Renewable Energy Park - Preliminary Feasibility & Engineering Report

Energy Technology Data Exchange (ETDEWEB)

Ariwite, Roderick [Fallon Paiute Shoshone Tribe, NV (United States)

2015-07-31

This "Renewable Energy Park - Preliminary Feasibility & Engineering Report" seeks to provide an overall assessment and review of renewable energy development opportunities on the Fallon Indian Reservation and Colony Lands.

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

DEFF Research Database (Denmark)

Falch, Morten; Nicolajsen, Hanne Westh

2009-01-01

This paper analyses the impact of the use of ICT in production and delivery of technical engineering consultancy services on business structures with regard to industry convergence and transaction costs. The paper takes an empirical study on the introduction of 3D-modelling tools in the building...... section in a Scandinavian engineering consultancy firm as its point of departure. The discussion identifies three different structural aspects, which all are affected by the use of ICT: Internationalisation vs. Local markets, Outsourcing vs. Structural integration, and Division of work between actors...

The impact of ICT on market organisation – A case of 3D-models in engineering consultancy

DEFF Research Database (Denmark)

Falch, Morten

2014-01-01

This paper analyses the impact of the use of ICT in production and delivery of technical engineering consultancy services on business structures with regard to industry convergence and transaction costs. The paper takes an empirical study on the introduction of 3D-modelling tools in the building...... section in a Scandinavian engineering consultancy firm as its point of departure. The discussion identifies three different structural aspects, which all are affected by the use of ICT: Internationalisation vs. Local markets, Outsourcing vs. Structural integration, and Division of work between actors...

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

Science.gov (United States)

Sørensen, Lene Bjerg; Broberg, Ole

2012-01-01

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

Preliminary Neutronics Design Studies for a Molten Salt Blanket LIFE Engine

International Nuclear Information System (INIS)

Powers, J.

2008-01-01

looking at fast ignition and hot spot ignition fusion options are documented, along with limited scoping studies performed to investigate other options of interest that surfaced during the main design effort. Lastly, side studies that were not part of the main design effort but may alter future work performed on LIFE engine designs are shown. The majority of all work reported in this document was performed during the Molten Salt Fast Ignition Moderator Study (MSFIMS) which sought to optimize the amount of moderator mixed into the molten salt region in order to produce the most compelling design. The studies in this report are of a limited scope and are intended to provide a preliminary neutronics analysis of the design concepts described herein to help guide decision processes and explore various options that a LIFE engine with a molten salt blanket might enable. None of the designs shown in this report, even reference cases selected for detailed description and analysis, have been fully optimized. The analyses were performed primarily as a neutronics study, though some consultation was made regarding thermal-hydraulic and structural concerns during both scoping out an initial model and subsequent to identifying a neutronics-based reference case to ensure that the design work contained no glaring mechanical or thermal issues that would preclude its feasibility. Any analyses and recommendations made in this report are either primarily or solely from the point of view of LIFE neutronics and ignore other fundamental issues related to molten salt fuel blankets such as chemical processing feasibility and political feasibility of a molten salt system

Preliminary Neutronics Design Studies for a Molten Salt Blanket LIFE Engine

Energy Technology Data Exchange (ETDEWEB)

Powers, J

2008-10-23

. Preliminary design studies looking at fast ignition and hot spot ignition fusion options are documented, along with limited scoping studies performed to investigate other options of interest that surfaced during the main design effort. Lastly, side studies that were not part of the main design effort but may alter future work performed on LIFE engine designs are shown. The majority of all work reported in this document was performed during the Molten Salt Fast Ignition Moderator Study (MSFIMS) which sought to optimize the amount of moderator mixed into the molten salt region in order to produce the most compelling design. The studies in this report are of a limited scope and are intended to provide a preliminary neutronics analysis of the design concepts described herein to help guide decision processes and explore various options that a LIFE engine with a molten salt blanket might enable. None of the designs shown in this report, even reference cases selected for detailed description and analysis, have been fully optimized. The analyses were performed primarily as a neutronics study, though some consultation was made regarding thermal-hydraulic and structural concerns during both scoping out an initial model and subsequent to identifying a neutronics-based reference case to ensure that the design work contained no glaring mechanical or thermal issues that would preclude its feasibility. Any analyses and recommendations made in this report are either primarily or solely from the point of view of LIFE neutronics and ignore other fundamental issues related to molten salt fuel blankets such as chemical processing feasibility and political feasibility of a molten salt system.

Researches on Preliminary Chemical Reactions in Spark-Ignition Engines

Science.gov (United States)

1943-06-01

compression type, without ignition, the resulting preliminary reactions being detectable and meas- urable thermometrically . Contents I. Influence of Preliminary...thoroughly insulated be- tween the carburettor and the engine, by aluminium foil and asbestos. -I -I " I" I ’I il i~ " !, I I 1𔃻I I’ ) To enable the

Improving Indonesian Construction Consulting Services

Directory of Open Access Journals (Sweden)

Rizal Z. Tamin

2015-05-01

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

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

OpenAIRE

Setyaman, Amy Maulany; Sunitiyoso, Yos

2013-01-01

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

Strangers at the Benchside: Research Ethics Consultation

Science.gov (United States)

Cho, Mildred K.; Tobin, Sara L.; Greely, Henry T.; McCormick, Jennifer; Boyce, Angie; Magnus, David

2008-01-01

Institutional ethics consultation services for biomedical scientists have begun to proliferate, especially for clinical researchers. We discuss several models of ethics consultation and describe a team-based approach used at Stanford University in the context of these models. As research ethics consultation services expand, there are many unresolved questions that need to be addressed, including what the scope, composition, and purpose of such services should be, whether core competencies for consultants can and should be defined, and how conflicts of interest should be mitigated. We make preliminary recommendations for the structure and process of research ethics consultation, based on our initial experiences in a pilot program. PMID:18570086

The consultation and relational empathy (CARE) measure: development and preliminary validation and reliability of an empathy-based consultation process measure.

Science.gov (United States)

Mercer, Stewart W; Maxwell, Margaret; Heaney, David; Watt, Graham Cm

2004-12-01

Empathy is a key aspect of the clinical encounter but there is a lack of patient-assessed measures suitable for general clinical settings. Our aim was to develop a consultation process measure based on a broad definition of empathy, which is meaningful to patients irrespective of their socio-economic background. Qualitative and quantitative approaches were used to develop and validate the new measure, which we have called the consultation and relational empathy (CARE) measure. Concurrent validity was assessed by correlational analysis against other validated measures in a series of three pilot studies in general practice (in areas of high or low socio-economic deprivation). Face and content validity was investigated by 43 interviews with patients from both types of areas, and by feedback from GPs and expert researchers in the field. The initial version of the new measure (pilot 1; high deprivation practice) correlated strongly (r = 0.85) with the Reynolds empathy measure (RES) and the Barrett-Lennard empathy subscale (BLESS) (r = 0.63), but had a highly skewed distribution (skew -1.879, kurtosis 3.563). Statistical analysis, and feedback from the 20 patients interviewed, the GPs and the expert researchers, led to a number of modifications. The revised, second version of the CARE measure, tested in an area of low deprivation (pilot 2) also correlated strongly with the established empathy measures (r = 0.84 versus RES and r = 0.77 versus BLESS) but had a less skewed distribution (skew -0.634, kurtosis -0.067). Internal reliability of the revised version was high (Cronbach's alpha 0.92). Patient feedback at interview (n = 13) led to only minor modification. The final version of the CARE measure, tested in pilot 3 (high deprivation practice) confirmed the validation with the other empathy measures (r = 0.85 versus RES and r = 0.84 versus BLESS) and the face validity (feedback from 10 patients). These preliminary results support the validity and reliability of the CARE

Development and preliminary evaluation of a rehabilitation consult for survivors of head and neck cancer: an intervention mapping protocol.

Science.gov (United States)

McEwen, Sara E; Davis, Aileen M; Jones, Jennifer M; Martino, Rosemary; Poon, Ian; Rodriguez, Ana Maria; Ringash, Jolie

2015-01-09

Evidence suggests that rehabilitation interventions can improve function and quality of life in survivors of head and neck cancer (HNC), but there is a lack of coordinated, integrated services, and those offered are inconsistent. To address these gaps, we will develop and conduct preliminary evaluation of a rehabilitation consult, built on the theoretical foundations of goal setting and self-management, and composed of a brief functional evaluation, a resource compendium, and collaborative goal-setting and action planning processes. The development of the rehabilitation consult will be guided by intervention mapping, which consists of six steps: 1. Needs assessment; 2. Definition of program objectives; 3. Selection of theory-based intervention methods; 4. Production and pretesting; 5. Adoption, implementation and sustainability planning; 6. Process and effect evaluation. Within the intervention mapping framework, an iterative process of constructing drafts and mini-evaluations with consumers and experts will be used, modifying the rehabilitation consult intervention until a version suitable for formal evaluation is established. The rehabilitation consult will then be evaluated using a prospective, mixed method, single group design with 30 survivors of head and neck cancer. Outcomes will be assessed pre- and post-intervention and at 6-month follow-up. Survivors of head and neck cancer have among the most complex rehabilitation needs of all cancer patients. The rehabilitation consult is expected to improve knowledge and uptake of rehabilitation resources and strategies in survivors of head and neck cancer and thereby improve long-term function and quality of life. If the rehabilitation consult is effective in cancer patients with such high and diverse needs, this project will produce a toolkit that will be adaptable for other types of cancer in other jurisdictions.

Energy Efficient Engine: Control system preliminary definition report

Science.gov (United States)

Howe, David C.

1986-01-01

The object of the Control Preliminary Definition Program was to define a preliminary control system concept as a part of the Energy Efficient Engine program. The program was limited to a conceptual definition of a full authority digital electronic control system. System requirements were determined and a control system was conceptually defined to these requirements. Areas requiring technological development were identified and a plan was established for implementing the identified technological features, including a control technology demonstration. A significant element of this program was a study of the potential benefits of closed-loop active clearance control, along with laboratory tests of candidate clearance sensor elements for a closed loop system.

Preliminary conceptual study of engineering-scale pyroprocess demonstration facility

International Nuclear Information System (INIS)

Moon, Seong-In; Chong, Won-Myung; You, Gil-Sung; Ku, Jeong-Hoe; Kim, Ho-Dong

2013-01-01

Highlights: ► The conceptual design of a pyroprocess demonstration facility was performed. ► The design requirements for the pyroprocess hot cell and equipment were determined. ► The maintenance concept for the pyroprocess hot cell was presented. -- Abstract: The development of an effective management technology of spent fuel is important to enhance environmental friendliness, cost viability and proliferation resistance. In Korea, pyroprocess technology has been considered as a fuel cycle option to solve the spent fuel accumulation problems. PRIDE (PyRoprocess Integrated inactive DEmonstration facility) has been developed from 2007 to 2012 in Korea as a cold test facility to support integrated pyroprocessing and an equipment demonstration, which is essential to verify the pyroprocess technology. As the next stage of PRIDE, the design requirements of an engineering-scale demonstration facility are being developed, and the preliminary conceptual design of the facility is being performed for the future. In this paper, the main design requirements for the engineering-scale pyroprocess demonstration facility were studied in the throughput of 10tHM a year. For the preliminary conceptual design of the facility, the design basis of the pyroprocess hot cell was suggested, and the main equipment, main process area, operation area, maintenance area, and so on were arranged in consideration of the effective operation of the hot cells. Also, the argon system was designed to provide and maintain a proper inert environment for the pyroprocess. The preliminary conceptual design data will be used to review the validity of the engineering-scale pyroprocess demonstration facility that enhances both safety and nonproliferation

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

Science.gov (United States)

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

2016-10-17

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

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

DEFF Research Database (Denmark)

Falch, Morten; Nicolajsen, Hanne Westh

2009-01-01

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

Draft audit report, human factors engineering control room design review: Saint Lucie Nuclear Power Plant, Unit No. 2

International Nuclear Information System (INIS)

Peterson, L.R.; Lappa, D.A.; Moore, J.W.

1981-01-01

A human factors engineering preliminary design review of the Saint Lucie Unit 2 control room was performed at the site on August 3 through August 7, 1981. This design review was carried out by a team from the Human Factors Engineering Branch, Division of Human Factors Safety. This report was prepared on the basis of the HFEB's review of the applicant's Preliminary Design Assessment and the human factors engineering design review/audit performed at the site. The review team included human factors consultants from BioTechnology, Inc., Falls Church, Virginia, and from Lawrence Livermore National Laboratory (University of California), Livermore, California

Professional Service innovations at Consulting Engineering - how change stay flat in project Organisations

DEFF Research Database (Denmark)

Koch, Christian; Bendixen, Mads

understood through a practicebased theory approach using predominantly Actor Network Theory (Latour 2005). The paper focus on attempts to innovate service products, within projects and the remaining organisation. A seven-year cooperation with a consulting engineering, now employing the one of the authors has...... production. One relates to the formation of a building envelope group and a design of a building with a double glass facade, the other to client counselling on realising a public private partnership, a 30 year contract of a public service, where the initial programming was followed. The analysis follows...

The MSFC Collaborative Engineering Process for Preliminary Design and Concept Definition Studies

Science.gov (United States)

Mulqueen, Jack; Jones, David; Hopkins, Randy

2011-01-01

This paper describes a collaborative engineering process developed by the Marshall Space Flight Center's Advanced Concepts Office for performing rapid preliminary design and mission concept definition studies for potential future NASA missions. The process has been developed and demonstrated for a broad range of mission studies including human space exploration missions, space transportation system studies and in-space science missions. The paper will describe the design team structure and specialized analytical tools that have been developed to enable a unique rapid design process. The collaborative engineering process consists of integrated analysis approach for mission definition, vehicle definition and system engineering. The relevance of the collaborative process elements to the standard NASA NPR 7120.1 system engineering process will be demonstrated. The study definition process flow for each study discipline will be will be outlined beginning with the study planning process, followed by definition of ground rules and assumptions, definition of study trades, mission analysis and subsystem analyses leading to a standardized set of mission concept study products. The flexibility of the collaborative engineering design process to accommodate a wide range of study objectives from technology definition and requirements definition to preliminary design studies will be addressed. The paper will also describe the applicability of the collaborative engineering process to include an integrated systems analysis approach for evaluating the functional requirements of evolving system technologies and capabilities needed to meet the needs of future NASA programs.

Deep Underground Science and Engineering Laboratory - Preliminary Design Report

CERN Document Server

Lesko, Kevin T; Alonso, Jose; Bauer, Paul; Chan, Yuen-Dat; Chinowsky, William; Dangermond, Steve; Detwiler, Jason A; De Vries, Syd; DiGennaro, Richard; Exter, Elizabeth; Fernandez, Felix B; Freer, Elizabeth L; Gilchriese, Murdock G D; Goldschmidt, Azriel; Grammann, Ben; Griffing, William; Harlan, Bill; Haxton, Wick C; Headley, Michael; Heise, Jaret; Hladysz, Zbigniew; Jacobs, Dianna; Johnson, Michael; Kadel, Richard; Kaufman, Robert; King, Greg; Lanou, Robert; Lemut, Alberto; Ligeti, Zoltan; Marks, Steve; Martin, Ryan D; Matthesen, John; Matthew, Brendan; Matthews, Warren; McConnell, Randall; McElroy, William; Meyer, Deborah; Norris, Margaret; Plate, David; Robinson, Kem E; Roggenthen, William; Salve, Rohit; Sayler, Ben; Scheetz, John; Tarpinian, Jim; Taylor, David; Vardiman, David; Wheeler, Ron; Willhite, Joshua; Yeck, James

2011-01-01

The DUSEL Project has produced the Preliminary Design of the Deep Underground Science and Engineering Laboratory (DUSEL) at the rehabilitated former Homestake mine in South Dakota. The Facility design calls for, on the surface, two new buildings - one a visitor and education center, the other an experiment assembly hall - and multiple repurposed existing buildings. To support underground research activities, the design includes two laboratory modules and additional spaces at a level 4,850 feet underground for physics, biology, engineering, and Earth science experiments. On the same level, the design includes a Department of Energy-shepherded Large Cavity supporting the Long Baseline Neutrino Experiment. At the 7,400-feet level, the design incorporates one laboratory module and additional spaces for physics and Earth science efforts. With input from some 25 science and engineering collaborations, the Project has designed critical experimental space and infrastructure needs, including space for a suite of multi...

Human-factors engineering control-room design review/audit: Waterford 3 SES Generating Station, Louisiana Power and Light Company

International Nuclear Information System (INIS)

Savage, J.W.

1983-01-01

A human factors engineering design review/audit of the Waterford-3 control room was performed at the site on May 10 through May 13, 1982. The report was prepared on the basis of the HFEB's review of the applicant's Preliminary Human Engineering Discrepancy (PHED) report and the human factors engineering design review performed at the site. This design review was carried out by a team from the Human Factors Engineering Branch, Division of Human Factors Safety. The review team was assisted by consultants from Lawrence Livermore National Laboratory (University of California), Livermore, California

Consultancy in the development of coal deposits all over the world

Energy Technology Data Exchange (ETDEWEB)

Gold, R.; Schiebel, W.

1977-04-01

Dr. Otto Gold, Consulting Engineers, Cologne, are working as consultants in the area of prospecting, exploration and development of lignite deposits. Some projects successfully carried out are reported on, being an example for other consulting projects on the coal sector.

Preliminary engineering specifications for a test demonstration multilayer protective barrier cover system

International Nuclear Information System (INIS)

Phillips, S.J.; Gilbert, T.W.; Adams, M.R.

1985-03-01

This report presents preliminary engineering specifications for a test protective barrier cover system and support radiohydrology facility to be constructed at the Hanford Protective Barrier Test Facility (PBTF). Construction of this test barrier and related radiohydrology facility is part of a continuing effort to provide construction experience and performance evaluation of alternative barrier designs used for long-term isolation of disposed radioactive waste materials. Design specifications given in this report are tentative, based on interim engineering and computer simulation design efforts. Final definitive design specifications and engineering prints will be produced in FY 1986. 6 refs., 10 figs., 1 tab

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

Science.gov (United States)

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

2017-09-01

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

Mutual construction and reconstruction in client-consultant interaction

DEFF Research Database (Denmark)

Smith, Irene Skovgaard

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2002-07-01

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

Towards a Tissue-Engineered Ligament: Design and Preliminary Evaluation of a Dedicated Multi-Chamber Tension-Torsion Bioreactor

Directory of Open Access Journals (Sweden)

Cédric P. Laurent

2014-02-01

Full Text Available Tissue engineering may constitute a promising alternative to current strategies in ligament repair, providing that suitable scaffolds and culture conditions are proposed. The objective of the present contribution is to present the design and instrumentation of a novel multi-chamber tension-torsion bioreactor dedicated to ligament tissue engineering. A preliminary biological evaluation of a new braided scaffold within this bioreactor under dynamic loading is reported, starting with the development of a dedicated seeding protocol validated from static cultures. The results of these preliminary biological characterizations confirm that the present combination of scaffold, seeding protocol and bioreactor may enable us to head towards a suitable ligament tissue-engineered construct.

Involving construction in the preliminary engineering process

International Nuclear Information System (INIS)

Mahoney, D.T. Jr.; Boccieri, S.V. Jr.

1994-01-01

With today's high cost associated with modifications in nuclear power plants, it is imperative that the authors continue to investigate ways to cut costs but at the same time improve efficiency and reduce radiation exposure to those directly associated with the implementation of modifications. The success associated with involving construction in the preliminary engineering process will not only cut costs and improve efficiency but will establish a Team Building concept to provide accountability to all those associated with the implementation of the task. This form of partnering focuses on the solutions rather than highlighting the difficulties. This paper will demonstrate techniques to implement such ideas and provide examples to corroborate actual successes already achieved

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

Directory of Open Access Journals (Sweden)

ali akbar Farghangi

2013-10-01

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

The preliminary research for biosynthetic engineering by radiation fusion technology

Energy Technology Data Exchange (ETDEWEB)

Roh, Chang Hyun; Jung, U Hee; Park, Hae Ran [KAERI, Daejeon (Korea, Republic of)

2012-01-15

The purpose of this project is to elucidate the solution to the production of bioactive substance using biotransformation process from core technology of biosynthetic engineering by radiation fusion technology. And, this strategy will provide core technology for development of drugs as new concept and category. Research scopes and contents of project include 1) The development of mutant for biosynthetic engineering by radiation fusion technology 2) The development of host for biosynthetic engineering by radiation fusion technology 3) The preliminary study for biosynthetic engineering of isoflavone by radiation fusion technology. The results are as follows. Isoflavone compounds(daidzein, hydroxylated isoflavone) were analyzed by GC-MS. The study of radiation doses and p-NCA high-throughput screening for mutant development were elucidated. And, it was carried out the study of radiation doses for host development. Furthermore, the study of redox partner and construction of recombinant strain for region-specific hydroxylation(P450, redox partner). In addition, the biological effect of 6,7,4'-trihydroxyisoflavone as an anti-obesity agent was elucidated in this study.

