, acidification remains an important issue in certain parts of Europe as well as in other continents. In spite of the European 88/609 directive limiting acid emissions from large fuel burning plants, a large part of Europe soils receives acid deposits superior to the tolerance threshold, known as critical loads. Thus, the European Union is considering several new measures, such as a more drastic 88/609 directive, the limitation of emissions country by country, the limitation of sulfur content in heavy fuels, etc. Emission inventories, evaluation tools, long range transfrontier pollution models, integrated assessment, etc. are presented, together with the positions of various French governmental departments, public authorities and industries concerning the european strategy against acidification

  5. La démarche RAROC utilisée en banque est-elle transposable à l’assurance-vie ?

    OpenAIRE

    Jean-Noël Ory

    2002-01-01

    L’objet de cet article est de dresser une tentative d’adaptation de la méthodologie RAROC (risk adjusted return on capital), utilisée en banque, au domaine de l’assurance-vie. Après avoir rappelé que la nécessité de constituer des fonds propres économiques est similaire pour une banque et pour une compagnie d’assurance-vie, nous rappelons la logique de construction de l’indicateur RAROC. Dans un deuxième temps, nous essayons de transposer cette logique à l’assurance-vie, en étudiant quels ser...

  6. La décomposition des biais de progrès technique est-elle réalisable avec une fonction production Cobb-Douglas ?

    OpenAIRE

    Georges Daw

    2014-01-01

    International audience; The neo-classic exercise of growth economic accounting for a given country leads to a quantified diagnosis of the characteristics (capital, work, total productivity of the factors) of this growth while working with a function of Cobb-Douglas production. In the presence of biased technical progress (i.e. progress not profiting identically with all the productive factors), this function is not able to separately provide the value of each bias, which can disorientate the ...

  7. Identification des triacylglycérols en HPLC. Comment se passer du couplage HPLC-SM ? Dans quel cas la chromatographie est-elle encore indispensable ?

    Directory of Open Access Journals (Sweden)

    Tamba Sompila Arnaud W. G.

    2014-11-01

    Full Text Available Les huiles et graisses sont principalement constituées de triacylglycérols. Ces derniers diffèrent par leur nombre total de carbone, la répartition des acides gras sur les trois sommets de la tête glycéryle et la configuration linéaire, ramifiée ou cyclique des chaînes grasses. Ils diffèrent aussi par leur nombre total de doubles liaisons, leur répartition sur les chaînes grasses, et au sein d’une chaîne grasse par leur position et leur configuration. Cela conduit à des mélanges complexes comprenant un grand nombre de congénères qu’il est classique d’analyser par chromatographie en phase liquide. Dans cet article, nous montrons qu’indépendamment du détecteur utilisé (DEDL, Corona, SM la seule utilisation des lois de rétention ln α = f(NC, ln α = f(NDL et ln α = f(NP permet d’identifier les triacylglycérols d’huiles d’Afrique équatoriale. La démarche proposée ne nécessite pas de couplage spécifique avec la spectrométrie de masse, un système HPLC de base suffit. À titre d’exemple nous avons choisi l’huile de Ricinodendron heudelotii qui contient majoritairement des acides gras polyinsaturés en C18:3 isomères de position et de configuration.

  8. Why is Dawsonite Absent in CO2 Charged Reservoirs? Pourquoi la dawsonite est-elle absente des réservoirs chargés en CO2 ?

    Directory of Open Access Journals (Sweden)

    Hellevang H.

    2011-03-01

    Full Text Available Growth of the sodiumaluminium-hydroxy carbonate dawsonite (NaAl(OH2CO3 after charging saline aquifers with CO2 has been assumed in a plethora of numerical simulations at different mineralogies, aqueous solutions, pressures and temperatures. It appears however that dawsonite is less abundant than expected in natural CO2 storage analogues if we take into account the thermodynamic stability alone. We have mapped the thermodynamic stability of dawsonite relative to mineral phases like albite, kaolinite and analcime from 37° to 200°C and performed closed-system batch kinetic simulations using a new kinetic expression including a nucleation term based on classical nucleation theory, and a growth term that was based on BCF growth theory. Using this rate equation, we have performed a sensitivity study on dawsonite growth on mineralogy, temperature, CO2 pressure, nucleation rate and its dependencies on temperature and affinity, and on the dawsonite precipitation rate coefficient. Simulations with dawsonite growth disabled showed that the maximum oversaturation reached for dawsonite for seawater-like solutions never exceeded 3-4 times oversaturation. The positive effect on dawsonite growth of increasing the CO2 pressure was mostly neutralized by higher acidity. Decreasing the precipitation rate coefficient by 5 orders of magnitude had a limited effect on the onset of significant growth, but the amount of dawsonite formed at the end of the 1 000 years simulated time was only 37% below the high-rate case. Reducing the nucleation rates had similar effects leading to postponed dawsonite growth. Finally, based on thermodynamic considerations and numerical simulations, we suggest that the potential of dawsonite growth is limited to a medium-temperature window framed by a high thermodynamic stability relative to competing mineral phases at low temperatures, but with rapidly diminishing nucleation and growth rates at lower temperatures constrained by energy barriers. La possibilité pour la dawsonite – un hydroxy-carbonate de sodium et d’aluminium (NaAl(OH2CO3 – de précipiter dans les aquifères salins dès lors que l’on y injecte du CO2 a été suggérée dans maintes simulations menées sur différentes compositions (minéraux et solution aqueuse et dans des conditions de pression et de température variées. Pourtant, sur le strict plan de la stabilité thermodynamique, la dawsonite paraît moins communément répandue que l’on pourrait s’y attendre dans les analogues naturels de stockages de CO2. On a cartographié la stabilité thermodynamique de la dawsonite par rapport à des phases minérales comme l’albite, la kaolinite et l’analcime, entre 37 et 200 °C, puis on a simulé numériquement des évolutions minérales en système fermé à l’aide d’un nouveau formalisme cinétique pour la précipitation, formalisme qui inclut (1 un terme de nucléation, basé sur la théorie classique de la nucléation, et (2 un terme de croissance, dérivant de la théorie BCF de la croissance. Utilisant cette équation de vitesse, on a réalisé une étude de sensibilité pour examiner comment la croissance de la dawsonite varie avec la composition minérale, la température, la pression partielle de CO2, la vitesse de nucléation – et les variations de cette dernière avec la température et l’affinité chimique –, et enfin la constante de vitesse adoptée pour la loi de précipitation de la dawsonite. Lorsqu’on empêche la dawsonite de précipiter, le rapport de sur-saturation ne dépasse jamais 3 ou 4 pour des solutions de type eau de mer. La propension accrue à précipiter si la pression partielle de CO2 augmente est contrebalancée par l’effet d’acidification de la solution. Diminuer jusqu’à 5 ordres de grandeur la vitesse de précipitation n’a qu’un effet limité sur le démarrage d’une croissance significative, et au bout de 1 000 ans de simulation la quantité de dawsonite formée est de 37 % ce qu’elle est dans le régime de précipitation maximale. Réduire le taux de nucléation a le même effet de retarder la croissance du minéral. Au bout du compte, sur la base de considérations thermodynamiques et au vu des simulations présentées, on suggère que le potentiel de croissance de la dawsonite est restreint à une fenêtre de températures médianes. À basse température, la stabilité relativement grande de la dawsonite vis-à-vis des minéraux en compétition est contrecarrée par la forte diminution des vitesses de nucléation et de croissance, ce qui reflète une puissante barrière énergétique.

  9. La langue des journalistes est-elle dictée par le public ? Attentes supposées du public en Belgique francophone

    Directory of Open Access Journals (Sweden)

    Antoine Jacquet

    2014-04-01

    Full Text Available Le public a tendance à être sévère à l’égard du français des journalistes, qui constitue à la fois le reflet et le modèle de la langue de la société. Vérifier la validité de ces critiques par une approche scientifique pose des problèmes méthodologiques importants. En s’inscrivant dans une autre voie, cet article s’attache au discours métalinguistique des journalistes. Il vise à comprendre la manière dont les journalistes considèrent le français qu’ils utilisent dans leur pratique professionnelle, au travers de la « relation » qui les lie à leur public. Nous avons interrogé 15 journalistes belges francophones. Il ressort de nos entretiens que les médias dans lesquels travaillent ces journalistes ne développent pas de politiques linguistiques fortes. Néanmoins, le français des médias est largement autorégulé par une série de facteurs. Parmi ceux-ci figure le public, ou plutôt les attentes de ce public, telles qu’elles sont imaginées par les journalistes. En effet, les journalistes justifient souvent leurs attitudes linguistiques par des considérations directement liées à leur public. D’abord, la volonté d’être crédible auprès de leur public incite les journalistes à une correction de leur langage. Cette correction constituerait également une forme de respect envers le public. Ensuite, les journalistes sont sans cesse préoccupés par l’intelligibilité de leurs productions : ils veulent être compris par un public le plus large possible, ce qui conditionne leur usage de la langue. Par ailleurs, ils semblent investis d’une volonté d’être pédagogues en matière de langue, et mettent en avant leur devoir d’utiliser un français exemplaire. Enfin, les journalistes ne veulent manifestement pas parler comme leur public, mais conformément à ce que ce public attend d’eux. Au final, faire parler les journalistes de la langue revient inévitablement à les faire parler de leur public. French-speaking Belgians tend to be harsh judges of journalists’ use of language, which serves both as a reflection and a model in society. Validating these criticisms by way of a scientific approach poses significantmethodological problems. Taking a different tack, this article focuses on the metalinguistic discourse of journalists and aims to understand how journalists view the language they use professionally through the “relationship” that binds them to their public. We interviewed fifteen Francophone Belgian journalists. Our interviews show that the media in which these journalists work do not adhere to strong language policies, but rather rely on self-regulation governed by a series of other factors. Among these is the public, or more precisely public expectation, as presumed by journalists. Indeed, journalists often justify their linguistic choices by invoking considerations directly related to their public. First, their desire to be credible to their audience encourages journalists to use correct language and constitutes a form of respect for the public. Journalists are also unwaveringly preoccupied with the intelligibility of their product – they want to be understood by the widest possible audience, which influences their use of language. Moreover, they seem invested with a desire to instruct in all matters of language, and prioritize their duty to use an exemplary French. Finally, though journalists have no desire to talk like their audience, they certainly want to conform to their expectations. And above all, talk to journalists about language and inevitably the talk turns to their public. O público tem uma tendência a ser rigoroso em relação ao domínio do francês pelos jornalistas, o que constitui, em alguns casos, no reflexo e no modelo do uso da língua pela sociedade. Verificar a validade dessas críticas por meio de uma abordagem científica traz consigo importantes problemas metodológicos. Este artigo aponta para outra direção ao se preocupar com o discurso metalinguístico dos jornalistas. Visa compreender a forma como eles consideram o francês empregado na prática profissional por meio da “relação” que estabelecem com o público. Para isso, foram entrevistados 15 jornalistas belgas francófonos. As entrevistas mostram que os veículos nos quais esses jornalistas trabalham não desenvolvem políticas linguísticas expressivas. No entanto, a expressão do francês na mídia é autorregulada por uma série de fatores. Dentre eles, a figura do público, ou mais precisamente as expectativas desse público na forma como elas são imaginadas pelos jornalistas. De fatos, os jornalistas frequentemente justificam suas atitudes linguísticas a partir de considerações que remetem diretamente ao seu público. Inicialmente, a vontade serem credíveis junto ao público incita os jornalistas a corrigirem sua linguagem. Essa correção constituiria igualmente em uma forma de respeito ao público. Em seguida, os jornalistas estão constantemente preocupados com a inteligibilidade de suas produções: eles querem ser compreendidos por um público o mais amplo possível, o que condiciona o uso da língua. Além disso, parecem estar investidos de uma vontade de atuarem como pedagogos no que se refere à língua, priorizando a obrigação de utilizarem um francês exemplar. Finalmente, os jornalistas não querem falar da mesma forma que o público, mas em conformidade com as expectativas que esse público possui deles. Ao final, fazer os jornalistas falarem do uso da língua implica inevitavelmente em fazê-los falar do seu público.

  10. Politique nationale et coopération européenne: La méthode ouverte de coordination ouverte est-elle devenue plus contraignante? (1)

    NARCIS (Netherlands)

    Vanhercke, B.; Hamel, M.P.

    2008-01-01

    De récentes « évaluations » de différentes MOC ont décrié ces processus de coordination, les qualifiant de « purement rhétoriques et de peu de valeur », de « lointains et peu pertinents », voire pire, de « diversion à la mode ». Les auteurs rejettent ce point de vue qui considère la MOC comme de la

  11. Politique nationale et coopération européenne: La méthode ouverte de coordination ouverte est-elle devenue plus contraignante? (1)

    NARCIS (Netherlands)

    Vanhercke, B.; Hamel, M.P.

    2008-01-01

    De récentes « évaluations » de différentes MOC ont décrié ces processus de coordination, les qualifiant de « purement rhétoriques et de peu de valeur », de « lointains et peu pertinents », voire pire, de « diversion à la mode ». Les auteurs rejettent ce point de vue qui considère la MOC comme de la

  12. L’évolution démographique en Andorre est-elle compatible avec le maintien de son identité culturelle ?

    OpenAIRE

    TOURBEAUX Jérôme

    2013-01-01

    La Principauté d’Andorre est un micro-État situé au cœur du massif des Pyrénées-Orientales, entre l’Espagne et la France. Elle fait partie des plus petits États du monde, tant d’un point de vue géographique que démographique.La population d’Andorre présente la particularité d’être majoritairement composée de non Andorrans. Par conséquent, les droits politiques, tel que le droit de vote, sont détenus par une minorité qui a le pouvoir de prendre des décisions pour l’ensemble des communautés qui...

  13. Need a carbon tax be socially regressive? True challenges and wrong debates; La fiscalite sur le carbone est-elle forcement injuste? Vrais defis et faux debats

    Energy Technology Data Exchange (ETDEWEB)

    Combet, E.; Ghersi, F.; Hourcade, J.Ch.; Thery, D

    2009-02-15

    This research aims at clearing up misunderstandings about the distributive impacts of carbon taxes, which proved to be a decisive obstacle to their further consideration in public debates. It highlights the gap between partial equilibrium analyses, which are close to the agents' perception of the costs of taxation, and general equilibrium analyses, which better capture its ultimate consequences. It shows that the real impact on households' income inequality is not mechanically determined by the initial energy budgets and their flexibilities but also depends upon the way tax revenues are recycled and its general equilibrium consequences. The comparison of five tax-recycling schemes highlights the existence of trade-off between maximizing total consumption, maximizing the consumption of the low-income classes and reducing income inequality. (authors)

  14. Consultant supported ERP implementation – a learning opportunity?

    OpenAIRE

    2005-01-01

    Management consultants are often described as accumulators, generators and disseminators of knowledge in the business world. Little research has however been devoted to the extent to which and the processes by which organizations hiring management consultants learn. This issue is addressed in the current paper based on a study of a consultant-supported ERP (Enterprise Resource Planning) implementation project. It is concluded, that projects in which consultants and employees of the hiring org...

  15. Innovation in consulting firms: what are the foundations?

    OpenAIRE

    Lemus Aguilar, Isaac; Hidalgo Nuchera, Antonio

    2015-01-01

    Innovation inside consulting firms has missed specific attention in academic research. Consulting firms usually are considered to be part of Knowledge-Intensive Business Services (KIBS), Professional Service Firms (PSF) or Project-based Firms (PbF). However, consultancies possess particular characteristics that might affect generalizations made in studies targeting all the categories stated before. Consulting firms usually help other companies to be innovative, but they also need to have inno...

  16. What to listen for in the consultation

    DEFF Research Database (Denmark)

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

    2014-01-01

    scale (CES-D). RESULTS: Among the qualitative themes, only the percentage of words spent on talking about 'Acceptance-based psychological coping' was related to symptoms. In regression models controlling for age, education and time since diagnosis, a stronger focus on acceptance-based coping predicted......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 their first consultation in a clinical registered trial (CRT identifier: NCT00990977). Self-presentations were categorized thematically and the most prevalent themes investigated as predictors for scores on the symptom check-list 90-revised (SCL-90-R) and the center for epidemiological studies depression...

  17. Consulting as a Strategy for Knowledge Transfer

    OpenAIRE

    Jacobson, Nora; Butterill, Dale; Goering, Paula

    2005-01-01

    Academic researchers who work on health policy and health services are expected to transfer knowledge to decision makers. Decision makers often do not, however, regard academics’ traditional ways of doing research and disseminating their findings as relevant or useful. This article argues that consulting can be a strategy for transferring knowledge between researchers and decision makers and is effective at promoting the “enlightenment” and “interactive” models of knowledge use. Based on thre...

  18. ACCOUNTING A CONSULTANT IN THE MANAGEMENT PROCESS

    Directory of Open Access Journals (Sweden)

    VIRAG NICOLAE PAUL

    2012-05-01

    Full Text Available Management process is a continuous activity that requires the achievement of the essential objectives of the entity. This involves knowing and understanding how should be implemented major functions of management to ensure the desired performance. Accounting, as part of the management process, specifically contribute to the value of the entity. In this paper we want to present how accounting acts as a consultant to managers, helping them in decision making process.

  19. 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)

  20. Republic of Kazakhstan; 2013 Article IV Consultation

    OpenAIRE

    International Monetary Fund

    2013-01-01

    This paper analyzes the Republic of Kazakhstan’s 2013 Article of Consultation. The IMF report focuses on vision of developing Kazakhstan into a leading emerging market economy requires concerted efforts to strengthen the policy architecture. It highlights the importance of enhancing the diversification strategy by strengthening institutions, the business environment, and human capital, while carefully managing the country’s oil wealth. It also discusses that the unification of the pension...

  1. Internship at Taylor Fry Consulting Actuaries

    OpenAIRE

    Kierkels, Bram Joseph Johannes

    2013-01-01

    Mestrado em Ciências Actuariais As the final part of the master degree, I started my internship on 25 Febru- ary 2013 at Taylor Fry Consulting Actuaries. During the internship my work mainly involved analyzing the outstanding workers compensation liabilities for self-insured clients. In this report I will describe the process of this anal- ysis. Throughout this report I will explain the procedures I used to value outstanding claims.

  2. Virtual slides: application in pulmonary pathology consultations.

    Directory of Open Access Journals (Sweden)

    Michał Wojciechowski

    2008-02-01

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

  3. Multilocation teleradiology system for emergency triage consultation

    Science.gov (United States)

    Herron, John M.; Yonas, Howard

    1996-05-01

    A remote consultation system is available at the University of Pittsburgh Medical Center (UPMC) which links four outlying hospitals in Western Pennsylvania and Eastern Ohio. This system has the potential to improve short and long term clinical outcomes and to reduce overall medical care cost by establishing improved emergency triage capability. An EMED, Inc. teleradiology system permits rapid, high-quality transfer of digitized film and CT images from the remote sites to the tertiary care center (UPMC). The images are sent over dial-on- demand ISDN and SW56 lines from the remote hospitals to a central server where they are transmitted to a dual 2K monitor workstation in the Emergency Department, thirteen Eastman Kodak PDS workstations within UPMC, and to three physician homes. Transmission to a workstation at each of the physician homes over ISDN lines enables `after hours' consultation. The radiographic images along with voice and fax communications provide a technique where physicians in outlying hospitals will be able to consult with specialists at any time. A study is in progress to evaluate the effectiveness of this system in terms of perception of utility and its potential to improve emergency triage capability, as well as selection of the appropriate transportation mode (helicopter versus ambulance).

  4. Bridging Theory and Practice: A Conceptual Framework for Consulting Organisations

    Science.gov (United States)

    Mohammed, Meca B.; Welch, Jennie; Hazle Bussey, Leslie

    2015-01-01

    A growing number of organisations are emerging as partners to districts pursuing systemic improvement. Given the critical role a consulting organisation could play in supporting system reform efforts, how does a district leader looking to establish a consulting partnership determine what characteristics in a consulting organisation may be more…

  5. 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…

  6. Bridging Theory and Practice: A Conceptual Framework for Consulting Organisations

    Science.gov (United States)

    Mohammed, Meca B.; Welch, Jennie; Hazle Bussey, Leslie

    2015-01-01

    A growing number of organisations are emerging as partners to districts pursuing systemic improvement. Given the critical role a consulting organisation could play in supporting system reform efforts, how does a district leader looking to establish a consulting partnership determine what characteristics in a consulting organisation may be more…

  7. Teaching Evaluation: A Student-Run Consulting Firm

    Science.gov (United States)

    Cundiff, Nicole; Nadler, Joel; Scribner, Shauna

    2011-01-01

    Applied Research Consultants (ARC) is a graduate student run consulting firm that provides experience to students in evaluation and consultation. An overview of this program has been compiled in order to serve as a model of a graduate training practicum that could be applied to similar programs or aid in the development of such programs. Key…

  8. 5 CFR 2426.13 - Obligation to consult.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Obligation to consult. 2426.13 Section 2426.13 Administrative Personnel FEDERAL LABOR RELATIONS AUTHORITY, GENERAL COUNSEL OF THE FEDERAL... Regulations § 2426.13 Obligation to consult. (a) When a labor organization has been accorded consultation...

  9. 5 CFR 2426.3 - Obligation to consult.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Obligation to consult. 2426.3 Section 2426.3 Administrative Personnel FEDERAL LABOR RELATIONS AUTHORITY, GENERAL COUNSEL OF THE FEDERAL LABOR... GOVERNMENT-WIDE RULES OR REGULATIONS National Consultation Rights § 2426.3 Obligation to consult. (a) When a...

  10. 29 CFR 779.515 - Regulations should be consulted.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Regulations should be consulted. 779.515 Section 779.515... Records to Be Kept by Employers § 779.515 Regulations should be consulted. This discussion in subpart F of... employer subject to any provision of the Act should consult the regulations to determine what records he...

  11. 15 CFR 200.103 - Consulting and advisory services.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Consulting and advisory services. 200..., SERVICES, PROCEDURES, AND FEES § 200.103 Consulting and advisory services. (a) In areas of its special competence, NIST offers consulting and advisory services on various problems related to measurement, e.g...

  12. 45 CFR 400.57 - Planning and consultation process.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 2 2010-10-01 2010-10-01 false Planning and consultation process. 400.57 Section... Refugee Cash Assistance § 400.57 Planning and consultation process. A State that wishes to establish a public/private RCA program must engage in a planning and consultation process with the local agencies...

  13. Multicultural Counseling Competence Training: Adding Value with Multicultural Consultation

    Science.gov (United States)

    Jones, Janine M.; Kawena Begay, Kristin; Nakagawa, Yoko; Cevasco, Molly; Sit, Janelle

    2016-01-01

    This study addresses the culturally responsive training process and highlights the integration of multicultural competence building in counseling consultation. Consultation was structured as client-centered case consultation. Before and after the intervention, clinician competence was assessed with the California Brief Multicultural Counseling…

  14. Multicultural Counseling Competence Training: Adding Value with Multicultural Consultation

    Science.gov (United States)

    Jones, Janine M.; Kawena Begay, Kristin; Nakagawa, Yoko; Cevasco, Molly; Sit, Janelle

    2016-01-01

    This study addresses the culturally responsive training process and highlights the integration of multicultural competence building in counseling consultation. Consultation was structured as client-centered case consultation. Before and after the intervention, clinician competence was assessed with the California Brief Multicultural Counseling…

  15. A Rational-Emotive Therapy Approach to Consultation

    Science.gov (United States)

    Forman, Susan G.; Forman, Bruce D.

    1978-01-01

    The application of Rational-Emotive Therapy in the practice of consultee-centered consultation is discussed. The consultant's task is to identify those irrational beliefs which are impeding consultee job-effectiveness and to help modify these beliefs. Several common consultation problems and techniques for their management are presented. (Author)

  16. 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.

  17. The Development of Behaviorally Based Public School Consultation Services

    Science.gov (United States)

    Putnam, Robert F.; Handler, Marcie W.; Rey, Jannette; McCarty, Joseph

    2005-01-01

    This article describes the development of behavioral school care consultation services to public schools within a not-for-profit community behavioral health organization. An overview of the process of behavior consultation is presented. A description of the growth of behavioral school consultation services is outlined in regard to (a) the types of…

  18. Psychiatric outpatient consultation for seniors. Perspectives of family physicians, consultants, and patients / family: A descriptive study

    Directory of Open Access Journals (Sweden)

    Dendukuri Nandini

    2005-04-01

    Full Text Available Abstract Background Family practitioners take care of large numbers of seniors with increasingly complex mental health problems. Varying levels of input may be necessary from psychiatric consultants. This study examines patients'/family, family practitioners', and psychiatrists' perceptions of the bi-directional pathway between such primary care doctors and consultants. Methods An 18 month survey was conducted in an out-patient psychogeriatric clinic of a Montreal university-affiliated community hospital. Cognitively intact seniors referred by family practitioners for assessment completed a satisfaction and expectation survey following their visits with the psychiatric consultants. The latter completed a self-administered process of care questionnaire at the end of the visit, while family doctors responded to a similar survey by telephone after the consultants' reports had been received. Responses of the 3 groups were compared. Results 101 seniors, referred from 63 family practitioners, met the study entry criteria for assessment by 1 of 3 psychogeriatricians. Both psychiatrists and family doctors agreed that help with management was the most common reason for referral. Family physicians were accepting of care of elderly with mental health problems, but preferred that the psychiatrists assume the initial treatment; the consultants preferred direct return of the patient; and almost 1/2 of patients did not know what to expect from the consultation visit. The rates of discordance in expectations were high when each unique patient-family doctor-psychiatrist triad was examined. Conclusion Gaps in expectations exist amongst family doctors, psychiatrists, and patients/family in the shared mental health care of seniors. Goals and anticipated outcomes of psychogeriatric consultation require better definition.

  19. 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.

  20. Child Care Reform Consultation Infopack = Consultation sur la reforme des services de garde d'enfants. Trousse d'information.

    Science.gov (United States)

    Ontario Ministry of Community and Social Services, Toronto.

    This information packet presented here in both the English and French language versions, summarizes the results of a public consultation on the subject of child care reform in Ontario, Canada. The packet consists of: (1) a table that describes the six modes of consultation that were used in the consultation process (public meetings, round table…

  1. Consultation needs in perinatal HIV care: experience of the National Perinatal HIV Consultation Service.

    Science.gov (United States)

    Fogler, Jessica A; Weber, Shannon; Goldschmidt, Ronald H; Mahoney, Megan R; Cohan, Deborah

    2007-09-01

    This study evaluates the consultation needs of clinicians who provide perinatal human immunodeficiency virus (HIV) care in the United States. The Perinatal Hotline (1-888-448-8765) is a telephone consultation service for providers who treat HIV-infected pregnant women and their infants. Hotline calls were analyzed for demographics about callers and their patients and information about consultation topics. There were 430 calls to the hotline from January 1, 2005, through June 30, 2006. Most calls (59.5%) were related to pregnant patients; 5.1% of the calls pertained to women currently in labor. The most common topic was HIV care in pregnancy (49.1%), particularly antiretroviral drug use (42.1%). HIV testing was discussed in 21.9%, and intrapartum treatment was discussed in 24.0%. Callers most often requested help choosing antiretroviral drug regimens; many of the discussions were about drug toxicities and viral resistance. Although the hotline received few calls about women in labor, the need for these consultations is expected to increase with the expanding use of rapid HIV testing. Access to 24-hour consultation can help ensure that state-of-the-art care is provided.

  2. [Tips for hosting a medical student in a PC consultation].

    Science.gov (United States)

    Félix, Sylvie; Bonvin, Raphaël; Bischoff, Thomas

    2010-05-19

    Hosting a medical student in one's primary care consultation challenges the practitioner to be a clinical teacher as well as providing high-quality patient care. A few tips can make this double task easier. Before the consultation it is possible to define the student's learning objectives and to plan the consultation. During the consultation itself some teaching models exist (One minute preceptor, SNAPP) that facilitate the teaching by maximising the teaching moments for each student-patient encounter. And finally after the consultation a time of reflection where both student and clinical teacher can think about what went well and what could be done better.

  3. 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.

  4. SOME REFLECTIONS UPON MANAGEMENT CONSULTING AS PROFESSIONAL SERVICES

    Directory of Open Access Journals (Sweden)

    Botezat Elena

    2008-05-01

    Full Text Available 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 other services of the firms. The study is based on an office documentation research within consulting firms and resources. The approach tries to be critical and reflective, examines different consulting roles by developing a typology. The purpose is to aware of these professional services young business people. The FAQ of this service are: “How to choose the best consultant?” and “Why did fail consultant?”.