A TOTAL QUALITY MANAGEMENT APPROACH TO CIVIL ENGINEERING CONSULTING

Directory of Open Access Journals (Sweden)

G.A.L. Ambrose

2012-01-01

Full Text Available

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

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

Textual appropriation in engineering master's theses: a preliminary study.

Science.gov (United States)

Eckel, Edward J

2011-09-01

In the thesis literature review, an engineering graduate student is expected to place original research in the context of previous work by other researchers. However, for some students, particularly those for whom English is a second language, the literature review may be a mixture of original writing and verbatim source text appropriated without quotations. Such problematic use of source material leaves students vulnerable to an accusation of plagiarism, which carries severe consequences. Is such textual appropriation common in engineering master's writing? Furthermore, what, if anything, can be concluded when two texts have been found to have textual material in common? Do existing definitions of plagiarism provide a sufficient framework for determining if an instance of copying is transgressive or not? In a preliminary attempt to answer these questions, text strings from a random sample of 100 engineering master's theses from the ProQuest Dissertations and Theses database were searched for appropriated verbatim source text using the Google search engine. The results suggest that textual borrowing may indeed be a common feature of the master's engineering literature review, raising questions about the ability of graduate students to synthesize the literature. The study also illustrates the difficulties of making a determination of plagiarism based on simple textual similarity. A context-specific approach is recommended when dealing with any instance of apparent copying.

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

NARCIS (Netherlands)

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

2011-01-01

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

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

Directory of Open Access Journals (Sweden)

Lukumon Oyedele

2012-11-01

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

Collaborative Care in Ambulatory Psychiatry: Content Analysis of Consultations to a Psychiatric Pharmacist

Science.gov (United States)

Gotlib, Dorothy; Bostwick, Jolene R.; Calip, Seema; Perelstein, Elizabeth; Kurlander, Jacob E.; Fluent, Thomas

2017-01-01

Objectives To determine the volume and nature (or topic) of consultations submitted to a psychiatric pharmacist embedded in an ambulatory psychiatry clinic, within a tertiary care academic medical center and to increase our understanding about the ways in which providers consult with an available psychiatric pharmacist. Experimental Design Authors analyze and describe the ambulatory psychiatric pharmacist consultation log at an academic ambulatory clinic. All consultation questions were submitted between July 2012 and October 2014. Principal Observations Psychiatry residents, attending physicians, and advanced practice nurse practitioners submitted 280 primary questions. The most common consultation questions from providers consulted were related to drug-drug interactions (n =70), drug formulations/dosing (n =48), adverse effects (n =43), and pharmacokinetics/lab monitoring/cross-tapering (n =36). Conclusions This is a preliminary analysis that provides information about how psychiatry residents, attending physicians, and advanced practice nurse practitioners at our health system utilize a psychiatric pharmacist. This collaborative relationship may have implications for the future of psychiatric care delivery. PMID:28936009

Collaborative Care in Ambulatory Psychiatry: Content Analysis of Consultations to a Psychiatric Pharmacist.

Science.gov (United States)

Gotlib, Dorothy; Bostwick, Jolene R; Calip, Seema; Perelstein, Elizabeth; Kurlander, Jacob E; Fluent, Thomas

2017-09-15

To determine the volume and nature (or topic) of consultations submitted to a psychiatric pharmacist embedded in an ambulatory psychiatry clinic, within a tertiary care academic medical center and to increase our understanding about the ways in which providers consult with an available psychiatric pharmacist. Authors analyze and describe the ambulatory psychiatric pharmacist consultation log at an academic ambulatory clinic. All consultation questions were submitted between July 2012 and October 2014. Psychiatry residents, attending physicians, and advanced practice nurse practitioners submitted 280 primary questions. The most common consultation questions from providers consulted were related to drug-drug interactions (n =70), drug formulations/dosing (n =48), adverse effects (n =43), and pharmacokinetics/lab monitoring/cross-tapering (n =36). This is a preliminary analysis that provides information about how psychiatry residents, attending physicians, and advanced practice nurse practitioners at our health system utilize a psychiatric pharmacist. This collaborative relationship may have implications for the future of psychiatric care delivery.

Services performed by an engineering consultant

International Nuclear Information System (INIS)

Seyffert, L.

1984-01-01

In the near future, services for the nuclear power plants in operation will become particularly important. Already at the present stage, engineering firms contribute to the planning of revisions and repair work, to the design, procurement and project management of new components and subsystems, respectively; they delegate supporting engineering personnel for the execution of in-plant measures, create special EDP software, develop quality assurance systems and work on quality control. This enumeration presents a rough outline of the field of activities, although it is far from complete. Also, the lines are drawn rather artibrarily, leaving out, for instance, the extensive activities in the fields of waste management and fuel management. These are main activities of specialized engineering firms which will be the subject of a future report. (orig.) [de

An IMP interaction approach to modelling business-to-business professional service quality: the case of Hong Kong consulting engineering service

OpenAIRE

Woo, Ka-shing

2001-01-01

In the domain of services marketing, the most researched area is in service quality. Since the pioneering stage of service quality research in the early 1980s, most of the studies have been conducted in the context of consumer services and consumer professional services. The purpose of this study is to bridge the gap in the existing literature to measure service quality of a particular business-to-business professional service industry (i.e., Hong Kong consulting engineering industry). I...

Human-factors engineering control-room design review/audit report: Byron Generating Station, Commonwealth Edison Company

International Nuclear Information System (INIS)

Savage, J.W.

1983-01-01

A human factors engineering design review/audit of the Byron Unit 1 control room was performed at the site on November 17 through November 19, 1981. This review was accomplished using the Unit 2 control room appropriately mocked-up to reflect design changes already committed to be incorporated in Unit 1. The report was prepared on the basis of the HFEB's audit of the applicant's Preliminary Design Assessment report and the human factors engineering design review performed at the site. This design review was carried out by a team from the Human Factors Engineering Branch, Division of Human Factors Safety. The review team was assisted by consultants from BioTechnology, Inc. (Falls Church, Virginia), and from Lawrence Livermore National Laboratory (University of California), Livermore, California

SECONDARY WASTE/ETF (EFFLUENT TREATMENT FACILITY) PRELIMINARY PRE-CONCEPTUAL ENGINEERING STUDY

International Nuclear Information System (INIS)

May, T.H.; Gehner, P.D.; Stegen, Gary; Hymas, Jay; Pajunen, A.L.; Sexton, Rich; Ramsey, Amy

2009-01-01

This pre-conceptual engineering study is intended to assist in supporting the critical decision (CD) 0 milestone by providing a basis for the justification of mission need (JMN) for the handling and disposal of liquid effluents. The ETF baseline strategy, to accommodate (WTP) requirements, calls for a solidification treatment unit (STU) to be added to the ETF to provide the needed additional processing capability. This STU is to process the ETF evaporator concentrate into a cement-based waste form. The cementitious waste will be cast into blocks for curing, storage, and disposal. Tis pre-conceptual engineering study explores this baseline strategy, in addition to other potential alternatives, for meeting the ETF future mission needs. Within each reviewed case study, a technical and facility description is outlined, along with a preliminary cost analysis and the associated risks and benefits.

Prediction of the Main Engine Power of a New Container Ship at the Preliminary Design Stage

Science.gov (United States)

Cepowski, Tomasz

2017-06-01

The paper presents mathematical relationships that allow us to forecast the estimated main engine power of new container ships, based on data concerning vessels built in 2005-2015. The presented approximations allow us to estimate the engine power based on the length between perpendiculars and the number of containers the ship will carry. The approximations were developed using simple linear regression and multivariate linear regression analysis. The presented relations have practical application for estimation of container ship engine power needed in preliminary parametric design of the ship. It follows from the above that the use of multiple linear regression to predict the main engine power of a container ship brings more accurate solutions than simple linear regression.

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

Science.gov (United States)

Strang, David; David, Robert J; Akhlaghpour, Saeed

2014-07-01

The rise of management consultancy has been accompanied by increasingly marked faddish cycles in management techniques, but the mechanisms that underlie this relationship are not well understood. The authors develop a simple agent-based framework that models innovation adoption and abandonment on both the supply and demand sides. In opposition to conceptions of consultants as rhetorical wizards who engineer waves of management fashion, firms and consultants are treated as boundedly rational actors who chase the secrets of success by mimicking their highest-performing peers. Computational experiments demonstrate that consultant-driven versions of this dynamic in which the outcomes of firms are strongly conditioned by their choice of consultant are robustly faddish. The invasion of boom markets by low-quality consultants undercuts popular innovations while simultaneously restarting the fashion cycle by prompting the flight of high-quality consultants into less densely occupied niches. Computational experiments also indicate conditions involving consultant mobility, aspiration levels, mimic probabilities, and client-provider matching that attenuate faddishness.

Consulting Basics for the Teacher-Turned-Technology Consultant.

Science.gov (United States)

Stager, Sue; Green, Kathy

1988-01-01

Discusses the role of educational technology consultants who may be classroom teachers with no formal training in consulting. Consulting models are described, including content-oriented and process-oriented approaches; Schein's process facilitator model is examined; and Kurpius' consulting model is explained and expanded. (LRW)

Preliminary experience of shared clinical management between Milan and Pointe Noire using the INteractive TeleConsultation Network for Worldwide HealthcAre Services (INCAS): telemedicine between Milan and Africa.

Science.gov (United States)

Malacarne, Mara; Lesma, Alessandro; Madera, Angelo; Malfatti, Eugenio; Castelli, Alberto; Lucini, Daniela; Pizzinelli, Paolo; Pagani, Massimo

2004-01-01

This paper describes preliminary experience in shared clinical management of patients located in Pointe Noire, Africa, and a referral center, Sacco University Hospital, located in Milan, Italy. The employed infrastructure INteractive TeleConsultation Network for Worldwide HealthcAre Services (INCAS) jointly developed by CEFRIEL (Center of Excellence For Research, Innovation, Education & Industrial Labs partnership) and ENI (Ente Nazionale Idrocarburi) is based on commercial off-the-shelf technology. This minimizes maintenance problems, while permitting a simple and friendly sharing of data using the telephone and e-mail for store-and-forward applications. The critical aspect of the flow of events comprising the exchange of information is discussed. In 60% of cases, only one telemedicine consultation was required. In the remainder 40%, a number of telemedicine consultations were required for appropriate management of clinical cases. The project demonstrated flexibility as documented by the wide range of pathologies that can be dealt with it. Finally the possibility of using shared clinical management as a learning tool is highlighted by the steep and rising learning curve. We conclude, however, that the patient, although handled in a "virtual" manner, should be viewed as very "real," as some of them elected to close the gap physically between Pointe Noire and Milan, and chose to be treated at the referral site.

Systems consultation: protocol for a novel implementation strategy designed to promote evidence-based practice in primary care.

Science.gov (United States)

Quanbeck, Andrew; Brown, Randall T; E Zgierska, Aleksandra; A Johnson, Roberta; Robinson, James M; Jacobson, Nora

2016-01-27

Adoption of evidence-based practices takes place at a glacial place in healthcare. This research will pilot test an innovative implementation strategy - systems consultation -intended to speed the adoption of evidence-based practice in primary care. The strategy is based on tenets of systems engineering and has been extensively tested in addiction treatment. Three innovations have been included in the strategy - translation of a clinical practice guideline into a checklist-based implementation guide, the use of physician peer coaches ('systems consultants') to help clinics implement the guide, and a focus on reducing variation in practices across prescribers and clinics. The implementation strategy will be applied to improving opioid prescribing practices in primary care, which may help ultimately mitigate the increasing prevalence of opioid abuse and addiction. The pilot test will compare four intervention clinics to four control clinics in a matched-pairs design. A leading clinical guideline for opioid prescribing has been translated into a checklist-based implementation guide in a systematic process that involved experts who wrote the guideline in consultation with implementation experts and primary care physicians. Two physicians with expertise in family and addiction medicine are serving as the systems consultants. Each systems consultant will guide two intervention clinics, using two site visits and follow-up communication by phone and email, to implement the translated guideline. Mixed methods will be used to test the feasibility, acceptability, and preliminary effectiveness of the implementation strategy in an evaluation that meets standards for 'fully developed use' of the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance). The clinic will be the primary unit of analysis. The systems consultation implementation strategy is intended to generalize to the adoption of other clinical guidelines. This pilot test is intended to prepare

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.

Preliminary systems engineering evaluations for the National Ecological Observatory Network.

Energy Technology Data Exchange (ETDEWEB)

Robertson, Perry J.; Kottenstette, Richard Joseph; Crouch, Shannon M.; Brocato, Robert Wesley; Zak, Bernard Daniel; Osborn, Thor D.; Ivey, Mark D.; Gass, Karl Leslie; Heller, Edwin J.; Dishman, James Larry; Schubert, William Kent; Zirzow, Jeffrey A.

2008-11-01

The National Ecological Observatory Network (NEON) is an ambitious National Science Foundation sponsored project intended to accumulate and disseminate ecologically informative sensor data from sites among 20 distinct biomes found within the United States and Puerto Rico over a period of at least 30 years. These data are expected to provide valuable insights into the ecological impacts of climate change, land-use change, and invasive species in these various biomes, and thereby provide a scientific foundation for the decisions of future national, regional, and local policy makers. NEON's objectives are of substantial national and international importance, yet they must be achieved with limited resources. Sandia National Laboratories was therefore contracted to examine four areas of significant systems engineering concern; specifically, alternatives to commercial electrical utility power for remote operations, approaches to data acquisition and local data handling, protocols for secure long-distance data transmission, and processes and procedures for the introduction of new instruments and continuous improvement of the sensor network. The results of these preliminary systems engineering evaluations are presented, with a series of recommendations intended to optimize the efficiency and probability of long-term success for the NEON enterprise.

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

Science.gov (United States)

2016-04-08

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

Preliminary design county plan Zeeland

International Nuclear Information System (INIS)

1987-01-01

The preliminary design 'Streekplan Zeeland' (Country plan Zeeland, with regard to the location of additional nuclear power plants in Zeeland, the Netherlands) has passed through a consultation and participation round. Thereupon 132 reactions have been received. These have been incorporated and answered in two notes. This proposal deals with the principal points of the preliminary design and treats also the remarks of the committees Environmental (town and country) Planning (RO), Provincial (town and country) Planning Committee (PPC) and Association of Communities of Zeeland (VZG), on the reply notes. The preliminary design with the modifications, collected in appendix 3, is proposed to be the starting point in the drawing-up of the design-country-plan. This design subsequently will pass the formal country-plan procedure. (author). 1 fig

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

Energy Technology Data Exchange (ETDEWEB)

Marquardt, Helmut

2011-07-01

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

Sludge Treatment Project Engineered Container Retrieval And Transfer System Preliminary Design Hazard Analysis Supplement 1

International Nuclear Information System (INIS)

Franz, G.R.; Meichle, R.H.

2011-01-01

This 'What/If' Hazards Analysis addresses hazards affecting the Sludge Treatment Project Engineered Container Retrieval and Transfer System (ECRTS) NPH and external events at the preliminary design stage. In addition, the hazards of the operation sequence steps for the mechanical handling operations in preparation of Sludge Transport and Storage Container (STSC), disconnect STSC and prepare STSC and Sludge Transport System (STS) for shipping are addressed.

What Chemistry To Teach Engineers?

Science.gov (United States)

Hawkes, Stephen J.

2000-01-01

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

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

Science.gov (United States)

2010-07-01

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

The Contemporary Consultant

DEFF Research Database (Denmark)

Olson, Thomas; Poulfelt, Flemming; Greiner, Larry

This book complements The handbook of Management Consulting: The Contemporary Consultant: Insights from Leading Experts, 1e but can also be studied separately. The book consists of 20 cases including Harvard and Stanford cases. The cases present the broad range of topics that are pertinent to cur...... current management issues facing consulting firms. These cases, together with the handbook, will prepare consultants and other business managers for a successful future in a highly competitive consulting environment.......This book complements The handbook of Management Consulting: The Contemporary Consultant: Insights from Leading Experts, 1e but can also be studied separately. The book consists of 20 cases including Harvard and Stanford cases. The cases present the broad range of topics that are pertinent...... to current management consulting. Each of the four parts of the text presents a cogent introduction by the editors, delineating topics that are critical for today's consultants to understand. The cases represent major practice areas of consulting and afford new insights into change processes and other...

Characteristics, finite element analysis, test description, and preliminary test results of the STM4-120 kinematic Stirling engine

Science.gov (United States)

Linker, K. L.; Rawlinson, K. S.; Smith, G.

1991-10-01

The Department of Energy's Solar Thermal Program has, as one of its program elements, the development and evaluation of conversion device technologies applicable to dish-electric systems. The primary research and development combines a conversion device (heat engine), solar receiver, and generator mounted at the focus of a parabolic dish concentrator. The Stirling-cycle heat engine was identified as the conversion device for dish-electric with the most potential for meeting the program's goals for efficiency, reliability, and installed cost. To advance the technology toward commercialization, Sandia National Laboratories has acquired a Stirling Thermal Motors, Inc. kinematic Stirling engine, STM4-120, for evaluation. The engine is being bench-tested at Sandia's Engine Test Facility and will be combined later with a solar receiver for on-sun evaluation. This report presents the engine characteristics, finite element analyses of critical engine components, test system layout, instrumentation, and preliminary performance results from the bench test.

Quiet engine program flight engine design study

Science.gov (United States)

Klapproth, J. F.; Neitzel, R. E.; Seeley, C. T.

1974-01-01

The results are presented of a preliminary flight engine design study based on the Quiet Engine Program high-bypass, low-noise turbofan engines. Engine configurations, weight, noise characteristics, and performance over a range of flight conditions typical of a subsonic transport aircraft were considered. High and low tip speed engines in various acoustically treated nacelle configurations were included.

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

Directory of Open Access Journals (Sweden)

Sigi Goode

2002-11-01

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

Preliminary investigation of airgap electrospun silk-fibroin-based structures for ligament analogue engineering.

Science.gov (United States)

Sell, S A; McClure, M J; Ayres, C E; Simpson, D G; Bowlin, G L

2011-01-01

The process of electrospinning has proven to be highly beneficial for use in a number of tissue-engineering applications due to its ease of use, flexibility and tailorable properties. There have been many publications on the creation of aligned fibrous structures created through various forms of electrospinning, most involving the use of a metal target rotating at high speeds. This work focuses on the use of a variation known as airgap electrospinning, which does not use a metal collecting target but rather a pair of grounded electrodes equidistant from the charged polymer solution to create highly aligned 3D structures. This study involved a preliminary investigation and comparison of traditionally and airgap electrospun silk-fibroin-based ligament constructs. Structures were characterized with SEM and alignment FFT, and underwent porosity, permeability, and mechanical anisotropy evaluation. Preliminary cell culture with human dermal fibroblasts was performed to determine the degree of cellular orientation and penetration. Results showed airgap electrospun structures to be anisotropic with significantly increased porosity and cellular penetration compared to their traditionally electrospun counterparts.

Aquarius study - engineering and economic considerations

International Nuclear Information System (INIS)

Griffin, Roger F.

1970-01-01

The two previous papers described the scope of the Aquarius Study and the various applications considered in evaluating the use of nuclear explosives for the development of water resources in Arizona. Surface storage behind a dam created with the use of nuclear explosives was selected for the major effort, primarily because it could afford the most valid direct comparison between nuclear and conventional methods. In this paper I will focus on the engineering and economic considerations involved in developing and evaluating three concepts for constructing a rockfill dam using nuclear explosives. Engineering development and economic evaluation of the concepts was the principal responsibility of Bechtel Corporation as a consultant in the study to the Arizona Atomic Energy Commission. We depended heavily on information supplied by the Federal participants, notably the U.S. Bureau of Reclamation for site data and the U.S. AEC*s Lawrence Radiation Laboratory for information on nuclear explosives effects. Since the study report has not yet been published and additional material is still forthcoming, some of the information I will present, such as the cost estimates, may be subject to change and should be considered preliminary. (author)

Aquarius study - engineering and economic considerations

Energy Technology Data Exchange (ETDEWEB)

Griffin, Roger F [Bechtel Corporation (United States)

1970-05-15

The two previous papers described the scope of the Aquarius Study and the various applications considered in evaluating the use of nuclear explosives for the development of water resources in Arizona. Surface storage behind a dam created with the use of nuclear explosives was selected for the major effort, primarily because it could afford the most valid direct comparison between nuclear and conventional methods. In this paper I will focus on the engineering and economic considerations involved in developing and evaluating three concepts for constructing a rockfill dam using nuclear explosives. Engineering development and economic evaluation of the concepts was the principal responsibility of Bechtel Corporation as a consultant in the study to the Arizona Atomic Energy Commission. We depended heavily on information supplied by the Federal participants, notably the U.S. Bureau of Reclamation for site data and the U.S. AEC*s Lawrence Radiation Laboratory for information on nuclear explosives effects. Since the study report has not yet been published and additional material is still forthcoming, some of the information I will present, such as the cost estimates, may be subject to change and should be considered preliminary. (author)

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

NARCIS (Netherlands)

I. Hollaender

2007-01-01

In this paper I’ll discuss the first outcomes of an explorative research concerning the consultancy projects of a consultancy-based learning programme (Minor Consultancy 2006 - 2007, half-year bachelor programme University of Applied Sciences, Hogeschool Utrecht, The Netherlands). In order to

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

Science.gov (United States)

2010-09-03

... State consultants performing worksite visits. Following the successful completion of an on-site... all types of complaints in a similar fashion. As a result, OSHA does not need to distinguish between...) * * * (2) The Consultant shall terminate an onsite consultative visit already in progress where one of the...