  5. Palliative treatment alternatives and euthanasia consultations: a qualitative interview study.

    Science.gov (United States)

    Buiting, Hilde M; Willems, Dick L; Pasman, H Roeline W; Rurup, Mette L; Onwuteaka-Philipsen, Bregje D

    2011-07-01

    There is much debate about euthanasia within the context of palliative care. The six criteria of careful practice for lawful euthanasia in The Netherlands aim to safeguard the euthanasia practice against abuse and a disregard of palliative treatment alternatives. Those criteria need to be evaluated by the treating physician as well as an independent euthanasia consultant. To investigate 1) whether and how palliative treatment alternatives come up during or preceding euthanasia consultations and 2) how the availability of possible palliative treatment alternatives are assessed by the independent consultant. We interviewed 14 euthanasia consultants and 12 physicians who had requested a euthanasia consultation. We transcribed and analyzed the interviews and held consensus meetings about the interpretation. Treating physicians generally discuss the whole range of treatment options with the patient before the euthanasia consultation. Consultants actively start thinking about and proposing palliative treatment alternatives after consultations, when they have concluded that the criteria for careful practice have not been met. During the consultation, they take into account various aspects while assessing the criterion concerning the availability of reasonable alternatives, and they clearly distinguish between euthanasia and continuous deep sedation. Most consultants said that it was necessary to verify which forms of palliative care had previously been discussed. Advice concerning palliative care seemed to be related to the timing of the consultation ("early" or "late"). Euthanasia consultants were sometimes unsure whether or not to advise about palliative care, considering it not their task or inappropriate in view of the previous discussions. Two different roles of a euthanasia consultant were identified: a limited one, restricted to the evaluation of the criteria for careful practice, and a broad one, extended to actively providing advice about palliative care. Further

  6. Risk communication in the clinical consultation.

    Science.gov (United States)

    Thomson, Richard; Edwards, Adrian; Grey, Jenny

    2005-01-01

    Modern healthcare and modern societies are facing up to the need for greater engagement of patients in treatment decisions. Shared and informed decision-making is replacing traditional paternalistic approaches to decisions; health policy both reflects and drives these changes. A critical contribution to better informed decisions by patients is the effective communication of risk in the clinical consultation. This is not straightforward, but there is a growing evidence base to improve performance in this area to the benefit of both patients and clinicians. The purpose of this review is to provide an accessible and practical guide to better communication of risk by clinicians.

  7. Pharmaceutical consultation in UAE community pharmacies

    Directory of Open Access Journals (Sweden)

    N M Hamoudi

    2011-01-01

    Full Text Available In recent years, the focus of pharmacists as traditional drug dispensers has shifted to more active and participative role in risk assessment, risk management, and other medication related consultation activities. Pharmacy profession is evolving steadily in the United Arab Emirates (UAE. Pharmacists in UAE are so much occupied in their administrative and managerial duties that dispensing is mostly attended to by pharmacy technicians. Pharmacist-led patient counseling is limited to the dosage and frequency of medications and rarely adverse reactions and drug interactions with other medications. Therefore we decided to perform quantitative questionnaires study to explore the role of pharmacist in patient counseling in UAE, the evaluation of pharmacist′s opinion on patient counseling and the potential determinants of personal consultation. Results show the frequency and nature of inquiries received by pharmacist. Five to twenty inquires per month are received from patient, most of them related to drug prescription and dose recommendation. Thirty nine percent of pharmacists received inquiries from doctors, most of them related to the dose and mode of action. Ninty two percent of the pharmacists agreed that patient counseling is their professional responsibility. About 82% of pharmacists agreed that counseling will increase their sales and enhance the reputation of their pharmacies. Seventy percent of pharmacists mentioned that they need to undergo training for effective counseling while 46% of pharmacists felt that more staff in the pharmacies would have a positive influence on patient compliance to medication therapies and patient safety. The potential determinants of personal consultation show that 52% of participants trusted pharmacist and 55% considered the pharmacist as a friend. Forty eight percent of participants visited the pharmacy for medical recommendation while 30% for drug compounding, 72% agreed that pharmacist conducts full

  8. 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.

  9. Pharmaceutical Consultation in UAE Community Pharmacies.

    Science.gov (United States)

    Hamoudi, N M; Shirwaikar, A A; Ali, H S; Al Ayoubi, E I

    2011-07-01

    In recent years, the focus of pharmacists as traditional drug dispensers has shifted to more active and participative role in risk assessment, risk management, and other medication related consultation activities. Pharmacy profession is evolving steadily in the United Arab Emirates (UAE). Pharmacists in UAE are so much occupied in their administrative and managerial duties that dispensing is mostly attended to by pharmacy technicians. Pharmacist-led patient counseling is limited to the dosage and frequency of medications and rarely adverse reactions and drug interactions with other medications. Therefore we decided to perform quantitative questionnaires study to explore the role of pharmacist in patient counseling in UAE, the evaluation of pharmacist's opinion on patient counseling and the potential determinants of personal consultation. Results show the frequency and nature of inquiries received by pharmacist. Five to twenty inquires per month are received from patient, most of them related to drug prescription and dose recommendation. Thirty nine percent of pharmacists received inquiries from doctors, most of them related to the dose and mode of action. Ninty two percent of the pharmacists agreed that patient counseling is their professional responsibility. About 82% of pharmacists agreed that counseling will increase their sales and enhance the reputation of their pharmacies. Seventy percent of pharmacists mentioned that they need to undergo training for effective counseling while 46% of pharmacists felt that more staff in the pharmacies would have a positive influence on patient compliance to medication therapies and patient safety. The potential determinants of personal consultation show that 52% of participants trusted pharmacist and 55% considered the pharmacist as a friend. Forty eight percent of participants visited the pharmacy for medical recommendation while 30% for drug compounding, 72% agreed that pharmacist conducts full instruction while 31% agreed

  10. 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

  11. 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.

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

    Science.gov (United States)

    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. PMID:28096715

  13. 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.

  14. Outreach surgical consulting services in North East Victoria.

    Science.gov (United States)

    Chittleborough, Timothy John; Lourensz, Kaleb; Elliott, Matthew; Thomas, Peter; Franzi, Stephen

    2013-12-01

    There is a paucity of data regarding the provision of consultative outreach specialist surgical services to rural areas. This paper aims to describe a model of outreach consultative practice to deliver specialist surgical services to rural communities. Analysis of prospectively collected data for consultations in a three month period for two surgeons based in Wangaratta. Two surgeons in regional Victoria based in Wangaratta, North East Victoria, conducting outreach consultations to Beechworth, Benalla, Bright and Mansfield. All patients seen in consultations over a 3-month period. Patient workload, casemix of presenting complaint, consultation outcome including plan for surgical procedure. Outreach surgical consulting was associated with a higher proportion of new consultations, and there was trend towards being more likely to result in a surgical procedure than consultations in the base rural centre. Outreach surgical consulting provides surgeons with a larger referral base and provides communities with better access to local specialists. Outreach practice should be encouraged for surgeons in regional centres. © 2013 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.

  15. 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.

  16. Interpersonal Consulting Skills for Instructional Technology Consultants: A Multiple Case Study

    Science.gov (United States)

    van Leusen, Peter; Ottenbreit-Lefwich, Anne T.; Brush, Thomas

    2016-01-01

    Building a trust-based relationship with faculty is one of the most important attributes of effective Instructional Technology Consultants (ITC) in order to integrate emerging technologies into higher education. Utilizing a multiple case study research design, four experienced ITCs at a large urban research university located in the Midwest showed…

  17. The "Consulting-Your-Consultants Interview": A Final Narrative Conversation with Graduating Family Therapy Masters' Students.

    Science.gov (United States)

    Keiley, Margaret K.; Piercy, Fred P.

    1999-01-01

    Discusses a Master's program exit interview that used questions from narrative therapy to celebrate the transition of Masters students into the world of marital and family therapy professionals. This process helps to underling students' agency and competence, and elevates them to the level of consultant during the interview. (Author/MKA)

  18. Interpersonal Consulting Skills for Instructional Technology Consultants: A Multiple Case Study

    Science.gov (United States)

    van Leusen, Peter; Ottenbreit-Lefwich, Anne T.; Brush, Thomas

    2016-01-01

    Building a trust-based relationship with faculty is one of the most important attributes of effective Instructional Technology Consultants (ITC) in order to integrate emerging technologies into higher education. Utilizing a multiple case study research design, four experienced ITCs at a large urban research university located in the Midwest showed…

  19. 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

  20. Veteran, Primary Care Provider, and Specialist Satisfaction With Electronic Consultation

    OpenAIRE

    2015-01-01

    Background Access to specialty care is challenging for veterans in rural locations. To address this challenge, in December 2009, the Veterans Affairs (VA) Pittsburgh Healthcare System (VAPHS) implemented an electronic consultation (e-consult) program to provide primary care providers (PCPs) and patients with enhanced specialty care access. Objective The aim of this quality improvement (QI) project evaluation was to: (1) assess satisfaction with the e-consult process, and (2) identify perceive...

  1. The nursing consultation to the carriers of hypertension: the practice

    OpenAIRE

    Francisca Bertilia Chaves Costa; Thelma Leite de Araújo

    2012-01-01

    The aim of this study was to investigate, in a specific group formed by nurses belonging to the teams of the Family Health Program of Ceará, the practice of the nursing consultation to the people with arterial hypertension. This study was characterized as exploratory-descriptive, developed from 2004 to 2005 with 17 nursing consultations professional promoters to assist the mentioned patients. Some topics inserted in the stages of the nursing consultation were described by the participants of ...

  2. Nursing consultation to the user with hypertension in primary attention

    OpenAIRE

    Gilvan Ferreira Felipe; Thereza Maria Magalhães Moreira; Lúcia de Fátima da Silva; Andressa Suelly Saturnino de Oliveira

    2012-01-01

    In primary care, the nursing care for hypertensive patients can be provided during the nursing consultation. The main aim of this research was to examine the activities developed by nurses during the nursing consultation for hypertensive patients followed in primary care. This descriptive study, developed in three Family Health Centers of the Regional IV Executive Secretary in Fortaleza, through monitoring of 39 consultations and completion of a checklist. It was found out that the consultati...

  3. Why are junior doctors reluctant to consult attending physicians?

    Science.gov (United States)

    Swank, Otto H

    2010-03-01

    A physician performs two tasks: making diagnoses and determining treatments. To reduce medical error, junior doctors are supposed to consult their supervisors when they face uncommon circumstances. However, recent research shows that junior doctors are reluctant to do so. This paper presents a model that explains (i) which junior doctors shy away from consulting; (ii) when junior doctors are reluctant; (iii) the importance of protocols in the medical sector; and (iv) when consulting is a sign of strength or a sign of weakness. Furthermore, I show that encouraging junior doctors to consult by investigating mishaps leads to another distortion: they will give too much weight to own assessments.

  4. Surgical consultation and intervention during pediatric hematopoietic stem cell transplantation.

    Science.gov (United States)

    Madenci, Arin L; Lehmann, Leslie E; Weldon, Christopher B

    2014-12-01

    Children undergoing HSCT are at risk for complications due to immune system impairment, toxicity from prior therapies and conditioning regimens, and long-term use of indwelling catheters. These problems may require assessment by the surgical team. We sought to characterize the role of surgical consultation during primary hospital stay for HSCT. We retrospectively reviewed the records of consecutive patients undergoing HSCT between September 2010 and September 2012. One hundred and seventy-three patients underwent 189 HSCTs. General surgery consultations occurred during 33% (n = 62) of primary hospitalizations for HSCT, with a total of 85 consults. Sixty-three (73%) consults resulted in an intervention in the operating room or at the bedside. The majority of consults were for CVL issues (59%, n = 50), followed by abdominal complaints (16%, n = 14). Patients requiring surgical consultation had significantly higher in-hospital mortality (16% vs. 2%, p consultation. Patients undergoing HSCT often require surgical consultation, most commonly for line-related issues. Surgical consultation heralded an increased risk of in-hospital and 100-day TRM. Issues among this high-risk cohort of children who have undergone HSCT must be familiar to the general surgeon and oncologist alike. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Community nurses and their collaboration with clinical nurse consultants.

    Science.gov (United States)

    Jannings, W; Maynard, C

    A survey was undertaken of 129 community nurses who had chosen to utilise a clinical nurse consultant for education and/or patient care at home. Accessibility, efficiency, usefulness of the consultation and the educative role of the clinical nurse consultant were examined. The responses indicated that the community nurses had positive perceptions regarding their collaboration with the clinical nurse consultants. It is recommended that an objective tool be developed to demonstrate the effectiveness of the collaboration, for data collection purposes, when measuring patient outcomes and evaluating specialist resources.

  6. Asynchronous Remote Medical Consultation for Ghana

    CERN Document Server

    Luk, Rowena; Aoki, Paul M

    2008-01-01

    Computer-mediated communication systems can be used to bridge the gap between doctors in underserved regions with local shortages of medical expertise and medical specialists worldwide. To this end, we describe the design of a prototype remote consultation system intended to provide the social, institutional and infrastructural context for sustained, self-organizing growth of a globally-distributed Ghanaian medical community. The design is grounded in an iterative design process that included two rounds of extended design fieldwork throughout Ghana and draws on three key design principles (social networks as a framework on which to build incentives within a self-organizing network; optional and incremental integration with existing referral mechanisms; and a weakly-connected, distributed architecture that allows for a highly interactive, responsive system despite failures in connectivity). We discuss initial experiences from an ongoing trial deployment in southern Ghana.

  7. 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.

  8. 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.

  9. 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.

  10. [ICD diagnoses in university polyclinic naturopathy consultation].

    Science.gov (United States)

    Hentschel, C; Lindner, M; Brinkhaus, B; Nagel, M R; Hahn, E G; Kohnen, R

    1996-08-01

    In a special consulting office for complementary medicine, ambulatory patients interested in receiving adjuvant treatment with complementary medicine can obtain a relevant advice and critical information regarding non-evaluated therapies. Within the framework of a retrospective statistical analysis, the diagnosis documented over a period of 24 months in accordance with the 4-digit ICD code were evaluated. In particular patients with chronic and/or functional illnesses had additional treatment needs. The exponential growth in the numbers of patients during the course of the observation period illustrates the increasing importance of complementary medical measures. However, in view of the considerable political significance of the cost factor and the possible risks of the treatment, only properly evaluated complementary medical therapies should be employed.

  11. Consulting Communities When Patients Cannot Consent: A Multi-Center Study of Community Consultation for Research in Emergency Settings

    Science.gov (United States)

    Dickert, Neal W; Mah, Victoria A; Biros, Michelle H; Harney, Deneil M; Silbergleit, Robert; Sugarman, Jeremy; Veledar, Emir; Weinfurt, Kevin P; Wright, David W; Pentz, Rebecca D

    2013-01-01

    Objective To assess the range of responses to community consultation efforts conducted within a large network and the impact of different consultation methods on acceptance of exception from informed consent (EFIC) research and understanding of the proposed study. Design A cognitively pre-tested survey instrument was administered to 2,612 community consultation participants at 12 US centers participating in a multi-center trial of treatment for acute traumatic brain injury (TBI). Setting Survey nested within community consultation for a Phase III, randomized controlled trial of treatment for acute TBI conducted within a multi-center trial network and using EFIC. Subjects Adult participants in community consultation events. Interventions Community consultation efforts at participating sites. Measurements and Main Results Acceptance of EFIC in general, attitude toward personal EFIC enrollment, and understanding of the study content were assessed. 54% of participants agreed EFIC was acceptable in the proposed study; 71% were accepting of personal EFIC enrollment. Participants in interactive versus non-interactive community consultation events were more accepting of EFIC in general (63% vs. 49%) and personal EFIC inclusion (77% vs. 67%). Interactive community consultation participants had high-level recall of study content significantly more often than non-interactive consultation participants (77% vs. 67%). Participants of interactive consultation were more likely to recall possible study benefits (61% vs. 45%) but less likely to recall potential risks (56% vs. 69%). Conclusions Interactive community consultation methods were associated with increased acceptance of EFIC and greater overall recall of study information but lower recall of risks. There was also significant variability in EFIC acceptance among different interactive consultation events. These findings have important implications for IRBs and investigators conducting EFIC research and for community

  12. Consulting communities when patients cannot consent: a multicenter study of community consultation for research in emergency settings.

    Science.gov (United States)

    Dickert, Neal W; Mah, Victoria A; Biros, Michelle H; Harney, Deneil M; Silbergleit, Robert; Sugarman, Jeremy; Veledar, Emir; Weinfurt, Kevin P; Wright, David W; Pentz, Rebecca D

    2014-02-01

    To assess the range of responses to community consultation efforts conducted within a large network and the impact of different consultation methods on acceptance of exception from informed consent research and understanding of the proposed study. A cognitively pretested survey instrument was administered to 2,612 community consultation participants at 12 U.S. centers participating in a multicenter trial of treatment for acute traumatic brain injury. Survey nested within community consultation for a phase III randomized controlled trial of treatment for acute traumatic brain injury conducted within a multicenter trial network and using exception from informed consent. Adult participants in community consultation events. Community consultation efforts at participating sites. Acceptance of exception from informed consent in general, attitude toward personal exception from informed consent enrollment, and understanding of the study content were assessed. Fifty-four percent of participants agreed exception from informed consent enrollment was acceptable in general in the proposed study; 71% were accepting of personal exception from informed consent enrollment. Participants in interactive versus noninteractive community consultation events were more accepting of exception from informed consent in general (63% vs 49%) and personal exception from informed consent inclusion (77% vs 67%). Interactive community consultation participants had high-level recall of study content significantly more often than noninteractive consultation participants (77% vs 67%). Participants of interactive consultation were more likely to recall possible study benefits (61% vs 45%) but less likely to recall potential risks (56% vs 69%). Interactive community consultation methods were associated with increased acceptance of exception from informed consent and greater overall recall of study information but lower recall of risks. There was also significant variability in exception from informed

  13. How head and neck consultants manage patients' emotional distress during cancer follow-up consultations: a multilevel study.

    Science.gov (United States)

    Zhou, Yuefang; Humphris, Gerry; Ghazali, Naseem; Friderichs, Simon; Grosset, David; Rogers, Simon N

    2015-09-01

    Head and neck cancer (HNC) patients suffer substantial emotional problems. This study aimed to explore how utterance-level variables (source, type and timing of emotional cues) and patient-level variables (e.g. age, gender and emotional well-being) relate to consultants' responses (i.e. reducing or providing space) to patient expressions of emotional distress. Forty-three HNC outpatient follow-up consultations were audio recorded and coded, for patients' expressions of emotional distress and consultants' responses, using the Verona Coding Definitions of Emotional Sequence. Multilevel logistic regression modelled the probability of the occurrence of consultant-reduced space response as a function of patient distress cue expression, controlling for consultation and patient-related variables. An average of 3.5 cues/concerns (range 1-20) was identified per consultation where 84 out of 152 total cues/concerns were responded by reducing space. Cue type did not impact on response; likewise for the quality of patient emotional well-being. However, consultants were more likely to reduce space to cues elicited by patients, as opposed to those initiated by themselves. This reduced space response was more pronounced as the consultation continued. However, about 6 min into the consultation, this effect (i.e. tendency to block patients) started to weaken. Head and neck consultants' responses to negative emotions depended on source and timing of patient emotional expressions. The findings are useful for training programme development to encourage consultants to be more flexible and open in the early stages of the consultation.

  14. 45 CFR 98.12 - Coordination and consultation.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Coordination and consultation. 98.12 Section 98.12 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND General Application Procedures § 98.12 Coordination and consultation. The Lead Agency shall:...

  15. Effects of a nurse practitioner on a multidisciplinary consultation team

    NARCIS (Netherlands)

    van der Sluis, Corry K.; Datema, Linetta; Saan, Ingrid; Stant, Dennis; Dijkstra, Pieter U.

    2009-01-01

    Effects of a nurse practitioner on a multidisciplinary consultation team. This paper is a report of a study to evaluate the impact on office hours capacity, patient satisfaction, quality of life and costs of including a nurse practitioner in a multidisciplinary consultation team for patients with ha

  16. 48 CFR 3437.270 - Consulting services reporting clause.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Consulting services reporting clause. 3437.270 Section 3437.270 Federal Acquisition Regulations System DEPARTMENT OF EDUCATION ACQUISITION REGULATION SPECIAL CATEGORIES OF CONTRACTING SERVICE CONTRACTING Consulting Services...

  17. 48 CFR 1552.211-78 - Management consulting services.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Management consulting services. 1552.211-78 Section 1552.211-78 Federal Acquisition Regulations System ENVIRONMENTAL PROTECTION... 1552.211-78 Management consulting services. As prescribed in 1511.011-78, insert the following...

  18. 48 CFR 3437.271 - Services of consultants clause.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Services of consultants clause. 3437.271 Section 3437.271 Federal Acquisition Regulations System DEPARTMENT OF EDUCATION ACQUISITION REGULATION SPECIAL CATEGORIES OF CONTRACTING SERVICE CONTRACTING Consulting Services...

  19. Structural Damage Prediction and Analysis for Hypervelocity Impact: Consulting

    Science.gov (United States)

    1995-01-01

    A portion of the contract NAS8-38856, 'Structural Damage Prediction and Analysis for Hypervelocity Impacts,' from NASA Marshall Space Flight Center (MSFC), included consulting which was to be documented in the final report. This attachment to the final report contains memos produced as part of that consulting.

  20. The social identity of hospital consultants as managers.

    Science.gov (United States)

    Russell, Vincent; Wyness, Laura A; McAuliffe, Eilish; Fellenz, Martin

    2010-01-01

    This paper aims to explore hospital consultants' social identification, in terms of perceptions of their position in society, the salient targets for their social identification and how this appears to influence their perceptions of management activities and change. A purposeful sample of 15 hospital consultants from a wide range of specialities and work locations in Ireland were recruited. Semi-structured, in-depth interviews were undertaken and thematic analysis was used to interpret the interview data. The paper finds that all interviewees perceived public attitudes towards hospital consultants, as a group, to be negative. Twelve interviewees derived most sense of belonging from group membership within their immediate work area. These groups seemed to represent sources of validation and esteem and enabled consultants to exercise control over their work. Many consultants, however, described a sense of detachment from their employing health boards. Management, as a salient target for social group identification, was perceived as associated with powerlessness and lack of respect. Interviewees generally viewed involvement in management with little enthusiasm and considerable caution. This paper shows that management approaches to hospital consultants could benefit from awareness that their social identity may already be under threat. Assaults on core professional values in the communication surrounding change are likely to provoke resistance. Existing work groups, with which consultants identify, could serve as a less threatening means to engage them with issues of cost and quality than externally imposed structures. This paper informs ways in which hospital consultants could be more successfully involved in health service management.

  1. 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.

  2. A Fish out of Water? Management Consultants in Academia

    Science.gov (United States)

    Serrano-Velarde, Kathia

    2010-01-01

    What happens when management consultants enter the academic arena and offer their services to universities? In the following article, we examine this question by drawing on findings from a qualitative study based on a series of 30 interviews with senior management consultants and academic managers in Germany. The aim of this explorative study is,…

  3. 76 FR 81527 - Notice of Tribal Consultations; Schedule Update

    Science.gov (United States)

    2011-12-28

    ... From the Federal Register Online via the Government Publishing Office NATIONAL INDIAN GAMING COMMISSION Notice of Tribal Consultations; Schedule Update AGENCY: National Indian Gaming Commission. ACTION: Notice of tribal consultations; schedule update. Authority: E.O. 13175. SUMMARY: On November 18,...

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

    DEFF Research Database (Denmark)

    Rasmussen, Anne

    2015-01-01

    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...

  5. Consultation in Bullying Prevention: An Elementary School Case Study

    Science.gov (United States)

    Morrow, Michael T.; Hooker, Steven D.; Cate, Rebecca Lynne

    2015-01-01

    This manuscript outlines a consultation with a public elementary school that was aimed at assessing and strengthening the school's antibullying programs. We gathered consultation data through interviews and observations and also reviewed existing program evaluation data. We evaluated these data in light of current research on bullying prevention…

  6. Reliability of consultation skills assessments using standardised versus real patients.

    NARCIS (Netherlands)

    Reinders, M.E.; Blankenstein, A.H.; Marwijk, H.W.J. van; Knol, D.L.; Ram, P.; Horst, H.E. van der; Vet, H.C. de; Vleuten, C.P.M. van der

    2011-01-01

    OBJECTIVES: Training in and assessment of consultation skills are high on the agenda of vocational training institutes for postgraduate training. There is a need to establish valid and reliable instruments to assess consultation skills in authentic settings. We investigated the number of assessors a

  7. 22 CFR 61.6 - Consultation with subject matter specialists.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Consultation with subject matter specialists... FREE FLOW OF AUDIO-VISUAL MATERIALS § 61.6 Consultation with subject matter specialists. (a) The Department may, in its discretion, solicit the opinion of subject matter specialists for the purpose...

  8. 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…

  9. A Model for Psychiatric Consultation in Systemic Therapy.

    Science.gov (United States)

    Griffith, James L.; And Others

    1991-01-01

    Discusses metaphors used to describe problems when family therapy and psychopharmacology are employed together. Identifies coupling metaphors that support both therapies as valid treatments and exclusionary metaphors that invalidate one approach. Presents consultation model for psychiatrists consulting to family therapists wherein the psychiatrist…

  10. A Grounded Theory Study of Supervision of Preservice Consultation Training

    Science.gov (United States)

    Newman, Daniel S.

    2012-01-01

    The purpose of this study was to explore a university-based supervision process for consultants-in-training (CITs) engaged in a preservice level consultation course with applied practicum experience. The study was approached from a constructivist worldview using a grounded theory methodology. Data consisted of supervision session transcripts,…

  11. Colonial connections and consulting engineers 1850-1914

    DEFF Research Database (Denmark)

    Andersen, Casper

    2011-01-01

    The paper analyses colonial connections and networks of British consulting engineers. It unravels how consulting engineers operated within different imperial contexts, including settler colonies, Egypt and Crown colonies in West Africa in particular. The paper also examines the close and at times...

  12. Characteristics of children consulting for cough, sore throat, or earache

    NARCIS (Netherlands)

    J.H.J.M. Uijen (Hans); H.J. van Duijn (Huug); M.M. Kuyvenhoven (Marijke); F.G. Schellevis (François); J.C. van der Wouden (Hans)

    2008-01-01

    textabstractAbstract BACKGROUND: GPs are often consulted for respiratory tract symptoms in children. AIM: To explore characteristics of children, their parents, and their GPs that are correlated with consulting a GP for cough, sore throat, or earache. DESIGN OF STUDY: Second Dutch National Survey o

  13. Characteristics of children consulting for cough, sore throat, or earache.

    NARCIS (Netherlands)

    Uijen, H.J.M.; Duijn, H.J. van; Kuyvenhoven, M.M.; Schellevis, F.G.; Wouden, J.C. van der

    2008-01-01

    BACKGROUND: GPs are often consulted for respiratory tract symptoms in children. AIM: To explore characteristics of children, their parents, and their GPs that are correlated with consulting a GP for cough, sore throat, or earache. DESIGN OF STUDY: Second Dutch National Survey of General Practice (DN

  14. Characteristics of children consulting for cough, sore throat, or earache

    NARCIS (Netherlands)

    Uijen, Johannes H. J. M.; van Duijn, Huug J.; Kuyvenhoven, Marijke M.; Schellevis, Francois G.; van der Wouden, Johannes C.

    2008-01-01

    Background GPs are often consulted for respiratory tract symptoms in children. Aim To explore characteristics of children, their parents, and their GPs that are correlated with consulting a GP for cough, sore throat, or earache. Design of study Second Dutch National Survey of General Practice (DNSGP

  15. Effects of a nurse practitioner on a multidisciplinary consultation team

    NARCIS (Netherlands)

    van der Sluis, Corry K.; Datema, Linetta; Saan, Ingrid; Stant, Dennis; Dijkstra, Pieter U.

    2009-01-01

    Effects of a nurse practitioner on a multidisciplinary consultation team. This paper is a report of a study to evaluate the impact on office hours capacity, patient satisfaction, quality of life and costs of including a nurse practitioner in a multidisciplinary consultation team for patients with ha

  16. Development of a teledermatopathology consultation system using virtual slides

    Directory of Open Access Journals (Sweden)

    Nakayama Ikunori

    2012-12-01

    Full Text Available Abstract Background An online consultation system using virtual slides (whole slide images; WSI has been developed for pathological diagnosis, and could help compensate for the shortage of pathologists, especially in the field of dermatopathology and in other fields dealing with difficult cases. This study focused on the performance and future potential of the system. Method In our system, histological specimens on slide glasses are digitalized by a virtual slide instrument, converted into web data, and up-loaded to an open server. Using our own purpose-built online system, we then input patient details such as age, gender, affected region, clinical data, past history and other related items. We next select up to ten consultants. Finally we send an e-mail to all consultants simultaneously through a single command. The consultant receives an e-mail containing an ID and password which is used to access the open server and inspect the images and other data associated with the case. The consultant makes a diagnosis, which is sent to us along with comments. Because this was a pilot study, we also conducted several questionnaires with consultants concerning the quality of images, operability, usability, and other issues. Results We solicited consultations for 36 cases, including cases of tumor, and involving one to eight consultants in the field of dermatopathology. No problems were noted concerning the images or the functioning of the system on the sender or receiver sides. The quickest diagnosis was received only 18 minutes after sending our data. This is much faster than in conventional consultation using glass slides. There were no major problems relating to the diagnosis, although there were some minor differences of opinion between consultants. The results of questionnaires answered by many consultants confirmed the usability of this system for pathological consultation. (16 out of 23 consultants. Conclusion We have developed a novel

  17. [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 < 0.05) and males are older than females (58.8 vs. 54.4 years, p < 0.05). For male patients, the psychiatric consultation service is contacted more often in cases of organic disorders, for females in adjustment disorders (p < 0.05). The diagnostic spectrum in psychiatric consultation service is different for males and females with relevance for diagnostic and therapeutic procedures. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Education, consultation, guidance, students, advisor, teacher

    Directory of Open Access Journals (Sweden)

    M Seyedmajidi

    2013-09-01

    Full Text Available Introduction: Student counseling and supervision play an important role to overcome learning problems and to achieve educational goals. The present study is intended to investigate viewpoints of students regarding educational guidance and advice studying at Babol University of Medical Sciences. Methods: In this descriptive cross-sectional survey, viewpoints of 480 students were collected by a questionnaire. The validity and reliability of the questionnaire had been approved before. Data were analyzed using SPSS version 17 software. Chi- square and ANOVA tests were administered. Results: 61.2% of all participants were female and 38.8% were males with mean age of 21.3±4.0. 37.2% of these students lacked sufficient knowledge and information on how to request from their advisors for help and guidance. Half of students (50.3% reported attendance of advisors and holding routine consultation is inappropriate. Advisors made more educational files for females compare to males (P=0.001. No difference observed regarding educational disciplines of the advisors regarding students were dissatisfied with help and guidance received from paramedics and dentistry students in most fields (87.3% and 81.5% respectively. Conclusion: It seems that either student has no sufficient information about tasks of advisors and/or advisors may not do their tasks properly. It is recommended the students to be acquainted with advisors’ tasks upon their entrance into the university. Training classes for new academics would be helpful.

  19. Clinical supervision by consultants in teaching hospitals.

    Science.gov (United States)

    Hore, Craig T; Lancashire, William; Fassett, Robert G

    2009-08-17

    Clinical supervision is a vital part of postgraduate medical education. Without it, trainees may not learn effectively from their experiences; this may lead to acceptance by registrars and junior doctors of lower standards of care. Currently, supervision is provided by consultants to registrars and junior doctors, and by registrars to junior doctors. Evidence suggests that the clinical supervision provided to postgraduate doctors is inadequate. Registrars and juniors doctors have the right to expect supervision in the workplace. Impediments to the provision of clinical supervision include competing demands of hospital service provision on trainees and supervisors, lack of clarity of job descriptions, private versus public commitments of supervisors and lack of interest. Supervisors should be trained in the process of supervision and provided with the time and resources to conduct it. Those being supervised should be provided with clear expectations of the process. We need to create and develop systems, environments and cultures that support high standards of conduct and effective clinical supervision. These systems must ensure the right to supervision, feedback, support, decent working conditions and respect for both trainees and their supervisors.

  20. 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...

  1. Automating radiologist workflow part 1: the digital consultation.

    Science.gov (United States)

    Reiner, Bruce

    2008-10-01

    With the widespread adoption of picture archiving and communication systems and filmless imaging, ubiquitous and instantaneous access to imaging data has resulted in decreased radiologist-clinician consultations. It is therefore imperative that the radiology community develop new communication strategies to improve both the timeliness and the perceived value of the radiology report. One strategy to accomplish this goal is the creation of electronic consultation tools, which can effectively recreate radiologist workflow and the identification of key pathologic findings in an easy-to-use, well-organized, and timely fashion. This would be accomplished by recording radiologist-computer interactions using an electronic auditing tool, storing these interactions in an extensible markup language schema, which can subsequently be played back at a later point in time to recreate the radiologist consultation. This approach has the added benefits of allowing the radiologist to selectively edit content to the needs of different clinician users, index the comprehensive consultation into pathology-specific components, and perform asynchronous bidirectional consultations. This electronic consultation tool would result in the creation of context and user-specific consultation files, which can in turn be integrated with clinical data from electronic medical records.

  2. 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 arra...... interaction between the GP/nurse and the patient, and therefore the GPs/nurses can in some respects experience it as difficult to apply the theoretical guidelines of the new consultation to their daily work with the patients.......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...

  3. The role of consulting psychiatrists for obstetric and gynecologic inpatients.

    Science.gov (United States)

    Lin, Huang-Li; Chou, Hung-Hsueh; Liu, Chia-Yih; Hsu, Shi-Chieh; Hsiao, Mei-Chun; Juang, Yeong-Yuh

    2011-01-01

    The purpose of this study was to investigate the consultation psychiatry service to the Obstetrics and Gynecology Department in a general hospital, focusing on referral patterns and consultation recommendations. A retrospective review of the medical charts and consultation records of obstetric and gynecological patients referred for psychiatric consultation from Dec. 2003 to Nov. 2009 was performed. One hundred and eleven patients were referred during the 6-year period, a psychiatric referral rate of 0.11% among 99,098 obstetric and gynecologic admissions. Obstetric and gynecologic consultations comprised 0.64% of all psychiatric consultations. The most common reasons for referral were depression (52.25%), past psychiatric history (31.53%), insomnia (29.73%) and confusion (24.32%). The most common DSM-IV psychiatric diagnoses were depressive disorder (37.84%), schizophrenia and other psychoses (20.72%), delirium (17.12%) and adjustment disorder (10.81%). The most frequent physical diagnoses of referred patients were neoplasms (72.97%), infectious diseases (42.34%) and complications of pregnancy and puerperium (17.12%). Recommendations included pharmacological intervention (89.19%) and psychological management (72.07%). The psychiatric referral rate of obstetric and gynecological inpatients was relatively low compared with that of other departments. More collaboration and liaison between gynecologists and consultation psychiatrists may provide better care for obstetric and gynecological inpatients.

  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. [Gerontopsychiatric problems in a consultation-liaison practice].

    Science.gov (United States)

    Gazdag, Gábor; Sebestyén, Gábor

    2005-09-01

    The most effective way for the diagnosing and the treatment of psychopathological symptoms appearing in non-psychiatric hospitalized patients is the utilization of consultation-liaison psychiatry. With the increasing number of the elderly patients, number of appearing gerontopsychiatric problems in consultation work is also growing. We have studied among the patients of a consultation-liaison service the problems which led to the psychiatric consultations, the diagnoses which were set up, the concomitant somatic disorders and the treatment recommendations. We have retrospectively studied the data of the patients in the consultation-liaison service of St. László Hospital. 77% of the consultations were asked from internal medicine. Most frequent reason of the requests were the presence of any psychiatric symptom, but unexplained somatic complains were also common. Gerontopsychiatric problems were most frequently associated to cardiovascular disorders. Demencia and delirium were the most frequent diagnoses. The rate of affective disorders was higher than reported in the literature. Consultations were most frequently asked for non-compliance in patients with demencia, and for unexplained somatic complain in affective disorders. Most frequent reason of psychiatric referrals was symptoms of delirium. Authors try to explain these results in accordance with the literature.

  6. Joining the team: ethics consultation at the Cleveland Clinic.

    Science.gov (United States)

    Agich, George J

    2003-12-01

    In this paper, I describe the development of ethics consultation services and their operation at the Cleveland Clinic; my own educational experiences and background and how I came to see the importance of setting and collaboration for successfully doing clinical ethics; the unique culture of the Cleveland Clinic and its influence on the ethics consultation services provided there; and, finally, the place of personal commitments and values on the conduct of ethics consultations. I stress the point that although philosophers (and perhaps other bioethicists without health professions training) are socialized and educated to do solitary work, successfully conducting ethics consultations requires relatively high levels of collaboration and cooperation that have not been sufficiently discussed. Although this paper is more a description than an analysis of the influence of institutional setting on ethics consultation, I would claim that attention to setting, either as the local scene of the consultation or the institutional and social framework, deserves more attention by bioethicists intent on understanding ethics consultation.

  7. Characteristics of children consulting for cough, sore throat, or earache

    Science.gov (United States)

    Uijen, Johannes HJM; van Duijn, Huug J; Kuyvenhoven, Marijke M; Schellevis, François G; van der Wouden, Johannes C

    2008-01-01

    Background GPs are often consulted for respiratory tract symptoms in children. Aim To explore characteristics of children, their parents, and their GPs that are correlated with consulting a GP for cough, sore throat, or earache. Design of study Second Dutch National Survey of General Practice (DNSGP-2) with a health interview and an additional questionnaire. Setting Children aged 0–17 years registered with 122 GPs in Dutch general practice. Method Characteristics of patients and their GPs were derived from the DNSGP-2 health interview and a questionnaire, respectively. Characteristics of the illness symptoms and GP consultation were acquired by means of an additional questionnaire. Data were analysed using multivariate logistic regression. Results Of all children who completed the questionnaire, 550 reported cough, sore throat, or earache in the 2 weeks preceding the interview with 147 of them consulting their GP. Young children more frequently consulted the GP for respiratory symptoms, as did children with fever, longer duration of symptoms, those reporting their health to be ‘poor to good’, and living in an urban area. When parents were worried, and when a child or their parents were cued by someone else, the GP was also consulted more often. GP-related determinants were not associated with GP consultation by children. Conclusion This study emphasises the importance of establishing the reasons behind children with respiratory tract symptoms consulting their GP. When GPs are aware of possible determinants of the decision to consult a GP, more appropriate advice and reassurance can be given regarding these respiratory symptoms, which are generally self-limiting. PMID:18387228

  8. Developing a model osteoarthritis consultation: a Delphi consensus exercise

    Directory of Open Access Journals (Sweden)

    Porcheret Mark

    2013-01-01

    Full Text Available Abstract Background Osteoarthritis (OA is a common condition managed in general practice, but often not in line with published guidance. The ideal consultation for a patient presenting with possible OA is not known. The aim of the study was to develop the content of a model OA consultation for the assessment and treatment of older adults presenting in general practice with peripheral joint problems. Methods A postal Delphi consensus exercise was undertaken with two expert groups: i general practitioners (GPs with expertise in OA management and ii patients with experience of living with OA. An advisory group generated 61 possible consultation tasks for consideration in the consensus exercise. Expert groups were asked to consider which tasks should be included in the model OA consultation. The exercise was completed by 15 GPs and 14 patients. The level of agreement for inclusion in the model was set at 90%. Results The model OA consultation included 25 tasks to be undertaken during the initial consultation between a GP and a patient presenting with peripheral joint pain. The 25 tasks provide detailed advice on how the following elements of the consultation should be addressed: i assessment of chronic joint pain, ii patient’s ideas and concerns, iii exclusion of red flags, iv examination, v provision of the diagnosis and written information, vi promotion of exercise and weight loss, vii initial pain management and viii arranging a follow-up appointment. Both groups prioritised a bio-medical approach to the consultation, rather than a bio-psycho-social one, suggesting a discordance between current thinking and research evidence. Conclusions This study has enabled the priorities of GPs and patients to be identified for a model OA consultation. The results of this consensus study will inform the development of best practice for the management of OA in primary care and the implementation of evidence-based guidelines for OA in primary care.

  9. Developing a model osteoarthritis consultation: a Delphi consensus exercise.

    Science.gov (United States)

    Porcheret, Mark; Grime, Janet; Main, Chris; Dziedzic, Krysia

    2013-01-16

    Osteoarthritis (OA) is a common condition managed in general practice, but often not in line with published guidance. The ideal consultation for a patient presenting with possible OA is not known. The aim of the study was to develop the content of a model OA consultation for the assessment and treatment of older adults presenting in general practice with peripheral joint problems. A postal Delphi consensus exercise was undertaken with two expert groups: i) general practitioners (GPs) with expertise in OA management and ii) patients with experience of living with OA. An advisory group generated 61 possible consultation tasks for consideration in the consensus exercise. Expert groups were asked to consider which tasks should be included in the model OA consultation. The exercise was completed by 15 GPs and 14 patients. The level of agreement for inclusion in the model was set at 90%. The model OA consultation included 25 tasks to be undertaken during the initial consultation between a GP and a patient presenting with peripheral joint pain. The 25 tasks provide detailed advice on how the following elements of the consultation should be addressed: i) assessment of chronic joint pain, ii) patient's ideas and concerns, iii) exclusion of red flags, iv) examination, v) provision of the diagnosis and written information, vi) promotion of exercise and weight loss, vii) initial pain management and viii) arranging a follow-up appointment. Both groups prioritised a bio-medical approach to the consultation, rather than a bio-psycho-social one, suggesting a discordance between current thinking and research evidence. This study has enabled the priorities of GPs and patients to be identified for a model OA consultation. The results of this consensus study will inform the development of best practice for the management of OA in primary care and the implementation of evidence-based guidelines for OA in primary care.

  10. 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

  11. Standardization In The Field Of Management Consulting Services

    Directory of Open Access Journals (Sweden)

    Ciumara Tudor

    2009-12-01

    Full Text Available The EU recognizes the importance of management consultancy, part of the services sector. To facilitate the matching of management consulting services at European level, work is carried out to develop an industry standard, which is meant to become a best practice guide for providers of these services. The proposed standard has both clear advantages and disadvantages. It represents essentially a solution for reducing information asymmetry between providers of consultancy services and their customers, an alternative to the implementation of legal regulations.

  12. Writing effective consultation letters: 12 tips for teachers.

    Science.gov (United States)

    Keely, Erin; Dojeiji, Suzan; Myers, Kathryn

    2002-11-01

    Written correspondence is the standard mode of communication between healthcare providers. Despite the importance of this skill and increased emphasis on ambulatory care, communication skills and professionalism in training programs, there has been very little written on the teaching and evaluation of consultation letter writing. Consultation letter writing is an essential skill that cannot be learned simply by reading others' letters and should be taught in a formal manner. This article describes the authors' experience in teaching the skill of writing effective consultation letters to residents and describes strategies for evaluating this skill.

  13. Ethics in independent nurse consulting: strategies for avoiding ethical quicksand.

    Science.gov (United States)

    Creel, Eileen L; Robinson, Jennifer C

    2010-11-01

    Changes in health care have created a variety of new roles and opportunities for nurses in advanced practice. One of these changes is the increasing number of advanced practice nurses carrying out independent consultation. Differences in goals between business and health care may create ethical dilemmas for nurse consultants. The purpose of this article is to describe possible ethical pitfalls that nurse consultants may encounter and strategies to prevent or solve these dilemmas. Three themes related to nursing codes of ethics will be discussed: the duty to uphold human rights, the duty to fulfill commitments, and the duty to practice the profession competently.

  14. 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.

  15. 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...

  16. Digital audio recordings improve the outcomes of patient consultations

    DEFF Research Database (Denmark)

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

    2016-01-01

    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...

  17. Teaching medical students consultation skills using e-learning

    DEFF Research Database (Denmark)

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

    2015-01-01

    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...... general practice consultations. 1. Levenstein JH, McCracken EC, McWhinney IR, Stewart MA, Brown JB. The patient-centred clinical method. A model for the doctor-patient interaction in family medicine. Fam Pract. 1986 Mar; 3(1):24-30. 2. Warnecke E, Pearson S. Medical students' perceptions of using e-learning...

  18. [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.

  19. 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.

  20. 76 FR 30396 - Deloitte Financial Advisory Services LLP, Real Estate Consulting, Houston, TX; Amended...

    Science.gov (United States)

    2011-05-25

    ... Financial Advisory Services LLP, Real Estate Consulting, Houston, TX; Amended Certification Regarding... of Deloitte Financial Advisory Services LLP, Real Estate Consulting, Houston, Texas (subject firm... Financial Advisory Services LLP, Real Estate Consulting, Houston, Texas who were adversely affected by a...

  1. 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...

  2. 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...

  3. 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 cons

  4. A Qualitative Study of Televideo Consultations for COPD Patients

    DEFF Research Database (Denmark)

    Mathar, Helle; Fastholm, Pernille; Sandholm Larsen, Niels

    2015-01-01

    . In public the expectations are high that digital mediation between clients' everyday lives and the health care system can strengthen patients' abilities regarding their self-management. Nonetheless, the study shows that patients have a number of reservations concerning televideo consultations at home......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...

  5. Mutual construction and reconstruction in client-consultant interaction

    DEFF Research Database (Denmark)

    Smith, Irene Skovgaard

    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......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...... 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...

  6. 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......This article reports a conversation analysis of assessment package consultations. Healthcare delivery packages belong to a highly structured mode of healthcare delivery, in which specific courses of healthcare interventions related to assessment and treatment are predefined, both as to timing...... is when the final clarification of the patient's symptoms takes place. The primary data of the study were eight audio recordings of consultations, and the secondary data were ethnographic field descriptions. In most consultations, packaged assessment was a resource as it provided fast and efficient...

  7. MARKETING CONSULTANCY IN AGROTOURISM ALONG THE ROMANIAN WEB SITES

    Directory of Open Access Journals (Sweden)

    NEGRUŢ CONSTANTIN

    2012-05-01

    Full Text Available This study assumed that the interest in agrotourism was increased in the last years of financial crisis. This paper is the result of Internet searches aimed at finding specialized companies and useful in agrotourism marketing and consulting.

  8. 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...

  9. 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.

  10. Contribution of respiratory pathogens to influenza-like illness consultations.

    Science.gov (United States)

    Bollaerts, K; Antoine, J; Van Casteren, V; Ducoffre, G; Hens, N; Quoilin, S

    2013-10-01

    Influenza-like illnesses (ILIs) are caused by several respiratory pathogens. These pathogens show weak to strong seasonal activity implying seasonality in ILI consultations. In this paper, the contribution of pathogens to seasonality of ILI consultations was statistically modelled. Virological count data were first smoothed using modulation models for seasonal time series. Second, Poisson regression was used regressing ILI consultation counts on the smoothed time series. Using ratios of the estimated regression parameters, relative measures of the underreporting of pathogens were obtained. Influenza viruses A and B, parainfluenza virus and respiratory syncytial virus (RSV) significantly contributed to explain the seasonal variation in ILI consultations. We also found that RSV was the least and influenza virus A is the most underreported pathogen in Belgian laboratory surveillance. The proposed methods and results are helpful in interpreting the data of clinical and laboratory surveillance, which are the essential parts of influenza surveillance.

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

    DEFF Research Database (Denmark)

    Broberg, Ole

    2004-01-01

    In carrying out consultancy the Danish occupational health services (OHS) are supposed to support and develop the capabilities of enterprises to manage work environment issues. This may be interpreted in a learning perspective: As part of the process consultancy the OHS consultants have to put...... 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...... on reduc-ing the work loads of delivery and warehouse personnel. In facilitating learning processes, deliberately or by incidence, the OHS consultants used different boundary objects. An example: In order to involve users in the design process it was better making a walk-through in a new catering centre...

  12. Notes: Public Consultation toward Ethiopia's Family Law Reform ...

    African Journals Online (AJOL)

    Notes: Public Consultation toward Ethiopia's Family Law Reform and the Revised Code's Response. ... Mizan Law Review ... inter alia, include the pros and cons of having a uniform family law, the various forms and impediments to marriage, ...

  13. Consultation letters for medically unexplained physical symptoms in primary care

    NARCIS (Netherlands)

    Hoedeman, Rob; Blankenstein, Annette H.; van der Feltz-Cornelis, Christina M.; Krol, Boudien; Stewart, Roy; Groothoff, Johan W.; van der Feltz-Cornelis, CM

    2010-01-01

    Background In primary care between 10% and 35% of all visits concern patients with medically unexplained physical symptoms (MUPS). MUPS are associated with high medical consumption, significant disabilities and psychiatricmorbidity. Objectives To assess the effectiveness of consultation letters (CLs

  14. Multidisciplinary teams in consultation-liaison psychiatry: the Yale model.

    Science.gov (United States)

    Leigh, H

    1987-01-01

    The consultation-liaison service at Yale features integrated teams of psychiatrists, social workers, and clinical nurse specialists working together in both consultation and outpatient settings. The model is based on the tenets that (1) comprehensive evaluation of patients is essential for effective treatment; (2) role definition is necessary for specific disciplines, including the definition of overlapping and separate areas of expertise and practice. The multidisciplinary teams are coordinated by a psychiatric resident, who is supervised by an attending psychiatrist. The role of the resident is that of a diagnostician and coordinating physician. The social worker functions as an expert in family evaluation and treatment, and the nurse specialist functions as supportive therapist and liaison with the nursing staff. The structure of the division of consultation-liaison and ambulatory services at Yale is described and the advantages and disadvantages of the multidisciplinary team concept are discussed in comparison with other models of consultation-liaison psychiatry.

  15. 42 CFR 431.105 - Consultation to medical facilities.

    Science.gov (United States)

    2010-10-01

    ... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS STATE ORGANIZATION AND GENERAL ADMINISTRATION... State agencies furnish consultative services to hospitals, nursing homes, home health agencies, clinics... and child health and crippled children's program (title V of the Act), Medicaid or Medicare;...

  16. Implications Of Using External Consultants In Diagnosing And ...

    African Journals Online (AJOL)

    The process of diagnosing need for the change, the problems/issues to be ... Some practical examples of the diagnosis by external consultants are also presented. ... Gaining co-operation from the client organization and the avoidance of ...

  17. US-USSR telemedicine consultation spacebridge to Armenia and Ufa

    Science.gov (United States)

    1991-01-01

    The Final Report on the U.S.-U.S.S.R. Telemedicine Consultation Spacebride to Armenia and Ufa is presented. The goal of this activity was to provide expert medical consultation to the Armenian medical personnel in the areas of plastic and reconstructive surgery, physical and psychological rehabilitation, public health, and epidemiology following the devastating earthquake in Dec. 1988. The U.S. and U.S.S.R. implementation teams developed new standards for medical information transmittal as well as protocols and schedules on how to conduct medical consultations. The consultations were provided to the Republic Diagnostic Center in Yerevan, U.S.S.R. by four U.S. medical centers: University of Utah/LDS Hospital, University of Texas, Maryland Institute for Emergency Medical Service Systems, and Uniformed Services University of the Health Sciences.

  18. The Statistical Consulting Center for Astronomy (SCCA)

    Science.gov (United States)

    Akritas, Michael

    2001-01-01

    The process by which raw astronomical data acquisition is transformed into scientifically meaningful results and interpretation typically involves many statistical steps. Traditional astronomy limits itself to a narrow range of old and familiar statistical methods: means and standard deviations; least-squares methods like chi(sup 2) minimization; and simple nonparametric procedures such as the Kolmogorov-Smirnov tests. These tools are often inadequate for the complex problems and datasets under investigations, and recent years have witnessed an increased usage of maximum-likelihood, survival analysis, multivariate analysis, wavelet and advanced time-series methods. The Statistical Consulting Center for Astronomy (SCCA) assisted astronomers with the use of sophisticated tools, and to match these tools with specific problems. The SCCA operated with two professors of statistics and a professor of astronomy working together. Questions were received by e-mail, and were discussed in detail with the questioner. Summaries of those questions and answers leading to new approaches were posted on the Web (www.state.psu.edu/ mga/SCCA). In addition to serving individual astronomers, the SCCA established a Web site for general use that provides hypertext links to selected on-line public-domain statistical software and services. The StatCodes site (www.astro.psu.edu/statcodes) provides over 200 links in the areas of: Bayesian statistics; censored and truncated data; correlation and regression, density estimation and smoothing, general statistics packages and information; image analysis; interactive Web tools; multivariate analysis; multivariate clustering and classification; nonparametric analysis; software written by astronomers; spatial statistics; statistical distributions; time series analysis; and visualization tools. StatCodes has received a remarkable high and constant hit rate of 250 hits/week (over 10,000/year) since its inception in mid-1997. It is of interest to

  19. 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.

  20. Aspects of statistical consulting not taught by acedemia

    DEFF Research Database (Denmark)

    Kenett, R.; Thyregod, Poul

    2006-01-01

    Education in statistics is preparing for statistical analysis but not necessarily for statistical consulting. The objective of this paper is to explore the phases that precede and follow statistical analysis. Specifically these include: problem elicitation, data collection and, following statisti......Education in statistics is preparing for statistical analysis but not necessarily for statistical consulting. The objective of this paper is to explore the phases that precede and follow statistical analysis. Specifically these include: problem elicitation, data collection and, following...

  1. Asynchronous vascular consultation via electronic methods: A feasibility pilot.

    Science.gov (United States)

    Chittle, Melissa D; Rao, Sandhya K; Jaff, Michael R; Patel, Virendra I; Gallen, Kathleen M; Avadhani, Radhika; Ferris, Timothy G; Wasfy, Jason H

    2015-12-01

    Management of chronic disease often requires multidisciplinary clinical efforts and specialist care. With the emergence of Accountable Care Organizations (ACOs), health care systems are incentivized to evaluate methods of information exchange between generalists and specialists in order to provide value while preserving quality. Our objective was to evaluate patient and referring provider satisfaction and outcomes of asynchronous electronic consultations in vascular care in a large tertiary academic medical center. Referring providers were offered a vascular 'e-consult' option through an electronic referral management system. We conducted chart review to understand the downstream effects and surveyed patients and referring providers to assess satisfaction. From 24 March 2014 to 1 March 2015, 54 e-consults were completed. Additional testing and recommendations were made in 49/54 (90.7%) e-consults, including lower-extremity venous duplex ultrasonography with reflux testing, duplex ultrasonography of the carotid artery, computed tomography, magnetic resonance imaging, non-invasive physiology arterial studies, laboratory tests, medications, compression stockings, and sequential lymphedema compression therapy. Referring providers were compliant with recommendations in 40/49 (81.6%) of e-consults. A total of 17/54 (31.5%) patients were surveyed with a median patient satisfaction score of 13.7/15 (91.3%) (SD ± 6.4). The program was associated with high referring provider satisfaction, with 87.0% finding the e-consult very helpful and 80.0% stating it averted the need for a traditional visit. Our experience suggests that e-consults are an effective way to provide vascular care in some patients and are associated with high patient and provider satisfaction. E-consults may therefore be an efficient method of care delivery for vascular patients within an ACO.

  2. Injuries of the central nervous system – mobile phone consultations

    OpenAIRE

    Filip, Michal; Linzer, Petr; Šámal, Filip; Jurek, Patrik; Tesař, Jiří

    2010-01-01

    Summary Transmission of visual documentation between a neurosurgery center and a regional hospital, with a mobile phone, significantly improves consultation on a craniocerebral injury. This is one of the methods of fast consultation on image documentation (CT). We reported on one year of experience (September 2007 to September 2008) of our department with this method of image transmission in 16 patients with craniocerebral injury. The images were exported, via the Internet, from local hospita...

  3. A Feasibility Study for Establishing a Sustainability Consulting Firm

    OpenAIRE

    Mathieu, Susan F.

    2011-01-01

    This study examines the feasibility of Mathieu Sustainability Consulting (MSC) entering the sustainability consulting industry and targeting the Canadian junior mineral exploration sector. The target market is attractive due to: (1) expanding domestic and foreign exploration investment; (2) increasing regulatory and societal pressures to integrate sustainability into exploration activities; and (3) the tendency of exploration companies to limit their size and retain specialized services on an...

  4. 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.