Team- and project work in engineering practices

DEFF Research Database (Denmark)

Buch, Anders; Andersen, Vibeke

2015-01-01

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

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

Science.gov (United States)

Liu, Xiao; Sawada, Yoshie; Takizawa, Takako; Sato, Hiroko; Sato, Mahito; Sakamoto, Hironosuke; Utsugi, Toshihiro; Sato, Kunio; Sumino, Hiroyuki; Okamura, Shinichi; Sakamaki, Tetsuo

2007-01-01

The objective of this study was to compare doctor-patient communications in clinical consultations via telemedicine technology to doctor-patient communications in face-to-face clinical consultations. Five doctors who had been practicing internal medicine for 8 to 18 years, and twenty patients were enrolled in this study; neither doctors nor patients had previous experience of telemedicine. The patients received both a telemedicine consultation and a face-to-face consultation. Three measures--video observation, medical record volume, and participants' satisfaction--were used for the assessment. It was found that the time spent on the telemedicine consultation was substantially longer than the time spent on the face-to-face consultation. No statistically significant differences were found in the number of either closed or open-ended questions asked by doctors between both types of consultation. Empathy-utterances, praise-utterances, and facilitation-utterances were, however, seen less in the telemedicine consultations than in the face-to-face consultations. The volume of the medical records was statistically smaller in the telemedicine consultations than in the face-to-face consultations. Patients were satisfied with the telemedicine consultation, but doctors were dissatisfied with it and felt hampered by the communication barriers. This study suggests that new training programs are needed for doctors to develop improved communication skills and the ability to express empathy in telemedicine consultations.

IMPLEMENTATION AND SUSTAINABILITY OF CHILD-PARENT PSYCHOTHERAPY: THE ROLE OF REFLECTIVE CONSULTATION IN THE LEARNING COLLABORATIVE MODEL.

Science.gov (United States)

Noroña, Carmen Rosa; Acker, Michelle L

2016-11-01

Recent implementation science in mental health has focused on identifying the most effective strategies to disseminate and implement evidence-based treatments (EBTs) into real-world practice settings. The learning collaborative training methodology and its use of expert trainers/consultants have become increasingly popular as one of these approaches. Moreover, there is preliminary evidence that ongoing expert consultation may increase the adoption, learning, and sustainability of EBTs by an already practicing workforce and, consequently, help trainers, practitioners, and organizations address implementation barriers. This article describes the authors' experiences in facilitating Child-Parent Psychotherapy (CPP) training and explores the role of reflective clinical consultation as an active process that supports the implementation of a rich, but complex, model that requires sophisticated knowledge and skills from practitioners. It examines the intricate range of the CPP consultant's functions, which ultimately support clinicians' reflective practice as they learn and adopt this EBT. Reflective consultation is proposed as an essential component for the integration of knowledge, experience, and emotions in practitioners and as a catalyst for organizational change. Using their voices as trainers-consultants and those of their trainees, the authors discuss the implications of reflective consultation for the effective implementation and sustainability of CPP. Reflections are offered on lessons learned. © 2016 Michigan Association for Infant Mental Health.

LASL experimental engineered waste burial facility: design considerations and preliminary plan

International Nuclear Information System (INIS)

DePoorter, G.L.

1980-01-01

The LASL Experimental Engineered Waste Burial Facility is a part of the National Low-Level Waste Management Program on Shallow-Land Burial Technology. It is a test facility where basic information can be obtained on the processes that occur in shallow-land burial operations and where new concepts for shallow-land burial can be tested on an accelerated basis on an appropriate scale. The purpose of this paper is to present some of the factors considered in the design of the facility and to present a preliminary description of the experiments that are initially planned. This will be done by discussing waste management philosophies, the purposes of the facility in the context of the waste management philosophy for the facility, and the design considerations, and by describing the experiments initially planned for inclusion in the facility, and the facility site

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

Science.gov (United States)

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

2017-08-01

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

Consultation Models Revisited

International Nuclear Information System (INIS)

Fawaz, S.; Khan, Zulfiquar A.; Mossa, Samir Y.

2006-01-01

A new definition is proposed for analyzing the consultation in the primary health care, integrating other models of consultation and provides a framework by which general practitioners can apply the principles of consultation using communication skills to reconcile the respective agenda and autonomy of both doctor and patient into a negotiated agreed plan, which includes both management of health problems and health promotion. Achieving success of consultations depends on time and mutual cooperation between patient and doctor showed by doctor-patient relationship. (author)

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

DEFF Research Database (Denmark)

Manske, Fred; Koch, Christian; Vogelius, Peter

1998-01-01

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

7 CFR 1753.17 - Engineering services.

Science.gov (United States)

2010-01-01

... form. (B) The contract will not accomplish loan purposes. (C) The engineering service fees are unreasonable. (D) The contract presents unacceptable loan security risk to RUS. (E) The consulting engineering... loan shall be rendered by a qualified engineer selected by the borrower or by qualified employees on...

On becoming a consultant: A study exploring the journey to consultant practice

International Nuclear Information System (INIS)

Henwood, S.; Booth, L.

2016-01-01

Background: This paper reports a qualitative study exploring the establishment of non-medical consultant roles in Radiography. Given the difficulties reported in recruiting and retaining staff in these posts, we hope this paper offers a historical documentation of those consultants who were some of the first in post, sharing their stories of how they obtained and transitioned into their roles. Methods: This paper is part of a two year case study exploring the leadership domain of consultant practice. The focus of this paper is a reflection, by the consultants, of their journey to becoming a consultant; a documentation of some of the practical issues in establishing the roles; and the transition to higher levels of practice. Eight consultant radiographers participated in the initial interviews (two consultants withdrew from the study subsequent to this). In-depth iterative interviewing was used to explore and record individual stories and experiences. Findings: The consultants shared their perceptions of being in post, including their own motivation to progress to a new role, how prepared they felt initially, the lack of role models, the lack of clarity surrounding the role and a perception of ‘being on display’. Conclusions: The paper offers insight into the journey of these consultants and some of the common characteristics they share. These characteristics give some indication of what motivated them to step into higher level roles, in particular the need to drive change and improvement. The paper also offers suggestions for how the transition into the role could be more effectively supported. - Highlights: • Identifies characteristics thought to contribute to effective consultant practice. • A desire to change practice is a major motivator in applying for a consultant post. • The consultant role was a natural evolution for some, not a desired career pathway. • There is recognition that the initial consultants were pioneers for the profession. �

The Effect of the Strictness of Consultation Requirements on Fraud Consultation

NARCIS (Netherlands)

Gold, A.H.; Knechel, W.R.; Wallage, P.

2012-01-01

We investigate how the strictness of a requirement to consult on potential client fraud affects auditors' propensity to consult with firm experts. We consider two specific forms of guidance about fraud consultations: (1) strict, i.e., mandatory and binding; and (2) lenient, i.e., advisory and

Inpatient Consultative Dermatology.

Science.gov (United States)

Biesbroeck, Lauren K; Shinohara, Michi M

2015-11-01

Dermatology consultation can improve diagnostic accuracy in the hospitalized patient with cutaneous disease. Dermatology consultation can streamline and improve treatment plans, and potentially lead to cost savings. Dermatology consultants can be a valuable resource for education for trainees, patients, and families. Inpatient consultative dermatology spans a breadth of conditions, including inflammatory dermatoses,infectious processes, adverse medication reactions, and neoplastic disorders, many of which can be diagnosed based on dermatologic examination alone, but when necessary, bedside skin biopsies can contribute important diagnostic information. Copyright © 2015 Elsevier Inc. All rights reserved.

Preliminary Axial Flow Turbine Design and Off-Design Performance Analysis Methods for Rotary Wing Aircraft Engines. Part 1; Validation

Science.gov (United States)

Chen, Shu-cheng, S.

2009-01-01

For the preliminary design and the off-design performance analysis of axial flow turbines, a pair of intermediate level-of-fidelity computer codes, TD2-2 (design; reference 1) and AXOD (off-design; reference 2), are being evaluated for use in turbine design and performance prediction of the modern high performance aircraft engines. TD2-2 employs a streamline curvature method for design, while AXOD approaches the flow analysis with an equal radius-height domain decomposition strategy. Both methods resolve only the flows in the annulus region while modeling the impact introduced by the blade rows. The mathematical formulations and derivations involved in both methods are documented in references 3, 4 for TD2-2) and in reference 5 (for AXOD). The focus of this paper is to discuss the fundamental issues of applicability and compatibility of the two codes as a pair of companion pieces, to perform preliminary design and off-design analysis for modern aircraft engine turbines. Two validation cases for the design and the off-design prediction using TD2-2 and AXOD conducted on two existing high efficiency turbines, developed and tested in the NASA/GE Energy Efficient Engine (GE-E3) Program, the High Pressure Turbine (HPT; two stages, air cooled) and the Low Pressure Turbine (LPT; five stages, un-cooled), are provided in support of the analysis and discussion presented in this paper.

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

DEFF Research Database (Denmark)

Buch, Anders; Andersen, Vibeke

2015-01-01

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

Opinions on SKB's Safety Assessments SR 97 and SFL 3-5. A Review by SKI Consultants

Energy Technology Data Exchange (ETDEWEB)

NONE

2000-12-01

The Swedish Nuclear Fuel and Waste Management Co. (SKB) has presented their safety assessment 'Deep repository for spent nuclear fuel, SR 97 - Post-closure safety'. SKB's report is part of the documentation that has been required by the Government before the start of site investigations. The Swedish Nuclear Power Inspectorate (SKI) is reviewing SR 97 according to earlier Government decisions. In its review work SKI has asked several consultants, that recently have been performing research work for SKI, to give their opinions on SR 97. SKI and the Swedish Radiation Protection Institute (SSI) have used these reports from the consultants as one complementary basis for the formulation of the SKI/SSI review report. This is a compilation of the reports from the different consultants, and therefore the different contributions vary in length, style and language. Included are also two consultant reports, giving comments on SKB's preliminary safety assessment for SFL 3-5 (deep repository for long-lived low- and intermediate-level waste). The 17 contributions have all been separately indexed.

Opinions on SKB's Safety Assessments SR 97 and SFL 3-5. A Review by SKI Consultants

International Nuclear Information System (INIS)

2000-12-01

The Swedish Nuclear Fuel and Waste Management Co. (SKB) has presented their safety assessment 'Deep repository for spent nuclear fuel, SR 97 - Post-closure safety'. SKB's report is part of the documentation that has been required by the Government before the start of site investigations. The Swedish Nuclear Power Inspectorate (SKI) is reviewing SR 97 according to earlier Government decisions. In its review work SKI has asked several consultants, that recently have been performing research work for SKI, to give their opinions on SR 97. SKI and the Swedish Radiation Protection Institute (SSI) have used these reports from the consultants as one complementary basis for the formulation of the SKI/SSI review report. This is a compilation of the reports from the different consultants, and therefore the different contributions vary in length, style and language. Included are also two consultant reports, giving comments on SKB's preliminary safety assessment for SFL 3-5 (deep repository for long-lived low- and intermediate-level waste). The 17 contributions have all been separately indexed

Affordable Development and Demonstration of a Small NTR Engine and Stage: A Preliminary NASA, DOE, and Industry Assessment

Science.gov (United States)

Borowski, Stanley K.; Sefcik, Robert J.; Fittje, James E.; McCurdy, David R.; Qualls, Arthur L.; Schnitzler, Bruce G.; Werner, James E.; Weitzberg, Abraham; Joyner, Claude R.

2015-01-01

The Nuclear Thermal Rocket (NTR) represents the next evolutionary step in cryogenic liquid rocket engines. Deriving its energy from fission of uranium-235 atoms contained within fuel elements that comprise the engine's reactor core, the NTR can generate high thrust at a specific impulse of approx. 900 seconds or more - twice that of today's best chemical rockets. In FY'11, as part of the AISP project, NASA proposed a Nuclear Thermal Propulsion (NTP) effort that envisioned two key activities - "Foundational Technology Development" followed by system-level "Technology Demonstrations". Five near-term NTP activities identified for Foundational Technology Development became the basis for the NCPS project started in FY'12 and funded by NASA's AES program. During Phase 1 (FY'12-14), the NCPS project was focused on (1) Recapturing fuel processing techniques and fabricating partial length "heritage" fuel elements for the two candidate fuel forms identified by NASA and the DOE - NERVA graphite "composite" and the uranium dioxide (UO2) in tungsten "cermet". The Phase 1 effort also included: (2) Engine Conceptual Design; (3) Mission Analysis and Requirements Definition; (4) Identification of Affordable Options for Ground Testing; and (5) Formulation of an Affordable and Sustainable NTP Development Strategy. During FY'14, a preliminary plan for DDT&E was outlined by GRC, the DOE and industry for NASA HQ that involved significant system-level demonstration projects that included GTD tests at the NNSS, followed by a FTD mission. To reduce development costs, the GTD and FTD tests use a small, low thrust (approx. 7.5 or 16.5 klbf) engine. Both engines use graphite composite fuel and a "common" fuel element design that is scalable to higher thrust (approx. 25 klbf) engines by increasing the number of elements in a larger diameter core that can produce greater thermal power output. To keep the FTD mission cost down, a simple "1-burn" lunar flyby mission was considered along with

Exploring the research domain of consultant practice: Experiences of consultant radiographers

International Nuclear Information System (INIS)

Harris, R.; Paterson, A.

2016-01-01

Aim: This paper reports on one part of a larger study. The aim of the overall study was to explore what the core domain of research means to consultant radiographers in clinical practice and to identify the key factors that facilitate or hinder research activity by this staff group. Design and method: Grounded theory research methodology was employed. This second part of the study involved telephone interviews with twenty five consultant radiographers. Results: Results indicate there are variations across clinical specialties as to the amount and level of research undertaken by consultant radiographers. The principal barriers revealed were: lack of time; excessive clinical workload; lack of skills and confidence to undertake research; poor research culture; and lack of support. The main facilitators noted were: dedicated time, research training and up-skilling; mutually beneficial collaborations; managerial understanding of the research domain of the role; and research focussed on clinical demand. Conclusion: Fulfilling the clinical role is imperative and integral to the profession at consultant level; however, if it is undertaken to the detriment of the other domains then these practitioners may not be operating at ‘consultant’ level. Overall improvements must be made to ensure that the consultant radiographer role is delivering on current expectations and is safeguarded for the future of the next generation of radiographers. - Highlights: • Consultant radiographers undertake research but have concerns about their research skills. • Research aims to improve practice and patients' experiences. • Relatively few consultant radiographers publish their work regularly. • Consultant radiographers allocate little protected time for research due to clinical demands.

Architectural Engineers

DEFF Research Database (Denmark)

Petersen, Rikke Premer

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

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

International Nuclear Information System (INIS)

Harris, R.; Paterson, A.

2016-01-01

Aim: This paper reports on one part of a larger study. The aim was to explore what the core domain of research means to consultant radiographers in clinical practice and to identify the key factors that facilitate or hinder research activity by this staff group. Design and method: Grounded theory research methodology was employed. This first part of the study involved electronic questionnaires being sent to all those known in consultant radiographer posts in the United Kingdom. Results: Results indicate there are variations across clinical specialties as to the amount and level of research undertaken by consultant radiographers, and not all agreed that research should be a core domain of consultant practice. Main facilitators to research were noted as: time; skills and knowledge of the researcher; a well defined research question. Main barriers to research were noted as: lack of allocated time; lack of skills/experience; clinical workload. Conclusion: Research is one of the four core domains of consultant allied health professional and nursing roles but, as yet, it is not fully embedded into those of all consultant radiographers. Many consultant radiographers appear to spend more of their time on the ‘clinical expert’ element of their role at the expense of the research domain. This study concludes that there is an urgent need for consultant radiographers to understand that research is one of the four core domains and to recognise the need to embed research into their clinical practice. - Highlights: • Consultant radiographers undertake research but have concerns about their research skills. • Research aims to improve practice and patients' experiences. • Relatively few consultant radiographers publish their work routinely. • Consultant radiographers allocate little protected time for research due to clinical demands. • Almost half of the consultant radiographers feel research should not be a core part of their roles.

Ideas of holistic engineering meet engineering work practices

DEFF Research Database (Denmark)

Buch, Anders

2016-01-01

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

Accompanied consultations in occupational health.

Science.gov (United States)

Hobson, J; Hobson, H; Sharp, R

2016-04-01

Accompanied consultations are often reported as difficult by occupational physicians but have not been studied in the occupational health setting. To collect information about accompanied consultations and the impact of the companion on the consultation. We collected data on all accompanied consultations by two occupational physicians working in a private sector occupational health service over the course of 16 months. Accompanied consultations were matched to non-accompanied consultations for comparison. We collected data on 108 accompanied consultations. Accompanied consultations were more likely to be connected with ill health retirement (P Occupational health practitioners may benefit from better understanding of accompanied consultations and guidance on their management. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Preliminary site design for the SP-100 ground engineering test

International Nuclear Information System (INIS)

Cox, C.M.; Miller, W.C.; Mahaffey, M.K.

1986-04-01

In November, 1985, Hanford was selected by the Department of Energy (DOE) as the preferred site for a full-scale test of the integrated nuclear subsystem for SP-100. The Hanford Engineering Development Laboratory, operated by Westinghouse Hanford Company, was assigned as the lead contractor for the Test Site. The nuclear subsystem, which includes the reactor and its primary heat transport system, will be provided by the System Developer, another contractor to be selected by DOE in late FY-1986. In addition to reactor operations, test site responsibilities include preparation of the facility plus design, procurement and installation of a vacuum chamber to house the reactor, a secondary heat transport system to dispose of the reactor heat, a facility control system, and postirradiation examination. At the conclusion of the test program, waste disposal and facility decommissioning are required. The test site must also prepare appropriate environmental and safety evaluations. This paper summarizes the preliminary design requirements, the status of design, and plans to achieve full power operation of the test reactor in September, 1990

Cultural consultation as a model for training multidisciplinary mental healthcare professionals in cultural competence skills: preliminary results.

Science.gov (United States)

Owiti, J A; Ajaz, A; Ascoli, M; de Jongh, B; Palinski, A; Bhui, K S

2014-01-01

Lack of cultural competence in care contributes to poor experiences and outcomes from care for migrants and racial and ethnic minorities. As a result, health and social care organizations currently promote cultural competence of their workforce as a means of addressing persistent poor experiences and outcomes. At present, there are unsystematic and diverse ways of promoting cultural competence, and their impact on clinician skills and patient outcomes is unknown. We developed and implemented an innovative model, cultural consultation service (CCS), to promote cultural competence of clinicians and directly improve on patient experiences and outcomes from care. CCS model is an adaptation of the McGill model, which uses ethnographic methodology and medical anthropological knowledge. The method and approach not only contributes both to a broader conceptual and dynamic understanding of culture, but also to learning of cultural competence skills by healthcare professionals. The CCS model demonstrates that multidisciplinary workforce can acquire cultural competence skills better through the clinical encounter, as this promotes integration of learning into day-to-day practice. Results indicate that clinicians developed a broader and patient-centred understanding of culture, and gained skills in narrative-based assessment method, management of complexity of care, competing assumptions and expectations, and clinical cultural formulation. Cultural competence is defined as a set of skills, attitudes and practices that enable the healthcare professionals to deliver high-quality interventions to patients from diverse cultural backgrounds. Improving on the cultural competence skills of the workforce has been promoted as a way of reducing ethnic and racial inequalities in service outcomes. Currently, diverse models for training in cultural competence exist, mostly with no evidence of effect. We established an innovative narrative-based cultural consultation service in an inner

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.

Team and Project Work in Engineering Practices

Directory of Open Access Journals (Sweden)

Anders Buch

2015-11-01

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

Ongkharak Nuclear Research Center-the role of the consultant

International Nuclear Information System (INIS)

Jacobi, A.; De Haller, L.

1998-01-01

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

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

OpenAIRE

Campion, P D; Gabriel, J

1984-01-01

All children's consultations with their general practitioner over a 12 month period in a small urban practice were analysed. Overall consultation rates ranged from 2.2 per child a year for 8 to 11 year olds, to 6.8 for those under 2. Families were grouped according to their average rate of new consultation for children, standardised for age. Families with higher consulting rates scored higher on an index of economic disadvantage, with mothers who scored higher on a test of "tendency to consul...