  5. Representation of Ecodesign Practice: International Comparison of Industrial Design Consultancies

    Directory of Open Access Journals (Sweden)

    Damien Giurco

    2011-10-01

    Full Text Available Ecodesign offers significant potential to reduce the environmental impacts of products. Whilst some integration of environmental considerations into design occurs in progressive companies when engineering the product, this only represents a small share of the possible design interventions to improve the environmental performance of products. For example, developing new product concepts to fulfill needs in a less environmentally harmful way and considering user related aspects offers a large, currently under-realized potential. This paper identifies industrial design (ID consultancies as potential agents to tackle this issue on a strategic and operational basis. The extent to which this potential is currently applied was assessed by conducting a content analysis of websites of ID consultancies in Australia, China, and Germany. How ID consultancies represent their ecodesign practice is country-specific. Despite the differences, some ID consultancies in all countries announce and/or show the capability to develop completely new concepts and to influence user related factors to improve environmental performance. This shows their potential to address current shortcomings in ecodesign practice. As ID consultancies embracing that potential still are a minority, further research should be directed to a deeper examination of barriers and stimuli for ID consultancies to take up ecodesign.

  6. 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.

  7. 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.

  8. Lactation Consultants' Perceived Barriers to Providing Professional Breastfeeding Support.

    Science.gov (United States)

    Anstey, Erica H; Coulter, Martha; Jevitt, Cecilia M; Perrin, Kay M; Dabrow, Sharon; Klasko-Foster, Lynne B; Daley, Ellen M

    2017-08-01

    Addressing suboptimal breastfeeding initiation and duration rates is a priority in the United States. To address challenges to improving these rates, the voices of the providers who work with breastfeeding mothers should be heard. Research aim: The purpose of this study was to explore lactation consultants' perceived barriers to managing early breastfeeding problems. This qualitative study was conducted with a grounded theory methodological approach. In-depth interviews were conducted with 30 International Board Certified Lactation Consultants across Florida. Lactation consultants were from a range of practice settings, including hospitals, Special Supplemental Nutrition Program for Women, Infants, and Children clinics, private practice, and pediatric offices. Data were digitally recorded, transcribed, and analyzed in Atlas.ti. A range of barriers was identified and grouped into the following categories/themes: indirect barriers (social norms, knowledge, attitudes); direct occupational barriers (institutional constraints, lack of coordination, poor service delivery); and direct individual barriers (social support, mother's self-efficacy). A model was developed illustrating the factors that influence the role enactment of lactation consultants in managing breastfeeding problems. Inadequate support for addressing early breastfeeding challenges is compounded by a lack of collaboration among various healthcare providers and the family. Findings provide insight into the professional management issues of early breastfeeding problems faced by lactation consultants. Team-based, interprofessional approaches to breastfeeding support for mothers and their families are needed; improving interdisciplinary collaboration could lead to better integration of lactation consultants who are educated and experienced in providing lactation support and management of breastfeeding problems.

  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

    2012-04-01

    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.

  10. A proposal for a behavioral pre-consultation: Analysis of the use of a protocol during consultations

    OpenAIRE

    Kohlsdorf,Marina; Costa Junior,Áderson Luiz

    2015-01-01

    This study aimed to analyze how physicians, caregivers, and children use protocols regarding estimated issues to medical visits, procedure named pre-consultation lists, along treatment for childhood cancer. Three pediatricians and 24 dyads child-caregiver took part; each pair was interviewed before medical visits in order to report doubts, needs and issues estimated to the consultation. This list was attached to child's medical record as a memo of themes to discuss in the next medical visit. ...

  11. Consultation de corpus et styles d’apprentissage Corpus consultation and learning styles

    OpenAIRE

    Alex Boulton

    2012-01-01

    Les corpus représentent une ressource avec de multiples possibilités pour l’apprentissage des langues, mais les résultats d’expériences avec les étudiants sont moins convaincants qu’on pourrait l’espérer. Une explication serait que les résultats quantitatifs cachent la diversité des profils d’apprenants. Cette étude décrit une expérience où des étudiants en architecture consultent soit un corpus, soit un dictionnaire pour résoudre des difficultés précises d’usage en anglais, et complètent un ...

  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. The Hannover Consultation Liaison model: some empirical findings.

    Science.gov (United States)

    Freyberger, H; Künsebeck, H W; Lempa, W; Avenarius, H J; Liedtke, R; Plassman, R; Nordmeyer, J

    1985-01-01

    Starting from the definitions concerning the concepts 'Liaison medicine' and 'Consultative Psychiatry' we begin with remarks with regard to the Consultation Liaison-Situation in West Germany on the basis of the key-words 'Brief history', 'Independent university units with regard to Psychotherapy and Psychosomatics as well as the connected organization' and 'Teaching procedures'. Following it the Hannover Consultation Liaison model is presented particularly with regard to both the psychosomatic inpatient ward including the functional organization and psychotherapeutic processes as well as the so-called 'Innere Ambulanz' which includes the consultation liaison services in the clinico-medical departments outside Psychiatry and Psychosomatics. Within the 'Innere Ambulanz', which is closely connected to our psychosomatic inpatient ward, the consultation liaison activities and the resulting supportive psychotherapeutic strategies are performed by student auxiliary therapists who are interested in completing their 4-5 months internship-time in our department. We describe both the three supportive psychotherapeutic steps, which may last months to years including subsequent dynamically psychotherapeutic strategies as well as the reactions of the auxiliary therapist function on the students. Furthermore, we may state that there exists no one more optional education procedure of graduate students than the student's confrontation with his partial self-responsibility vis-à-vis a patient who is being supportive-psychotherapeutically treated by him. Specific empirical proofs concerning our patient oriented consultation liaison activities are demonstrated on the basis of previous psychotherapeutic findings in Crohn patients. Here we are able to demonstrate the effectivity of psychotherapy in the case of the supplementarily psychotherapeutically treated patients in comparison to the patients who received medical therapy only. Finally we are able to present quantitative clinico

  14. 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…

  15. The value of peri-operative consultation on a general surgical ward by the internist

    NARCIS (Netherlands)

    Mollema, R; Berger, P.; Girbes, ARJ

    2000-01-01

    Background: Medical peri-operative consultation plays an important role in the practice of the internist. It represents 13-33% of the total consultation done by the internist. The value of preoperative consultation by the internist is still unclear and the place of the consultations is under discuss

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

    NARCIS (Netherlands)

    Hicks, Jeff; Nair, Padmakumar; 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, pract

  17. Reflecting on the Role of Competence and Culture in Consultation at the International Level

    Science.gov (United States)

    Rosenfield, Sylvia

    2014-01-01

    International educational consultation is challenging work that requires not only attention to best practices in consultation but also additional focus on cultural norms and regularities. In the three articles of this special issue, the consultation competencies of consultants play a critical role, as exemplified by entry issues, problem-solving…

  18. Maximizing the Effectiveness of External Consultants in the Educational Reform Agenda.

    Science.gov (United States)

    Sulla, Nancy

    Factors that contribute to the success of an educational consultant and the school partnership were studied through a qualitative exploration of the consultant's role in two reform efforts. The study explored the work of one educational consultant in two school districts, one in which the consultant had been working for 27 years and one in which…

  19. Training interventions for improving telephone consultation skills in clinicians.

    Science.gov (United States)

    Vaona, Alberto; Pappas, Yannis; Grewal, Rumant S; Ajaz, Mubasshir; Majeed, Azeem; Car, Josip

    2017-01-05

    Since 1879, the year of the first documented medical telephone consultation, the ability to consult by telephone has become an integral part of modern patient-centred healthcare systems. Nowadays, upwards of a quarter of all care consultations are conducted by telephone. Studies have quantified the impact of medical telephone consultation on clinicians' workload and detected the need for quality improvement. While doctors routinely receive training in communication and consultation skills, this does not necessarily include the specificities of telephone communication and consultation. Several studies assessed the short-term effect of interventions aimed at improving clinicians' telephone consultation skills, but there is no systematic review reporting patient-oriented outcomes or outcomes of interest to clinicians. To assess the effects of training interventions for clinicians' telephone consultation skills and patient outcomes. We searched CENTRAL, MEDLINE, Embase, five other electronic databases and two trial registers up to 19 May 2016, and we handsearched references, checked citations and contacted study authors to identify additional studies and data. We considered randomised controlled trials, non-randomised controlled trials, controlled before-after studies and interrupted time series studies evaluating training interventions compared with any control intervention, including no intervention, for improving clinicians' telephone consultation skills with patients and their impact on patient outcomes. Two review authors independently selected studies for inclusion, extracted data and assessed the risk of bias of eligible studies using standard Cochrane and EPOC guidance and the certainty of evidence using GRADE. We contacted study authors where additional information was needed. We used standard methodological procedures expected by Cochrane for data analysis. We identified one very small controlled before-after study performed in 1989: this study used a

  20. Incidence and outcomes of intraoperative vascular surgery consultations.

    Science.gov (United States)

    Danczyk, Rachel C; Coleman, Jake; Allensworth, Jordan; Azarbal, Amir F; Mitchell, Erica L; Liem, Timothy K; Landry, Gregory J; Moneta, Gregory L

    2015-07-01

    Vascular surgeons may aid in primarily nonvascular procedures. Such activity has not been quantified, and hospital administrators may be unaware of the importance of vascular surgeons to support other hospital-based surgical programs. This study reviewed intraoperative consultations by vascular surgeons to support other surgical services. Intraoperative vascular consultations were reviewed from January 2006 to January 2014 for consulting service, indication, and whether consultation occurred with advanced notice. Patient demographics, operative times, estimated blood loss, length of stay, and relative value units (RVUs) assigned for each consultation were also assessed. Consultations for trauma and iatrogenic injuries occurring outside the operating theater were excluded. Vascular surgeons performed 225 intraoperative consultations in support of procedures by nonvascular surgeons. Requesting services were surgical oncology (46%), orthopedics (17%), urology (11%), otolaryngology (7%), and others (19%). Reasons for consultation overlapped and included vascular reconstruction (53%), control of hemorrhage (39%), and assistance with difficult dissections (43%). Seventy-four percent were for intra-abdominal procedures, and venous (53%) and arterial (50%) problems were encountered equally with some overlap. Most patients were male (59%), overweight (56%; body mass index ≥25 kg/m(2)), had previous surgery (72%) and were undergoing elective procedures (89%). Mean total procedural anesthesia time was 9.4 hours, mean procedural operating time was 7.9 hours, and mean total and vascular-related estimated blood loss was 1702 mL and 327 mL, respectively. Mean length of stay was 14.7 days, mean intensive care unit stay was 2.9 days, and 30-day mortality was 6.2%. Mean nonvascular RVUs per operation were 46.0, and mean vascular RVUs per operation were 30.9. Unexpected intraoperative need for vascular surgical expertise occurs often enough that vascular surgeons should be regarded

  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. 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

  3. Survey of perceived stress and work demands of consultant doctors.

    Science.gov (United States)

    Agius, R M; Blenkin, H; Deary, I J; Zealley, H E; Wood, R A

    1996-01-01

    OBJECTIVES: The objectives of this study were to assess the work demands as potential stressors of health service consultants, and to describe the development of tools for measuring stress experiences of consultants. METHODS: A stratified random sample of 500 NHS consultants in Scotland was targeted by a postal questionnaire and 375 (75%) returned a valid response. They completed questionnaires, including information on demographic factors, work demands, occupational stressors, and burnout. RESULTS: Principal components analysis showed that professional work demands of consultants fell into three categories: clinical, academic, and administrative. Their perceived stressors separated into four main factors: clinical responsibility, demands on time, organisational constraints, and personal confidence. These were assessed by 25 questions in the specialist doctors' stress inventory. Specific questions about perceived stressors which resulted in a high positive response included questions about demands on time, and organisational change in the NHS. CONCLUSION: These self reported data characterise and measure the consultants' work demands and their role as potential stressors. These measurements could form the basis for strategies to reduce occupational stress in these workers. PMID:8664957

  4. [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.

  5. Differentiating between a consultant nurse and a clinical nurse specialist.

    Science.gov (United States)

    Maylor, Miles

    With the introduction of nurse consultants, and regulation of the use of the designation 'specialist nurse', experienced practitioners such as clinical nurse specialists have seen their position eroded. Nurse consultants are a new NHS-employment category, and are expected to be at the top rank of the profession both in status and in salary. However, this article argues that nurses at various levels have the same core functions, and that these do not differ for nurse consultants. Distinguishing between practitioners that might have the same job description could be better done by measuring outcomes. More care needs to be taken over the use of words such as 'expert', which is used differently in different contexts, and it is suggested that competencies be developed by which to measure the effects of expertise. Although nurse consultant appointments are often driven by various political directives and they are employed to meet local and national priorities, difficult issues need to be faced. First, if nurse consultant jobs are the top of the clinical career ladder, will clinical nurse specialists (CNSs) need to accept a lower rung on it? Further, perhaps the title CNS should become obsolete or be regulated? Can CNSs claim parity of pay using the 'Agenda for Change' framework?

  6. 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.

  7. 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.

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

    OpenAIRE

    2016-01-01

    Background Electronic consultations (e-consults) offer rapid access to specialist input without the need for a patient visit. E-consult implementation began in 2011 at VA Boston Healthcare System (VABHS). By early 2013, e-consults were available for all clinical services. In this implementation, the requesting clinician selects the desired consultation within the electronic health record (EHR) ordering menu, which creates an electronic form that is pre-populated with patient demographic infor...

  9. Personality characteristics of effective Organizational Effectiveness consultants in the U.S. Navy

    OpenAIRE

    Hackett, William S.; McInerney, John Francis

    1984-01-01

    Approved for public release; distribution is unlimited This study examines the relationship between personality variables and the effectiveness of U. S. Navy Organizational Effectiveness (OE) consultants. The hypothesis of the study is that personality characteristics of effective OE consultants differ significantly from those of less effective consultants. The corollary hypothesis is that consultant knowledge is a factor contributing to consultant effectiveness. The sample, which co...

  10. Formation of the system of indicators of effectiveness of the consulting activity

    OpenAIRE

    Verba Veronika A.

    2013-01-01

    The article presents own vision of methodological principles of assessment of managerial consulting in the knowledge economy. The goal of the article is justification of the own position of principles and methodical provisions of assessing the consulting activity and developing the consulting company scorecard with consideration of the focus of their strategic consulting. In the result of the conducted study the article justifies expediency of assessment of effectiveness of managerial consult...

  11. Capturing the complexity of first opinion small animal consultations using direct observation

    OpenAIRE

    Robinson, N. J.; Brennan, Marnie L.; Cobb, M.; Dean, R. S.

    2014-01-01

    Various different methods are currently being used to capture data from small animal consultations. The aim of this study was to develop a tool to record detailed data from consultations by direct observation. A second aim was to investigate the complexity of the consultation by examining the number of problems discussed per patient. A data collection tool was developed and used during direct observation of small animal consultations in eight practices. Data were recorded on consultation type...

  12. Between exploitation and control – Clients’ conceptions of the consultant-client relationship

    OpenAIRE

    2005-01-01

    During the past years, the use of management consultants has increased significantly, giving managers repeated experiences of both hiring and working with them. In an effort to understand the managers’ use of management consultants, this paper sets out to investigate managers’ conceptions of management consultants, as they are assumed to influence how consultants are used and managed. Based on the study of ten managers, four conceptions of management consultants, their roles and how they shou...

  13. The construction of global management consulting - a study of consultancies’ web presentations

    OpenAIRE

    2001-01-01

    Management consulting increasingly appears as a global endeavour as reflected in the increasing dominance of a few large, global management-consulting firms. However, features of the consulting service (e.g. its immaterial and interactional character) as well as aspects of management (e.g. its cultural anchoredness) highlight the locality of management consulting. In this paper we approach this tension between the global and the local by seeing consulting as involving the creation of generali...

  14. 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......Introduction Information provided in an outpatient consultation concerns medication, diagnostic tests, treatment and rehabilitation which is crucial knowledge in regards of patient compliance, decision making and general patient satisfaction. Despite good communication skills among clinicians...... the communication is challenged by the fact that patients tend to forget or misunderstand a great deal of the information given. The primary objective of this study is to investigate the effects of providing patients with an audio recording of the consultation. Methods A randomized controlled trial involving four...

  15. Meeting the challenge of consultation and collaboration: developing interactive teams.

    Science.gov (United States)

    Coben, S S; Thomas, C C; Sattler, R O; Morsink, C V

    1997-01-01

    The roles of special educators as consultants and collaborators have long been established and supported. The rationale for these roles is also well documented. Many models--consultative, collaborative, and teaming--have been suggested in the literature; sometimes, these models exhibit similar goals, competencies, and processes. Because of intensified pressures to collaborate, successful implementation of collaborative and team efforts requires that special educators expand their roles as interactive professionals. The purpose of this article is to define and describe the consultation, collaboration, and teaming models that have been implemented, discuss their strengths and limitations, delineate how these models contribute to interactive teaming, outline key features of the interactive team, and provide some guiding principles for successful implementation.

  16. The uses and implications of standards in general practice consultations

    DEFF Research Database (Denmark)

    Lippert, Maria Laura; Reventlow, Susanne; Kousgaard, Marius Brostrøm

    2017-01-01

    was observed among general practitioners who strictly adhered to the procedural standards on the interactional aspects of care. Thus, when allowed to function as an overall frame for consultations, those standards supported adherence to general recommendations regarding which elements to be included in chronic...... standards for the ‘softer’ aspects of care. This article explores the consequences of both kinds of quality standards for chronic care consultations. The article presents findings from an explorative qualitative field study in Danish general practice where a standardized technology for quality development...... disease consultations. However, at the same time, adherence to those standards was observed to narrow the focus of doctor–patient dialogues and to divert general practitioners’ attention from patients’ personal concerns. Similar consequences of quality standards have previously been framed...

  17. Colonial connections and consulting engineers 1850-1914

    DEFF Research Database (Denmark)

    Andersen, Casper

    2011-01-01

    The paper analyses colonial connections and networks of British consulting engineers. It unravels how consulting engineers operated within different imperial contexts, including settler colonies, Egypt and Crown colonies in West Africa in particular. The paper also examines the close and at times...... strained connections that existed between London's consulting engineers and British engineers stationed overseas in colonial public works departments. By examining the colonial connections of metropolitan engineers, the paper sheds light on a hitherto ignored factor that tied Britain and the colonies...... together during the diaspora of British engineering. It argues that personal connections and relations remained of paramount importance during this period, which has traditionally been described as characterised by growing professionalisation and a subsequent loss of the personal element in British...

  18. 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

  19. Using professional interpreters in undergraduate medical consultation skills teaching.

    Science.gov (United States)

    Bansal, Aarti; Swann, Jennifer; Smithson, William Henry

    2014-01-01

    The ability to work with interpreters is a core skill for UK medical graduates. At the University of Sheffield Medical School, this teaching was identified as a gap in the curriculum. Teaching was developed to use professional interpreters in role-play, based on evidence that professional interpreters improve health outcomes for patients with limited English proficiency. Other principles guiding the development of the teaching were an experiential learning format, integration to the core consultation skills curriculum, and sustainable delivery. The session was aligned with existing consultation skills teaching to retain the small-group experiential format and general practitioner (GP) tutor. Core curricular time was found through conversion of an existing consultation skills session. Language pairs of professional interpreters worked with each small group, with one playing patient and the other playing interpreter. These professional interpreters attended training in the scenarios so that they could learn to act as patient and family interpreter. GP tutors attended training sessions to help them facilitate the session. This enhanced the sustainability of the session by providing a cohort of tutors able to pass on their expertise to new staff through the existing shadowing process. Tutors felt that the involvement of professional interpreters improved student engagement. Student evaluation of the teaching suggests that the learning objectives were achieved. Faculty evaluation by GP tutors suggests that they perceived the teaching to be worthwhile and that the training they received had helped improve their own clinical practice in consulting through interpreters. We offer the following recommendations to others who may be interested in developing teaching on interpreted consultations within their core curriculum: 1) consider recruiting professional interpreters as a teaching resource; 2) align the teaching to existing consultation skills sessions to aid integration

  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. Consultation of medical narratives in the electronic medical record.

    Science.gov (United States)

    Tange, H J

    1999-12-01

    This article presents an overview of a research project concerning the consultation of medical narratives in the electronic medical record (EMR). It describes an analysis of user needs, the design and implementation of a prototype EMR system, and the evaluation of the ease of consultation of medical narratives when using this system. In a questionnaire survey, 85 hospital physicians judged the quality of their paper-based medical record with respect to data entry, information retrieval and some other aspects. Participants were more positive about the paper medical record than the literature suggests. They wished to maintain the flexibility of data entry but indicated the need to improve the retrieval of information. A prototype EMR system was developed to facilitate the consultation of medical narratives. These parts were divided into labeled segments that could be arranged source-oriented and problem-oriented. This system was used to evaluate the ease of information retrieval of 24 internists and 12 residents at a teaching hospital when using free-text medical narratives divided at different levels of detail. They solved, without time pressure, some predefined problems concerning three voluminous, inpatient case records. The participants were randomly allocated to a sequence that was balanced by patient case and learning effect. The division of medical narratives affected speed, but not completeness of information retrieval. Progress notes divided into problem-related segments could be consulted 22% faster than when undivided. Medical history and physical examination divided into segments at organ-system level could be consulted 13% faster than when divided into separate questions and observations. These differences were statistically significant. The fastest divisions were also appreciated as the best combination of easy searching and best insight in the patient case. The results of our evaluation study suggest a trade-off between searching and reading: too much

  2. A protocol for consultation of another physician in cases of euthanasia and assisted suicide

    Science.gov (United States)

    van der

    2001-01-01

    Objective—Consultation of another physician is an important method of review of the practice of euthanasia. For the project "support and consultation in euthanasia in Amsterdam" which is aimed at professionalising consultation, a protocol for consultation was developed to support the general practitioners who were going to work as consultants and to ensure uniformity. Participants—Ten experts (including general practitioners who were experienced in euthanasia and consultation, a psychiatrist, a social geriatrician, a professor in health law and a public prosecutor) and the general practitioners who were going to use the protocol. Evidence—There is limited literature on consultation: discursive articles and empirical studies describing the practice of euthanasia. Consensus—An initial draft on the basis of the literature was commented on by the experts and general practitioners in two rounds. Finally, the protocol was amended after it had been used during the training of consultants. Conclusions—The protocol differentiates between steps that are necessary in a consultation and steps that are recommended. Guidelines about four important aspects of consultation were given: independence, expertise, tasks and judgment of the consultant. In 97% of 109 consultations in which the protocol was used the consultant considered the protocol to be useful to a greater or lesser extent. Although this protocol was developed locally, it also employs universal principles. Therefore it can be of use in the development of consultation elsewhere. Key Words: Euthanasia • assisted suicide • consultation • quality assurance • protocol PMID:11579191

  3. Contentious Conversations: Using Mediation Techniques in Difficult Clinical Ethics Consultations.

    Science.gov (United States)

    Fiester, Autumn

    2015-01-01

    Mediators utilize a wide range of skills in the process of facilitating dialogue and resolving conflicts. Among the most useful techniques for clinical ethics consultants (CECs)-and surely the least discussed-are those employed in acrimonious, hostile conversations between stakeholders. In the context of clinical ethics disputes or other bedside conflicts, good mediation skills can reverse the negative interactions that have prevented the creation of workable treatment plans or ethical consensus. This essay lays out the central framework mediators use in distinguishing positions from interests and describes a set of strategies for managing contentious ethics consultations or working with "difficult" patients, families, or patient-careprovider interactions.

  4. 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.

  5. Development of a telepresence robot for medical consultation

    Science.gov (United States)

    Bugtai, Nilo T.; Ong, Aira Patrice R.; Angeles, Patrick Bryan C.; Cervera, John Keen P.; Ganzon, Rachel Ann E.; Villanueva, Carlos A. G.; Maniquis, Samuel Nazirite F.

    2017-02-01

    There are numerous efforts to add value for telehealth applications in the country. In this study, the design of a telepresence doctor to facilitate remote medical consultations in the wards of Philippine General Hospital is proposed. This includes the design of a robot capable of performing a medical consultation with clear audio and video information for both ends. It also provides the operating doctor full control of the telepresence robot and gives a user-friendly interface for the controlling doctor. The results have shown that it provides a stable and reliable mobile medical service through the use of the telepresence robot.

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

    DEFF Research Database (Denmark)

    Broberg, Ole

    2004-01-01

    . In a traditional conflict-oriented brewery organization the consultant had a major role in facilitating a cross functional work group of workers and managers that were able to set up and implement an action plan for the implementation of new technology and new work organization in the logistic department focussing...... on reduc-ing the work loads of delivery and warehouse personnel. In facilitating learning processes, deliberately or by incidence, the OHS consultants used different boundary objects. An example: In order to involve users in the design process it was better making a walk-through in a new catering centre...

  7. A Marketing Study into Consumer Needs for Consulting Services

    Directory of Open Access Journals (Sweden)

    Marya V. Shendo

    2016-03-01

    Full Text Available Any service ought to be analyzed, first and foremost, in terms of its usefulness to consumers and its ability to meet their needs. An effective way of studying consumer needs is to conduct marketing research. This marketing study, which factored in the specificity of the issue in question and the characteristics of accounting consulting services and their consumers, was conducted in 3 stages. Its findings reveal that the need for accounting and taxation consulting services does exist today, and that the way it is currently being met needs improvement.

  8. A clinical information consultation service at a teaching hospital.

    Science.gov (United States)

    Tobia, R C; Kronick, D A; Harris, G D

    1983-10-01

    The library and the department of medicine at the University of Texas Health Science Center at San Antonio cooperated in a three-month pilot project to test a clinical information consultation service that provides patient care information to house staff members in the clinical setting. Evaluation indicated that users were highly satisfied with the service. Results of our pilot project seem to show that a clinical information consultation service can be an efficient and cost-effective means to provide information in a patient-care setting.

  9. Impact of Consultation on Hospital Outcomes and Resource Utilization for Patients with Acute Congestive Heart Failure.

    Science.gov (United States)

    Varga, Zoltan; Sabzwari, Syed Ali Rafay; Abusaada, Khalid

    2017-07-01

    Consultation is an important tool for acquiring subspecialty support when managing patients with acute congestive heart failure (CHF). The effect of consultation on hospital outcomes and resource utilization in CHF is unknown. The objectives of our study were to determine the effect of consultation on outcomes in CHF and to evaluate factors affecting the frequency of consultation. Our study was a retrospective cohort study of patients admitted to Florida Hospital Orlando for CHF between January 1, 2011 and December 31, 2013. Data on demographics, number of consultations, length of stay (LOS), readmissions within 30 days, cost of care, and mortality were compared according to the number of consultations. For statistical analysis, analysis of variance, the χ(2) test, and multivariate linear regression analysis were used. Risk-adjusted outcomes were reported as observed/expected. A total of 1554 patients were included; 103 (6.6%) patients received no consultation; 482 (31%) received 1; 365 (23.5%) received 2; 229 (14%) received 3; and 375 (24%) received ≥4. Teaching service, age, and African American race were associated with decreased consultation (P consultation (P consultations (P consultations (P = 0.35 and 0.98, respectively). Increased consultation with patients with CHF is associated with increased costs and LOS without improved mortality or readmission rate. Decreased utilization of consultations by the teaching service suggests that there is an opportunity to decrease utilization of healthcare resources by streamlining the utilization of consultations.

  10. A Behavior Modification Approach to Elementary School Consultation.

    Science.gov (United States)

    Callister, Sheldon L.

    The Weber Mental Health Center consultation program to schools is described. The conditions under which children might be directly treated at the center are enumerated, but the essential thrust of the program is to train teachers, administrators, and parents the principles and application of learning theory to the management of children's…

  11. Novice-Expert Design Consultations: Findings from a Field Study

    NARCIS (Netherlands)

    Deken, F.; Aurisicchio, M.; Kleinsmann, M.; Lauche, K.

    2009-01-01

    This study aimed to investigate the process of novice-expert consultation meetings in an organizational context by identifying phases of the discourse and analysing the nature of these phases. An empirical study was performed at Rolls-Royce Aerospace Engineering by capturing 7 audio-records of

  12. ICU Multipoint Military Pacific Consultation using Telehealth (IMMPACT)

    Science.gov (United States)

    2010-05-01

    Medical Center Department of Defense eICU Program Director in Chief eICU Director COL Joseph Pina , MD LTC Eric Crawley, MD Principal...Liaisons Steven Sellner, RN Ms. Laurie Kalleberg, CCRN - Korea LCDR Robert Krejci, CCRN - Guam eICU Intensive Care Consultants COL J Pina , MD

  13. Early Childhood Mental Health Consultation: Common Questions and Answers

    Science.gov (United States)

    Hughes, Mary-alayne; Spence, Christine M.; Ostrosky, Michaelene M.