A preliminary census of engineering activities located in Sicily (Southern Italy) which may "potentially" induce seismicity

Science.gov (United States)

Aloisi, Marco; Briffa, Emanuela; Cannata, Andrea; Cannavò, Flavio; Gambino, Salvatore; Maiolino, Vincenza; Maugeri, Roberto; Palano, Mimmo; Privitera, Eugenio; Scaltrito, Antonio; Spampinato, Salvatore; Ursino, Andrea; Velardita, Rosanna

2015-04-01

The seismic events caused by human engineering activities are commonly termed as "triggered" and "induced". This class of earthquakes, though characterized by low-to-moderate magnitude, have significant social and economical implications since they occur close to the engineering activity responsible for triggering/inducing them and can be felt by the inhabitants living nearby, and may even produce damage. One of the first well-documented examples of induced seismicity was observed in 1932 in Algeria, when a shallow magnitude 3.0 earthquake occurred close to the Oued Fodda Dam. By the continuous global improvement of seismic monitoring networks, numerous other examples of human-induced earthquakes have been identified. Induced earthquakes occur at shallow depths and are related to a number of human activities, such as fluid injection under high pressure (e.g. waste-water disposal in deep wells, hydrofracturing activities in enhanced geothermal systems and oil recovery, shale-gas fracking, natural and CO2 gas storage), hydrocarbon exploitation, groundwater extraction, deep underground mining, large water impoundments and underground nuclear tests. In Italy, induced/triggered seismicity is suspected to have contributed to the disaster of the Vajont dam in 1963. Despite this suspected case and the presence in the Italian territory of a large amount of engineering activities "capable" of inducing seismicity, no extensive researches on this topic have been conducted to date. Hence, in order to improve knowledge and correctly assess the potential hazard at a specific location in the future, here we started a preliminary study on the entire range of engineering activities currently located in Sicily (Southern Italy) which may "potentially" induce seismicity. To this end, we performed: • a preliminary census of all engineering activities located in the study area by collecting all the useful information coming from available on-line catalogues; • a detailed compilation

Skills for Effective Consultation.

Science.gov (United States)

Dustin, Dick; Ehly, Stewart

1984-01-01

Discusses counselor skills that promote effective consultation. Reviews research on effective school consultation and presents a five-stage model which involves phasing in, problem identification, implementation, evaluation, and termination. Provides recommendations for the process and products of consultation. (JAC)

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

OpenAIRE

Joseph Lampel; Ajay Bhalla; Kaivalya Vishnu

2010-01-01

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

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

OpenAIRE

Kreutzer, Markus; Menz, Markus

2012-01-01

This study report provides European management consulting firms' assessment of trends and currently prevailing business models in the industry. It depicts the different threats and opportunities that consulting firms with different business models, consulting foci, sizes, leverage ratios, international orientations, and geographical footprints face; it also reveals these firms' adaptation strategies. Based on an analysis of a survey of 311 consulting firms from 26 European countries, the repo...

Preliminary Performance Data on Westinghouse Electronic Power Regulator Operating on J34-WE-32 Turbojet Engine in Altitude Wind Tunnel

Science.gov (United States)

Ketchum, James R.; Blivas, Darnold; Pack, George J.

1950-01-01

The behavior of the Westinghouse electronic power regulator operating on a J34-WE-32 turbojet engine was investigated in the NACA Lewis altitude wind tunnel at the request of the Bureau of Aeronautics, Department of the Navy. The object of the program was to determine the, steady-state stability and transient characteristics of the engine under control at various altitudes and ram pressure ratios, without afterburning. Recordings of the response of the following parameters to step changes in power lever position throughout the available operating range of the engine were obtained; ram pressure ratio, compressor-discharge pressure, exhaust-nozzle area, engine speed, turbine-outlet temperature, fuel-valve position, jet thrust, air flow, turbine-discharge pressure, fuel flow, throttle position, and boost-pump pressure. Representative preliminary data showing the actual time response of these variables are presented. These data are presented in the form of reproductions of oscillographic traces.

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.

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.

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

Science.gov (United States)

Steenbeek, M; van Baarsen, C; Koekkoek, B

2012-01-01

Psychiatric symptoms occur frequently in nursing-home residents. The psychiatric expertise and support available to residents vary from one nursing home to another. International studies show that psychiatric consultations can be effective, but in the Netherlands very little research has been done on this topic. To list the types of psychiatric problems and symptoms for which consultations are requested and to determine whether a psychiatric consultation can have positive results for nursing-home residents and staff. The psychiatric consultations requested were tabulated and were analysed. Details of 71 psychiatric consultations were recorded. The percentage of women (average age 74 years) was slightly higher than the percentage of men. More than 75% of the patients suffered from agitation/aggression or irritability, 65% suffered from depression, 63% from anxiety and 56% from dysinhibition. A post-intervention assessment was performed in 54 patients (76%). In this group psychiatric symptoms were found to be greatly reduced, with regard to both frequency and severity. In addition, nursing staff seemed to suffer less of the stress and strain in their work. The patients for whom a consultation was requested seemed to suffer from serious psychiatric symptoms and were often aggressive. It was possible to achieve substantial progress as a result of a simple intervention. A possible explanation for this effect is probably the nature of the psychiatric consultation used; it was structured, multi-disciplinary and time-consuming. However, since no control group was involved, it is impossible to say with certainty that the reduction in symptoms can be attributed solely to the consultation.

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

Science.gov (United States)

2013-08-08

... clarify the high priority enforcement cases when OSHA may initiate a non-programmed inspection at those.... OSHA-2010-0010] RIN 1218-AC32 Consultation Agreements: Proposed Changes to Consultation Procedures AGENCY: Occupational Safety and Health Administration (OSHA), Labor. ACTION: Withdrawal of proposed rule...

3 CFR - Tribal Consultation

Science.gov (United States)

2010-01-01

.... Recommendations for improving the plans and making the tribal consultation process more effective, if any, should... 3 The President 1 2010-01-01 2010-01-01 false Tribal Consultation Presidential Documents Other Presidential Documents Memorandum of November 5, 2009 Tribal Consultation Memorandum for the Heads of Executive...

Opinions on SKB's Safety Assessments SR 97 and SFL 3-5. A Review by SKI Consultants

Energy Technology Data Exchange (ETDEWEB)

NONE

2000-12-01

The Swedish Nuclear Fuel and Waste Management Co. (SKB) has presented their safety assessment 'Deep repository for spent nuclear fuel, SR 97 - Post-closure safety'. SKB's report is part of the documentation that has been required by the Government before the start of site investigations. The Swedish Nuclear Power Inspectorate (SKI) is reviewing SR 97 according to earlier Government decisions. In its review work SKI has asked several consultants, that recently have been performing research work for SKI, to give their opinions on SR 97. SKI and the Swedish Radiation Protection Institute (SSI) have used these reports from the consultants as one complementary basis for the formulation of the SKI/SSI review report. This is a compilation of the reports from the different consultants, and therefore the different contributions vary in length, style and language. Included are also two consultant reports, giving comments on SKB's preliminary safety assessment for SFL 3-5 (deep repository for long-lived low- and intermediate-level waste). The 17 contributions have all been separately indexed.

A preliminary survey of the National Wetlands Inventory as mapped for the Idaho National Engineering Laboratory

International Nuclear Information System (INIS)

Hampton, N.L.; Rope, R.C.; Glennon, J.M.; Moor, K.S.

1995-02-01

Approximately 135 areas within the boundaries of the Idaho National Engineering Laboratory (INEL) have been mapped as wetland habitat as part of the United States Fish and Wildlife Service (FWS) National Wetlands Inventory (NWI). A preliminary survey of these wetlands was conducted to examine their general characteristics and status, to provide an estimation of relative ecological importance, to identify additional information needed to complete ecological characterization of important INEL wetlands, and to identify high priority wetland areas on the INEL. The purpose of the survey was to provide information to support the preparation of the Environmental Restoration and Waste Management (ER ampersand WM) Environmental Impact Statement (EIS). Information characterizing general vegetation, hydrology, wildlife use, and archaeology was collected at 105 sample sites on the INEL. Sites representing NWI palustrine, lacustrine, and riverine wetlands (including manmade), and areas unmapped or unclassified by the NWI were included in the sample. The field information was used to develop a preliminary ranking of relative ecological importance for each wetland visited during this survey. Survey limitations are identified

Preliminary study on the control of direct injection diesel engine for better fuel flexibility and emissions control. Pt. 3

Energy Technology Data Exchange (ETDEWEB)

Egnell, R.; Kassem, N.; Bohlin, T.

1985-01-01

This report summarizes the results of a preliminary study on turbocharged direct injection diesel engines. The objectives and scope of this study are: 1. To explore the potential of using electronic control systems based on dynamic models of the engine in order to reduce fuel consumption, while maintaining good driveability. 2. To analyze the transient response of a turbocharged diesel engine based on experimental data collected from one of SAAB-SCANIA's test cells. 3. To survey the hardware components that would satisfy the requirements of the electronic control systems mentioned above. Part III discusses the transient response measurements obtained from two sets of experiments conducted on a six-cylinder motor working under varying conditions of load and speed. The objective of the first set of experiments was to quantify the difference in ignition delay between the transient and steady state operating conditions. The second set of experiments were aimed to provide a basis on which the engine efficiency obtained under transient conditions can be compared to that obtained from a single-cylinder motor working under steady state conditions.

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.

External Tank Liquid Hydrogen (LH2) Prepress Regression Analysis Independent Review Technical Consultation Report

Science.gov (United States)

Parsons, Vickie s.

2009-01-01

The request to conduct an independent review of regression models, developed for determining the expected Launch Commit Criteria (LCC) External Tank (ET)-04 cycle count for the Space Shuttle ET tanking process, was submitted to the NASA Engineering and Safety Center NESC on September 20, 2005. The NESC team performed an independent review of regression models documented in Prepress Regression Analysis, Tom Clark and Angela Krenn, 10/27/05. This consultation consisted of a peer review by statistical experts of the proposed regression models provided in the Prepress Regression Analysis. This document is the consultation's final report.

Danish energy-sector exports. Products and consulting services

International Nuclear Information System (INIS)

Wolter, H.C.

2000-06-01

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

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

OpenAIRE

Hartley, Jeanette

2017-01-01

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

Reflections on the role of consultant radiographers in the UK: What is a consultant radiographer?

International Nuclear Information System (INIS)

Booth, L.; Henwood, S.; Miller, P.

2016-01-01

Context: This paper is the second paper from a two year in depth case study, exploring the role of consultant radiographers in the UK. Methods: A longitudinal case study approach was used to determine the role of consultant radiographers. Interviews were used to explore experiences of being a consultant, which were analysed using thematic analysis. Eight consultant radiographers participated (Note, two of the consultants withdrew after the first interview due to workload). Therefore two consultants were interviewed only once. The remaining six consultants were interviewed twice over a 12 month period. Findings: The data presented in this paper explores the nature of the role, differences between roles, the four domains of practice, and how the role fits into local organisational structures. The study shows wide variation in the types of roles undertaken, reflecting that the creation of these roles were in response to local clinical need and often related to an individual practitioner's skills. The broad scope of the role was shown across all the consultants, with evidence of roles developing into new areas of service delivery. Conclusions: The paper offers insight into the role(s) of consultant radiographers in the UK. The range and scope of their practice is extensive, with much variation. It is evident that the clinical aspect of the role dominates, with research being the least supported domain of practice. There remains a lack of clarity around the role, with concerns about remuneration and other limitations that may restrict the role developing further. - Highlights: • This paper shows the variation in roles between consultant radiographers. • The commonality with medical roles is highlighted. • Problem solving is identified as a core skill in consultant radiography. • Consultants offered evidence of the roles developing service provision. • While all four domains of practice are covered, research is the least well supported.

The Dream Consultant

DEFF Research Database (Denmark)

Muhr, Sara Louise; Kirkegaard, Line

2013-01-01

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

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.

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.

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.

Starting a nursing consultation practice.

Science.gov (United States)

Schulmeister, L

1999-03-01

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

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

Science.gov (United States)

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

2000-01-01

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

Preliminary engineering assessment of treatment alternatives for groundwater from the Hanford 200 Area 200-BP-5 plumes

International Nuclear Information System (INIS)

1996-05-01

This report presents the results of the Preliminary Engineering Assessment of Treatment Alternatives (PEATA), an engineering evaluation of potential treatment alternatives for groundwater extracted from the 200-BP-5 Area's 216-BY Cribs and 216-B-5 Reverse Well plumes. The primary objective of the PEATA was to identify treatment technologies that are worth further consideration (i.e., treatability testing or a more refined engineering evaluation). It will also provide a basis for evaluating the results of the treatability testing that is currently being conducted on the presumptive remedy of ion exchange with disposal of spent resin and will serve as a guide for selection of other technologies for additional testing. Because there are little data or past experience with groundwater similar to the BY-Crib and B-5 Reverse Well Plumes, treatment efficiencies cannot be predicted with certainty and rigorous treatment system designs and costs cannot be developed. This applies to all alternatives, including the presumptive remedy of ion exchange. The approach for this study was to develop conceptual designs and approximate costs for the treatment technologies that were most likely to be effective on the BY-Crib and B-5 Reverse Well groundwater

Efficiency principles of consulting entrepreneurship

OpenAIRE

Moroz Yustina S.; Drozdov Igor N.

2015-01-01

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

Preliminary collection 891 of lectures/papers in symposium by Society of Automotive Engineers of Japan. Jidosha gijutsukai gakujutsu koenkai maezurishu 891

Energy Technology Data Exchange (ETDEWEB)

1989-05-29

This preliminary collection collected lectures given and papers presented in the symposium by the Society of Automotive Engineers of Japan to be held in May, 1989. Totally 86 papers, together with two basic lectures, were presented therein. The categories comprise two basic lectures titled Future problems on CVT and automatic transmission and Advances of gasoline engine and measuring techniques, ten papers for the gasoline engine, covering the supercharger, air/fuel mixture, noise, bore deformation, etc., ten papers for the diesel engine, covering the exhaust gas, supercharger, methanol engine, etc., ten papers for the car body, covering the aerodynamical characteristics and movement of car body, movement analysis of motor bicycle, head lamp, painting, etc., ten papers for the car parts, ten papers for the fuel injection, ten papers for the engine parts, covering the piston, oil ring, cylinder, connecting rod, plug, rotary, car heater, etc., three papers for the car production, covering the line control, welding, production method, etc., seven papers for the car steering and stability, eight papers for the vibration and noise attenuation and three papers for the others. 370 refs., 857 figs., 100 tabs.

Toward a Definition of the Engineering Method.

Science.gov (United States)

Koen, Billy V.

1988-01-01

Describes a preliminary definition of engineering method as well as a definition and examples of engineering heuristics. After discussing some alternative definitions of the engineering method, a simplified definition of the engineering method is suggested. (YP)

The art of consultation.

Science.gov (United States)

Bhangoo, Kulwant S

2014-05-01

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

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...

Exoskeletal Engine Concept: Feasibility Studies for Medium and Small Thrust Engines

Science.gov (United States)

Halliwell, Ian

2001-01-01

The exoskeletal engine concept is one in which the shafts and disks are eliminated and are replaced by rotating casings that support the blades in spanwise compression. Omission of the shafts and disks leads to an open channel at the engine centerline. This has immense potential for reduced jet noise and for the accomodation of an alternative form of thruster for use in a combined cycle. The use of ceramic composite materials has the potential for significantly reduced weight as well as higher working temperatures without cooling air. The exoskeletal configuration is also a natural stepping-stone to complete counter-rotating turbomachinery. Ultimately this will lead to reductions in weight, length, parts count and improved efficiency. The feasibility studies are in three parts. Part I-Systems and Component Requirements addressed the mechanical aspects of components from a functionality perspective. This effort laid the groundwork for preliminary design studies. Although important, it is not felt to be particularly original, and has therefore not been included in the current overview. Part 2-Preliminary Design Studies turned to some of the cycle and performance issues inherent in an exoskeletal configuration and some initial attempts at preliminary design of turbomachinery were described. Twin-spoon and single-spool 25.800-lbf-thrust turbofans were used as reference vehicles in a mid-size commercial subsonic category in addition to a single-spool 5,000-lbf-thrust turbofan that represented a general aviation application. The exoskeletal engine, with its open centerline, has tremendous potential for noise suppression and some preliminary analysis was done which began to quantify the benefits. Part 3-Additional Preliminary Design Studies revisited the design of single-spool 25,800-lbf-thrust turbofan configurations, but in addition to the original FPR = 1.6 and BPR = 5.1 reference engine, two additional configurations used FPR = 2.4 and BPR = 3.0 and FPR = 3.2 and BPR

A preliminary mixed-method investigation of trust and hidden signals in medical consultations.

Directory of Open Access Journals (Sweden)

Silvia Riva

Full Text Available Several factors influence patients' trust, and trust influences the doctor-patient relationship. Recent literature has investigated the quality of the personal relationship and its dynamics by considering the role of communication and the elements that influence trust giving in the frame of general practitioner (GP consultations.We analysed certain aspects of the interaction between patients and GPs to understand trust formation and maintenance by focusing on communication channels. The impact of socio-demographic variables in trust relationships was also evaluated.A cross-sectional design using concurrent mixed qualitative and quantitative research methods was employed. One hundred adults were involved in a semi-structured interview composed of both qualitative and quantitative items for descriptive and exploratory purposes. The study was conducted in six community-based departments adjacent to primary care clinics in Trento, Italy.The findings revealed that patients trusted their GP to a high extent by relying on simple signals that were based on the quality of the one-to-one communication and on behavioural and relational patterns. Patients inferred the ability of their GP by adopting simple heuristics based mainly on the so-called social "honest signals" rather than on content-dependent features. Furthermore, socio-demographic variables affected trust: less literate and elderly people tended to trust more.This study is unique in attempting to explore the role of simple signals in trust relationships within medical consultation: people shape trust and give meaning to their relationships through a powerful channel of communication that orbits not around words but around social relations. The findings have implications for both clinicians and researchers. For doctors, these results suggest a way of thinking about encounters with patients. For researchers, the findings underline the importance of analysing some new key factors around trust for

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

Science.gov (United States)

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

2015-01-01

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

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.

The art of consultation

Directory of Open Access Journals (Sweden)

Kulwant S Bhangoo

2014-01-01

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

Ethics in Management Consulting

OpenAIRE

Carlo Vallini

2007-01-01

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

Why do people consult the doctor?

Science.gov (United States)

Campbell, S M; Roland, M O

1996-02-01

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

Summary Report of Consultants' Meeting on Beta-Delayed Neutron Emission Evaluation

International Nuclear Information System (INIS)

Abriola, Daniel; Singh, Balraj; Dillmann, Iris

2011-12-01

A summary is given of a Consultants' Meeting assembled to assess the viability of a new IAEA Co-ordinated Research Project (CRP) on Beta-delayed neutron emission evaluation. The current status of the field was reviewed, cases in which new measurements are needed were identified and the current theoretical models were examined. The best known cases were selected as standards and were assessed and preliminary best values of the emission probabilities were obtained. The need of such a CRP was strongly agreed. Both the technical discussions and the expected outcome of such a project are described, along with detailed recommendations for its implementation. (author)

Vickers Attenuator. Volume 3C(VA) - Technical appraisal. Consultants' 1983 report

Energy Technology Data Exchange (ETDEWEB)

1986-01-01

A report is given by a team of Consultants on the estimated cost of converting wave energy to electrical energy by a 2 GW array of Vickers Attenuator wave energy devices and delivering this to a sub-station on the west coast of Skye. Comparisons of the estimates made by the team developing the concept are presented and discrepancies discussed. A detailed engineering assessment is given.

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

Science.gov (United States)

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

2018-01-01

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

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

Science.gov (United States)

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

2013-10-01

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

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…

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

OpenAIRE

Ceptureanu, Eduard-Gabriel; Ceptureanu, Sebastian-Ion; Luchian, Cristian-Eugen; Luchian, Iuliana

2017-01-01

The present paper addresses quality management from the specific perspective of project management consulting service providers, in the framework of large infrastructure projects. Because of their supposed superiority in knowledge and experience, project management consultants have an ultimate responsibility for the proper implementing of the project. Therefore, quality management in consulting organizations should focus on critical success factors. As there is no consensus yet regarding the ...

Preliminary Results From a Heavily Instrumented Engine Ice Crystal Icing Test in a Ground Based Altitude Test Facility

Science.gov (United States)

Flegel, Ashlie B.; Oliver, Michael J.

2016-01-01

Preliminary results from the heavily instrumented ALF502R-5 engine test conducted in the NASA Glenn Research Center Propulsion Systems Laboratory are discussed. The effects of ice crystal icing on a full scale engine is examined and documented. This same model engine, serial number LF01, was used during the inaugural icing test in the Propulsion Systems Laboratory facility. The uncommanded reduction of thrust (rollback) events experienced by this engine in flight were simulated in the facility. Limited instrumentation was used to detect icing on the LF01 engine. Metal temperatures on the exit guide vanes and outer shroud and the load measurement were the only indicators of ice formation. The current study features a similar engine, serial number LF11, which is instrumented to characterize the cloud entering the engine, detect/characterize ice accretion, and visualize the ice accretion in the region of interest. Data were acquired at key LF01 test points and additional points that explored: icing threshold regions, low altitude, high altitude, spinner heat effects, and the influence of varying the facility and engine parameters. For each condition of interest, data were obtained from some selected variations of ice particle median volumetric diameter, total water content, fan speed, and ambient temperature. For several cases the NASA in-house engine icing risk assessment code was used to find conditions that would lead to a rollback event. This study further helped NASA develop necessary icing diagnostic instrumentation, expand the capabilities of the Propulsion Systems Laboratory, and generate a dataset that will be used to develop and validate in-house icing prediction and risk mitigation computational tools. The ice accretion on the outer shroud region was acquired by internal video cameras. The heavily instrumented engine showed good repeatability of icing responses when compared to the key LF01 test points and during day-to-day operation. Other noticeable

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

Science.gov (United States)

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

2017-08-04

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

Unified Engineering Software System

Science.gov (United States)

Purves, L. R.; Gordon, S.; Peltzman, A.; Dube, M.

1989-01-01

Collection of computer programs performs diverse functions in prototype engineering. NEXUS, NASA Engineering Extendible Unified Software system, is research set of computer programs designed to support full sequence of activities encountered in NASA engineering projects. Sequence spans preliminary design, design analysis, detailed design, manufacturing, assembly, and testing. Primarily addresses process of prototype engineering, task of getting single or small number of copies of product to work. Written in FORTRAN 77 and PROLOG.

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

Energy Technology Data Exchange (ETDEWEB)

1986-01-01

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

Engineers win award for Swiss tunnel

CERN Multimedia

2003-01-01

A Derby engineering consultancy has won the Tunnelling Industry Award 2003 for Excellence in Tunnel Design, offered by the British Tunnelling Society, for its work on the LHC in Geneva, Switzerland (1/2 page).

Preliminary test results from a free-piston Stirling engine technology demonstration program to support advanced radioisotope space power applications

International Nuclear Information System (INIS)

White, Maurice A.; Qiu Songgang; Augenblick, Jack E.

2000-01-01

Free-piston Stirling engines offer a relatively mature, proven, long-life technology that is well-suited for advanced, high-efficiency radioisotope space power systems. Contracts from DOE and NASA are being conducted by Stirling Technology Company (STC) for the purpose of demonstrating the Stirling technology in a configuration and power level that is representative of an eventual space power system. The long-term objective is to develop a power system with an efficiency exceeding 20% that can function with a high degree of reliability for up to 15 years on deep space missions. The current technology demonstration convertors (TDC's) are completing shakedown testing and have recently demonstrated performance levels that are virtually identical to projections made during the preliminary design phase. This paper describes preliminary test results for power output, efficiency, and vibration levels. These early results demonstrate the ability of the free-piston Stirling technology to exceed objectives by approximately quadrupling the efficiency of conventional radioisotope thermoelectric generators (RTG's)

Preliminary test results from a free-piston Stirling engine technology demonstration program to support advanced radioisotope space power applications

Science.gov (United States)

White, Maurice A.; Qiu, Songgang; Augenblick, Jack E.

2000-01-01

Free-piston Stirling engines offer a relatively mature, proven, long-life technology that is well-suited for advanced, high-efficiency radioisotope space power systems. Contracts from DOE and NASA are being conducted by Stirling Technology Company (STC) for the purpose of demonstrating the Stirling technology in a configuration and power level that is representative of an eventual space power system. The long-term objective is to develop a power system with an efficiency exceeding 20% that can function with a high degree of reliability for up to 15 years on deep space missions. The current technology demonstration convertors (TDC's) are completing shakedown testing and have recently demonstrated performance levels that are virtually identical to projections made during the preliminary design phase. This paper describes preliminary test results for power output, efficiency, and vibration levels. These early results demonstrate the ability of the free-piston Stirling technology to exceed objectives by approximately quadrupling the efficiency of conventional radioisotope thermoelectric generators (RTG's). .

Preliminary analysis of engineered barrieer performances in geological disposal of high level waste

International Nuclear Information System (INIS)

Ohe, Toshiaki; Maki, Yasuo; Tanaka, Hiroshi; Kawanishi, Motoi.

1988-01-01

This report represents preliminary results of safety analysis of a engineered barrier system in geological disposal of high level radioactive waste. Three well-known computer codes; ORIGEN 2, TRUMP, and SWIFT were used in the simulation. Main conceptual design of the repository was almost identical to that of SKB in Sweden and NAGRA in Switzerland; the engineered barrier conasists glass solidified waste, steel overpack, and compacted bentonite. Two different underground formations are considered; granite and neogene sedimentary rock, which are typically found in Japan. We first determined the repository configuration, particularly the space between disposal pitts. The ORIGEN 2 was used to estimate heat generation in the waste glass reprocessed at 4 years after removal from PWR. Then, temperature distribution was calculated by the TRUMP. The results of two or three dimensional calculation indicated that the pit interval should be kept more than 5 m in the case of granite formation at 500 m depth, according to the temperature criteria in the bentonite layer ( 90 Sr, 241 Am, 239 Pu, and 237 Np were chosen in one or two dimensional calculations. For both cases of steady release and instanteneous release, the maximum concentration in the pore water at the boundary between bentonite and surrounding rock had the following order; 237 Np> 239 Pu> 90 Sr> 241 Am. Sensitivity analysis showed that the order mainly due to the different adsorption characteristics of the nuclides in bentonite layer. (author)

Consultant breast radiographers: Where are we now?

International Nuclear Information System (INIS)

Rees, Zebby

2014-01-01

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

Transaction cost analysis of in-clinic versus telehealth consultations for chronic pain: preliminary evidence for rapid and affordable access to interdisciplinary collaborative consultation.

Science.gov (United States)

Theodore, Brian R; Whittington, Jan; Towle, Cara; Tauben, David J; Endicott-Popovsky, Barbara; Cahana, Alex; Doorenbos, Ardith Z

2015-06-01

With ever increasing mandates to reduce costs and increase the quality of pain management, health care institutions are faced with the challenge of adopting innovative technologies and shifting workflows to provide value-based care. Transaction cost economic analysis can provide comparative evaluation of the consequences of these changes in the delivery of care. The aim of this study was to establish proof-of-concept using transaction cost analysis to examine chronic pain management in-clinic and through telehealth. Participating health care providers were asked to identify and describe two comparable completed transactions for patients with chronic pain: one consultation between patient and specialist in-clinic and the other a telehealth presentation of a patient's case by the primary care provider to a team of pain medicine specialists. Each provider completed two on-site interviews. Focus was on the time, value of time, and labor costs per transaction. Number of steps, time, and costs for providers and patients were identified. Forty-six discrete steps were taken for the in-clinic transaction, and 27 steps were taken for the telehealth transaction. Although similar in costs per patient ($332.89 in-clinic vs. $376.48 telehealth), the costs accrued over 153 business days in-clinic and 4 business days for telehealth. Time elapsed between referral and completion of initial consultation was 72 days in-clinic, 4 days for telehealth. U.S. health care is moving toward the use of more technologies and practices, and the information provided by transaction cost analyses of care delivery for pain management will be important to determine actual cost savings and benefits. Wiley Periodicals, Inc.

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.

Psychiatric consultation in the collaborative care model: The "bipolar sieve" effect.

Science.gov (United States)

Phelps, James R; James, James

2017-08-01

Around the world, psychiatrists are in exceptionally short supply. The majority of mental health treatment is delivered in primary care. In the United States, the Collaborative Care Model (CCM) addresses the shortfall of psychiatrists by providing indirect consultation in primary care. A Cochrane meta-analysis affirms the efficacy this model for depression and anxiety. However, our experience with the CCM suggests that most patients referred for consultation have problems far more complex than simple depression and anxiety. Based on preliminary data, we offer five linked hypotheses: (1) in an efficient collaborative care process, the majority of mental illnesses can be handled by providers who are less expensive and more plentiful than psychiatrists. (2) A majority of the remaining cases will be bipolar disorder variations. Differentiating these from PTSD, the most common alternative or comorbid diagnosis, is challenging and often requires a psychiatrist's input. (3) Psychiatric consultants can teach their primary care colleagues that bipolar diagnoses are estimations based on rigorously assessed probabilities, and that cases fall on a spectrum from unipolar to bipolar. (4) All providers must recognize that when bipolarity is missed, antidepressant prescription often follows. Antidepressants can induce bipolar mixed states, with extreme anxiety and potentially dangerous impulsivity and suicidality. (5) Psychiatrists can help develop clinical approaches in primary care that identify bipolarity and differentiate it from (or establish comorbidity with) PTSD; and psychiatrists can facilitate appropriate treatment, including bipolar-specific psychotherapies as well as use of mood stabilizers. Copyright © 2017 Elsevier Ltd. All rights reserved.

resolution of the first national conference of engin·eers and architects

African Journals Online (AJOL)

including Codes or Practices for the construction trades; .... The Ethiopian Cement Corporation. The Research Department ... Authority. SAUTJ - Consulting Engineers (Rome). The 1971 graduating class of Electrical and Civil. Engineers at the ...

Consultation on the implementation of Engineering Recommendation ER G77. Volume 1: Summary report

Energy Technology Data Exchange (ETDEWEB)

Thornycroft, J; Cotterell, M; Collinson, A

2002-07-01

The paper is a summary report on consultation inside the Electricity and PV Industry leading to publication of ER G77/1: 'Connection of Single-Phase Inverter Connected Photovoltaic (PV) Generating Equipment of up to 5kVA in Parallel with a Distribution Network Operators (DNOs) Distribution System'. Technical work on ETSU/S/P2/0040 is also reported. The project is a continuation of ETSU/S/P2/00215 which set-up the 'ER G77 Working Group' in order to (i) continue consultation with DNOs and the PV industry; (ii) monitor and make use of experience resulting from implementation of ER G77; (iii) act as a forum for discussion of improvements to ER G77; (iv) assist projects like the DTI supported Domestic Field Trial; (v) provide a link to BSI Standards Work in the field; (vi) provide a link with sub-projects investigating questions related to ER G77. Overall, the goal is to develop a final version of ER G77/1 acceptable to both the electricity supply industry and the PV industry. A revised version of ER G/771 is included.

Lay Consultations in Heart Failure Symptom Evaluation.

Science.gov (United States)

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

2017-01-01

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

Reflections on New Search Engine 新型搜索引擎畅想

OpenAIRE

Huang, Jiannian

2007-01-01

English abstract]Quick increment of need on internet information resources leads to a rush of search engines. This article introduces some new type of search engines which is appearing and will appear. These search engines includes as follows: grey document search engine, invisible web search engine, knowledge discovery search engine, clustering meta search engine, academic clustering search engine, conception comparison and conception analogy search engine, consultation search engine, teachi...

A PRELIMINARY STUDY OF HUMOUR IN ENGINEERING EDUCATION

Directory of Open Access Journals (Sweden)

SIOW C. LIM

2017-01-01

Full Text Available It is commonly known that humour has an implication on the process of teaching and learning. However, there is still limited study done on the implication of humour in teaching and learning engineering courses. This paper studies the perception and experience of engineering lecturers and students towards the incorporation of sense of humour in the teaching and learning of engineering courses. Online and offline surveys were conducted on the students and lecturers from the school of engineering, Taylors’ University respectively. Several interesting insights were drawn from the responses with the general consensus from both students and lecturers that humour helps in enhancing the teaching and learning process. Real case examples of how the lecturers deliver their lectures with humour were also presented.

Developing a new industrial engineering curriculum using a systems engineering approach

Science.gov (United States)

Buyurgan, Nebil; Kiassat, Corey

2017-11-01

This paper reports on the development of an engineering curriculum for a new industrial engineering programme at a medium-sized private university in the northeast United States. A systems engineering process has been followed to design and develop the new curriculum. Considering the programme curriculum as a system, first the stakeholders have been identified, and some preliminary analysis on their needs and requirements has been conducted. Following that, the phases of conceptual design, preliminary design, and detailed design have been pursued during which different levels of validation, assessment, and evaluation processes have been utilised. In addition, a curriculum assessment and continuous improvement process have been developed to assess the curriculum and the courses frequently. The resulting curriculum is flexible, allowing the pursuit of accelerated graduate programmes, a second major, various minor options, and study-abroad; relevant, tailored to the needs of industry partners in the vicinity; and practical, providing hands-on education, resulting in employment-ready graduates.

Applications of Statistics and Probability in Civil Engineering

DEFF Research Database (Denmark)

Faber, Michael Havbro

contains the proceedings of the 11th International Conference on Applications of Statistics and Probability in Civil Engineering (ICASP11, Zürich, Switzerland, 1-4 August 2011). The book focuses not only on the more traditional technical issues, but also emphasizes the societal context...... and reliability in engineering; to professionals and engineers, including insurance and consulting companies working with natural hazards, design, operation and maintenance of civil engineering and industrial facilities; and to decision makers and professionals in the public sector, including nongovernmental...

34 CFR 75.191 - Consultation costs.

Science.gov (United States)

2010-07-01

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

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…

Consultations

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

IDRC CRDI

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

Polish forensic medicine A.D. 2016 – report of the National Consultant

Directory of Open Access Journals (Sweden)

Grzegorz Teresiński

2017-06-01

Full Text Available The aim of the study was to present the current state and basis of functioning of an academic model of forensic expert activities in Poland and perspectives of their further development. The study material included information obtained from a preliminary survey among regional consultants within the ongoing activities of the national consultant team. The recently completed period of research infrastructure support within the policy of coherence of the European Union contributed to significant advances in scientific-educational potential of the majority of university forensic medicine centres. However, the improved educational base and purchases of new diagnostic devices were not associated with a considerable increase in staff resources of individual units, which finally decides about the renown of the entire discipline. It is necessary to undertake initiatives to highlight the importance of forensic medicine as a separate medical field and to increase the number of physicians starting specialist trainings. A highly profiled nature of the speciality necessitates cooperation with other centres and receptiveness to clinical fields. The establishment of various forms of cooperation is a measure of optimal use of equipment and stimulation of multi-centre research.

15 CFR 923.57 - Continuing consultation.

Science.gov (United States)

2010-01-01

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

Learning to consult with computers.

Science.gov (United States)

Liaw, S T; Marty, J J

2001-07-01

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

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

Science.gov (United States)

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

2007-01-01

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

Making consultations run smoothly

DEFF Research Database (Denmark)

Jespersen, Astrid Pernille; Elgaard Jensen, Torben

2012-01-01

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

Patient assessment: effective consultation and history taking.

Science.gov (United States)

Kaufman, Gerri

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

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

Energy Technology Data Exchange (ETDEWEB)

DiPiro, Pamela J.; Krajewski, Katherine M.; Giardino, Angela A.; Braschi-Amirfarzan, Marta; Ramaiya, Nikhil H. [Dept. of Radiology, Brigham and Women' s Hospital, Harvard Medical School, Boston (United States)

2017-01-15

The purpose of the article is to describe the various radiology consultation models in the Era of Precision Medicine. Since the inception of our specialty, radiologists have served as consultants to physicians of various disciplines. A variety of radiology consultation services have been described in the literature, including clinical decision support, patient-centric, subspecialty interpretation, and/or some combination of these. In oncology care in particular, case complexity often merits open dialogue with clinical providers. To explore the utility and impact of radiology consultation services in the academic setting, this article will further describe existing consultation models and the circumstances that precipitated their development. The hybrid model successful at our tertiary cancer center is discussed. In addition, the contributions of a consultant radiologist in breast cancer care are reviewed as the archetype of radiology consultation services provided to oncology practitioners.

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

Science.gov (United States)

DiPiro, Pamela J; Krajewski, Katherine M; Giardino, Angela A; Braschi-Amirfarzan, Marta; Ramaiya, Nikhil H

2017-01-01

The purpose of the article is to describe the various radiology consultation models in the Era of Precision Medicine. Since the inception of our specialty, radiologists have served as consultants to physicians of various disciplines. A variety of radiology consultation services have been described in the literature, including clinical decision support, patient-centric, subspecialty interpretation, and/or some combination of these. In oncology care in particular, case complexity often merits open dialogue with clinical providers. To explore the utility and impact of radiology consultation services in the academic setting, this article will further describe existing consultation models and the circumstances that precipitated their development. The hybrid model successful at our tertiary cancer center is discussed. In addition, the contributions of a consultant radiologist in breast cancer care are reviewed as the archetype of radiology consultation services provided to oncology practitioners.

Consultation document Energy Market Concentrations

International Nuclear Information System (INIS)

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

2006-06-01

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

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.

Knowledge Sharing in IT Consultant and SME Interactions

Directory of Open Access Journals (Sweden)

Adrian Bradshaw

2015-10-01

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

Political consultation and large-scale research

International Nuclear Information System (INIS)

Bechmann, G.; Folkers, H.

1977-01-01

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

Understanding the consultation processes

International Nuclear Information System (INIS)

Laing, A.C.

1998-01-01

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

B 150 civil engineering futures

DEFF Research Database (Denmark)

Foreword B150 –Civil Engineering Futures consists of interviews made, articles written, and projects presented in connection with the 150th anniversary celebrations of the study of civil engineering in Denmark. Instead of a historical retrospect, it was decided to look into the future. What...... challenges will the next 150 years bring civil engineers? Researchers and lecturers at DTU’s Department of Civil Engineering (known as DTU Byg) suggested possible events, and we also consulted civil engineers and their business partners in the building industry. In this way, a programme was put together...... theme in twentieth century architecture. Together, civil engineer Peter Rice and architect Ian Ritchie created a paradigm shift with their revolutionary ideas for glass facades supported by cables. Glued and bolted constructions made entirely of glass are now a reality in small-scale projects, yet...

Nuclear consultant - a new profession

International Nuclear Information System (INIS)

Hardung von Hardung, H.

1976-01-01

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

Nuclear consultant: a new profession

Energy Technology Data Exchange (ETDEWEB)

Hardung von Hardung, H

1976-02-01

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

Comparative analysis of a DI diesel engine fuelled with biodiesel blends during the European MVEG-A cycle: Preliminary study (I)

Energy Technology Data Exchange (ETDEWEB)

Lujan, J.M.; Tormos, B.; Salvador, F.J.; Gargar, K. [CMT-Motores Termicos, Universidad Politecnica de Valencia, Valencia (Spain)

2009-06-15

The present work consists of introducing the tests and facilities used to perform a comparative analysis of a diesel engine working with different blends of biodiesel fuel during the New European Driving Cycle. Furthermore, as a preliminary study, it was interesting to know the effects of biodiesel fuel on a common-rail high pressure injection system, those more useful in modern light duty diesel engines, as a consequence of its different physicochemical properties compared with conventional diesel fuel. As the real goal of the study is to compare fairly performance and emissions from the engine, it was essential to know any injection effects owed to fuel's own characteristics that finally would affect those parameters that will be evaluated. A complete fuel characterization for diesel and biodiesel fuels, as the EN 590 and the EN 14214 standard specifications, was performed in order to quantify the differences between both fuels. A priori, it could be thought that viscosity and density values will be the most significant parameters capable of altering the injection rate. As positive results, it was obtained that the common-rail high pressure injection system was totally blind in the injection rate measurements, even the significant differences between both fuels, taking into account the counterbalancing effects generated by two parameters mentioned before. The second part of the study deals with engine performance and pollutant emissions on an unmodified common-rail turbocharged diesel engine running with biodiesel fuel blends during the New European Driving Cycle. (author)

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

Energy Technology Data Exchange (ETDEWEB)

1986-01-01

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

Preliminary engineering assessment of the HCLL and HCPB Neutron Activation System

Energy Technology Data Exchange (ETDEWEB)

Calderoni, Pattrick; Leichtle, Dieter [Fusion for Energy, Barcelona, (Spain); Angelone, Maurizio [ENEA, Unita Tecnica Fusione, Frascati, (Italy); Klix, Axel [KIT, Eggenstein-Leopoldshafen, (Germany)

2015-07-01

The Neutron Activation System (NAS) is one of the four types of neutronics sensors considered for the testing of the HCLL and HCPB Test Blanket Module (TBM) in ITER. It measures the absolute neutron flux intensity with information on the neutron spectrum in selected positions of the TBM. The working principle of the NAS is as follows: the system moves small activation probes (capsules) into selected positions in the TBM (irradiation ends) by means of pneumatic transport with pressurized helium gas; the capsules are irradiated for a selected period, depending on their materials composition (several tens of seconds up to the full plasma pulse length); immediately after the irradiation they are extracted and transported to a gamma spectrometer by means of the same pneumatic transport system; the gamma spectrometer determines the induced gamma activity; the neutron flux and neutron fluence is calculated from the measured gamma activity and the known activation cross section of the materials in the activation probe; after the measurement the capsule is sent either to a disposal or storage (for later measurement). This paper summarizes the results of the feasibility assessment of the TBM NAS in the conceptual design phase, including design justification, identification of requirements based on the expected operating conditions in ITER and preliminary engineering assessment of the activation materials, irradiation ends integration in the modules design and the counting station. (authors)

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

Science.gov (United States)

Galimberti, Fabrizio; Guren, Lauren; Fernandez, Anthony P; Sood, Apra

2016-10-01

Cutaneous abnormalities are common in hospitalized patients but are frequently missed or misdiagnosed by admitting teams. Inpatient dermatology consultations provide important information to help diagnose and manage these patients. However, few studies have analyzed dermatology inpatient consultations and their effect. We prospectively collected information for 691 consecutive dermatology consultations from November 2013 to November 2014. Patients ranged in age from newborns to 97 years old. The internal medicine service requested the most consultations (45%). Only 6.5% of consultations were requested within 24 hours of appearance of cutaneous findings. Before consultation, 70.3% of patients did not receive treatment for or based on their cutaneous findings. Dermatology consultation resulted in treatment change in 81.9% of patients. The most common diagnoses were drug rash and contact dermatitis. Biopsies confirmed 71.7% of the initial bedside diagnoses by the dermatology consultation team. Common skin diseases were responsible for the majority of dermatology consultations. Most patients were not treated for their cutaneous conditions before the dermatology consultation. Dermatology consultations resulted in treatment changes in the majority of cases. © 2016 The International Society of Dermatology.