    2015-01-01

    As the field of early childhood mental health continues to expand and evolve, the evidence base is growing, and early childhood mental health consultation is viewed as a promising practice. However, there continues to be a need for further research, with particular attention given to the utility and effectiveness of this approach with infants and…

  14. Expertise, Ethics Expertise, and Clinical Ethics Consultation: Achieving Terminological Clarity.

    Science.gov (United States)

    Iltis, Ana S; Sheehan, Mark

    2016-08-01

    The language of ethics expertise has become particularly important in bioethics in light of efforts to establish the value of the clinical ethics consultation (CEC), to specify who is qualified to function as a clinical ethics consultant, and to characterize how one should evaluate whether or not a person is so qualified. Supporters and skeptics about the possibility of ethics expertise use the language of ethics expertise in ways that reflect competing views about what ethics expertise entails. We argue for clarity in understanding the nature of expertise and ethics expertise. To be an ethics expert, we argue, is to be an expert in knowing what ought to be done. Any attempt to articulate expertise with respect to knowing what ought to be done must include an account of ethics that specifies the nature of moral truth and the means by which we access this truth or a theoretical account of ethics such that expertise in another domain is linked to knowing or being better at judging what ought to be done and the standards by which this "knowing" or "being better at judging" is determined. We conclude with a discussion of the implications of our analysis for the literature on ethics expertise in CEC. We do think that there are clear domains in which a clinical ethics consultant might be expert but we are skeptical about the possibility that this includes ethics expertise. Clinical ethics consultants should not be referred to as ethics experts.

  15. Consulting Psychiatry within an Integrated Primary Care Model

    Science.gov (United States)

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

    2014-01-01

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

  16. Personalized Antenatal Consultations for Preterm Labor: Responding to Mothers' Expectations.

    Science.gov (United States)

    Gaucher, Nathalie; Nadeau, Sophie; Barbier, Alexandre; Janvier, Annie; Payot, Antoine

    2016-11-01

    To explore prospective mothers' perspectives regarding antenatal consultations by neonatology teams for threatened preterm delivery. In a prospective multicenter study, women at risk of preterm delivery between 26 and 32 weeks of gestational age were surveyed during the 72 hours following their antenatal consultation. The questionnaire used was developed and validated during a single-center study. Over 18 months, 229 mothers completed the survey (73% response rate), at a median gestational age of 30 weeks. Spouses/partners were present for 49% of consultations. Most women (90%) reported a positive experience. They found it important to discuss the outcomes of prematurity (96%), but 39% of them reported receiving too much information. Women wanted their spouse/partner to be present (71%) and wished to discuss parental concerns: their roles as mother of a premature baby (82%), their integration in their baby's care (83%), and a better understanding of the neonatal intensive care unit (NICU) environment, including antenatal NICU visits (69%). The majority (56%) wanted a follow-up consultation: this was less likely if a NICU visit had been offered (P child-centered information. Although clinicians follow these guidelines, mothers want personalized information focusing on their individual concerns and questions, such as what they can do for their baby, how NICUs work, and the integration of their family. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. State S&T Plan Consultation Tops CASAD Priorities

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    @@ The Executive Committee of the CAS Presidium sets the consultative work on the State long-and medium-term S&T development plan the top priority for the CAS Academic Divisions (CASAD)in the coming two years. This was announced at the second session of the fourth CAS presidium executive committee convened on June 10 in Beijing.

  18. Treatment Integrity in Behavioral Consultation: Measurement, Promotion, and Outcomes

    Science.gov (United States)

    Sanetti, Lisa M. Hagermoser; Kratochwill, Thomas R.

    2008-01-01

    The purpose of this article is to provide an overview of the current state of research in the area of treatment integrity as it relates to behavioral consultation. To this end, four primary topics are discussed. First, a rationale for why treatment integrity is an important professional and methodological concern is presented. Second,…

  19. The Concept of Body Language in the Medical Consultation.

    Science.gov (United States)

    Lindsley, Isabella; Woodhead, Sophie; Micallef, Claranne; Agius, Mark

    2015-09-01

    In this paper we wish to argue that the human body is an instrument of communication that can be used by the individual. This can be shown by the use of phenomenology, as described by Husserl, and that indeed empathy, as described by phenomenology, can be seen as a link enabling two human bodies/persons to communicate. We then wish to show from neuroscience that empathy can itself be seen as a bodily function. We then will describe how the doctor-patient relationship in the consultation is an extremely important type of communication between two persons, and how teaching of consultation skills has developed. We will show that, once consultation skills teaching was established, then study of body language became an essential part of this teaching, as soon as the technology was developed, and finally we will demonstrate that it is now possible to confirm by observational and controlled trials that appropriate use of body language does indeed enhance the effectiveness of the consultation, including, we would suggest, by appropriate communication of empathy and understanding.

  20. Spatial information in public consultation within environmental impact assessments

    NARCIS (Netherlands)

    Mwenda, A.N.

    2015-01-01

    Thesis Summary Spatial information in public consultation within Environmental Impact Assessments Angela N. Mwenda Established in the United States of America in 1970, Environmental Impact Assessment (EIA) is an interdisciplinary approach that considers the anticipated impacts of

  1. CONSULT-I Reading. Cincinnati Project. Final Report.

    Science.gov (United States)

    Newman, Anabel; And Others

    A study examined the effectiveness of the spring-semester 1993 implementation of the CONSULT-I(R) program, which uses artificial intelligence with statistical pattern recognition in constructing a diagnosis and recommending treatment of reading difficulties. Eight classroom teachers and two Gifted and Talented coordinators at South Avondale…

  2. CONSULT-I Reading. Ohio Project. Final Report.

    Science.gov (United States)

    Newman, Anabel; And Others

    A study examined the effectiveness of the 1991-1992 implementation of the CONSULT-I(R) program (which uses artificial intelligence with statistical pattern recognition in constructing a diagnosis and recommending treatment of reading difficulties) at five cities in Ohio (Akron, Cincinnati, Cleveland, Columbus, and Toledo). A total of 30 teachers…

  3. 14 CFR 1261.403 - Consultation with appropriate officials; negotiation.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Consultation with appropriate officials; negotiation. 1261.403 Section 1261.403 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION... appropriate officials; negotiation. (a) The authority pursuant to § 1261.402 to determine to forego...

  4. Consulting Young Children about Barriers and Supports to Learning

    Science.gov (United States)

    Georgeson, Jan; Porter, Jill; Daniels, Harry; Feiler, Anthony

    2014-01-01

    From consideration of children's rights in general and equal opportunities for disabled children in particular, it is important to consult children about barriers and supports to learning and participation. Finding appropriate and feasible ways, however, to incorporate this into educational programmes for younger children can present challenges.…

  5. 42 CFR 493.1411 - Standard; Technical consultant qualifications.

    Science.gov (United States)

    2010-10-01

    ... Testing Laboratories Performing Moderate Complexity Testing § 493.1411 Standard; Technical consultant qualifications. The laboratory must employ one or more individuals who are qualified by education and either... service in which the laboratory performs moderate complexity tests or procedures. The director of a...

  6. Industrial Buying Behavior Related to Human Resource Consulting Services

    DEFF Research Database (Denmark)

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

    2013-01-01

    Early B2B buying-behavior literature strongly emphasizes the rational aspects of buying behavior in B2B services. Based on a comprehensive exploratory study of Danish companies’ purchases of HR consulting services, the authors provide insights into the factors that determine how Danish companies ...

  7. 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...

  8. Assessing University Nephrology Training as Preparation for Community Consultative Practice.

    Science.gov (United States)

    Muther, Richard S.; And Others

    1989-01-01

    Information about the consultative practice of nephrology in a community environment was gathered and used to speculate about improvements that could be made in the training of nephrologists in academic medical centers, based on their knowledge of such training. (Author/MLW)

  9. Teaching Medical Gerontology: Utilization of a Psychiatry Consultation Program.

    Science.gov (United States)

    Hall, Georgia G.; Starkman, Monica N.

    1979-01-01

    A pilot project to explore the feasibility of using the clinical Adult Service Psychiatry Consultation-Liaison Program at the University of Michigan as the locus for teaching medical gerontology to psychiatric and medical/surgical residents and medical students is described. The goals, techniques, content, and implementation procedures are…

  10. Consultants: Love-Hate Relationships with Communities of Practice

    Science.gov (United States)

    Pastoors, Katja

    2007-01-01

    Purpose: This paper aims to explore consultants' experiences of communities of practice (CoPs) in one of the world's largest information technology companies against organisational strategies. The research focus concerns experiences of formal top-down and underground CoPs. Design/methodology/approach: The paper is an exploratory case study.…

  11. Spatial information in public consultation within environmental impact assessments

    NARCIS (Netherlands)

    Mwenda, A.N.

    2015-01-01

    Thesis Summary Spatial information in public consultation within Environmental Impact Assessments Angela N. Mwenda Established in the United States of America in 1970, Environmental Impact Assessment (EIA) is an interdisciplinary approach that considers the anticipated impacts of de

  12. 24 CFR 971.9 - Tenant and local government consultation.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Tenant and local government... REQUIRED BY LAW § 971.9 Tenant and local government consultation. (a) PHAs are required to proceed in... approved by the local officials as not inconsistent with the Consolidated Plan....

  13. Directed Consultation, the SEALS Model, and Teachers' Classroom Management

    Science.gov (United States)

    Motoca, Luci M.; Farmer, Thomas W.; Hamm, Jill V.; Byun, Soo-yong; Lee, David L.; Brooks, Debbie S.; Rucker, Nkecha; Moohr, Michele M.

    2014-01-01

    Directed consultation is presented as a professional development framework to guide and support teachers in the implementation of evidence-based interventions that involve contextual and process-oriented approaches designed to be incorporated into daily classroom management. This approach consists of four components: pre-intervention observations…

  14. Hanging Out My Shingle: From Librarian to Consultant.

    Science.gov (United States)

    DeCandido, Graceanne A.

    2000-01-01

    Discusses the transition from being a full-time librarian to a consultant working out of a home office. Topics include workspace; the need for an accountant; how to get work; marketing; support networks; work schedules; and how to charge clients. (LRW)

  15. 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...

  16. Industrial Buying Behavior Related to Human Resource Consulting Services

    DEFF Research Database (Denmark)

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

    2013-01-01

    Early B2B buying-behavior literature strongly emphasizes the rational aspects of buying behavior in B2B services. Based on a comprehensive exploratory study of Danish companies’ purchases of HR consulting services, the authors provide insights into the factors that determine how Danish companies ...

  17. HRC's SHP Consultation Mission in Rwanda

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Invited by Kigali Institute of Science, Technology and Management, four specialists from Hangzhou Regional Center for small Hydro Power (HRC), China, have conducted study tour in Rwanda to provide consultation service to Kavumu and Rutongo sites as well as several other hydropower sites for potential construction from 11 to 22 May 2005.The team leader of the group is Prof.

  18. 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.

  19. Networking: A Key to Career Communication and Management Consulting Success

    Science.gov (United States)

    Clark, Thomas

    2009-01-01

    Now that job security with one organization is a relic of the past and companies are outsourcing training and other "nonessential" functions, the author suggests in his career communication classes that students develop the same inventive strategies to plan their employment futures that management consultants use to market themselves in the 21st…

  20. HEFCE Staff Recruitment Incentives: Consultation on "Golden Hellos".

    Science.gov (United States)

    Higher Education Funding Council for England, Bristol.

    This "consultation" notifies interested parties of the plans by the Higher Education Funding Council for England (HEFCE) to introduce recruitment incentives for teaching staff in higher education, also known as "golden hellos." These are being introduced from 2003-2004 to encourage new entrants to teaching in higher education…

  1. 41 CFR 101-1.107 - Agency consultation regarding FPMR.

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Agency consultation regarding FPMR. 101-1.107 Section 101-1.107 Public Contracts and Property Management Federal Property Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS GENERAL 1-INTRODUCTION 1.1-Regulation...

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

    African Journals Online (AJOL)

    Consultants in the built environment of South Africa are facing financial risks due to clients' ... Chris Adendorff, NMMU Business School, ,Nelson Mandela Metropolitan University,. PO Box ... The financial uncertainty as a result of the current economic cycle ... their existing stock and delay new work, and therefore the number.

  3. Consultation with Aboriginal peoples : impacts on the petroleum industry

    Energy Technology Data Exchange (ETDEWEB)

    Fogarassy, A. [Clark Wilson, Vancouver, BC (Canada); Litton, K. [Macleod Dixon LLP, Calgary, AB (Canada)

    2003-07-01

    Two recent rulings by the British Columbia Court of Appeal have placed the onus for consultation and accommodation with Aboriginal peoples affected by resource development on the shoulders of industry. The authors discussed this new responsibility for the petroleum industry from a legal perspective. The first part of the document consists of an overview of Aboriginal and treaty rights. The Supreme Court of Canada's justification test of infringement of Aboriginal and treaty rights were reviewed in the second part. In part three, the authors reviewed the scope and nature of consultation, as well as the various sources for duty of consultation. These sources include administrative law, legislation, and potential new sources of the law of fiduciaries, and the 1982 Constitution Act between Aboriginal peoples and industry. Part four reviewed the Haida decisions and the duty of consultation with Aboriginal peoples as formulated by the British Columbia Court of Appeal. The impact of this decision on the petroleum industry was then discussed. refs.

  4. 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.

  5. School Counselors and Consultants: Legal Duties and Liabilities.

    Science.gov (United States)

    McCarthy, Martha M.; Sorenson, Gail Paulus

    1993-01-01

    Provides overview of legal issues and problems salient to school counselors who provide direct services to students or indirect services through consultation. Among legal issues addressed are privacy, confidentiality, and privilege. Also covered are legal duties pertaining to handling student records, conducting research, reporting child abuse,…

  6. The Manager's Role in Financial Reporting: A Risk Consultant's Perspective

    Science.gov (United States)

    Bell, Reginald L.

    2007-01-01

    This article presents an interview with Ray Gonzalez, a risk consultant at Deloitte & Touche LLP, in Houston, Texas, about the financial reporting responsibilities of top, middle, and frontline managers in large and medium-size firms. This interview spotlights the necessity for timely and accurate reporting of financial information relating to…

  7. Teachers and Consultation: Applying Research and Development in Organisations (RADIO)

    Science.gov (United States)

    Timmins, Paul; Bham, Mohammed; McFadyen, Jane; Ward, Joanna

    2006-01-01

    In this article we describe how the RADIO process enabled EPiTs to negotiate research with an EPS around its desire to evaluate and develop its consultation work with schools. Findings of the evaluation and their implications for the Service are described and the potential of RADIO as a tool for providing external research support from HEIs for…

  8. HEFCE Staff Recruitment Incentives: Consultation on "Golden Hellos".

    Science.gov (United States)

    Higher Education Funding Council for England, Bristol.

    This "consultation" notifies interested parties of the plans by the Higher Education Funding Council for England (HEFCE) to introduce recruitment incentives for teaching staff in higher education, also known as "golden hellos." These are being introduced from 2003-2004 to encourage new entrants to teaching in higher education in subject areas…

  9. School Evaluation and Consultancy in Italy. Sliding Doors towards Privatisation?

    Science.gov (United States)

    Serpieri, Roberto; Grimaldi, Emiliano; Vatrella, Sandra

    2015-01-01

    This article focuses on the increasing centrality assumed by non-educational consultants in the processes of policy design and knowledge production about education in Italy. We identify the recent establishment of the National School Evaluation System as a key policy trajectory and we focus on the case of the last policies to evaluate Italian…

  10. Establishing an HRD Program in an HRD Consulting Firm.

    Science.gov (United States)

    Rothwell, William J.

    1983-01-01

    Establishing a human resource development (HRD) program for HRD practitioners frequently results in problems of organizational change. The author has applied the theories of three contemporary sociologists--Talcott Parsons, Lewis Coser, and Peter Blau--to a hypothetical case study of an HRD consulting firm faced with developing its own human…

  11. Communication during haematological consultations; patients' preferences and professionals' performances.

    Science.gov (United States)

    van Bruinessen, Inge R; van der Hout, Lotte E; van Weel-Baumgarten, Evelyn M; Gouw, Hans; Zijlstra, Josée M; van Dulmen, Sandra

    2016-06-01

    Many patients with haematological malignancies experience barriers in clinical communication. Reaching effective communication is of great importance as it has been linked to a range of improved patient outcomes such as satisfaction, compliance to treatment, perceived quality of life and physical and mental health. To get a better understanding how communication in haematological consultations can be improved, the current study focussed on patients' preferences and perceived performances regarding the communicative behaviour of their health care professional. Secondly, the mediation of an online communication tool for patients was analysed. Within a controlled pre- post-test design, 78 datasets of clinical consultations could be analysed. Patients considered both affective and instrumental communication aspects important. The affective communication behaviour of the health care professional met the patients' pre-visit preferences well. In the information exchange, more variability and discrepancies were found. Overall, the online intervention did not seem to influence the patients' perceived communication performance of their health care professional much. To further improve the communication during clinical consultations, health care professionals should inquire about patients' expectations, especially during the exchange of information and advices. At the same time, patients should be supported to express their preferences at the start of the consultation. The study was registered in the Netherlands Trial Register, number 3779.

  12. HEFCE Staff Recruitment Incentives: Consultation on "Golden Hellos".

    Science.gov (United States)

    Higher Education Funding Council for England, Bristol.

    This "consultation" notifies interested parties of the plans by the Higher Education Funding Council for England (HEFCE) to introduce recruitment incentives for teaching staff in higher education, also known as "golden hellos." These are being introduced from 2003-2004 to encourage new entrants to teaching in higher education…

  13. One-time physical therapist consultation in primary health care.

    NARCIS (Netherlands)

    Hendriks, E.J.M.; Kerssens, J.J.; Dekker, J.; Nelson, R.M.; Oostendorp, R.A.B.; Zee, J. van der

    2003-01-01

    BACKGROUND AND PURPOSE: One-time physical therapist consultation, prior to possible referral for physical therapy intervention, may enhance the quality of patient care, particularly if the referring physician is uncertain as to whether intervention by a physical therapist will be beneficial. The pur

  14. Learnings from an Entrepreneur: How to Start a Consulting Practice

    Science.gov (United States)

    Bowes, Debra

    2013-03-01

    There are important basic learnings I have experienced in starting my own consulting practice over 7 years ago. These learnings will help you maximize your value, reduce competition and build your reputation and business income. I believe these can apply to many fields but certainly for the Life Sciences. A few of the basic I will cover are

  15. Public consultation in ethics: an experiment in representative ethics.

    Science.gov (United States)

    Burgess, Michael M

    2004-01-01

    Genome Canada has funded a research project to evaluate the usefulness of different forms of ethical analysis for assessing the moral weight of public opinion in the governance of genomics. This paper will describe a role of public consultation for ethical analysis and a contribution of ethical analysis to public consultation and the governance of genomics/biotechnology. Public consultation increases the robustness of ethical analysis with a more diverse set of moral experiences. Consultation must be carefully and respectfully designed to generate sufficiently diverse and rich accounts of moral experiences. Since dominant groups tend to define ethical or policy issues in a manner that excludes some interests or perspectives, it is important to identify the range of interests that diverse publics hold before defining the issue and scope of the discussion and the premature foreclosure of ethical dialogue. Consequently, a significant contribution of ethical dialogue strengthened by social analysis is to consider the context and non-policy use of power to govern genomics and to sustain social debate on enduring ethical issues.

  16. Establishing an HRD Program in an HRD Consulting Firm.

    Science.gov (United States)

    Rothwell, William J.

    1983-01-01

    Establishing a human resource development (HRD) program for HRD practitioners frequently results in problems of organizational change. The author has applied the theories of three contemporary sociologists--Talcott Parsons, Lewis Coser, and Peter Blau--to a hypothetical case study of an HRD consulting firm faced with developing its own human…

  17. 36 CFR 1270.50 - Consultation with law enforcement agencies.

    Science.gov (United States)

    2010-07-01

    ... Enforcement Purposes § 1270.50 Consultation with law enforcement agencies. (a) For the processing of Presidential records compiled for law enforcement purposes that may be subject to 5 U.S.C. 552(b)(7), the... for law enforcement purposes and may be subject to the exemption provided by 5 U.S.C. 552(b)(7) for...

  18. Health care provider satisfaction with telephone consultations provided by pharmacists and physicians at the National HIV/AIDS Clinicians' Consultation Center.

    Science.gov (United States)

    Sherman, Elizabeth M; Cocohoba, Jennifer M; Neff, Sarah E; Dong, Betty J

    2011-12-01

    The federally funded National HIV/AIDS Clinicians' Consultation Center (NCCC) offers US health care providers expert telephone consultations for managing HIV/AIDS and occupational exposures to blood-borne pathogens through 3 telephone services: the National Clinicians' Post-Exposure Prophylaxis Hotline (PEPline), the National HIV Telephone Consultation Service (Warmline), and the Perinatal HIV Hotline. Callers to the NCCC receive consultation from either a clinical pharmacist (PharmD) or a physician (MD) with HIV expertise. To compare the satisfaction of NCCC callers who received clinical consultations from clinical pharmacists and physicians with HIV expertise. We prospectively mailed 1256 satisfaction surveys to NCCC health care provider callers during a 7-month period. Survey recipients were not aware that satisfaction surveys compared PharmD and MD consultation services. Respondents rated their level of agreement with 8 statements about the quality of consultation, the quality of clinical information given, and future calls to the NCCC. Survey return rates were 43% for PEPline and 40% for Warmline and Perinatal HIV Hotline combined. Overall, caller satisfaction with the telephone consultation service was extremely high (>4 in all categories on a 1-5 Likert scale). There was no significant difference in PEPline caller satisfaction ratings between PharmD and MD consultations. Callers to the Warmline and Perinatal HIV Hotline agreed with all 8 satisfaction statements. For the following 3 statements, however, satisfaction was higher when Warmline and Perinatal HIV Hotline consultation was provided by an MD: "Overall, I was pleased with the quality of my consultation" (p = 0.04); "I would use this service again" (p HIV/AIDS telephone consultation service. By measuring callers' survey response to PharmD and MD consultations, the importance of the clinicians' contributions to this advanced HIV/AIDS consultation service is documented.

  19. 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.

  20. Analysis of Parent, Teacher, and Consultant Speech Exchanges and Educational Outcomes of Students with Autism during COMPASS Consultation

    Science.gov (United States)

    Ruble, Lisa; Birdwhistell, Jessie; Toland, Michael D.; McGrew, John H.

    2011-01-01

    The significant increase in the numbers of students with autism combined with the need for better trained teachers (National Research Council, 2001) call for research on the effectiveness of alternative methods, such as consultation, that have the potential to improve service delivery. Data from 2 randomized controlled single-blind trials indicate…

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

    NARCIS (Netherlands)

    Noordman, J.; Verhaak, P.; Dulmen, S. van

    2010-01-01

    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 a

  2. \\Defining Patient Advocacy for the Context of Clinical Ethics Consultation: A Review of the Literature and Recommendations for Consultants.

    Science.gov (United States)

    Brazg, Tracy; Lindhorst, Taryn; Dudzinski, Denise; Wilfond, Benjamin

    2016-01-01

    The idea of patient advocacy as a function of clinical ethics consultation (CEC) has been debated in the bioethics literature. In particular, opinion is divided as to whether patient advocacy inherently is in conflict with the other duties of the ethics consultant, especially that of impartial mediator. The debate is complicated, however, because patient advocacy is not uniformly conceptualized. This article examines two literatures that are crucial to understanding patient advocacy in the context of bioethical deliberations: the CEC literature and the literature on advocacy in the social work profession. A review of this literature identifies four distinct approaches to patient advocacy that are relevant to CEC: (1) the best interest approach, (2) the patient rights approach, (3) the representational approach, and (4) the empowerment approach. After providing a clearer understanding of the varied meanings of patient advocacy in the context of CEC, we assert that patient advocacy is not inherently inconsistent with the function of the ethics consultant and the CEC process. Finally, we provide a framework to help consultants determine if they should adopt an advocacy role.

  3. 77 FR 31348 - Boott Hydropower, Inc.; Notice of Consulting Parties and Agenda for Section 106 Consultation Meeting

    Science.gov (United States)

    2012-05-25

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Boott Hydropower, Inc.; Notice of Consulting Parties and Agenda for Section..., National Park Service, City of Lowell, and Boott Hydropower, Inc. and the Eldred L. Field Hydroelectric...

  4. Summary of Consultations on Child Care Reform = Sommaire des consultations sur la reforme des services de garde d'enfants.

    Science.gov (United States)

    Ontario Ministry of Community and Social Services, Toronto.

    This document contains the English and French language versions of a report summarizing the results of a public consultation process on the subject of child care reform in Ontario, Canada. The process began with province-wide distribution of a public document called "Setting the Stage" which outlined a child care reform agenda as a focus for…

  5. Monitoring Treatment Integrity: An Alternative to the "Consult and Hope" Strategy in School-Based Behavioural Consultation

    Science.gov (United States)

    Wilkinson, Lee A.

    2006-01-01

    An international trend in school psychology services is a shift from an emphasis on assessment-based activities to a paradigm of consultation problem-solving and behavioural intervention. As the profession experiences an expansion of roles and functions, school psychologists should have an understanding of a critical aspect of behaviour change:…

  6. Using professional interpreters in undergraduate medical consultation skills teaching

    Directory of Open Access Journals (Sweden)

    Bansal A

    2014-11-01

    Full Text Available Aarti Bansal,1 Jennifer Swann,1 William Henry Smithson2 1Academic Unit of Primary Medical Care, University of Sheffield, UK; 2Department of General Practice, University College Cork, Cork, Ireland Abstract: The ability to work with interpreters is a core skill for UK medical graduates. At the University of Sheffield Medical School, this teaching was identified as a gap in the curriculum. Teaching was developed to use professional interpreters in role-play, based on evidence that professional interpreters improve health outcomes for patients with limited English proficiency. Other principles guiding the development of the teaching were an experiential learning format, integration to the core consultation skills curriculum, and sustainable delivery. The session was aligned with existing consultation skills teaching to retain the small-group experiential format and general practitioner (GP tutor. Core curricular time was found through conversion of an existing consultation skills session. Language pairs of professional interpreters worked with each small group, with one playing patient and the other playing interpreter. These professional interpreters attended training in the scenarios so that they could learn to act as patient and family interpreter. GP tutors attended training sessions to help them facilitate the session. This enhanced the sustainability of the session by providing a cohort of tutors able to pass on their expertise to new staff through the existing shadowing process. Tutors felt that the involvement of professional interpreters improved student engagement. Student evaluation of the teaching suggests that the learning objectives were achieved. Faculty evaluation by GP tutors suggests that they perceived the teaching to be worthwhile and that the training they received had helped improve their own clinical practice in consulting through interpreters. We offer the following recommendations to others who may be interested in

  7. Are GPs’ feelings of burnout and discontent reflected in the psychological content of their consultations?

    NARCIS (Netherlands)

    Zantinge, E.; Verhaak, P.F.M.; Bakker, D.H. de; Bensing, J.M.

    2007-01-01

    Aims: To investigate if consultations from general practitioners (GPs) with feelings of burnout or dissatisfaction contain less psychological elements compared to consultations from GPs without these negative feelings. It is known that GPs’ available time and specific communication tools are

  8. Participation of chronic patients in medical consultations: patients’ perceived efficacy, barriers and interest in support.

    NARCIS (Netherlands)

    Henselmans, I.; Heijmans, M.; Rademakers, J.; Dulmen, S. van

    2015-01-01

    Aims: Chronic patients are increasingly expected to participate actively in medical consultations. This study examined (i) patients' perceived efficacy and barriers to participation in consultations, (ii) patients' interest in communication support and (iii) correlates of perceived efficacy and

  9. Search Consultants: Boon or Bane to Non-Traditional Candidates for the Superintendency?

    Science.gov (United States)

    Chion-Kenney, Linda

    1994-01-01

    Women and minorities are still underrepresented in the superintendency. Search consultants can tackle discrimination by helping a school board consider desirable administrator competencies and personality traits and by advancing outstanding "nontraditional" candidates. Candidates should take consultants' advice about networking, resume…

  10. Collaborating with Design Consultancy firms for Effective Strategic Decision-Making in New Product Development

    NARCIS (Netherlands)

    Calabretta, G.; Gemser, G.; Wijnberg, N.M.; Hekkert, P.P.M.

    2013-01-01

    To contain risks and increase the profitability of innovation efforts, firms frequently engage in joint innovation activities with external sources of knowledge, like design consultancies. Innovation literature has given limited consideration to the strategic role that design consultancies can play

  11. Balancing intuition and rationality for improving innovation decision-making: The role of design consultancies

    NARCIS (Netherlands)

    Calabretta, G.; Gemser, G.; Wijnberg, N.M.; Hekkert, P.P.M.

    2013-01-01

    To contain risks and increase the profitability of innovation efforts, firms frequently engage in joint innovation activities with external sources of knowledge, like design consultancies. Innovation literature has given limited consideration to the strategic role that design consultancies can play

  12. HCEC pearls and pitfalls: suggested do's and don't's for healthcare ethics consultants.

    Science.gov (United States)

    Carrese, Joseph A; Antommaria, Armand H Matheny; Berkowitz, Kenneth A; Berger, Jeffrey; Carrese, Joseph; Childs, Brian H; Derse, Arthur R; Gallagher, Colleen; Gallagher, John A; Goodman-Crews, Paula; Heesters, Ann; Jurchak, Martha; Mitchell, Christine; Mokwyune, Nneka; Parsi, Kayhan; Powell, Tia; Powderly, Kathleen E; Rosell, Tarris; Shelton, Wayne; Smith, Martin L; Spike, Jeffrey; Tarzian, Anita; Wocial, Lucia

    2012-01-01

    Members of the Clinical Ethics Consultation Affairs Standing Committee of the American Society for Bioethics and Humanities present a collection of insights and recommendations developed from their collective experience, intended for those engaged in the work of healthcare ethics consultation.

  13. Supervisors' and residents' patient-education competency in challenging outpatient consultations

    NARCIS (Netherlands)

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

    2015-01-01

    Objectives: We compared supervisors' and residents' patient-education competency in challenging consultations in order to establish whether supervisors demonstrate sufficient patient-education competency to act credibly as role models and coaches for residents. Methods: All consultations conducted a

  14. 30 CFR 285.203 - With whom will MMS consult before issuance of a lease?

    Science.gov (United States)

    2010-07-01

    ... other relevant Federal laws. Federal statutes that require us to consult with or respond to findings... process, MMS prior to issuing the lease, will coordinate and consult with relevant Federal...

  15. Target Markets for Grain and Cotton Marketing Consultants and Market Information Systems

    OpenAIRE

    Vergara, Oscar; Coble, Keith H.; Hudson, Darren; Knight, Thomas O.; Patrick, George F.; Baquet, Alan E.

    2005-01-01

    This paper examines the use of market consultants and market information systems by grain and cotton producers. A model of producer demand for marketing information and consultants is proposed that decomposes price received into exogenous and endogenous components. The analysis is based on a survey of over 1,600 producers. The results suggest that expenditures on market information systems and market consultants are not independent and, more specifically, expenditures on marketing consultants...

  16. Effect of computer use in the consultation on the delivery of care.

    OpenAIRE

    Brownbridge, G; Evans, A.; Wall, T

    1985-01-01

    The effects of the use of a computer on the delivery of care in consultations in general practice were examined. In this trial a computer system provided for the review and update of patients' medical histories, notes on doctor-patient contacts, and information on repeat prescribing. Thirty consultations in which the computer system was used and 30 consultations in which no computer was used were matched individually for the doctor consulted, the sex and age of the patient, and the presenting...

  17. Choosing a Model for eConsult Specialist Remuneration: Factors to Consider

    OpenAIRE

    2016-01-01

    Electronic consultation (eConsult) is an innovative solution that allows specialists and primary care providers to communicate electronically, improving access to specialist care. Understanding the cost implications of different remuneration models available to pay specialists is of critical importance as adoption of these services continues to increase. We used data collected through the Champlain BASE (Building Access to Specialists through eConsultation) eConsult service to simulate the co...

  18. The role of a clinical nurse consultant in an Australian Health District: a quantitative survey

    OpenAIRE

    Wilkes, Lesley; Luck, Lauretta; O’Baugh, Jennifer

    2015-01-01

    Background This study replicates previous research undertaken in 2013 that explored the role of the Clinical Nurse Consultant in a metropolitan health district in Sydney, Australia. Methods A descriptive survey, using Likert scales, was used to collect data from Clinical Nurse Consultants. Results Clinical Nurse Consultants are well informed about the domains and functions of their role, as stipulated in the relevant award. They identified clinical service and consultancy as the area in which...

  19. Government agencies’ use of management consulting services in Sweden – an explorative study

    OpenAIRE

    2014-01-01

    The current paper investigates the use of management consultants in the Swedish public sector. Based on an analysis of the use of management consulting services in 55 Government agencies (GAs) in the years 2004-2011 the paper makes a number of contributions. First it confirms an overall growth of the use of consulting services in the public sector. However, it also shows that the use of consulting services and its growth are unevenly distributed across organizations, where GAs with a highly p...

  20. Consulting to change media contents: two cases in alcohol education.

    Science.gov (United States)

    Defoe, J R; Breed, W

    1988-01-01

    Two ten-year studies featuring intervention with media on the topic of alcohol are presented. The method of intervention, called cooperative consultation, is described and contrasted with other methods. Earlier experience dealing with prime-time television program personnel is reported. The first study involved a soap opera, which proved different from prime-time programs. Using the methods of content analysis, before-and-after studies found change in the desired direction. The second study was done with a business columnist on a daily newspaper. Again, before-and-after tests showed the indicated change-in some categories more than others. The efficacy of particular characteristics of the method of cooperative consultation are noted, and further work in related areas is suggested.

  1. Consultant-Guided Search Algorithms for the Quadratic Assignment Problem

    Science.gov (United States)

    Iordache, Serban

    Consultant-Guided Search (CGS) is a recent swarm intelligence metaheuristic for combinatorial optimization problems, inspired by the way real people make decisions based on advice received from consultants. Until now, CGS has been successfully applied to the Traveling Salesman Problem. Because a good metaheuristic should be able to tackle efficiently a large variety of problems, it is important to see how CGS behaves when applied to other classes of problems. In this paper, we propose an algorithm for the Quadratic Assignment Problem (QAP), which hybridizes CGS with a local search procedure. Our experimental results show that CGS is able to compete in terms of solution quality with one of the best Ant Colony Optimization algorithms, the MAX-MIN Ant System.

  2. Consulting to Star Trek: to boldly go into dynamic neuropsychiatry.

    Science.gov (United States)

    Forrest, David V

    2005-01-01

    Technical consultation to a screenwriter of episodes for The Next Generation, Deep Space Nine, and Voyager series of Star Trek drew upon the new discipline of dynamic neuropsychiatry to originate ideas for the alien experiences in the science fiction scripts. In particular, the neurologic misidentification syndromes, which elicit complex neuropsychic defenses and illustrate the psychodynamics of object relations, provided a sense of strangeness. The wide, creepy popular appeal of the syndromes, described here, reveals a latent mental defensive structure that is activated by psychopathology and neuropathology, but that is also somehow sensed by those who are more or less neurologically intact. Illustrative examples are drawn from these series and the more recent Enterprise series that has been aired since the consultation. In addition, the changing persona of the physician character in Star Trek is a projection of our changing status in American society.

  3. Organizational cultural competence consultation to a mental health institution.

    Science.gov (United States)

    Fung, Kenneth; Lo, Hung-Tat Ted; Srivastava, Rani; Andermann, Lisa

    2012-04-01

    Cultural competence is increasingly recognized as an essential component of effective mental health care delivery to address diversity and equity issues. Drawing from the literature and our experience in providing cultural competence consultation and training, the paper will discuss our perspective on the foundational concepts of cultural competence and how it applies to a health care organization, including its programs and services. Based on a recent consultation project, we present a methodology for assessing cultural competence in health care organizations, involving mixed quantitative and qualitative methods. Key findings and recommendations from the resulting cultural competence plan are discussed, including core principles, change strategies, and an Organizational Cultural Competence Framework, which may be applicable to other health care institutions seeking such changes. This framework, consisting of eight domains, can be used for organizational assessment and cultural competence planning, ultimately aiming at enhancing mental health care service to the diverse patients, families, and communities.

  4. Patients' perspectives on antidepressant treatment in consultations with physicians.

    Science.gov (United States)

    Fosgerau, Christina Fogtmann; Davidsen, Annette Sofie

    2014-05-01

    Patient perspectives on antidepressant treatment and physician attention, and responses toward these in consultations with patients diagnosed with depression, are rarely studied. We analyzed video-recorded consultations with general practitioners (GPs) and psychiatrists. We used conversation analysis and systemic functional linguistics and found that the perspectives patients expressed related to the possibility of achieving, and the inability to retain, a sense of agency. Patients also presented indirect expressions of shame and expressions suggesting alienation toward medical treatment. GPs attended to patient perspectives by talking about medication indirectly. When patients expressed their perspectives, GPs responded by being nonauthoritative but also without prompting patients to elaborate on their reflections. Psychiatrists responded authoritatively and never urged patients to reflect on their perspectives. Shared decision making did not take place because physicians did not explore patients' perspectives in depth or offer their expertise by taking these perspectives into consideration.

  5. Case Complexity and Quality Attestation for Clinical Ethics Consultants.

    Science.gov (United States)

    Spielman, Bethany; Craig, Jana; Gorka, Christine; Miller, Keith

    2015-01-01

    A proposal by the American Society for Bioethics and Humanities (ASBH) to identify individuals who are qualified to perform ethics consultations neglects case complexity in candidates' portfolios. To protect patients and healthcare organizations, and to be fair to candidates, a minimum case complexity level must be clearly and publicly articulated. This proof-of-concept study supports the feasibility of assessing case complexity. Using text analytics, we developed a complexity scoring system, and retrospectively analyzed more than 500 ethics summaries of consults performed at an academic medical center during 2013. We demonstrate its use with seven case summaries that range in complexity from uncomplicated to very complicated. We encourage the ASBH to require a minimum level of case complexity, and recommend that attestation portfolios include several cases of moderate complexity and at least one very complex case.

  6. The consultant nurse - expert practitioner and much more.

    Science.gov (United States)

    Mitchell, Theresa; Butler-Williams, Carole; Easton, Karen; Ingledew, Ian; Parkin, Donna; Wade, Sharon; Warner, Richard

    The consultant nurse (CN) role is usually described in terms of four domains devised by the Department of Health - clinical practice, education and training, leadership, and research and service development. This study set out to explicate the diversity and complexity of CN roles in an NHS trust; to describe aspects of extraordinary practice and to identify perceived differences between this role and other advanced practice roles. Accounts were written by six CNs and subjected to concept mapping to facilitate identification of extraordinary practice. Four themes emerged: entrepreneurial activity and innovation; clinical autonomy and role dynamism; influential national and international research conduct; consultancy and education across discipline boundaries. These included descriptions of higher order skills that surpass usual requirements of 'expert' or 'advanced' practice. Comparisons with other advanced practice roles are drawn from the literature and data collected in this study. Differences between the roles have implications for sustainability.

  7. [Analysis of ambulatory consultation length in medical clinics].

    Science.gov (United States)

    Outomuro, Delia; Actis, Andrea Mariel

    2013-03-01

    Planning a schedule for medical appointments in health services must be efficient and flexible, but also it has to meet the needs of patients, health professionals and non-medical staff. There are large differences in the opinión about the optimal duration to meet these objectives, across countries. In this paper we propose to perform a review of the literature to estímate the appropriate length ofa medical consultation in primary care, based on international standards. We conclude that managers of health systems should rethink the way they organize the agenda for medical appointments. Medical and bioethical reasons suggest assigning a lapse cióse to 20 minutes for consultations in medical clinics.

  8. Job competencies for the malaysian consultant project managers

    Directory of Open Access Journals (Sweden)

    Dr. Ilias Said

    2009-12-01

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

  9. The consultation timetabling problem at Danish high schools

    DEFF Research Database (Denmark)

    Kristiansen, Simon; Sørensen, Matias; Herold, Michald B.

    2013-01-01

    In the different stages of the educational system, the demand for efficient planning is increasing. This article treats the $$\\mathcal NP $$ NP -hard Consultation Timetabling Problem, a recurrent planning problem for the high schools in Denmark, which has not been described in the literature before......, it is shown that the ALNS algorithm in average provides results within 5 % of optimum. The developed algorithm has been implemented in the commercial product Lectio, and is therefore available for approximately 95 % of the Danish high schools....

  10. New Consultant Joins Occupational Health Services’ Team | Poster

    Science.gov (United States)

    One of Occupational Health Services’ (OHS') most valuable resources is new medical consultant Anusha Belani, M.D., chief of epidemiology at Frederick Memorial Hospital (FMH). Belani graduated from the University of Delhi and received her medical degree from Lady Hardinge Medical College in 1979. She is currently the only physician in Frederick County who specializes in infectious diseases. After completing her residency at Sinai Hospital, Belani established her own practice in Frederick in January of 1987.

  11. Growth Drivers for IT Consultancy Services in Latin America (LATAM)

    OpenAIRE

    Shergill, Darvinder

    2014-01-01

    With slower than anticipated growth over the last decade there is renewed impetus for a leading global IT Consultancy Services company to identify new and exciting opportunities in the emerging market of Latin America (LATAM) to increase market share and revenue. With an ever increasing portfolio of services, strategic alignment and renewed prioritization is required on high value industry segments in order to maximize profit margins, while at the same time continuing to maintain a competitiv...

  12. Chile; Staff Report for the 2015 Article IV Consultation

    OpenAIRE

    2015-01-01

    This 2015 Article IV Consultation highlights that the GDP growth of Chile has remained lackluster over the past year. The main force behind the economic slowdown in 2014 has been the sharp fall in private investment, mainly the consequence of the end of the mining boom, but also reflecting the uncertainty and adjustment costs associated with the structural reform agenda. The IMF staff expects growth to increase modestly to 2.5 percent in 2015, mainly thanks to strong fiscal support. Private d...

  13. Cyprus; Staff Report for the 2002 Article IV Consultation

    OpenAIRE

    International Monetary Fund

    2003-01-01

    This 2002 Article IV Consultation highlights that after four years of strong growth, economic activity in Cyprus has tailed off since late 2001, affected by the global economic slowdown. The authorities estimate growth for 2002 to have declined to 2.3 percent, with falling tourist arrivals and weakening consumer and business confidence. Inflation has risen to 2.9 percent year-over-year in December on account of indirect tax increases, but core inflation remains low. The current account defici...

  14. Enhancing consultating services to address national demands of strategic importance

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    @@ As China's top advisory body in science and technology (S&T), over the past four years, CAS has completed nearly 60 consultative reports by pooling the collective wisdom of prestigious scientists across China. Focusing on issues related to the national drive for a comprehensive, balanced and sustainable social- economic development and major S&T strategies, these reports offered scientific insights for decision-making of the central authorities and attracted their close attention.

  15. Consultative committee on ionizing radiation: Impact on radionuclide metrology.

    Science.gov (United States)

    Karam, L R; Ratel, G

    2016-03-01

    In response to the CIPM MRA, and to improve radioactivity measurements in the face of advancing technologies, the CIPM's consultative committee on ionizing radiation developed a strategic approach to the realization and validation of measurement traceability for radionuclide metrology. As a consequence, measurement institutions throughout the world have devoted no small effort to establish radionuclide metrology capabilities, supported by active quality management systems and validated through prioritized participation in international comparisons, providing a varied stakeholder community with measurement confidence.

  16. Consultant pharmacists, advanced practice nurses, and the interdisciplinary team.

    Science.gov (United States)

    Resnick, Barbara

    2014-03-01

    Although in geriatrics we are better than many other clinical disciplines in terms of providing interdisciplinary care to older adults, I hope that we will continue to recognize how much more could actually be done. Before addressing the relationship between advanced practice nurses (APNs) and consultant pharmacists in real world settings, I want to review teamwork in geriatrics in general. It is critical to define what we mean by team, what type of team, and what the goals are of this teamwork.

  17. Ad hoc statistical consulting within a large research organization

    CSIR Research Space (South Africa)

    Elphinstone, CD

    2009-08-01

    Full Text Available and scientific development ... and thereby to contribute to the improvement of the quality of life of the people of the Republic... " The CSIR receives an annual grant from Parliament, through the Department of Science and Technology (DST), which accounts.... Prior to 1987, the emphasis of the CSIR was on promoting science with most of the statistical work involving either statistical theory development or consulting to CSIR researchers. In 1987, the CSIR went through a period of transition, with the focus...

  18. Première consultation de contraception chez les adolescentes

    OpenAIRE

    Beliard, Aude

    2016-01-01

    Adequate contraception prescription is mandatory for teenagers to avoid any unwanted pregnancy. Counselling and description of side effect improve compliance. Use of condom is important to avoid sexually transmitted infections. Combined estroprogestin contraception has multiple non-contraceptive benefits, e.g. dysmenorrhea improvement. Familial and personal history is needed before contraception prescription. Further consultation 3 months later has to be planned to evaluate compliance, side e...

  19. MANAGEMENT COACHING VERSUS MANAGEMENT CONSULTING: WHICH COMES FIRST?

    OpenAIRE

    Maria HERMEL STĂNESCU; Mihai SVASTA

    2014-01-01

    In the fast growing business services market today, one manager may wonder whether to use coaching services or consultancy services. Questions might arise: which are the differences between the two types of services, their common points and the relationship between the two? This paper aims to explore the above mentioned questions while pleading for both services. The fact is that they are powerful processes that can bring added value to the organization through use of knowledge. The bottom li...

  20. Highlights of Selected Consultative Studies of CASAD in 2010

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    Focusing on issues critical to national economy, people's livelihood and sustainable development, such as energy, resources and the environment, in 2010, the Academic Divisions of CAS (CASAD) completed a number of consultative studies on a variety of topics, ranging from land reclamation, exploiting the Heishanxia Reach of the Yellow River, developing a national energy base for large-scale hybrid PV-hydro power generation in Qinghai, to the development of a largescale integrated energy base in Xinjiang, and industrial energy saving in China.In line with China's pressing needs for developing strategically-important emerging industries, and at the request of the General Office of the State Council, CASAD carried out a questionnaire survey and convened many seminars of CAS Members to work out an Investigation Report on Developing Strategic Emerging Industries in China, providing important scientific evidence to the State Council and related government departments.In all, ten consultative reports were presented to the State Council and 12 CAS Member Suggestions were submitted to the State Council and related government departments, which attracted close attention from policymakers.The followings are highlights of some of the consultation reports.

  1. e-EPS News: Consultation on European Research, Innovation & Gender

    CERN Multimedia

    e-EPS

    2011-01-01

    e-EPS News is a monthly addition to the CERN Bulletin line-up, showcasing an article by the e-EPS – the European Physical Society newsletter – as part of a new collaboration between the two publications.   EPS members have been invited to take part in a Public Consultation on the Future of Gender and Innovation in Europe. The consultation, which is intended to complement the EC Green Paper ‘From Challenges to Opportunities: Towards a Common Strategic Framework for EU Research and Innovation Funding’, will be published and discussed during the first European Gender Summit in Brussels on 8-9 November this year. It is hoped that the consultation – which is being coordinated by genSET and the organisers of the European Gender Summit – will create a better understanding of how Europe might benefit from a more effective mainstreaming of the gender dimension in research, innovation and scientific systems. Responses from the co...

  2. Consultation and cooperation in NATO: nuclear planning, 1975-1987

    Energy Technology Data Exchange (ETDEWEB)

    Chernoff, F.B.

    1987-01-01

    This study looks at three types of explanation of international cooperation, which deal in different ways with communication and consultation. Themost-general theoretical explanation contrasts recent realist theories, like those of Waltz and Gilpin, with Keohane's functional theory of regimes. Secondly, the study looks at theories of information flow and processing (an element of consultation) within the alliance, like those of Deutsch and Steinbruner. Such theories explain governmental behavior using concepts like equilibrium of systems and feedback loop. Third, the study considers hypotheses that deal specifically with NATO and military alliances. The hypotheses relate alliance consultation processes to the cooperativeness of the cases' outcomes. Evidence is drawn from case studies of NATO decision-making. The cases include politically sensitive deployment issues, like the enhanced radiation warhead controversy in 1977-78 and the intermediate-range nuclear force deployment decision in 1979, and important, but less politically volatile arms-control decisions, including the 1975 option three proposal, the French plan for a conference on disarmament in Europe, approved in 1980, and the 1987 American zero-zero proposal on short- and intermediate-range nuclear forces in Europe.

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

    Science.gov (United States)

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

    2015-05-01

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

  4. Research Ethics Consultation: Ethical and Professional Practice Challenges and Recommendations

    Science.gov (United States)

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

    2015-01-01

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

  5. Starting a business as a nurse consultant: practical considerations.

    Science.gov (United States)

    Papp, E M

    2000-03-01

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

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

    Science.gov (United States)

    Afifi, Ladan; Shinkai, Kanade

    2017-03-01

    Inpatient dermatology consultative services care for hospitalized patients with skin disease in collaboration with the primary inpatient team. Effective, efficient communication is important. A consultation service must develop strong relationships with primary inpatient teams requesting consults in order to provide optimal patient care. Prior studies have identified effective communication practices for inpatient consultative services. This narrative review provides a summary of effective communication practices for an inpatient dermatology consultation service organized into 5 domains: (1) features of the initial consult request; (2) best practices in responding to the initial consult; (3) effective communication of recommendations; (4) interventions to improve consultations; and (5) handling curbside consultations. Recommendations include identifying the specific reason for consult; establishing urgency; secure sharing of sensitive clinical information such as photographs; ensuring timely responses; providing clear yet brief documentation of the differential diagnosis, problem list, final diagnosis and recommendations; and limiting curbside consultations. Future studies are needed to validate effective strategies to enhance communication practices within an inpatient dermatology consultative service. ©2017 Frontline Medical Communications.

  7. 6 CFR 27.120 - Designation of a coordinating official; Consultations and technical assistance.

    Science.gov (United States)

    2010-01-01

    ...; Consultations and technical assistance. 27.120 Section 27.120 Domestic Security DEPARTMENT OF HOMELAND SECURITY... coordinating official; Consultations and technical assistance. (a) The Assistant Secretary will designate a... permit, be available to consult and to provide technical assistance to an owner or operator who seeks...

  8. 48 CFR 452.237-78 - Contracts with Consulting Firms for Services.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Contracts with Consulting....237-78 Contracts with Consulting Firms for Services. As prescribed in 437.270(b), insert a clause substantially as follows: Contracts with Consulting Firms for Services (FEB 1988) Offerors are specifically...

  9. Faculty Consulting in Natural Sciences and Engineering: Between Formal and Informal Knowledge Transfer

    Science.gov (United States)

    Amara, Nabil; Landry, Rejean; Halilem, Norrin

    2013-01-01

    Academic consulting is a form of knowledge and technology transfer largely under-documented and under-studied that raises ethical and resources allocation issues. Based on a survey of 2,590 Canadian researchers in engineering and natural sciences, this paper explores three forms of academic consulting: (1) paid consulting; (2) unpaid consulting…

  10. 77 FR 69820 - Access to Confidential Business Information by Electronic Consulting Services, Inc., and Its...

    Science.gov (United States)

    2012-11-21

    ... AGENCY Access to Confidential Business Information by Electronic Consulting Services, Inc., and Its... Protection Agency (EPA). ACTION: Notice. SUMMARY: EPA has authorized its contractor, Electronic Consulting... to a particular entity, consult the technical person listed under FOR FURTHER INFORMATION CONTACT. B...

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

    Science.gov (United States)

    Koper, Ian; van der Heide, Agnes; Janssens, Rien; Swart, Siebe; Perez, Roberto; Rietjens, Judith

    2014-01-01

    Palliative sedation is considered a normal medical practice by the Royal Dutch Medical Association. Therefore, consultation of an expert is not considered mandatory. The European Association of Palliative Care (EAPC) framework for palliative sedation, however, is more stringent: it considers the use of palliative sedation without consulting an expert as injudicious and insists on input from a multi-professional palliative care team. This study investigates the considerations of Dutch physicians concerning consultation about palliative sedation with specialist palliative care services. Fifty-four physicians were interviewed on their most recent case of palliative sedation. Reasons to consult were a lack of expertise and the view that consultation was generally supportive. Reasons not to consult were sufficient expertise, the view that palliative sedation is a normal medical procedure, time pressure, fear of disagreement with the service and regarding consultation as having little added value. Arguments in favour of mandatory consultation were that many physicians lack expertise and that palliative sedation is an exceptional intervention. Arguments against mandatory consultation were practical obstacles that may preclude fulfilling such an obligation (i.e. lack of time), palliative sedation being a standard medical procedure, corroding a physician's responsibility and deterring physicians from applying palliative sedation. Consultation about palliative sedation with specialist palliative care services is regarded as supportive and helpful when physicians lack expertise. However, Dutch physicians have both practical and theoretical objections against mandatory consultation. Based on the findings in this study, there seems to be little support among Dutch physicians for the EAPC recommendations on obligatory consultation.

  12. 76 FR 9012 - Access to Confidential Business Information by Electronic Consulting Services, Inc.

    Science.gov (United States)

    2011-02-16

    ... AGENCY Access to Confidential Business Information by Electronic Consulting Services, Inc. AGENCY... Consulting Services, Inc. (ECS) of Fairfax, VA, to access information which has been submitted to EPA under... applicability of this action to a particular entity, consult the technical person listed under FOR FURTHER...

  13. 21 CFR 200.10 - Contract facilities (including consulting laboratories) utilized as extramural facilities by...

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Contract facilities (including consulting... GENERAL General Provisions § 200.10 Contract facilities (including consulting laboratories) utilized as... Cosmetic Act specifically authorizes inspection of consulting laboratories as well as any factory...

  14. Consultation in Special Needs Education in Sweden and Finland: A Comparative Approach

    Science.gov (United States)

    Sundqvist, Christel; von Ahlefeld Nisser, Désirée; Ström, Kristina

    2014-01-01

    The article compares the conditions and implementation of special education professionals' consulting task in Sweden and Finland. The article first describes the background of the consulting teacher role and special education in Sweden and in Finland. Two different perspectives in the continuum on consultation are presented, followed by a…

  15. 40 CFR Appendix D to Subpart E of... - EPA Transition Policy-Existing Consulting Engineering Agreements

    Science.gov (United States)

    2010-07-01

    ... Consulting Engineering Agreements D Appendix D to Subpart E of Part 35 Protection of Environment... Transition Policy—Existing Consulting Engineering Agreements a. access to records—audit 1. Access clause... access clause is included in the consulting engineering subagreement. The clause contained in appendix C...

  16. STATE AND DEVELOPMENT PROSPECTS OF GERMANY CONSULTING MARKET IN THE CONTEXT OF EUROPE-WIDE TRENDS

    Directory of Open Access Journals (Sweden)

    K. Kovalska

    2014-09-01

    Full Text Available The paper deals with the actual state of consulting market in Germany. The structural configuration of the Germany consulting market on functional grounds, with the customer's branch, as well as geographically were analyzed. The main prospects of German consulting market development in the context of Europe-wide trends have been defined.

  17. Use of Uncertainty Reduction and Narrative Paradigm Theories in Management Consulting and Teaching: Lessons Learned

    Science.gov (United States)

    Barker, Randolph T.; Gower, Kim

    2009-01-01

    Teaching business communication while performing professional business consulting is the perfect learning match. The bizarre but true stories from the consulting world provide excellent analogies for classroom learning, and feedback from students about the consulting experiences reaffirms the power of using stories for teaching. When discussing…

  18. 18 CFR 5.1 - Applicability, definitions, and requirement to consult.

    Science.gov (United States)

    2010-04-01

    ..., definitions, and requirement to consult. 5.1 Section 5.1 Conservation of Power and Water Resources FEDERAL... LICENSE APPLICATION PROCESS § 5.1 Applicability, definitions, and requirement to consult. (a) This part..., municipality, or state may develop and file a license application under this part. (d) Requirement to consult...

  19. 75 FR 26345 - Agency Information Collection (Ethics Consultation Feedback Tool (ECFT)) New Enrollee Survey...