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.

Engineering computer graphics in gas turbine engine design, analysis and manufacture

Science.gov (United States)

Lopatka, R. S.

1975-01-01

A time-sharing and computer graphics facility designed to provide effective interactive tools to a large number of engineering users with varied requirements was described. The application of computer graphics displays at several levels of hardware complexity and capability is discussed, with examples of graphics systems tracing gas turbine product development, beginning with preliminary design through manufacture. Highlights of an operating system stylized for interactive engineering graphics is described.

Preliminary comparison of the Essie and PubMed search engines for answering clinical questions using MD on Tap, a PDA-based program for accessing biomedical literature.

Science.gov (United States)

Sutton, Victoria R; Hauser, Susan E

2005-01-01

MD on Tap, a PDA application that searches and retrieves biomedical literature, is specifically designed for use by mobile healthcare professionals. With the goal of improving the usability of the application, a preliminary comparison was made of two search engines (PubMed and Essie) to determine which provided most efficient path to the desired clinically-relevant information.

Systems engineering implementation in the preliminary design phase of the Giant Magellan Telescope

Science.gov (United States)

Maiten, J.; Johns, M.; Trancho, G.; Sawyer, D.; Mady, P.

2012-09-01

Like many telescope projects today, the 24.5-meter Giant Magellan Telescope (GMT) is truly a complex system. The primary and secondary mirrors of the GMT are segmented and actuated to support two operating modes: natural seeing and adaptive optics. GMT is a general-purpose telescope supporting multiple science instruments operated in those modes. GMT is a large, diverse collaboration and development includes geographically distributed teams. The need to implement good systems engineering processes for managing the development of systems like GMT becomes imperative. The management of the requirements flow down from the science requirements to the component level requirements is an inherently difficult task in itself. The interfaces must also be negotiated so that the interactions between subsystems and assemblies are well defined and controlled. This paper will provide an overview of the systems engineering processes and tools implemented for the GMT project during the preliminary design phase. This will include requirements management, documentation and configuration control, interface development and technical risk management. Because of the complexity of the GMT system and the distributed team, using web-accessible tools for collaboration is vital. To accomplish this GMTO has selected three tools: Cognition Cockpit, Xerox Docushare, and Solidworks Enterprise Product Data Management (EPDM). Key to this is the use of Cockpit for managing and documenting the product tree, architecture, error budget, requirements, interfaces, and risks. Additionally, drawing management is accomplished using an EPDM vault. Docushare, a documentation and configuration management tool is used to manage workflow of documents and drawings for the GMT project. These tools electronically facilitate collaboration in real time, enabling the GMT team to track, trace and report on key project metrics and design parameters.

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

Science.gov (United States)

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

2018-04-01

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

Scope and purpose of the preliminary planning work

International Nuclear Information System (INIS)

Kalas, P.

1976-01-01

The results of preliminary planning work are usually expressed in a number of recommendations covering mainly: long-term national policy in the field of energy resources and selection of projects to be further studied at the feasibility level. Moreover, recommendations on further actions are made including: inventory of generation and transmission facilities recommended for the implementation in order to meet the load forecasted for medium-term period, preparation of a preliminary calender of decisions to be taken for the implementation of the projects recommended, preparation of a preliminary construction schedule, preparation of a preliminary investment program, preparation of a program of necessary engineering works, and performance of study on electricity rates which would adjust existing tariffs to proposed development program of the utility. (HP) [de

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

Science.gov (United States)

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

2009-06-01

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

Services of strategic consulting: special features and types

Directory of Open Access Journals (Sweden)

Klenin Oleh Volodymyrovych

2016-09-01

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

Engineering Design Handbook. Helicopter Engineering. Part One. Preliminary Design

Science.gov (United States)

1974-08-30

the cost of prime interest being life-cycle cost, climate that is hot or cold, in atmosphere that is humid Chapter 3 discusses helicopter performance...required to satisfy 8-3.2 ENGINE INSTALLATION LOSSES varying climatic and environmental factors. For in- stance, maintenance of the helicopter should be...thammable h aulic , asytem l at mhtproidtem a considering the overall flight mission in segments, dur- source of flammable fluids, as well as electrical

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…

Decommissioning Trawsfynydd - How public consultation shaped the strategy

Energy Technology Data Exchange (ETDEWEB)

Kay, Martin J [Nuclear Electric plc. (United Kingdom)

1995-07-01

This case study discusses the ned of consulting the public when decommissioning a nuclear power plants. When Trawsfynydd power station in North Wales shutdown in July 1993, Nuclear Electric's strategy for decommissioning its stations was not clearly defined. The company had altered its corporate policy on decommissioning fro he strategy referred to as the 'Reference Case' which had been approved by the Government, to the preferred 'Deferred Safestore' strategy, which was waiting Government approval. Deferred Safestore is preferred as it simplifies the engineering work involved by capitalising an the basic strength and integrity of the reactor building. It minimises thd radiation exposure to workers and radioactivity released to the environment, reduces the amount of radioactive waste produced and significantly cuts the total decommissioning cost. The closure and the decommissioning of Trawsfynydd power station was a sensitive issue as: The station lies within a National Park of outstanding beauty. The economic circumstances in the area are such that employment opportunities are very limited. At a crucial time when the company was approaching a Government review which would decide its future, Nuclear Electric could not afford to lose any credibility. A public consultation programme was launched in the vicinity of the power station To gauge the reactions of the public and elected local government bodies to a series of decommissioning options. Nuclear Electric presented three main options with details on the employment opportunities, the costs, and the lorry loads of material involved with each. The people were identified on whom decommissioning Trawsfynydd power station is likely to have an environmental or socioeconomic impact. As a result of the polls the Nuclear Electric received feedback in two ways. Formal feedback from the local councils Independent analysis of the completed questionnaires. The company was wholly committed to a meaningful consultation. Before

Decommissioning Trawsfynydd - How public consultation shaped the strategy

International Nuclear Information System (INIS)

Kay, Martin J.

1995-01-01

This case study discusses the ned of consulting the public when decommissioning a nuclear power plants. When Trawsfynydd power station in North Wales shutdown in July 1993, Nuclear Electric's strategy for decommissioning its stations was not clearly defined. The company had altered its corporate policy on decommissioning fro he strategy referred to as the 'Reference Case' which had been approved by the Government, to the preferred 'Deferred Safestore' strategy, which was waiting Government approval. Deferred Safestore is preferred as it simplifies the engineering work involved by capitalising an the basic strength and integrity of the reactor building. It minimises thd radiation exposure to workers and radioactivity released to the environment, reduces the amount of radioactive waste produced and significantly cuts the total decommissioning cost. The closure and the decommissioning of Trawsfynydd power station was a sensitive issue as: The station lies within a National Park of outstanding beauty. The economic circumstances in the area are such that employment opportunities are very limited. At a crucial time when the company was approaching a Government review which would decide its future, Nuclear Electric could not afford to lose any credibility. A public consultation programme was launched in the vicinity of the power station To gauge the reactions of the public and elected local government bodies to a series of decommissioning options. Nuclear Electric presented three main options with details on the employment opportunities, the costs, and the lorry loads of material involved with each. The people were identified on whom decommissioning Trawsfynydd power station is likely to have an environmental or socioeconomic impact. As a result of the polls the Nuclear Electric received feedback in two ways. Formal feedback from the local councils Independent analysis of the completed questionnaires. The company was wholly committed to a meaningful consultation. Before

B 150 civil engineering futures

DEFF Research Database (Denmark)

specific climatic challenge or clean the air. With nanotechnology, the artificial and the natural move closer together; this is the perspective for civil engineer Chris McCarthy’s work all over the world. And what is new is not just the way the construction materials are put together; they also require......Foreword B150 –Civil Engineering Futures consists of interviews made, articles written, and projects presented in connection with the 150th anniversary celebrations of the study of civil engineering in Denmark. Instead of a historical retrospect, it was decided to look into the future. What...... challenges will the next 150 years bring civil engineers? Researchers and lecturers at DTU’s Department of Civil Engineering (known as DTU Byg) suggested possible events, and we also consulted civil engineers and their business partners in the building industry. In this way, a programme was put together...

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

Science.gov (United States)

La Via, Jennifer; Schiedermayer, David

2012-01-01

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

Engineering hydro's future

International Nuclear Information System (INIS)

Anderson, J.L.

1992-01-01

In this challenging hydropower market, hydropower engineering services are in high demand. The number of new hydropower projects entering the pipeline may have slowed in recent years but that does not mean work is not being done. Independent developers, utilities and municipalities are carrying out a considerable amount of hydropower activity. Whatever the work involves - preliminary planning, licensing and relicensing, environmental mitigation, plant rehabilitation or new-plant startup - engineering firms are finding a brisk market for their services. The complexity of the regulatory framework makes hydropower facility and other water resource work more important then ever. Executives of three engineering firms - Acres International, Harza Engineering and Black and Veatch - active in these areas discuss their views on the future of the hydropower engineering market

Hospitalist Perspective of Interactions with Medicine Subspecialty Consult Services.

Science.gov (United States)

Adams, Traci N; Bonsall, Joanna; Hunt, Daniel; Puig, Alberto; Richards, Jeremy B; Yu, Liyang; McSparron, Jakob I; Shah, Nainesh; Weissler, Jonathan; Miloslavsky, Eli M

2018-05-01

Medicine subspecialty consultation is becoming increasingly important in inpatient medicine. We conducted a survey study in which we examined hospitalist practices and attitudes regarding medicine subspecialty consultation. The survey instrument was developed by the authors based on prior literature and administered online anonymously to hospitalists at 4 academic medical centers in the United States. The survey evaluated 4 domains: (1) current consultation practices, (2) preferences regarding consultation, (3) barriers to and facilitating factors of effective consultation, and (4) a comparison between hospitalist-fellow and hospitalist-subspecialty attending interactions. One hundred twenty-two of 261 hospitalists (46.7%) responded. The majority of hospitalists interacted with fellows during consultation. Of those, 90.9% reported that in-person communication occurred during less than half of consultations, and 64.4% perceived pushback at least "sometimes " in their consult interactions. Participants viewed consultation as an important learning experience, preferred direct communication with the consulting service, and were interested in more teaching during consultation. The survey identified a number of barriers to and facilitating factors of an effective hospitalist-consultant interaction, which impacted both hospitalist learning and patient care. Hospitalists reported more positive experiences when interacting with subspecialty attendings compared to fellows with regard to multiple aspects of the consultation. The hospitalist-consultant interaction is viewed as important for both hospitalist learning and patient care. Multiple barriers and facilitating factors impact the interaction, many of which are amenable to intervention.

Compensation Consultants and CEO Pay

NARCIS (Netherlands)

Kabir, Mohammed Rezaul; Minhat, Marizah

2014-01-01

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

The Lawyer-Therapist Consultation Team.

Science.gov (United States)

Korelitz, Ann; Schulder, Diane

1982-01-01

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

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

Directory of Open Access Journals (Sweden)

van Dulmen Sandra

2010-11-01

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

Definition study for variable cycle engine testbed engine and associated test program

Science.gov (United States)

Vdoviak, J. W.

1978-01-01

The product/study double bypass variable cycle engine (VCE) was updated to incorporate recent improvements. The effect of these improvements on mission range and noise levels was determined. This engine design was then compared with current existing high-technology core engines in order to define a subscale testbed configuration that simulated many of the critical technology features of the product/study VCE. Detailed preliminary program plans were then developed for the design, fabrication, and static test of the selected testbed engine configuration. These plans included estimated costs and schedules for the detail design, fabrication and test of the testbed engine and the definition of a test program, test plan, schedule, instrumentation, and test stand requirements.

How Can Air Force Civil Engineers Use Expert Systems?

Science.gov (United States)

1988-09-01

Acknowledgements On this academic path called "thesis", many individuals have befriended me along the way. I would like to express my thanks to Maj James R...that provided their insight into civil engineering throughout the interviews: Col James G. Zody, Col Thomas E. Lollis, Col Joe L. Hicks, Col Nicholas A...training role" ( Basden , 1984: 63-64). Consultant. Using an expert system as a consultant, the non- specialist can obtain counsel, guidance, or information

FUEL HANDLING FACILITY BACKUP CENTRAL COMMUNICATIONS ROOM SPACE REQUIREMENTS CALCULATION

International Nuclear Information System (INIS)

SZALEWSKI, B.

2005-01-01

The purpose of the Fuel Handling Facility Backup Central Communications Room Space Requirements Calculation is to determine a preliminary estimate of the space required to house the backup central communications room in the Fuel Handling Facility (FHF). This room provides backup communications capability to the primary communication systems located in the Central Control Center Facility. This calculation will help guide FHF designers in allocating adequate space for communications system equipment in the FHF. This is a preliminary calculation determining preliminary estimates based on the assumptions listed in Section 4. As such, there are currently no limitations on the use of this preliminary calculation. The calculations contained in this document were developed by Design and Engineering and are intended solely for the use of Design and Engineering in its work regarding the FHF Backup Central Communications Room Space Requirements. Yucca Mountain Project personnel from Design and Engineering should be consulted before the use of the calculations for purposes other than those stated herein or use by individuals other than authorized personnel in Design and Engineering

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…

Edgar Schein's Process versus Content Consultation Models.

Science.gov (United States)

Rockwood, Gary F.

1993-01-01

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

Trade-off results and preliminary designs of Near-Term Hybrid Vehicles

Science.gov (United States)

Sandberg, J. J.

1980-01-01

Phase I of the Near-Term Hybrid Vehicle Program involved the development of preliminary designs of electric/heat engine hybrid passenger vehicles. The preliminary designs were developed on the basis of mission analysis, performance specification, and design trade-off studies conducted independently by four contractors. THe resulting designs involve parallel hybrid (heat engine/electric) propulsion systems with significant variation in component selection, power train layout, and control strategy. Each of the four designs is projected by its developer as having the potential to substitute electrical energy for 40% to 70% of the petroleum fuel consumed annually by its conventional counterpart.

Inconsistency of residents' communication performance in challenging consultations.

Science.gov (United States)

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

2013-12-01

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

Engineering test facility

International Nuclear Information System (INIS)

Steiner, D.; Becraft, W.R.; Sager, P.H.

1981-01-01

The vehicle by which the fusion program would move into the engineering testing phase of fusion power development is designated the Engineering Test Facility (ETF). The ETF would provide a test-bed for reactor components in the fusion environment. In order to initiate preliminary planning for the ETF decision, the Office of Fusion Energy established the ETF Design Center activity to prepare the design of the ETF. This paper described the design status of the ETF

Does professional-centred training improve consultation outcomes?

DEFF Research Database (Denmark)

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

2006-01-01

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

Hot air balloon engine

Energy Technology Data Exchange (ETDEWEB)

Edmonds, Ian [Solartran Pty Ltd, 12 Lentara Street, Kenmore, Brisbane 4069 (Australia)

2009-04-15

This paper describes a solar powered reciprocating engine based on the use of a tethered hot air balloon fuelled by hot air from a glazed collector. The basic theory of the balloon engine is derived and used to predict the performance of engines in the 10 kW to 1 MW range. The engine can operate over several thousand metres altitude with thermal efficiencies higher than 5%. The engine thermal efficiency compares favorably with the efficiency of other engines, such as solar updraft towers, that also utilize the atmospheric temperature gradient but are limited by technical constraints to operate over a much lower altitude range. The increased efficiency allows the use of smaller area glazed collectors. Preliminary cost estimates suggest a lower $/W installation cost than equivalent power output tower engines. (author)

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

Science.gov (United States)

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

2015-09-01

Evidence for the use of telephone consultation in childhood inflammatory bowel disease (IBD) is lacking. We aimed to assess the effectiveness and cost consequences of telephone consultation compared with the usual out-patient face-to-face consultation for young people with IBD. We conducted a randomised-controlled trial in Manchester, UK, between July 12, 2010 and June 30, 2013. Young people (aged 8-16 years) with IBD were randomized to receive telephone consultation or face-to-face consultation for 24 months. The primary outcome measure was the paediatric IBD-specific IMPACT quality of life (QOL) score at 12 months. Secondary outcome measures included patient satisfaction with consultations, disease course, anthropometric measures, proportion of consultations attended, duration of consultations, and costs to the UK National Health Service (NHS). Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT02319798. Eighty six patients were randomised to receive either telephone consultation (n = 44) or face-to-face consultation (n = 42). Baseline characteristics of the two groups were well balanced. At 12 months, there was no evidence of difference in QOL scores (estimated treatment effect in favour of the telephone consultation group was 5.7 points, 95% CI - 2.9 to 14.3; p = 0.19). Mean consultation times were 9.8 min (IQR 8 to 12.3) for telephone consultation, and 14.3 min (11.6 to 17.0) for face-to-face consultation with an estimated reduction (95% CI) of 4.3 (2.8 to 5.7) min in consultation times (p consultation had a mean cost of UK£35.41 per patient consultation compared with £51.12 for face-face consultation, difference £15.71 (95% CI 11.8-19.6; P consultation compared with face-to-face consultation with regard to improvements in QOL scores, and telephone consultation reduced consultation time and NHS costs. Telephone consultation is a cost-effective alternative to face-to-face consultation for the

IT Consultants in Acquisition IT Integration

DEFF Research Database (Denmark)

Henningsson, Stefan; Øhrgaard, Christian

2016-01-01

strategic IT initiatives and how companies can draw effectively on their services. The paper investigates the use of consultants in relation to one type of major strategic IT initiative: acquisition IT integration. Acquisition IT integration, which is the integration of the acquirer’s and target......’s IT following a corporate acquisition, presents a difficult but crucial IT challenge for the many acquiring organizations. Through a comparative case study of four acquirers, theoretically grounded in the resource-based view of the firm, it is analyzed how acquirers draw on external consultants to realize...... acquisition IT integration. Two complementary and two supplementary roles consultants assume in these projects are identified. Additionally, three characteristics of the acquisition IT integration strategy are identified that influence how the acquirers assign different roles to IT consultants. The resulting...

"Systematizing" ethics consultation services.

Science.gov (United States)

Bruce, Courtenay R; Eves, Margot M; Allen, Nathan G; Smith, Martin L; Peña, Adam M; Cheney, John R; Majumder, Mary A

2015-03-01

While valuable work has been done addressing clinical ethics within established healthcare systems, we anticipate that the projected growth in acquisitions of community hospitals and facilities by large tertiary hospitals will impact the field of clinical ethics and the day-to-day responsibilities of clinical ethicists in ways that have yet to be explored. Toward the goal of providing clinical ethicists guidance on a range of issues that they may encounter in the systematization process, we discuss key considerations and potential challenges in implementing system-wide ethics consultation services. Specifically, we identify four models for organizing, developing, and enhancing ethics consultation activities within a system created through acquisitions: (1) train-the-trainer, (2) local capacity-building, (3) circuit-riding, and (4) consolidated accountability. We note each model's benefits and challenges. To our knowledge, this is the first paper to consider the broader landscape of issues affected by consolidation. We anticipate that clinical ethicists, volunteer consultants, and hospital administrators will benefit from our recommendations.

Consultant radiographers: Profile of the first generation

International Nuclear Information System (INIS)

Forsyth, Lesley J.; Maehle, Valerie

2010-01-01

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

Consultant radiographers: Profile of the first generation

Energy Technology Data Exchange (ETDEWEB)

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

2010-11-15

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

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

Science.gov (United States)

Pecina, Jennifer L; North, Frederick

2017-06-01

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

Knowledge creation for practice in public sector management accounting by consultants and academics: Preliminary findings and directions for future research

NARCIS (Netherlands)

van Helden, G.J.; Aardema, H.; ter Bogt, H.J.; Groot, T.L.C.M.

2010-01-01

This study is about knowledge creation for practice in public sector management accounting by consultants and academics. It shows that researchers emphasize the importance of practice, but worry about the prospects of a successful cross-fertilization between practice and research, because of the

Knowledge creation for practice in public sector management accounting by consultants and academics : Preliminary findings and directions for future research

NARCIS (Netherlands)

van Helden, G. Jan; Aardema, Harrie; ter Bogt, Henk J.; Groot, Tom L. C. M.