    Science.gov (United States)

    2010-05-11

    ... AFFAIRS Agency Information Collection (Ethics Consultation Feedback Tool (ECFT)) New Enrollee Survey.... 2900-New (VA Form 10-0502).'' SUPPLEMENTARY INFORMATION: Title: Ethics Consultation Feedback Tool (ECFT... experience during the Ethics Consultation Service. VA will be used the data to improve the process of...

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

    Directory of Open Access Journals (Sweden)

    Timur A. Tultaev

    2013-01-01

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

  1. The Effect of Audit Standards on Fraud Consultation and Auditor Judgment

    NARCIS (Netherlands)

    A.H. Gold-Nöteberg (Anna); W.R. Knechel (Robert); P. Wallage (Philip)

    2008-01-01

    textabstractWe investigate how the strictness of a requirement to consult on potential client fraud affects auditor assessments of fraud risk and the propensity to consult with firm experts. We test two specific forms of guidance about fraud consultations: (1) relatively strict (i.e., mandatory and

  2. 48 CFR 52.244-4 - Subcontractors and outside associates and consultants (Architect-engineer services).

    Science.gov (United States)

    2010-10-01

    ... associates and consultants (Architect-engineer services). 52.244-4 Section 52.244-4 Federal Acquisition... consultants (Architect-engineer services). As prescribed in 44.204(b), insert the following clause: Subcontractors and Outside Associates and Consultants (Architect-Engineer Services) (AUG 1998) Any...

  3. Conjoint Behavioral Consultation: Application to the School-Based Treatment of Anxiety Disorders

    Science.gov (United States)

    Auster, Elana R.; Feeney-Kettler, Kelly A.; Kratochwill, Thomas R.

    2006-01-01

    In the current paper we discuss the treatment of childhood anxiety disorders using a problem-solving consultation framework. The role of consultation as a service delivery model in a school setting is elaborated on, as well as the contribution that consultation has in the movement towards evidence-based practices in school psychology.…

  4. The Influence of Gender on the Likelihood of Using Soft Social Power Strategies in School Consultation

    Science.gov (United States)

    Getty, Kimberly C.; Erchul, William P.

    2009-01-01

    The social power typology developed originally by French and Raven in 1959 and revised by Raven in 1965 and 1992 was applied to study school consultation. Specifically, we investigated how the gender of school psychologist consultants and teacher consultees influence how likely consultants are to use soft power strategies, identified as those…

  5. Faculty Consulting in Natural Sciences and Engineering: Between Formal and Informal Knowledge Transfer

    Science.gov (United States)

    Amara, Nabil; Landry, Rejean; Halilem, Norrin

    2013-01-01

    Academic consulting is a form of knowledge and technology transfer largely under-documented and under-studied that raises ethical and resources allocation issues. Based on a survey of 2,590 Canadian researchers in engineering and natural sciences, this paper explores three forms of academic consulting: (1) paid consulting; (2) unpaid consulting…

  6. The Effect of Audit Standards on Fraud Consultation and Auditor Judgment

    NARCIS (Netherlands)

    A.H. Gold-Nöteberg (Anna); W.R. Knechel (Robert); P. Wallage (Philip)

    2008-01-01

    textabstractWe investigate how the strictness of a requirement to consult on potential client fraud affects auditor assessments of fraud risk and the propensity to consult with firm experts. We test two specific forms of guidance about fraud consultations: (1) relatively strict (i.e., mandatory and

  7. Consultation in Special Needs Education in Sweden and Finland: A Comparative Approach

    Science.gov (United States)

    Sundqvist, Christel; von Ahlefeld Nisser, Désirée; Ström, Kristina

    2014-01-01

    The article compares the conditions and implementation of special education professionals' consulting task in Sweden and Finland. The article first describes the background of the consulting teacher role and special education in Sweden and in Finland. Two different perspectives in the continuum on consultation are presented, followed by a…

  8. Direct Behavioral Consultation: Effects on Teachers' Praise and Student Disruptive Behavior

    Science.gov (United States)

    Dufrene, Brad A.; Lestremau, Lauren; Zoder-Martell, Kimberly

    2014-01-01

    Direct behavioral consultation is an extension of traditional behavioral consultation and focuses on assessment and training in the classroom during ongoing classroom activities. This study evaluated direct behavioral consultation services in two elementary alternative classrooms referred following a program evaluation in which data suggested…

  9. Teachers' Perceptions and Experiences Consulting with School Counselors: A Qualitative Study

    Science.gov (United States)

    Cholewa, Blair; Goodman-Scott, Emily; Thomas, Antoinette; Cook, Jennifer

    2016-01-01

    School counselor-teacher consultation is an efficient strategy for school counselors to indirectly serve students on their caseload. Teachers' perceptions are crucial in examining this consultation process. This qualitative study examined elementary school teachers' perceptions and experiences of school counselor-teacher consultation. The…

  10. NATO (North Atlantic Treaty Organization) Politico-Military Consultation: Shaping Alliance Decisions,

    Science.gov (United States)

    1984-01-01

    to the relative size of the country involved. Former Secretary General Manlio Brosio has observed that for the larger allies, consultation is "a way...consultation. 21. Manlio Brosio, "Consultation and the Atlantic Alliance," Survival 16 (May-June 1974): 117. 22. Cleveland, NATO: The Transatlantic

  11. "Well, Now, Okey Dokey": English Discourse Markers in Spanish-Language Medical Consultations

    Science.gov (United States)

    Vickers, Caroline; Goble, Ryan

    2011-01-01

    The purpose of this article is to examine the use of English discourse markers (EDMs) in medical consultations that were conducted in Spanish. Data are collected from an audio-recorded corpus of Spanish-language consultations that took place in a small community clinic in the United States as well as post-consultation interviews with patients and…

  12. Consulting a trained physician when considering a request for euthanasia: an evaluation of the process in flanders and the Netherlands.

    Science.gov (United States)

    Van Wesemael, Yanna; Cohen, Joachim; Bilsen, Johan; Onwuteaka-Philipsen, Bregje D; Distelmans, Wim; Deliens, Luc

    2010-12-01

    In Belgium and the Netherlands, consultation of a second independent physician by the attending physician is mandatory in euthanasia cases. In both countries, specialized consultation services have been established to provide physicians trained for that purpose. This retrospective study describes and compares the quality of consultation of both services based on surveys of attending physicians and those providing the consultation (consultants). While Dutch consultants discussed certain subjects, for example, alternative curative or palliative treatment more often with the attending physician than Belgian consultants, both usually discussed those subjects considered necessary for a quality consultation and were independent from patient and attending physician. Over 90% of attending physicians in both countries evaluated the consultant's knowledge of palliative care, patient's disease, and judicial procedure, and their communication skills, as sufficient. Consultation with specialized consultation services seems to promote quality of euthanasia consultations.

  13. 18 CFR 401.116 - Disclosure to consultants, advisory committees, State and local government officials, and other...

    Science.gov (United States)

    2010-04-01

    ... consultants, advisory committees, State and local government officials, and other special government employees... Disclosure to consultants, advisory committees, State and local government officials, and other special... Commission consultants, advisory committees, state and local government officials, and other...

  14. Internationalisation of small consultancy firms: An exploratory study on how small Dutch consultancy firms achieve and maintain successful establishment in the Spanish market

    OpenAIRE

    Schnepper, Nicolette

    2007-01-01

    This paper analyse the internationalisation process of small Dutch consultancy firms into the Spanish market. The central research question is: How do small Dutch consultancy firms achieve and maintain successful establishment in the Spanish market? In order to answer this question, a literature review has been conducted about factors that concern why and how SMEs internationalise, what problems and obstacles they encounter, internationalisation in the consultancy sector, inves...

  15. CONCEPTUALIZING SPECIALIZED PSYCHOSOCIAL CONSULTING FOR PERSONS WITH EPILEPSY

    Directory of Open Access Journals (Sweden)

    Polina Šedienė

    2016-09-01

    Full Text Available The goal of the article is to describe and to reason conception of specialized psychosocial consulting, revealing definition of epilepsy as disease in classical sociological and existential theories and from rights of disabled person’s perspectives. Restriction of social life and possibilities for disabled, person’s with epilepsy and social worker’s interactions, which have importance for development of disabled people participation in social life, are analysed in the article. In order to achieve the goal various methods are used: scientific literature review, reflection of social worker who works with persons with epilepsy, interviews with the clients of Psychosocial consulting centre for persons with epilepsy in 2015, groups discussions (2013, 2016, analysis of conception of Psychosocial consulting centre for persons with epilepsy. 139SPECIALIZUOTO PSICHOSOCIALINIO KONSULTAVIMO EPILEPSIJA S ERGANTIEMS ASMENIMS KONCEPCIJOS PAGRINDIMAS Based on classical sociological theories, people with disease and society members attach such meanings to the illness, which support and enforce stigmatized attitude and behaviour toward person with disease, strengthens negative social aspects of epilepsy, which restricts present and new developed social interactions, full engagement into society. Historical cultural context of epilepsy presupposes attitude that epileptic seizure is “an awful” event, encounter with death, which reminds finality of human, event which causes fear, panic, rejection of surrenders and which restrains social life of person with epilepsy, his or her selfperception. Therefore people with epilepsy very often confine themselves in sick person role, isolate themselves from society, and become dependent on others. Positive interaction between social worker and person with epilepsy during epileptic seizure strengthens understanding of possibilities of person with epilepsy. Specialised psychosocial consulting services for people with

  16. Consultants as victims of bullying and undermining: a survey of Royal College of Obstetricians and Gynaecologists consultant experiences

    Science.gov (United States)

    Shabazz, Tariq; Parry-Smith, William; Oates, Sharon; Henderson, Steven; Mountfield, Joanna

    2016-01-01

    Objective To explore incidents of bullying and undermining among obstetrics and gynaecology (O&G) consultants in the UK, to add another dimension to previous research and assist in providing a more holistic understanding of the problem in medicine. Design Questionnaire survey. Setting Royal College of Obstetricians and Gynaecologists (RCOG). Participants O&G consultant members/fellows of the RCOG working in the UK. Main outcome measures Measures included a typology of 4 bullying and undermining consequences from major to coping. Results There was a 28% (664) response rate of whom 44% (229) responded that they had been persistently bullied or undermined. Victims responded that bullying and undermining is carried out by those senior or at least close in the hierarchy. Of the 278 consultants who answered the question on ‘frequency of occurrence’, 50% stated that bullying and undermining occurs on half, or more, of all encounters with perpetrators and two-thirds reported that it had lasted more than 3 years. The reported impact on professional and personal life spans a wide spectrum from suicidal ideation, depression and sleep disturbance, and a loss of confidence. Over half reported problems that could compromise patient care. When victims were asked if the problem was being addressed, 73% of those that responded stated that it was not. Conclusions Significant numbers of consultants in O&G in the UK are victims of bullying and undermining behaviour that puts their own health and patient care at risk. New interventions to tackle the problem, rather than its consequences, are required urgently, together with greater commitment to supporting such interventions. PMID:27324715

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

    Science.gov (United States)

    Van Campen, Luann E; Allen, Albert J; Watson, Susan B; Therasse, Donald G

    2015-04-03

    Background: Bioethics consultations are conducted in varied settings, including hospitals, universities, and other research institutions, but there is sparse information about bioethics consultations conducted in corporate settings such as pharmaceutical companies. The purpose of this article is to describe a bioethics consultation service at a pharmaceutical company, to report characteristics of consultations completed by the service over a 6-year period, and to share results of a consultation feedback survey. Methods: Data on the descriptive characteristics of bioethics consultations were collected from 2008 to 2013 and analyzed in Excel 2007. Categorical data were analyzed via the pivot table function, and time-based variables were analyzed via formulas. The feedback survey was administered to consultation requesters from 2009 to 2012 and also analyzed in Excel 2007. Results: Over the 6-year period, 189 bioethics consultations were conducted. The number of consultations increased from five per year in 2008 to approximately one per week in 2013. During this time, the format of the consultation service was changed from a committee-only approach to a tiered approach (tailored to the needs of the case). The five most frequent topics were informed consent, early termination of a clinical trial, benefits and risks, human biological samples, and patient rights. The feedback survey results suggest the consultation service is well regarded overall and viewed as approachable, helpful, and responsive. Conclusions: Pharmaceutical bioethics consultation is a unique category of bioethics consultation that primarily focuses on pharmaceutical research and development but also touches on aspects of clinical ethics, business ethics, and organizational ethics. Results indicate there is a demand for a tiered bioethics consultation service within this pharmaceutical company and that advice was valued. This company's experience indicates that a bioethics consultation service raises

  18. Changes in the remuneration system for general practitioners: effects on contact type and consultation length.

    Science.gov (United States)

    van Dijk, Christel E; Verheij, Robert A; te Brake, Hans; Spreeuwenberg, Peter; Groenewegen, Peter P; de Bakker, Dinny H

    2014-01-01

    In The Netherlands, the remuneration system for GPs changed in 2006. Before the change, GPs received a capitation fee for publicly insured patients and fee for service (FFS) for privately insured patients. In 2006, a combined system was introduced for all patients, with elements of capitation as well as FFS. This created a unique opportunity to investigate the effects of the change in the remuneration system on contact type and consultation length. Our hypothesis was that for former publicly insured patients the change would lead to an increase in the proportion of home visits, a decrease in the proportion of telephone consultations and an increase in consultation length relative to formerly privately insured patients. Data were used from electronic medical records from 36 to 58 Dutch GP practices and from 532,800 to 743,961 patient contacts between 2002 and 2008 for contact type data. For consultation length, 1,994 videotaped consultations were used from 85 GP practices in 2002 and 499 consultations from 16 GP practices in 2008. Multilevel multinomial regression analysis was used to analyse consultation type. Multilevel logistic and linear regression analyses were used to examine consultation length. Our study shows that contact type and consultation length were hardly affected by the change in remuneration system, though the proportion of home visits slightly decreased for privately insured patients compared with publicly insured patients. Declaration behaviour regarding telephone consultations did change; GP practices more consistently declared telephone consultations after 2006.

  19. Role of external management consultants in health-care organizations implementing TQM.

    Science.gov (United States)

    Badrick, Tony C; Preston, Arthur P

    2002-01-01

    The reliance of organizations on consultants generally is increasing. Although the efficacy of the use of consultants in implementing change programs has been questioned, there have been limited attempts to systematically analyze the contribution of consultants. This article reports observations on the use of consultants in health-care organizations implementing total quality management (TQM). The relationship between the use of external management consultants and successful TQM implementation is not simple. There appears to be a difference in the way consultants are used by the public and private sectors, with the private organizations forming long-term relationships with their consultants. The perceived value of consultants to the private organizations was higher. Consultants are not a substitute for leadership, and the success of outside consultants probably depends on the commitment of senior management. External management consultants appeared to be linked to the successful implementation of TQM. Further, despite the conventional wisdom to the contrary, some prepackaged programs may be beneficial for the introduction of TQM into an organization.

  20. An Analysis of WhatsApp Usage for Communication Between Consulting and Emergency Physicians.

    Science.gov (United States)

    Gulacti, Umut; Lok, Ugur; Hatipoglu, Sinan; Polat, Haci

    2016-06-01

    The aim of this study was to evaluate WhatsApp messenger usage for communication between consulting and emergency physicians. A retrospective, observational study was conducted in the emergency department (ED) of a tertiary care university hospital between January 2014 and June 2014. A total of 614 consultations requested by using the WhatsApp application were evaluated, and 519 eligible consultations were included in the study. The WhatsApp messages that were transferred to consultant physicians consisted of 510 (98.3%) photographic images, 517 (99.6%) text messages, 59 (11.3%) videos, and 10 (1.9%) voice messages. Consultation was most frequently requested from the orthopedics clinic (n = 160, 30.8%). The majority of requested consultations were terminated only by evaluation via WhatsApp messages. (n = 311, 59.9%). Most of the consulting physicians were outside of the hospital or were mobile at the time of the consultation (n = 292, 56.3%). The outside consultation request rate was significantly higher for night shifts than for day shifts (p = .004), and the majority of outside consultation request were concluded by only WhatsApp application (p WhatsApp is useful a communication tool between physicians, especially for ED consultants who are outside the hospital, because of the ability to transfer large amounts of clinical and radiological data during a short period of time.

  1. Applying Motivational Interviewing to School-Based Consultation: A Commentary on "Has Consultation Achieved Its Primary Prevention Potential?," an Article by Joseph E. Zins

    Science.gov (United States)

    Blom-Hoffman, Jessica; Rose, Gary S.

    2007-01-01

    Despite a decade of advances since Zins' 1995 article on prevention, much work lies ahead to make prevention everyday consultation activities for school psychologists. To foster prevention efforts, this commentary discusses how motivational interviewing in school-based consultation (a) might peak consultees' initial interest in change, and (b)…

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

    Science.gov (United States)

    Franks, Helen; Howarth, Michelle

    2012-10-01

    This study established key attributes and perceived strengths, weaknesses, opportunities and threats (SWOT) of nurse consultants specializing in safeguarding children. The nurse consultant role in England spans four domains--clinical, leadership, education and research--and was intended to enable senior nurses to remain in clinical practice. ata identifying the time spent by the nurse consultants in the four domains was collated and a thematic content analysis of the SWOT of the role was ascertained from semi-structured interviews with nurse consultants (n = 4) and stakeholders (n = 6). Strengths and opportunities in clinical (consultancy), leadership and educational functions were identified but some weaknesses and threats in terms of nurse consultant's contributions to research were also identified. The role was neither wholly strategic nor clinical. Role ambiguity meant that they were not always valued by managers, making the role potentially expendable. Nurse consultants are pivotal within health-care organizations because they span clinical practice and leadership enabling them to support managers in strategic planning, commissioning and implementation of policy. Nurse consultants can support strategic practice development and influence quality and effectiveness service-wide. To succeed they must be understood, supported and nurtured by managers. © 2012 Blackwell Publishing Ltd.

  3. Peer assessment of outpatient consultation letters – feasibility and satisfaction

    Directory of Open Access Journals (Sweden)

    Dojeiji Suzan

    2007-05-01

    Full Text Available Abstract Background Written correspondence is one of the most important forms of communication between health care providers, yet there is little feedback provided to specialists. The objective of this study was to determine the feasibility and satisfaction of a peer assessment program on consultation letters and to determine inter-rater reliability between family physicians and specialists. Methods A rating scale of nine 5-point Likert scale items including specific content, style items, education value of the letter and an overall rating was developed from a previous validated tool. Nine Internal Medicine specialists/subspecialists from two tertiary care centres submitted 10 letters with patient and physician identifiers removed. Two Internal Medicine specialists, and 2 family physicians from the other centre rated each letter (to protect writer anonymity. A satisfaction survey was sent to each writer and rater after collation of the results. A follow-up survey was sent 6–8 months later. Results There was a high degree of satisfaction with the process and feedback. The rating scale information was felt to be useful and appropriate for evaluating the quality of consultation letters by 6/7 writers. 5/7 seven writers felt that the feedback they received resulted in immediate changes to their letters. Six months later, 6/9 writers indicated they had maintained changes in their letters. Raters rank ordered letters similarly (Cronbach's alpha 0.57–0.84 but mean scores were highly variant. At site 1 there were significant differences in scoring brevity (p Conclusion Most participants found peer assessment of letters feasible and beneficial and longstanding changes occurred in some individuals. Family physicians and specialists appear to have different expectations on some items. Further studies on reliability and validity, with a larger sample, are required before high stakes professional assessments include consultation letters.

  4. The Adult Educator of Immigrants as an Intercultural Consultant

    Directory of Open Access Journals (Sweden)

    Athina A. Sipitanou

    2012-01-01

    Full Text Available Problem statement: Inspired by this multi-cultural situation in Greece and the need of immigrants for participation in adult education, this article examines an aspect of the Adult Educator who has to develop intercultural techniques in the frame of his role in order to become an Intercultural consultant. Therefore the aim of this study is to examine specific characteristics that define the Adult Educator as an Intercultural Consultant. In this way, the Adult Educator contributes to the smooth functioning of educational and thus socialization process in a multinational class. Approach: We present some statements that are likely to occur during an educational program when the student group is culturally different. In particular we focus on situations that are perceived as challenges by the Adult Educator and also recommend practices and guidelines for facing them. Results: The challenges that the Educator has to repeal, expressed in the student group, from the Educator to group and from the group to Educator. The description of possible situations shows up lingering stereotypes, negative attitudes, difficulties in interpreting multicultural communication styles and conflict. Combining practices which the Educator could apply in similar situations, we end up proposing the revision of views through acquaintance with the “other” culture, empathy, promote parity of relationships, humor and cultivating a climate of cooperation. Conclusion: Consequently the Adult Educator as an Intercultural Consultant can adjust the presence of immigrant student in the classroom and contribute to redefining experiences and perceptions of both-culturally diverse learners and the Educator.

  5. Asthma consultations with specialists: what do the pediatricians seek?

    Science.gov (United States)

    Poowuttikul, Pavadee; Kamat, Deepak; Thomas, Ronald; Pansare, Milind

    2011-01-01

    "Expert Panel Report 3 (EPR-3): Guidelines for the Diagnosis and Management of Asthma" includes guidelines for referral to an asthma specialist. Because most cases of asthma are managed by primary care physicians, we intended to explore the referral practices of pediatricians managing childhood asthma. This study was designed to identify important considerations by pediatricians while referring a child to an asthma specialist. An electronic survey was sent to 1200 graduated pediatricians enlisted in the Michigan Chapter, American Academy of Pediatrics directory. The questions explored asthma disease characteristics, physician preferences when referring children with asthma, and reasons and barriers for asthma consultations. All responses were collected anonymously. We received 240/1200 (20%) questionnaires. The majority of pediatricians considered referral to a specialist if a child had severe persistent asthma (201/236 [85.2%]) or had a single life-threatening asthma event (188/229 [82.1%]). The top two likely reasons of referral included poor asthma control (200/224 [89.3%]) and unclear diagnosis (139/224 [62.1%]). We found 74/219 (33.8%) preferred consultation to a pediatric pulmonologist when compared with 93/219 (42.5%) allergists. We found the minority of pediatricians "always" recommended referral to a specialist for the following reasons: allergy skin testing (30/222 [13.5%]), possible allergen immunotherapy (54/223 [24.2%]), and spirometry (26/221 [11.8%]). The major barrier for childhood asthma specialist consultations was issues with medical insurance coverage (137/205 [66.8%]). Allergists have to educate primary care providers about the importance of allergen control, role of allergen immunotherapy, and updating current asthma treatment guidelines when treating a child with allergic asthma.

  6. MANAGEMENT COACHING VERSUS MANAGEMENT CONSULTING: WHICH COMES FIRST?

    Directory of Open Access Journals (Sweden)

    Maria HERMEL STĂNESCU

    2014-04-01

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

  7. A Computer Aided Consultant System for Mammogram Diagnosis

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    A computer-aided consultant system for mammogram diagnosis is proposed in this paper based on mam-mogram segmentation as an image mining technique, to aid radiologistis in X-ray film interpretation. The generalarchitecture of the system is introduced first, followed by a discussion of mammogram segmentation using logic fil-ter, an analysis of the statistical data to the diagnostics with respect to different clinical information, and a brief in-troduction to a fuzzy decision making subsystem. Finally some experimental results are given.

  8. Mexico; Staff Report for the 2013 Article IV Consultation

    OpenAIRE

    International Monetary Fund.

    2013-01-01

    This 2013 Article IV Consultation highlights that over the past year, Mexico has maintained macroeconomic policy continuity, while pursuing an ambitious agenda of growth-enhancing reforms. Reforms have already been approved to upgrade education, make labor markets more flexible, and foster competition in telecommunications. In 2013, the economy has begun to operate well below capacity, with real GDP growth expected to slow to 1.2 percent (down from 3.6 percent in 2012). The banking system—w...

  9. MANAGEMENT COACHING VERSUS MANAGEMENT CONSULTING: WHICH COMES FIRST?

    Directory of Open Access Journals (Sweden)

    Maria HERMEL STĂNESCU

    2014-04-01

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

  10. Organization and Management Problem Solving A Systems and Consulting Approach

    CERN Document Server

    Ziegenfuss, Dr James T

    2001-01-01

    Based on a broad range of case studies, Organization and Management Problem Solving is an insightful text designed to improve the application of organization theory and systems thinking in teaching and practice. This book illustrates the five key themes in the nature of organization and management-technical, structural, psychosocial, managerial, and cultural-through the analysis of measured incidents tested by students. This book is relevant to consultants, academics, and professional managers in a number of settings (academic, military, business organizations, and research institutes) an

  11. Real Time Medical Image Consultation System Through Internet

    Directory of Open Access Journals (Sweden)

    D. Durga Prasad

    2010-01-01

    Full Text Available Teleconsultation among doctors using a telemedicine system typically involves dealing with and sharing medical images of the patients. This paper describes a software tool written in Java which enables the participating doctors to view medical images such as blood slides, X-Ray, USG, ECG etc. online and even allows them to mark and/or zoom specific areas. It is a multi-party secure image communication system tool that can be used by doctors and medical consultants over the Internet.

  12. The frequency of dietary references in homeopathic consultations.

    Science.gov (United States)

    Filho, Rubens Dolce

    2011-07-01

    A retrospective quantitative study on dietary references found in medical records of 2753 patients attending consultations from 10/1/1994 to 5/31/2007 was conducted. The symptoms found in the rubrics relating to food and drink aggravation and amelioration, aversion and craving of homeopathic repertories reflect diets at different places and times and do not correspond fully, to contemporary gastronomy. Desires for sweet and spicy foods were statistically more frequent, revealing the prevailing taste for such food among the studied population. Food cravings should be carefully analyzed before considering them as indications for choosing homeopathic therapy, they are less significant than aversions, aggravations and ameliorations.

  13. Professional ethics. A case study of infusion nurse consultants.

    Science.gov (United States)

    Adams, J

    2000-01-01

    As the healthcare system continues to reform, opportunities exist for infusion nurses to expand their practice into the business world. Traditionally, biomedical ethics have been used in nursing education as a framework for identifying and responding to ethical dilemmas. However, in the business world, professional ethics may be more subtle and insidious. A case study of ten infusion nurse consultants and their experiences with professional ethical issues is presented. Data were obtained using interviews, and content analysis revealed emergent themes of integrity and intuitive knowing with related categories.

  14. Czech Republic; Staff Report for the 2004 Article IV Consultation

    OpenAIRE

    2004-01-01

    This 2004 Article IV Consultation highlights that the Czech Republic’s GDP expanded by 3.1 percent in 2003 and the first quarter of 2004, mainly supported by household consumption. Investment was also strong in 2003—driven by spending on public infrastructure—and swelled in early 2004 owing to one-off influences associated with European Union accession. The fiscal deficit continued to drift upward in 2003. The general government deficit widened relative to GDP by about 1 percentage poin...

  15. Tu m'as donné ta boue et j'en ai fait de l'or ou l'écriture poétique en classe de langues est-elle transgression ?

    Directory of Open Access Journals (Sweden)

    Marie André-Milesi

    2015-05-01

    Full Text Available Notre propos souhaite éclairer la notion de transgression dans le cadre des cours de langues avec l'aide des outils d'analyse du philosophe humaniste Paul Ricœur. Le jeu sémantique en donnant l'impression aux apprenants de sortir du sillon scolaire permet-il de penser soi-même comme un autre, d'ouvrir des axes de réflexion et de créativité dans le respect du Cadre Européen de Référence pour les Langues ? From rags to riches or transforming mud into gold : how and why poetry writing in the language classroom is a form of transgression? Abstract: Our analysis aims at enriching the notion of transgression with the analytical tools of the philosopher-cum-humanist Paul Ricœur. We may wonder if the semantic work at play with words giving learners the impression to walk out of the commonly established path allows to think oneself as another and to open new vistas for learners in the respect of the Common European Framework of Reference for Languages?

  16. On which term is the prediction of the behaviour of glass necessary and reliable?; A quelle echeance la prediction du comportement a long terme des verres de confinement est-elle necessaire et realiste?

    Energy Technology Data Exchange (ETDEWEB)

    Lefevre, J. [CEA, 75 - Paris (France)

    1997-07-01

    The author questions the ethics of the deep underground storage of high-level radioactive wastes. The time periods that are considered for the confinement are so long that it is completely impossible to predict the way of life of people at that time and the level of knowledge they will have reached. There is a total agreement about the ethics principle of not jeopardizing life and environment of future generations but the difficulty is to draw the limits of this protection. In the regulations of most countries 2 periods of time are defined: the first 500 years and 10.000 years. 500 years is the period of high heat releases due to the decay of most fission products and is also a reasonable time during which the confining site (structures and packages) stays accessible. 10.000 years is considered as the period of time during which predictions are reliable, beyond this time uncertainties become too important and more and more numerous. (A.C.)