This study is about knowledge creation for practice in public sector management accounting by consultants and academics. It shows that researchers emphasize the importance of practice, but worry about the prospects of a successful cross-fertilization between practice and research, because of the

Hydrogen hybrid vehicle engine development: Experimental program

Energy Technology Data Exchange (ETDEWEB)

Van Blarigan, P. [Sandia National Lab., Livermore, CA (United States)

1995-09-01

A hydrogen fueled engine is being developed specifically for the auxiliary power unit (APU) in a series type hybrid vehicle. Hydrogen is different from other internal combustion (IC) engine fuels, and hybrid vehicle IC engine requirements are different from those of other IC vehicle engines. Together these differences will allow a new engine design based on first principles that will maximize thermal efficiency while minimizing principal emissions. The experimental program is proceeding in four steps: (1) Demonstration of the emissions and the indicated thermal efficiency capability of a standard CLR research engine modified for higher compression ratios and hydrogen fueled operation. (2) Design and test a new combustion chamber geometry for an existing single cylinder research engine, in an attempt to improve on the baseline indicated thermal efficiency of the CLR engine. (3) Design and build, in conjunction with an industrial collaborator, a new full scale research engine designed to maximize brake thermal efficiency. Include a full complement of combustion diagnostics. (4) Incorporate all of the knowledge thus obtained in the design and fabrication, by an industrial collaborator, of the hydrogen fueled engine for the hybrid vehicle power train illustrator. Results of the CLR baseline engine testing are presented, as well as preliminary data from the new combustion chamber engine. The CLR data confirm the low NOx produced by lean operation. The preliminary indicated thermal efficiency data from the new combustion chamber design engine show an improvement relative to the CLR engine. Comparison with previous high compression engine results shows reasonable agreement.

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....

The mining engineer as an international consultant; El ingeniero de minas como consultor internacional

Energy Technology Data Exchange (ETDEWEB)

Arias, A. M.

2009-07-01

These notes are a summary of the lecture I had the honor of giving on 5 May 2009, invited by the Higher Council of Mining Engineers of Spain, in the Engineering Institute of Spain. Interventions that, next to mine, were held that day, were integrated into the framework of an organized cycle, in which the different branches of engineering were encouraged to provide an overview of its current occupation. (Author)

Experience of a year of adult hospital dermatology consultations.

Science.gov (United States)

Storan, Eoin R; McEvoy, Marian T; Wetter, David A; El-Azhary, Rokea A; Camilleri, Michael J; Bridges, Alina G; Davis, Mark D P

2015-10-01

Dermatology consultations are frequently requested by inpatient hospital services. As inpatient dermatology services in the USA decline, dermatology hospital consultations are becoming increasingly important. We aim to describe the spectrum of skin diseases encountered and the health care subspecialties requesting dermatology hospital consultations. We performed a retrospective chart review of adult patient (age: ≥18 years) dermatology hospital consultations from January 1 to December 31, 2010. We examined patient demographic characteristics, consultation requesting services, and consultation diagnoses. Among dermatology services, 614 patients had 674 separate inpatient dermatology consultations during 2010. Of these patients, 55.9% were male (mean age: 59 years). In total, 205 consultations (30.4%) were requested by the internal medicine subspecialty, 137 (20.3%) by the hematology and oncology subspecialty, and 93 (13.8%) by the surgical subspecialty. The most common conditions seen by the hospital dermatology consulting service were skin infections (n = 125, 18.5%), dermatitis (n = 120, 17.8%), drug eruptions (n = 87, 12.9%), chronic wounds and ulcers (n = 55, 8.1%), cutaneous neoplasms (n = 39, 5.8%), graft-versus-host disease (n = 37, 5.5%), ecchymosis, purpura simplex or petechia (n = 26, 3.8%), intertrigo (n = 21, 3.1%), and urticaria (n = 20, 3.0%). The majority of consultations conducted by the dermatology hospital consulting service were for the management of common skin diseases, such as cutaneous infections, dermatitis, and drug eruptions. Most consultations were requested by the departments of internal medicine, hematology and oncology, and surgical services. © 2014 The International Society of Dermatology.

Development and preliminary analyses of material balance evaluation model in nuclear fuel cycle

International Nuclear Information System (INIS)

Matsumura, Tetsuo

1994-01-01

Material balance evaluation model in nuclear fuel cycle has been developed using ORIGEN-2 code as basic engine. This model has feature of: It can treat more than 1000 nuclides including minor actinides and fission products. It has flexibility of modeling and graph output using a engineering work station. I made preliminary calculation of LWR fuel high burnup effect (reloading fuel average burnup of 60 GWd/t) on nuclear fuel cycle. The preliminary calculation shows LWR fuel high burnup has much effect on Japanese Pu balance problem. (author)

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

Directory of Open Access Journals (Sweden)

Christine Chemin

2010-02-01

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

42 CFR 493.1419 - Standard; Clinical consultant responsibilities.

Science.gov (United States)

2010-10-01

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

40 CFR 725.17 - Consultation with EPA.

Science.gov (United States)

2010-07-01

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

Versator divertor experiment: preliminary designs

International Nuclear Information System (INIS)

Wan, A.S.; Yang, T.F.

1984-08-01

The emergence of magnetic divertors as an impurity control and ash removal mechanism for future tokamak reactors bring on the need for further experimental verification of the divertor merits and their ability to operate at reactor relevant conditions, such as with auxiliary heating. This paper presents preliminary designs of a bundle and a poloidal divertor for Versator II, which can operate in conjunction with the existing 150 kW of LHRF heating or LH current drive. The bundle divertor option also features a new divertor configuration which should improve the engineering and physics results of the DITE experiment. Further design optimization in both physics and engineering designs are currently under way

Managing outpatient consultations: from referral to discharge.

Science.gov (United States)

Mitchell, Rachael; Jacob, Hannah; Morrissey, Benita; Macaulay, Chloe; Gomez, Kumudini; Fertleman, Caroline

2017-08-01

Although a great deal of paediatric consultations are not urgent, doctors in training spend so much time providing service for acute conditions that they spend little time focusing on outpatient work before they become a consultant. Engaging clinicians in the managerial aspects of providing clinical care is a key to improving outcomes, and this article addresses these aspects of the outpatient consultation from referral to discharge. We aim to provide doctors in training with a tool to use during their training and their first few years as a consultant, to think about how outpatient work is organised and how it can be improved to maximise patient experience. The non-urgent consultation varies across the world; this article is aimed to be relevant to an international audience. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The International Consultant: Substance and Culture.

Science.gov (United States)

Fest, Thorrel B.

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

BNFL Sellafield further public consultation

International Nuclear Information System (INIS)

1994-01-01

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

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…

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

Science.gov (United States)

Erbas, Dilek

2010-01-01

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

Preliminary Evaluation of a Turbine/Rotary Combustion Compound Engine for a Subsonic Transport. [fuel consumption and engine tests of turbofan engines

Science.gov (United States)

Civinskas, K. C.; Kraft, G. A.

1976-01-01

The fuel consumption of a modern compound engine with that of an advanced high pressure ratio turbofan was compared. The compound engine was derived from a turbofan engine by replacing the combustor with a rotary combustion (RC) engine. A number of boost pressure ratios and compression ratios were examined. Cooling of the RC engine was accomplished by heat exchanging to the fan duct. Performance was estimated with an Otto-cycle for two levels of energy lost to cooling. The effects of added complexity on cost and maintainability were not examined and the comparison was solely in terms of cruise performance and weight. Assuming a 25 percent Otto-cycle cooling loss (representative of current experience), the best compound engine gave a 1.2 percent improvement in cruise. Engine weight increased by 23 percent. For a 10 percent Otto-cycle cooling loss (representing advanced insulation/high temperature materials technology), a compound engine with a boost PR of 10 and a compression ratio of 10 gave an 8.1 percent lower cruise than the reference turbofan.

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

Science.gov (United States)

Unterecker, Stefan; Maloney, Julia; Pfuhlmann, Bruno; Deckert, Jürgen; Warrings, Bodo

2014-05-01

To optimize psychiatric consultation service epidemiological information is needed. We compared data on gender, age and diagnoses of patients in the consultation service to psychiatric inpatients. In psychiatric consultation service patients are older (56.6 vs. 44.9 years, p psychiatric consultation service is contacted more often in cases of organic disorders, for females in adjustment disorders (p psychiatric consultation service is different for males and females with relevance for diagnostic and therapeutic procedures. © Georg Thieme Verlag KG Stuttgart · New York.

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.

20 CFR 404.1616 - Medical or psychological consultants.

Science.gov (United States)

2010-04-01

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

Options for change in the NHS consultant contract.

Science.gov (United States)

Clarke, R W; Gray, C

The lead negotiators for the management and consultant sides in an NHS trust in northern England responded to debate in their trust about consultant contracts by offering to research the attitudes of their peers towards a variety of contract options. The options tested included the current contract; models already examined in the trust and elsewhere, such as time sensitive and mild performance related contracts; and some more radical and speculative possibilities, including consultants franchising their services to the trust. Beyond the predictable conclusion that consultants would prefer no change while managers desired it, a time sensitive contract emerged as having potential for successful negotiation. On the other hand, neither consultants nor managers favoured a strict performance related contract or a fee for service contract. There was a strong similarity of opinion between the two groups on the relative salary values of the options, though the consultants consistently priced these higher than the managers.

Multiple Compensation Consultants and CEO Pay

NARCIS (Netherlands)

Kabir, Mohammed Rezaul; Minhat, Marizah

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

Consultants' Corner: System Performance. A Forum.

Science.gov (United States)

Drabenstott, John, Ed.

1986-01-01

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

Therapists perspectives on the effective elements of consultation following training.

Science.gov (United States)

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

2013-11-01

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

Therapists’ Perspectives on the Effective Elements of Consultation Following Training

Science.gov (United States)

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

2013-01-01

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

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

Science.gov (United States)

2012-05-25

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

Psychiatric Consultation and Substance Use Disorders

Directory of Open Access Journals (Sweden)

Sheila Specker

2009-01-01

Full Text Available Background A substantial number of patients in general hospitals will evince substance abuse problems but a majority is unlikely to be adequately identified in the referral-consultation process. This failure may preclude patients from receiving effective interventions for substance use disorders. Objectives 1. To evaluate all referred patients for possible substance use disorders. 2. To ascertain the degree of convergence between patients referred for chemical problems and the corresponding DSM diagnosis. 3. To compare demographic data for substance abusing patients and referrals not so classified. 4. To evaluate conditions concomitant with substance use disorders. Method Consecutive one-year referrals (524 to consultation-liaison psychiatric services were scrutinized for chemically-related problems by psychiatric consultants. Results Of the referrals, 176 met criteria for substance use disorders (SUD (57% alcohol; 25% other drugs; 18% both alcohol and other drugs. Persons diagnosed with SUD tended to be younger, male, non-Caucasian, unmarried, and unemployed. They were more likely to be depressed, have liver and other gastrointestinal problems, and to have experienced traumatic events; they also tended to have current financial difficulties. Most were referred for SUD evaluation by personnel in general medicine and family practice. Following psychiatric consultation, SUD designated patients were referred mainly to substance abuse treatment programs. The only variable related to recommended inpatient versus outpatient services for individuals with SUD was the Global Assessment of Functioning Axis (GAF with persons having lower estimated functioning more likely to be referred for inpatient interventions. Conclusions These data are similar to the results of past studies in this area. Unlike previous investigations in the domain of consultative-liaison psychiatry, financial stressors and specific consultant recommendations were included in data

Psychiatric Consultation and Substance Use Disorders

Directory of Open Access Journals (Sweden)

Sheila Specker

2009-11-01

Full Text Available Background: A substantial number of patients in general hospitals will evince substance abuse problems but a majority is unlikely to be adequately identified in the referral-consultation process. This failure may preclude patients from receiving effective interventions for substance use disorders. Objectives: 1. To evaluate all referred patients for possible substance use disorders. 2. To ascertain the degree of convergence between patients referred for chemical problems and the corresponding DSM diagnosis. 3. To compare demographic data for substance abusing patients and referrals not so classified. 4. To evaluate conditions concomitant with substance use disorders. Method: Consecutive one-year referrals (524 to consultation-liaison psychiatric services were scrutinized for chemically-related problems by psychiatric consultants. Results: Of the referrals, 176 met criteria for substance use disorders (SUD (57% alcohol; 25% other drugs; 18% both alcohol and other drugs. Persons diagnosed with SUD tended to be younger, male, non-Caucasian, unmarried, and unemployed. They were more likely to be depressed, have liver and other gastrointestinal problems, and to have experienced traumatic events; they also tended to have current financial difficulties. Most were referred for SUD evaluation by personnel in general medicine and family practice. Following psychiatric consultation, SUD designated patients were referred mainly to substance abuse treatment programs. The only variable related to recommended inpatient versus outpatient services for individuals with SUD was the Global Assessment of Functioning Axis (GAF with persons having lower estimated functioning more likely to be referred for inpatient interventions. Conclusions: These data are similar to the results of past studies in this area. Unlike previous investigations in the domain of consultative-liaison psychiatry, financial stressors and specific consultant recommendations were included in

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

Telephone consultations on exposure to nuclear disaster radiation

International Nuclear Information System (INIS)

Yashima, Sachiko; Chida, Koichi

2014-01-01

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

Information giving and receiving in hematological malignancy consultations.

Science.gov (United States)

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

2012-03-01

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

Utilizing the ECHO Model in the Veterans Health Affairs System: Guidelines for Setup, Operations and Preliminary Findings

Directory of Open Access Journals (Sweden)

Herschel Knapp

2015-06-01

Full Text Available Background: In 2011, the Veterans Health Administration (VHA consulted with the Project ECHO (Extension for Community Healthcare Outcomes team at the University of New Mexico, Albuquerque, to reproduce their successful model within the VHA. Methods: The VHA launched SCAN-ECHO (Specialty Care Access Network-Extension for Community Healthcare Outcomes, a multisite videoconferencing system to conduct live clinical consultations between specialists at a VHA Medical Center (hospital and primary care providers stationed at satellite VHA CBOCs (Community-Based Outpatient Clinic. Results: Analysis of the first three years rendered a mean attendee satisfaction of 89.53% and a consultation satisfaction score of 88.10%. About half of the SCAN-ECHO consultations resulted in patients receiving their treatment from their local primary care providers; the remaining half were referred to the VHA Medical Center when the treatment involved equipment or services not available at the CBOCs (e.g., MRI, surgery. Conclusion: This paper details the setup, operation logistics and preliminary findings, suggesting that SCAN-ECHO is a viable model for providing quality specialty clinical consultation service, prompter access to care, reduced commutes and continuing education. Additionally, the use of a secured Internet-based videoconferencing system that supports connectivity to multiple (mobile devices could expand the utilization of this service.

Diesel engine emission deterioration - a preliminary study

CSIR Research Space (South Africa)

Pretorius, Cecilia J

2016-04-01

Full Text Available The objective of this study was to find a parameter in diesel and oil analysis of underground mining vehicles that can be correlated with personal diesel particulate matter (DPM) exposure and used as part of an engine maintenance programme. A number...

Wood-waste fuelled indirectly-fired gas turbine cogeneration plant for sawmill applications. Phase 2. Site-specific preliminary engineering and financial analysis

Energy Technology Data Exchange (ETDEWEB)

1988-03-01

The use of conventional steam/electricity cogeneration systems is not generally economical at the sawmill scale of operation. This paper describes an evaluation of a wood-waste fueled and, indirectly, gas fired turbine cogeneration plant aimed at developing a cost-effective wood-waste fired power generation and dry kiln heating system for sawmill applications. A preliminary engineering design and financial analysis of the system was prepared for a demonstration site in British Columbia. A number of alternative system configurations were identified and preliminary engineering designs prepared for each. In the first option , wood wastes combusted in a wet cell hot gas generator powered a 600 kW turbine, and produced 7,000 kW for the drying kilns. The second option provided the same electrical and heat output but used a down-fired suspension burner unit fuelled by clean, dried sawdust, together with an integral air heater heat exchanger. The third option represented a commercial-scale configuration with an electrical output of 1,800 kW, and sufficient heat output for the dry kilns. A financial analyis based on a computerized feasibility model was carried out on the last two options. Low electricity rates in British Columbia combined with the small scale of a demonstration project provide an inadequate rate of return at the site without substantial outside support. At a commercial scale of operation and with the higher electricity prices that exist outside of British Columbia the financial analysis indicates that the incremental investment in the electric generation portion of the system provides very attractive rates of return for the 3 options. 11 figs., 10 tabs.

Sustainability of a Primary Care-Driven eConsult Service.

Science.gov (United States)

Liddy, Clare; Moroz, Isabella; Afkham, Amir; Keely, Erin

2018-03-01

Excessive wait times for specialist appointments pose a serious barrier to patient care. To improve access to specialist care and reduce wait times, we launched the Champlain BASE (Building Access to Specialists through eConsultation) eConsult service in April 2011. The objective of this study is to report on the impact of our multiple specialty eConsult service during the first 5 years of use after implementation, with a focus on growth and sustainability. We conducted a cross-sectional study of all eConsult cases submitted between April 1, 2011 and April 30, 2016, and measured impact with system utilization data and mandatory close-out surveys completed at the end of each eConsult. Impact indicators included time interval to obtain specialist advice, effect of specialist advice on the primary care clinician's course of action, and rate of avoidance of face-to-face visits. A total of 14,105 eConsult cases were directed to 56 different medical specialty groups, completed with a median response time of 21 hours, and 65% of all eConsults were resolved without a specialist visit. We observed rapid growth in the use of eConsult during the study period: 5 years after implementation the system was in use by 1,020 primary care clinicians, with more than 700 consultations taking place per month. This study presents the first in-depth look at the growth and sustainability of the multispecialty eConsult service. The results show the positive impact of an eConsult service and can inform other regions interested in implementing similar systems. © 2018 Annals of Family Medicine, Inc.

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…

The engineering test facility

International Nuclear Information System (INIS)

Steiner, D.; Becraft, W.R.; Sager, P.H.

1981-01-01

The vehicle by which the fusion program would move into the engineering testing phase of fusion power development is designated the Engineering Test Facility (ETF). The ETF would provide a test-bed for reactor components in the fusion environment. In order to initiate preliminary planning for the ETF decision, the Office of Fusion Energy established the ETF Design Center activity to prepare the design of the ETF. This paper describes the design status of the ETF. (orig.)

Bladder Pain Syndrome International Consultation on Incontinence

DEFF Research Database (Denmark)

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

2010-01-01

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

Qualification of contractor/consultant instructors

International Nuclear Information System (INIS)

Hanson, H.D.

1985-01-01

Following a brief discussion of the role of consultant instructors in Public Service Electric and Gas Company's training organization, the qualification process is presented. Consultant instructors are provided with information regarding supervision of the trainees and the instructional process and procedures required. Each individual must have his or her instructional capability, supervisory skills and technical competence verified and documented prior to conducting training independently. Concluding comments describe the overall satisfactory experience with this program

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

Science.gov (United States)

Kaufman, Roger

1996-01-01

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

Group Work in Schools: A Process Consultation Approach

Science.gov (United States)

Farouk, Shaalan

2004-01-01

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

Expert System Approach For Generating And Evaluating Engine Design Alternatives

Science.gov (United States)

Shen, Stewart N. T.; Chew, Meng-Sang; Issa, Ghassan F.

1989-03-01

Artificial intelligence is becoming an increasingly important subject of study for computer scientists, engineering designers, as well as professionals in other fields. Even though AI technology is a relatively new discipline, many of its concepts have already found practical applications. Expert systems, in particular, have made significant contributions to technologies in such fields as business, medicine, engineering design, chemistry, and particle physics. This paper describes an expert system developed to aid the mechanical designer with the preliminary design of variable-stroke internal-combustion engines. The expert system accomplished its task by generating and evaluating a large number of design alternatives represented in the form of graphs. Through the application of structural and design rules directly to the graphs, optimal and near optimal preliminary design configurations of engines are deduced.

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.

76 FR 55678 - Tribal Consultation Policy

Science.gov (United States)

2011-09-08

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

Improving access to urologists through an electronic consultation service

Science.gov (United States)

Witherspoon, Luke; Liddy, Clare; Afkham, Amir; Keely, Erin; Mahoney, John

2017-01-01

Introduction Access to specialist services is limited by wait times and geographic availability. Champlain Building Access to Specialist Advice (BASE) has been implemented in our service region to facilitate access to specialists by primary care providers (PCPs). Through a secure web-based system, PCPs are able to send eConsults instead of requesting a formal in-office consultation. Methods Urology eConsults completed through the Champlain BASE service from March 2013 to January 2015 were analyzed. Each consult was characterized in regard to the type of question asked by the referring physician and the clinical content of the referral. Using the mandatory close-out surveys, we analyzed rates of referral avoidance, physician satisfaction, and overall impact on patient care. Results Of 190 eConsultations, 70% were completed in less than 10 minutes. The most common clinical questions related to the interpretation of imaging reports (16%) and tests to choose for investigating a condition (15%). The most common diagnoses were hematuria (13%) and renal mass (8%). In 35% of cases, referral to a urologist had originally been contemplated and was avoided. In 8% of cases, a PCP did not believe a consultation was initially needed, but a referral was ultimately initiated after the eConsultation. Conclusions Our study shows that although certain clinical presentations still require a formal in-person urological consultation, eConsultations can potentially reduce unnecessary clinic visits while identifying patients who may benefit from early urological consultation. Through both these mechanisms, we may improve timely access to urologists. PMID:28798830

Simulated consultations: a sociolinguistic perspective.