  17. L'organisation territoriale en Colombie et les compétences des collectivités territoriales. Une action internationale est-elle possible depuis le contexte local?

    Directory of Open Access Journals (Sweden)

    Angel Tuirán Sarmiento

    2010-01-01

    Full Text Available Para entender con mayor claridad la forma como está construido el edificio de la organización territorial y las facultades de que gozan los entes territoriales en Colombia se hace necesario definir de antemano los conceptos de República unitaria, descentralización y autonomía. La autonomía otorgada por la descentralización a las colectividades territoriales ha traído consigo un aumento significativo en las competencias y facultades de los gobiernos locales, que están siendo confrontados a nuevas responsabilidades, viéndose en la necesidad de reforzar su capacidad de respuesta frente a las demandas y necesidades locales. Por tal motivo, las colectividades territoriales colombianas han trascendido sus fronteras en búsqueda de herramientas que posibiliten una mejor gestión de los asuntos locales; es así como las colectividades territoriales vienen interactuando en el escenario internacional con otros gobiernos locales, aprovechando la autonomía otorgada por el proceso de descentralización y las ventajas estratégicas que ofrece hoy día la globalización.

  18. Climatic change: is the truth at the bottom of the carbon sink?; Changement climatique: la verite est-elle au fond du puits?. Une analyse des controverses sur les puits de carbone

    Energy Technology Data Exchange (ETDEWEB)

    Localli, B. [Centre de Cooperation Internationale en Recherche Agronomique pour le Developpement, CIRAD Foret-Catie, Turrialba (Costa Rica); Loisel, C. [Office national des Forets, mission Effet de Serre expert Foret et Changement Climatique, 75 - Paris (France)

    2002-12-01

    This article presents the controversy about the concept of carbon sinks that was mentioned in the Kyoto protocol. A carbon sink is for instance an ecosystem that absorbs more carbon than it releases. A forest absorbs carbon during its growth period then reaches a level where the quantity of carbon absorbed equals the quantity of carbon emitted. In the case of a forest managed by man the mature stage is never reached since a forest is exploited and continuously renewed. The global balance of the forest depends greatly on the fate of the wood produced: if the wood is abandoned on the forest soil the balance is negative, on the contrary if the energetic valorization of the wood allows a reduction of the consumption of fossil fuels the balance is positive. In northern zones, a forest presents an albedo coefficient that is weaker than that of a barren zone, some climate models suggest that in this case the presence of the forest itself contributes directly to the earth warming in way that counterbalances by far the positive effects expected from the management of the forest. Opponents to carbon sinks also explain that carbon sinks could hamper or slow down efforts that have to be taken by public authorities to change their energy policies and to curb their energy consumption, which stays the great and real challenge. (A.C.)

  19. L’anthropologie historique par le détour de la musicologie : une ethnomusicologie historique du Moyen âge est-elle souhaitable ?

    Directory of Open Access Journals (Sweden)

    Eduardo Henrik Aubert

    2010-06-01

    Full Text Available Tout comme l’on a proposé d’intégrer anthropologie et histoire dans différents champs interdisciplinaires (« anthropologie historique », « ethno-histoire », des phénomènes similaires de rapprochement sont identifiables à l’intérieur de la musicologie où les branches historique (« musicologie historique » et anthropologique (« musicologie comparée » et « ethnomusicologie » ont essayé de s’intégrer dans ce qu’on a appelé « ethnomusicologie historique ». Le propos de cet article est de déplacer la discussion du niveau interdisciplinaire au supra-disciplinaire, l’argument étant que l’interdisciplinarité n’est pas la solution pour des problèmes déterminés par un cadre de pensée qui structure tout un ensemble de disciplines. Nous nous livrons alors à l’examen du contexte de formation des disciplines modernes et de leurs présupposés partagés, spécialement en ce qui touche à l’étude de la musique médiévale.In keeping with the attempt to integrate anthropology and history in interdisciplinary study programmes such as “historical anthropology” or “ethno-history,” it has been proposed that the historical and anthropological branches of musicology should be united in the broad interdisciplinary field of “historical ethnomusicology.” This would include “historical musicology,” and what was initially termed “comparative musicology,” which eventually developed into “ethnomusicology”. This article argues that it is necessary to move the discussion from an inter- to a supra-disciplinary level, since the interdisciplinary approach cannot address issues determined by a framework of thought that structures all disciplines which may be brought together. This article examines the context in which the modern disciplines were shaped and their shared presuppositions, with a particular focus on the study of medieval music.Così come è stato proposto di integrare antropologia e storia in diversi campi disciplinari, (« antropologia storica », « etnostoria », è possibile riscontrare dei fenomeni analoghi di accostamento nell’ambito della musicologia, nella quale si è cercato in particolare di integrare la sezione storica (« musicologia storica » e quella antropologica (« musicologia comparata » e « etnomusicologia » in quel che si è definito « etnomusicologia storica ». L’obiettivo di questo articolo è di spostare l’accento del dibattito dal livello interdisciplinare al livello supra-disciplinare, nella convinzione che l’interdisciplinarietà non possa essere la soluzione a quei problemi che sono posti dall’orizzonte concettuale che struttura l’insieme delle discipline che si pongono in relazione. Si offrirà pertanto un esame del contesto di formazione delle discipline moderne e dei loro presupposti condivisi, in riferimento particolare allo studio della musica medievale.

  20. La question de l’autosuffisance protéique est-elle définitivement obsolète pour l’Union Européenne ?

    Directory of Open Access Journals (Sweden)

    Mahé Louis-Pascal

    2005-05-01

    Full Text Available Is the issue of European self-sufficiency in vegetal proteins definitely obsolete? The issue is reviewed from two standpoints: economic relevance and political feasibility in regards to international relations. Self sufficiency has a cost in terms of global welfare. Be it defined at the aggregate for food, or even for a core input of the European animal sector such as feed proteins, full self sufficiency is not seen as defensible from an economic standpoint. However food security may be a legitimate objective. It should be pursued by many tools and should first resort to the most efficient ones. Self supply is just one among several. A sensible criterion for a target degree of self sufficiency is when the marginal welfare cost of self sufficiency balances the welfare gain in terms of food security. Given the very low level of coverage of the European demand by domestic sources (20% and due to other risk factors, it seems plausible that an increase in self sufficiency would be appropriate. The political feasibility is low, due to the built-in bias of the CAP in favour of grains. The zero bound tariff in the first GATT round, the Blair House agreement in the Uruguay round have kept the EU in a straight jacket. In the Agenda 2000, the Commission has even anticipated the pressure of the US, probably excessively in view of the extension of flexibility payments to Soya in the 2002 US Farm Act. The concern for increased self sufficiency seems now to have faded away. What is left is mostly a strategy of security through a reliable rule-based trading system. The club of multifunctionnal countries should press exporters to concede the end the derogation to the GATT Article XI which allows them to restrain export in case of shortage. If a crisis on world markets would occur, followed as in the past by embargoes or other export restraints, the issue of self sufficiency would come back to the front scene.

  1. Is the nuclear phaseout compatible with the respect of the Kyoto protocol? The example of Belgium; La sortie du nucleaire est-elle compatible avec le respect du protocole de Kyoto? l'exemple de la Belgique

    Energy Technology Data Exchange (ETDEWEB)

    Berger, A

    2008-12-15

    This document provides data and operations needed to evaluate the impacts of the nuclear phaseout on the respect of the Kyoto protocol. The data are based on the belgium electricity production. The author concludes that the nuclear power plants shutdown will lead to a non respect of the kyoto protocol in unacceptable limits. To respect the protocol, he presents two possibilities: the today nuclear park and the use of 1600 wind turbines of 2 MW, or the improvement of the energy efficiency of the thermal power plants. (A.L.B.)

  2. La réglementation de l'audit est-elle dans l'intérêt public : quelques enseignements du modèle français

    OpenAIRE

    C. Piot; A. Schatt

    2010-01-01

    Cahier de recherche n° 2010-09 E2; This paper draws on the growing academic literature, over the last decade, to assess the effects of the French regulation aimed at promoting external auditor independence. For listed companies, the joint-audit requirement results in a less concentrated audit market: Big 4 auditors have a weaker market share as compared with other markets. But audit fees are not lower, however. This could be explained by (1) coordination costs between joint-auditors that outw...

  3. À l’heure de la « deuxième » mondialisation, une ville mondiale est-elle forcément une ville globale ?

    Directory of Open Access Journals (Sweden)

    Cynthia Ghorra-Gobin

    2009-04-01

    Full Text Available La globalisation de l’économie, également qualifiée de « nouvelle étape du capitalisme », a sensiblement modifié la géographie économique, à l’échelle mondiale, au cours de ces trois dernières décennies.  Les chercheurs anglo-américains furent parmi les premiers à analyser l’impact de l’économie globale principalement dans les villes anglo-américaines et à identifier le rôle de commandement de certaines d’entre elles.  Ils utilisent ainsi de manière indifférente les expressions de « world city » et « global city ». Cet article, fondé sur une perspective historique, part du principe qu’il est nécessaire d’établir une distinction entre les deux.  Se qualifie de ville globale  toute ville  a priori bien positionnée dans les flux globaux (information, finance et connaissances alors qu’une ville mondiale fait référence à sa contribution à l’histoire de l’humanité.  Cette contribution se lit au travers de son patrimoine historique, de l’influence culturelle, de la mémoire sociale véhiculée ainsi que  sa capacité à attirer des visiteurs venus du reste du monde.    The globalization of the economy of the last three decades understood as a new phase of the capitalist system has seriously reshaped the geography of the economic production at the world scale.  Anglo-American researchers were among the first to analyze the impacts of this global economy mainly (Anglo-American cities and to identify the role of command (of some of them.  They indifferently used the two following expressions “world city” and “global city” to stress the new hierarchy of cities, beyond their demographic weight.  This article based on the inclusion of a historical perspective argues in favour of a distinction between these two expressions.  A “global city” refers to the city integrated in global flows of capital, information and knowledge while a “world city” should refer to the contribution of any given city to the world history.  Its contribution could be measured in terms of legacy, culture influence, social memory and, its capacity of attracting visitors from the rest of the world.A globalização da economia, igualmente qualificada de “nova etapa do capitalismo” modificou sensivelmente a geografia econômica, na escala mundial, ao longo das três últimas décadas. Os pesquisadores anglo-americanos se colocaram entre os primeiros a analisar o impacto da economia global principalmente no seio das cidades anglo-americanas e a identificar o papel de comando de algumas entre elas. Eles utilizam de maneira indiferente as expressões “cidade mundial” e “cidade global”. Esse artigo, baseado em uma perspectiva histórica, parte do principio que e necessário estabelecer una distinção entre os dois.  Qualifica-se como uma “cidade global” toda cidade, a priori, bem posicionada no contexto dos fluxos globais (informação, finanças e conhecimentos enquanto que uma cidade mundial refere-se a sua contribuição para a história da humanidade. Esta contribuição se faz por meio de seu patrimônio histórico, da influencia cultural, da memória social veiculada bem como sua capacidade a atrair visitantes vindos do resto do mundo.

  4. Incongruous consultation behaviour: results from a UK-wide population survey

    Directory of Open Access Journals (Sweden)

    Elliott Alison M

    2012-03-01

    Full Text Available Abstract Background Symptom characteristics are strong drivers of care seeking. Despite this, incongruous consultation behaviour occurs and has implications for both individuals and health-care services. The aim of this study was to determine how frequently incongruous consultation behaviour occurs, to examine whether it is more common for certain types of symptoms and to identify the factors associated with being an incongruous consulter. Methods An age and sex stratified random sample of 8,000 adults was drawn from twenty UK general practices. A postal questionnaire was used to collect detailed information on the presence and characteristics of 25 physical and psychological symptoms, actions taken to manage the symptoms, general health, attitudes to symptom management and demographic/socio-economic details. Two types of incongruous consultation behaviour were examined: i consultation with a GP for symptoms self-rated as low impact and ii no consultation with a GP for symptoms self-rated as high impact. Results A fifth of all symptoms experienced resulted in consultation behaviour which was incongruous based on respondents' own rating of the symptoms' impact. Low impact consultations were not common, although symptoms indicative of a potentially serious condition resulted in a higher proportion of low impact consultations. High impact non-consultations were more common, although there was no clear pattern in the type of associated symptoms. Just under half of those experiencing symptoms in the previous two weeks were categorised as an incongruous consulter (low impact consulter: 8.3%, high impact non-consulter: 37.1%. Employment status, having a chronic condition, poor health, and feeling that reassurance or advice from a health professional is important were associated with being a low impact consulter. Younger age, employment status, being an ex-smoker, poor health and feeling that not wasting the GPs time is important were associated with

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

    Science.gov (United States)

    Mullen, Chris; Gavin-Daley, Ann; Kilgannon, Helen; Swift, Juliette

    2011-09-01

    To evaluate the Non-Medical Consultant role in the North West of England. The objective was to identify the current number of Non-Medical Consultants, what they do and the impact of the role in practice. The Non-Medical Consultant role for nursing and midwifery was introduced in the UK in 2000 to provide better outcomes for patients by improving service and quality; strengthening clinical leadership; and providing a new career opportunity to help retain experienced and expert professionals in practice. A combined qualitative and quantitative design was adopted. This included desktop review of previous studies, a survey questionnaire to current consultants, focus group meetings with Non-Medical Consultants, sponsors and champions. The role is effective, flexible, responsive and outward facing both internal to the organization and externally on a local, regional and national basis. A key challenge for the Non-Medical Consultants was organizational understanding of the role. The small size of the Non-Medical Consultant workforce can limit individual organizations experience of establishing and supporting the role. Effective Non-Medical Consultants lead, drive and support quality improvement, increased productivity and service effectiveness. Other impacts include sharing and promoting best practice with colleagues, income generation and financial savings through service redesign and/or staff skill mix changes. Managerial issues identified may assist Nurse Managers seeking to introduce new consultant roles and/or support, and retain existing consultants to reach their full potential. 2011 Blackwell Publishing Ltd.

  6. Relation between a career and family life for English hospital consultants: qualitative, semistructured interview study

    Science.gov (United States)

    Dumelow, Carol; Littlejohns, Peter; Griffiths, Sîan

    2000-01-01

    Objective To explore the relation between work and family life among hospital consultants and their attitude towards the choices and constraints that influence this relation. Design Qualitative study of consultants' experiences and views based on tape recorded semistructured interviews. Setting Former South Thames health region in southeast England. Participants 202 male and female NHS hospital consultants aged between 40 to 50 years representing all hospital medical specialties. Results Three types of relation between work and family life (career dominant, segregated, and accommodating) were identified among hospital consultants. Most consultants had a segregated relation, although female consultants were more likely than male consultants to have a career dominant or an accommodating relation. Many male consultants and some female consultants expressed considerable dissatisfaction with the balance between their career and family life. A factor influencing this dissatisfaction was the perceived lack of choice to spend time on their personal or family life, because of the working practices and attitudes within hospital culture, if they wanted a successful career. Conclusions Consultants are currently fitting in with the profession rather than the profession adapting to enable doctors to have fulfilling professional and personal lives. Current government policies to increase the medical workforce and promote family friendly policies in the NHS ought to take account of the need for a fundamental change in hospital culture to enable doctors to be more involved in their personal or family life without detriment to their career progress. PMID:10827044

  7. Periodic gastroenterology and hepatology meetings with primary care: reasons for consultation

    Directory of Open Access Journals (Sweden)

    Laura Mata-Román

    2013-10-01

    Full Text Available Introduction: care overload, aging of population, and increased chronic diseases lead to increased referrals from primary care, which may sometimes overload the health system. Thus, different interventions have been carried out attempting to improve these aspects. Objectives: to assess the most frequent causes of consultation of general physicians, both in joint consultations and clinical sessions held jointly with specialist consultant in primary care, in the urban and rural setting, and the influence on referrals to first consultations of gastroenterology. Material and methods: a mainly training type of intervention was carried out, consisting of regular meetings in both urban and rural primary care center, to perform joint consultations and clinical sessions on patients and topics related to the specialty of gastroenterology. The intervention period (divided in two subperiods was compared with a control period. Results: most reasons for consultation were those corresponding to lower gastrointestinal tract, followed by liver disease and upper gastrointestinal tract. Significant differences were only found in distribution of diagnoses between the two centers in joint consultations. There was a relative (percent decrease in referrals at the global level in both subperiods, only significant in the first (51.45%, as well as in rural setting (45.24%. Conclusion: common consultations motifs were similar in urban and rural settings, with some relevance of lower gastrointestinal tract disease. Most of them can be solved at primary care, with the help of consultant specialist. There is impact on referrals to the outpatient first consultations of gastroenterology, mainly in rural setting.

  8. Psychiatric Consultation in Community Clinics: A Decade of Experience in the Community Clinics in Jerusalem.

    Science.gov (United States)

    Avny, Ohad; Teitelbaum, Tatiana; Simon, Moshe; Michnick, Tatiana; Siman-Tov, Maya

    2016-01-01

    A consultation model between primary care physicians and psychiatrists that has been in operation for 12 years in the Jerusalem district of the Clalit Health Services in Israel is evaluated. In this model psychiatrists provide consultations twice a month at the primary care clinic. All patients are referred by their family physicians. Communication between the psychiatric consultant and the referring physician is carried out by telephone, correspondence and staff meetings. Evaluation of the psychiatric care consultation model in which a psychiatrist consults at the primary care clinic. A questionnaire-based survey distributed to 17 primary care physicians in primary care clinics in Jerusalem in which a psychiatric consultant is present. Almost all of the doctors (93%) responded that the consultation model was superior to the existing model of referral to a secondary psychiatric clinic alone and reduced the workload in caring for the referred patients. The quality of psychiatric care was correlated with the depression prevalence among patients referred for consultation at their clinic (r=0.530, p=0.035). In addition, correlation was demonstrated between primary care physicians impression of alleviation of care of patients and their impression of extent of the patients' cooperation with the consulting psychiatrist (r=0.679, p = 0.015) Conclusions: Very limited conclusions may be drawn from this questionnaire distributed to primary care physicians who were asked to assess psychiatric consultation in their clinic. Our conclusion could be influenced by the design and the actual distribution of the questionnaires by the consulting psychiatrist. Nevertheless answers to the questionnaire might imply that the consultation model of care between a psychiatric consultant and the primary care physician, where the patient's primary care physician takes a leading role in his psychiatric care, is perceived by family physicians as a good alternative to referral to a psychiatric

  9. Beyond the ‘dyad’: a qualitative re-evaluation of the changing clinical consultation

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2014-09-29

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

  11. Lung cancer physicians' referral practices for palliative care consultation.

    Science.gov (United States)

    Smith, C B; Nelson, J E; Berman, A R; Powell, C A; Fleischman, J; Salazar-Schicchi, J; Wisnivesky, J P

    2012-02-01

    Integration of palliative care with standard oncologic care improves quality of life and survival of lung cancer patients. We surveyed physicians to identify factors influencing their decisions for referral to palliative care. We provided a self-administered questionnaire to physicians caring for lung cancer patients at five medical centers. The questionnaire asked about practices and views with respect to palliative care referral. We used multiple regression analysis to identify predictors of low referral rates (consultation. Multivariate analysis, controlling for provider characteristics, found that low referral rates were associated with physicians' concerns that palliative care referral would alarm patients and families [odds ratio (OR) 0.45, 95% confidence interval (CI) 0.21-0.98], while the belief that palliative care specialists have more time to discuss complex issues (OR 3.07, 95% CI 1.56-6.02) was associated with higher rates of referral. Although palliative care consultation is increasingly available and recommended throughout the trajectory of lung cancer, our data indicate it is underutilized. Understanding factors influencing decisions to refer can be used to improve integration of palliative care as part of lung cancer management.

  12. Sustainability of a proactive geriatric trauma consultation service.

    Science.gov (United States)

    Wong, Camilla L; Al Atia, Raghda; McFarlan, Amanda; Lee, Holly Y; Valiaveettil, Christina; Haas, Barbara

    2017-02-01

    Proactive geriatric trauma consultation service (GTCS) models have been associated with better delivery of geriatric care and functional outcomes. Whether such collaborative models can be improved and sustained remains uncertain. We describe the sustainability and process improvements of an inpatient GTCS. We assessed workflow using interviews and surveys to identify opportunities to optimize the referral process for the GTCS. Sustainability of the service was assessed via a prospective case series (July 2012-December 2013). Study data were derived from a review of the medical record and trauma registry database. Metrics to determine sustainability included volume of cases, staffing levels, rate of adherence to recommendations, geriatric-specific clinical outcomes, trauma quality indicators, consultation requests and discharge destination. Through process changes, we were able to ensure every eligible patient was referred for a comprehensive geriatric assessment. Compared with the implementation phase, volume of assessments increased and recommendation adherence rates were maintained. Delirium and/or dementia were the most common geriatric issue addressed. The rate of adherence to recommendations made by the GTCS team was 88.2%. Only 1.4% of patients were discharged to a nursing home. Workflow assessment is a useful means to optimize the referral process for comprehensive geriatric assessment. Sustainability of a GTCS was shown by volume, staffing and recommendation adherence.

  13. Expert system for skin problem consultation in Thai traditional medicine.

    Science.gov (United States)

    Nopparatkiat, Pornchai; na Nagara, Byaporn; Chansa-ngavej, Chuvej

    2014-01-01

    This paper aimed to demonstrate the research and development of a rule-based expert system for skin problem consulting in the areas of acne, melasma, freckle, wrinkle, and uneven skin tone, with recommended treatments from Thai traditional medicine knowledge. The tool selected for developing the expert system is a software program written in the PHP language. MySQL database is used to work together with PHP for building database of the expert system. The system is web-based and can be reached from anywhere with Internet access. The developed expert system gave recommendations on the skin problem treatment with Thai herbal recipes and Thai herbal cosmetics based on 416 rules derived from primary and secondary sources. The system had been tested by 50 users consisting of dermatologists, Thai traditional medicine doctors, and general users. The developed system was considered good for learning and consultation. The present work showed how such a scattered body of traditional knowledge as Thai traditional medicine and herbal recipes could be collected, organised and made accessible to users and interested parties. The expert system developed herein should contribute in a meaningful way towards preserving the knowledge and helping promote the use of Thai traditional medicine as a practical alternative medicine for the treatment of illnesses.

  14. Hospitalized hunger-striking prisoners: the role of ethics consultations.

    Science.gov (United States)

    Caenazzo, Luciana; Tozzo, Pamela; Rodriguez, Daniele

    2016-12-01

    We refer to hospitalized convicted hunger strikers in Padua Hospital who decided to fast for specific reasons, often demanding, to be heard by the judge, to complain about the existing custodial situation or to claim unjust treatment. The medical ethics of hunger strikers are debated because the use of force feeding by physicians is widely condemned as unethical, but courts, in Italy, sometimes order to transfer the convicted person to hospital and oblige healthcare practitioners to perform forcible feeding. This can engender a profound insecurity for the physicians taking action on the one hand, while preventing patients from fully availing themselves of this principle of self-determination on the other. Physicians are mainly concerned about how to manage this situation and they may request ethical consultation. When it comes to managing hospitalized hunger strikers, the ethics consultant may be able to facilitate the relationship between physicians and hunger strikers, enhance the latter's trust in the former, ensuring that strikers are aware of the risks associated with their fasting, and helping them to arrive of their own free will at the right decision concerning their behavior and their demands.

  15. The Effect of Training and Consultation Condition on Teachers' Self-Reported Likelihood of Adoption of a Daily Report Card

    Science.gov (United States)

    Holdaway, Alex S.; Owens, Julie Sarno

    2015-01-01

    Using a within-subjects design and validated vignettes, this study examined the relative effects of four training and consultation conditions (i.e., consultation with key opinion leaders, consultation with observation and performance feedback, consultation with motivational interviewing, and professional development-as-usual) on teachers' (N =…

  16. Why Some Students Continue to Value Individual, Face-to- Face Research Consultations in a Technology-Rich World

    Science.gov (United States)

    Magi, Trina J.; Mardeusz, Patricia E.

    2013-01-01

    For decades, academic librarians have provided individual research consultations for students. There is little information, however, about why students schedule consultations, the kinds of assistance students feel are provided by librarians during consultations, and what students find valuable about face-to-face consultations, even with the…

  17. Consultation on urological specimens from referred cancer patients using real-time digital microscopy

    DEFF Research Database (Denmark)

    Holten-Rossing, Henrik; Larsen, Lise Grupe; Toft, Birgitte Grønkær

    2016-01-01

    digital consultation took place over the telephone using remote access software. Time of start and finish for each case was logged. For the physically referred cases, time from arrival to sign-out was logged in the national pathology information system, and time spent on microscopy and reporting was noted...... Finetek) was employed. The Pathology Department at Næstved Hospital was equipped with a digital microscope and three consultant pathologists were stationed at Rigshospitalet with workstations optimized for digital microscopy. Representative slides for each case were selected for consultation and live......, reporting and sign-out per case. For live digital consultations, a mean of 18 min 37 s was spent on each consultation with 4 min 43 s for each case, depending on the number of digital slides included. Only in two cases could a consensus regarding the diagnosis not be reached during live consultation...

  18. Smoking cessation advice in consultations with health problems not related to smoking?

    DEFF Research Database (Denmark)

    Guassora, Ann Dorrit Kristiane; Baarts, Charlotte

    2010-01-01

    Objective. To identify frames of interaction that allow smoking cessation advice in general practice consultations. Design . Qualitative study based on individual in-depth interviews with GPs and their patients. Each of the GPs’ consultations were observed during a three-day period. Interviews...... primarily addressed the consultations that had been observed. The concept of “ frames ” described by Goffman was deployed as an analytic tool. Setting . Danish general practice. Subjects. Six GPs and 11 of their patients. Results . Both GPs and patients evaluated potential issues to be included during...... consultations by relevance criteria. Relevance criteria served the purpose of limiting the number of issues in individual consultations. Issues could be included if they connected to something already communicated in a consultation. Smoking cessation advice was subject to these relevance criteria...

  19. Decrease in Statewide Antipsychotic Prescribing after Implementation of Child and Adolescent Psychiatry Consultation Services.

    Science.gov (United States)

    Barclay, Rebecca P; Penfold, Robert B; Sullivan, Donna; Boydston, Lauren; Wignall, Julia; Hilt, Robert J

    2017-04-01

    To learn if a quality of care Medicaid child psychiatric consultation service implemented in three different steps was linked to changes in statewide child antipsychotic utilization. Washington State child psychiatry consultation program primary data and Medicaid pharmacy division antipsychotic utilization secondary data from July 1, 2006, through December 31, 2013. Observational study in which consult program data were analyzed with a time series analysis of statewide antipsychotic utilization. All consultation program database information involving antipsychotics was compared to Medicaid pharmacy division database information involving antipsychotic utilization. Washington State's total child Medicaid antipsychotic utilization fell from 0.51 to 0.25 percent. The monthly prevalence of use fell by a mean of 0.022 per thousand per month following the initiation of elective consults (p = .004), by 0.065 following the initiation of age/dose triggered mandatory reviews (p consultation and best-practice education service. © Health Research and Educational Trust.

  20. Harnessing competence and confidence: Dimensions in education and development for advanced and consultant practice

    Energy Technology Data Exchange (ETDEWEB)

    Price, Richard C. [School of Health and Emergency Professions, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB (United Kingdom)], E-mail: r.c.price@herts.ac.uk; Edwards, Hazel M. [School of Health and Emergency Professions, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB (United Kingdom)

    2008-12-15

    Consultant and advanced practice are relatively new concepts in radiography. There is evidence to show that as the career progression framework is being adopted the numbers of consultant and advanced practitioners in radiography are growing with the latter growing at a faster rate. The article considers the concept of advanced and consultant practice and the education requirements to support development. Preparation for an advanced practice role begins at the practitioner stage. Masters' level programmes are available to support the development of advanced practice. Education needs to be flexible as new advanced practice roles emerge. It is necessary to take practitioners beyond a defined modality to include leadership and people skills. These are essential for those aspiring to become consultants. Consultants require a high level of clinical knowledge for expert practice but also strategic vision and interpersonal intelligence to facilitate leadership and practice innovation. A model for developing leadership skills for consultants focussing on competence, confidence and capacity is proposed.