Science.gov (United States)

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

2016-01-15

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

Preliminary study on the control of direct injection diesel engine for better fuel flexibility and emissions control. Pt. 1 and 2

Energy Technology Data Exchange (ETDEWEB)

Egnell, R.; Kassem, N.; Bohlin, T.

1985-01-01

This report summarizes the results of a preliminary study on turbocharged direct injection diesel engines. Part I reviews the qualitative dynamic aspects of turbocharged diesel engine and the factors that affect its transient behaviour. It gives a brief account of the model structure and the interrelationships between the different components of the model as well as the different types of engine models and the methods of simulation. The transient response of a turbocharged engine under changing load, speed, and ambient conditions are discussed. Methods to improve the transient response, thus reducing fuel consumption and smoke emissions are briefly reviewed. Finally, both conventional and advanced control strategies are discussed with emphasis on the control of fuel injection (Delta-control), injection time (Alfa-control), and exhaust gas recirculation (EGR-control). Part II (in Swedish) consists of a literature survey on hardware components such as sensors, actuators, and injection systems that are, or expect to be, available with reasonable commercial costs. The objective of this survey is to provide the grounds on which to decide if these components satisfy the requirements of electronic control systems. Part III (in Swedish) discusses the transient response measurements obtained from two sets of experiments conducted on a six-cylinder motor working under varying conditions of load and speed. The objective of the first set of experiments was to quantify the difference in ignition delay between the transient and steady state operating conditions. The second set of experiments were aimed to provide a basis on which the engine efficiency obtained under transient conditions can be compared to that obtained from a single-cylinder motor working under steady state conditions.

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

Science.gov (United States)

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

2007-11-01

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

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

The IAHR project CCHE-Climate Change impact on the Hydrological cycle, water management and Engineering: an overview and preliminary results

Science.gov (United States)

Ranzi, Roberto; Kojiri, T.; Mynett, A.; Barontini, S.; van de Giesen, N.; Kolokytha, E.; Ngo, L. A.; Oreamuno, R.; Renard, B.; Sighomnou, D.; Vizina, A.

2010-05-01

IAHR, the International Association for Hydro-Environment Engineering and Research launched a research Project called Climate Change impact on the Hydrological cycle, water management and Engineering (IAHR CCHE Project). It was motivated by the fact that, although it is now well accepted that, in the light of the recent IPCC reports the vast majority of members of the scientific community are convinced that the climate is changing or at least will experience a significant fluctuation already during the current century, it is perceived that some hydrologists, water experts and hydraulic engineers are not yet ready to incorporate climate change scenarios in their designs for such projects as: - flood protection and river training, - dam rehabilitation, - water resources management under water scarcity and changes in the hydrological regimes. The objective of the project is to encourage a close co-operation between the scientific and engineering communities in taking appropriate and timely action in response to the impact of climate change on the hydrological regime and on water resource projects. The project aims at reporting on (a) the current state of knowledge as regards the impact of projected climate change on the hydrological regime in different regions of the world, where these regions are defined not just in geographic terms but also on the basis of their level of economic and water resources development; (b) the extent to which these impacts are recognized and taken into account by national water authorities, engineering organizations and other regulating bodies in setting their standard practices and procedures for the planning, design and operation of water works. These adaptation measures will include both "hard" responses, such as the construction or enlargement of engineering structures, and "soft" responses, such as changes in legislation or the operating rules of existing structures. An overview of the project and preliminary results extracted from of

A free-piston Stirling engine/linear alternator controls and load interaction test facility

Science.gov (United States)

Rauch, Jeffrey S.; Kankam, M. David; Santiago, Walter; Madi, Frank J.

1992-01-01

A test facility at LeRC was assembled for evaluating free-piston Stirling engine/linear alternator control options, and interaction with various electrical loads. This facility is based on a 'SPIKE' engine/alternator. The engine/alternator, a multi-purpose load system, a digital computer based load and facility control, and a data acquisition system with both steady-periodic and transient capability are described. Preliminary steady-periodic results are included for several operating modes of a digital AC parasitic load control. Preliminary results on the transient response to switching a resistive AC user load are discussed.

Preliminary engineering analysis for clothes washers

Energy Technology Data Exchange (ETDEWEB)

Biermayer, Peter J.

1996-10-01

The Engineering Analysis provides information on efficiencies, manufacturer costs, and other characteristics of the appliance class being analyzed. For clothes washers, there are two classes: standard and compact. Since data were not available to analyze the compact class, only clothes washers were analyzed in this report. For this analysis, individual design options were combined and ordered in a manner that resulted in the lowest cumulative cost/savings ratio. The cost/savings ratio is the increase in manufacturer cost for a design option divided by the reduction in operating costs due to fuel and water savings.

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

Science.gov (United States)

Barnes, M L; Hussain, S S M

2011-12-01

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

Investigating a self-scoring interview simulation for learning and assessment in the medical consultation

Directory of Open Access Journals (Sweden)

Bruen C

2017-05-01

Full Text Available Catherine Bruen,1 Clarence Kreiter,2 Vincent Wade,3 Teresa Pawlikowska1 1Health Professions Education Centre, Faculty of Medicine and Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland; 2Department of Family Medicine, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA; 3School of Computer Science and Statistics, Faculty of Engineering, Mathematics and Science, Trinity College Dublin, Dublin, Ireland Abstract: Experience with simulated patients supports undergraduate learning of medical consultation skills. Adaptive simulations are being introduced into this environment. The authors investigate whether it can underpin valid and reliable assessment by conducting a generalizability analysis using IT data analytics from the interaction of medical students (in psychiatry with adaptive simulations to explore the feasibility of adaptive simulations for supporting automated learning and assessment. The generalizability (G study was focused on two clinically relevant variables: clinical decision points and communication skills. While the G study on the communication skills score yielded low levels of true score variance, the results produced by the decision points, indicating clinical decision-making and confirming user knowledge of the process of the Calgary–Cambridge model of consultation, produced reliability levels similar to what might be expected with rater-based scoring. The findings indicate that adaptive simulations have potential as a teaching and assessment tool for medical consultations. Keywords: medical education, simulation technology, competency assessment, generalizability theory

The guideline "consultation psychiatry" of the Netherlands Psychiatric Association

NARCIS (Netherlands)

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

2009-01-01

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

Consultation for Parents of Young Gifted Children.

Science.gov (United States)

Wolf, Joan S.

1989-01-01

The article describes private evaluation and consultation services provided to parents of young gifted children, and discusses the benefits of private consultation and the potential role of school personnel in meeting the needs of this population. (Author/JDD)

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

African Journals Online (AJOL)

Mandefrot Belay

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

Engineering test facility design center

International Nuclear Information System (INIS)

Anon.

1980-01-01

The vehicle by which the fusion program would move into the engineering testing phase of fusion power development is designated the Engineering Test Facility (ETF). The ETF would provide a test bed for reactor components in the fusion environment. In order to initiate preliminary planning for the ETF decision, the Office of Fusion Energy established the ETF Design Center activity to prepare the design of the ETF. This section describes the status of this design

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

International Nuclear Information System (INIS)

2002-01-01

The consultants were requested to advise the Agency on the realization of a harmonized approach to internationally compatible quality assurance systems. The consultants presented their viewpoint and position papers in relation to initial questions posed, reflecting the international efforts and their own experiences in analytical quality assurance. The consultants made specific recommendations concerning various aspects of the Agency's Analytical Quality Assurance Services Programme

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

African Journals Online (AJOL)

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

Vibrational Based Inspection of Civil Engineering Structures

DEFF Research Database (Denmark)

Rytter, Anders

at the University of Aalborg from 1988 to 1991. Secondly, a research project, In-Field Vibration Based Inspection of Civil Engineering Structures, which has been performed as a pilot project by the Consulting Engineers Rambøll, Hannemann and Højlund in cooperation with the department of Building Technology......The thesis has been written in relation to two different research projects. Firstly, an offshore test programme, Integrated Experimental/Numerical Analysis of the Dynamic behavior of offshore structures, which was performed at the department of Building Technology and Structural Engineering...... and Structural Engineering at the University of Aalborg since the beginning of 1992. Both projects have been supported by the Danish Technical Research Council. Further, the first mentioned project was supported by the Danish Energy Agency. Their financial support is gratefully acknowledged....

Energy consultancy in the year 2000

International Nuclear Information System (INIS)

Loeve, M.J.

1998-01-01

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

Finite-element model evaluation of barrier configurations to reduce infiltration into waste-disposal structures: preliminary results and design considerations

International Nuclear Information System (INIS)

Lu, A.H.; Phillips, S.J.; Adams, M.R.

1982-09-01

Barriers to reduce infiltration into waste burial disposal structures (trenches, pits, etc.) may be required to provide adequate waste confinement. The preliminary engineering design of these barriers should consider interrelated barrier performance factors. This paper summarizes preliminary computer simulation activities to further engineering barrier design efforts. Several barrier configurations were conceived and evaluated. Models were simulated for each barrier configuration using a finite element computer code. Results of this preliminary evaluation indicate that barrier configurations, depending on their morphology and materials, may significantly influence infiltration, flux, drainage, and storage of water through and within waste disposal structures. 9 figures

Energy saving consulting in Hamburg

Energy Technology Data Exchange (ETDEWEB)

1982-10-01

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

Implementation of an Arranged Preventive Consultation in Danish General Practice

DEFF Research Database (Denmark)

Junge, Anne Gram; Kirkegaard, Pia; Thomsen, Janus Laust

Background: In 2006 an arranged preventive consultation (0106-service) was implemented in Danish general practice. The purpose of the consultation is an attempt to improve the systematic prevention of the main chronic lifestyle diseases. Aim: This study examines the GP's experiences...... with the arranged preventive consultation with focus on facilitators and barriers in the implementation of the consultation. Material & Method: Semi-structured interviews with 10 GPs and nurses in general practice. Results & Conclusions: Economically lucrative services are not an isolated motivation for the GPs....../nurses, but must be accompanied with a basic belief in the effect of preventive consultations in general practice. The better payment of the 0106-service is used to spend more time per consultation and it makes the GPs/nurses feel rewarded for the preventive work they perform. The consultation frames a social...

Mental Health Consultation Among Ontario's Immigrant Populations.

Science.gov (United States)

Islam, Farah; Khanlou, Nazilla; Macpherson, Alison; Tamim, Hala

2017-11-16

To determine the prevalence rates and characteristics of past-year mental health consultation for Ontario's adult (18 + years old) immigrant populations. The Canadian Community Health Survey (CCHS) 2012 was used to calculate the prevalence rates of past-year mental health consultation by service provider type. Characteristics associated with mental health consultation were determined by carrying out multivariable logistic regression analysis on merged CCHS 2008-2012 data. Adult immigrant populations in Ontario (n = 3995) had lower estimated prevalence rates of past-year mental health consultation across all service provider types compared to Canadian-born populations (n = 14,644). Amongst those who reported past-year mental health consultation, 57.89% of Ontario immigrants contacted their primary care physician, which was significantly higher than the proportion who consulted their family doctor from Canadian-born populations (45.31%). The factors of gender, age, racial/ethnic background, education level, working status, food insecurity status, self-perceived health status, smoking status, alcohol drinking status, years since immigration, and age at time of immigration were significantly associated with past-year mental health consultation for immigrant populations. Ontario's adult immigrant populations most commonly consult their family doctor for mental health care. Potential exists for expanding the mental health care role of primary care physicians as well as efforts to increase accessibility of specialized mental health services. Integrated, coordinated care where primary care physicians, specialized mental health professionals, social workers, and community educators, etc. working together in a sort of "one-stop-shop" may be the most effective way to mitigate gaps in the mental health care system. In order to effectively tailor mental health policy, programming, and promotion to suit the needs of immigrant populations initiatives that focus on

14 CFR 413.5 - Pre-application consultation.

Science.gov (United States)

2010-01-01

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

Economic Evaluation of Pediatric Telemedicine Consultations to Rural Emergency Departments.

Science.gov (United States)

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

2015-08-01

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

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

Science.gov (United States)

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

2015-12-01

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

Systems consultation: protocol for a novel implementation strategy designed to promote evidence-based practice in primary care

OpenAIRE

Quanbeck, Andrew; Brown, Randall T; E Zgierska, Aleksandra; A Johnson, Roberta; Robinson, James M; Jacobson, Nora

2016-01-01

Background Adoption of evidence-based practices takes place at a glacial place in healthcare. This research will pilot test an innovative implementation strategy ? systems consultation ?intended to speed the adoption of evidence-based practice in primary care. The strategy is based on tenets of systems engineering and has been extensively tested in addiction treatment. Three innovations have been included in the strategy ? translation of a clinical practice guideline into a checklist-based im...

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

The preoperative cardiology consultation: indications and risk modification.

Science.gov (United States)

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

2017-11-01

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

N. E. L. Floating Terminator. Volume 3C(NFT) - Technical appraisal. Consultants' 1983 report

Energy Technology Data Exchange (ETDEWEB)

1986-01-01

A report is given by a team of Consultants on the estimated cost of converting wave energy into electrical energy by a 2 GW array of NEL Floating Terminator Devices and delivering the electricity to a sub-station on the west coast of Skye. A detailed engineering assessment is given. Comparisons with the estimates made by the team developing the concept are presented and discrepancies discussed. The main cost differences are caused by the different assessments of the power conversion efficiency and the electrical transmission costs.

Public consultation: regulatory requirement or business principle?

International Nuclear Information System (INIS)

Seeley, R.

1999-01-01

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

Public consultation: regulatory requirement or business principle?

Energy Technology Data Exchange (ETDEWEB)

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

1999-07-01

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

Working with boundaries in systems psychodynamic consulting

Directory of Open Access Journals (Sweden)

Henk Struwig

2012-03-01

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

Identifying challenges in project consultants engagement practices

Science.gov (United States)

Shariffuddin, Nadia Alina Amir; Abidin, Nazirah Zainul

2017-10-01

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

Preliminary summary of the ETF conceptual studies

Science.gov (United States)

Seikel, G. R.; Bercaw, R. W.; Pearson, C. V.; Owens, W. R.

1978-01-01

Power plant studies have shown the attractiveness of MHD topped steam power plants for baseload utility applications. To realize these advantages, a three-phase development program was initiated. In the first phase, the engineering data and experience were developed for the design and construction of a pilot plant, the Engineering Test Facility (ETF). Results of the ETF studies are reviewed. These three parallel independent studies were conducted by industrial teams led by the AVCO Everett Research Laboratory, the General Electric Corporation, and the Westinghouse Corporation. A preliminary analysis and the status of the critical evaluation of these results are presented.

Preliminary cost estimating for the nuclear industry

International Nuclear Information System (INIS)

Klumpar, I.V.; Soltz, K.M.

1985-01-01

The nuclear industry has higher costs for personnel, equipment, construction, and engineering than conventional industry, which means that cost estimation procedures may need adjustment. The authors account for the special technical and labor requirements of the nuclear industry in making adjustments to equipment and installation cost estimations. Using illustrative examples, they show that conventional methods of preliminary cost estimation are flexible enough for application to emerging industries if their cost structure is similar to that of the process industries. If not, modifications can provide enough engineering and cost data for a statistical analysis. 9 references, 14 figures, 4 tables

Impact of Diabetes E-Consults on Outpatient Clinic Workflow.

Science.gov (United States)

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

2015-08-01

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

SOME REFLECTIONS UPON MANAGEMENT CONSULTING AS PROFESSIONAL SERVICES

OpenAIRE

Tomescu Ada; Botezat Elena

2008-01-01

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

Services of strategic consulting: special features and types

OpenAIRE

Klenin Oleh Volodymyrovych

2016-01-01

In the article essence of terms “consulting” and “strategic consulting” was studied. It was proved that strategic consulting must be analyzed as professional activity in the system of enterprise strategic management. Specific features of consultative services and its composition was added from the point of view of strategic management and innovative development were studied. In the process of providing consulting services it was suggested to take into account the strategic orientation of huma...

Space Transportation Engine Program (STEP), phase B

Science.gov (United States)

1990-01-01

The Space Transportation Engine Program (STEP) Phase 2 effort includes preliminary design and activities plan preparation that will allow smooth and time transition into a Prototype Phase and then into Phases 3, 4, and 5. A Concurrent Engineering approach using Total Quality Management (TQM) techniques, is being applied to define an oxygen-hydrogen engine. The baseline from Phase 1/1' studies was used as a point of departure for trade studies and analyses. Existing STME system models are being enhanced as more detailed module/component characteristics are determined. Preliminary designs for the open expander, closed expander, and gas generator cycles were prepared, and recommendations for cycle selection made at the Design Concept Review (DCR). As a result of July '90 DCR, and information subsequently supplied to the Technical Review Team, a gas generator cycle was selected. Results of the various Advanced Development Programs (ADP's) for the Advanced Launch Systems (ALS) were contributive to this effort. An active vehicle integration effort is supplying the NASA, Air Force, and vehicle contractors with engine parameters and data, and flowing down appropriate vehicle requirements. Engine design and analysis trade studies are being documented in a data base that was developed and is being used to organize information. To date, seventy four trade studies were input to the data base.

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…

Career opportunities in clinical engineering.

Science.gov (United States)

Morse, W A

1992-01-01

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

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.

Variable Cycle Engine Technology Program Planning and Definition Study

Science.gov (United States)

Westmoreland, J. S.; Stern, A. M.

1978-01-01

The variable stream control engine, VSCE-502B, was selected as the base engine, with the inverted flow engine concept selected as a backup. Critical component technologies were identified, and technology programs were formulated. Several engine configurations were defined on a preliminary basis to serve as demonstration vehicles for the various technologies. The different configurations present compromises in cost, technical risk, and technology return. Plans for possible variably cycle engine technology programs were formulated by synthesizing the technology requirements with the different demonstrator configurations.

Conceptual model of integrated apiarian consultancy

OpenAIRE

Bodescu, Dan; Stefan, Gavril; Paveliuc Olariu, Codrin; Magdici, Maria

2010-01-01

The socio-economic field researches have indicated the necessity of realizing an integrated consultancy service for beekeepers that will supply technical-economic solutions with a practical character for ensuring the lucrativeness and viability of the apiaries. Consequently, an integrated apiarian consultancy model has been built holding the following features: it realizes the diagnosis of the meliferous resources and supplies solutions for its optimal administration; it realizes the technica...

Lessons Learned from a Consultation Process Overseas

Science.gov (United States)

Merino-Soto, César

2014-01-01

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

Vývoj interního manažerského informačního systému ve společnosti Dolphin consulting, s.r.o.

OpenAIRE

Církovský, Tomáš

2016-01-01

Main goal of this master thesis is to create Management Information System for company Dolphin consulting, s.r.o. based on technologies available within its infrastructure. Next goal is conduct preliminary verification of the created Management Information System. Generally, the Management Information System is created in accordance with resources including but not limited to Business Intelligence, Management Information Systems literature and experiences of the author. The most important ass...

Therapists’ Perspectives on the Effective Elements of Consultation Following Training

OpenAIRE

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

2013-01-01

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

Compliance with dental treatment recommendations by rural paediatric patients after a live-video teledentistry consultation: A preliminary report.

Science.gov (United States)

McLaren, Sean W; Kopycka-Kedzierawski, Dorota T

2016-04-01

The purpose of this research was to assess the compliance rate with recommended dental treatment by rural paediatric dental patients after a live-video teledentistry consultation. A retrospective dental chart review was completed for 251 rural paediatric patients from the Finger Lakes region of New York State who had an initial teledentistry appointment with a paediatric dentist located remotely at the Eastman Institute for Oral Health in Rochester, NY. The recommended treatment modalities were tabulated and comprehensive dental treatment completion rates were obtained. The recommended treatment modality options of: treatment in the paediatric dental clinic; treatment using nitrous oxide anxiolysis; treatment with oral sedation; treatment in the operating room with general anaesthesia; or teleconsultation were identified for the 251 patients. Compliance rates for completed dental treatment based on initial teleconsultation recommendations were: 100% for treatment in the paediatric dental clinic; 56% for nitrous oxide patients; 87% for oral sedation; 93% for operating room; and 90% for teleconsultations. The differences in the compliance rates for all treatment modalities were not statistically significant (Fisher's exact test, p > 0.05). Compliance rates for completed comprehensive dental treatment for this rural population of paediatric dental patients were quite high, ranging from 56% to 100%, and tended to be higher when treatment was completed in fewer visits. Live-video teledentistry consultations conducted among rural paediatric patients and a paediatric dentist in the specialty clinic were feasible options for increasing dental treatment compliance rates when treating complex paediatric dental cases. © The Author(s) 2015.

Codes of Practice related to Harbour and Coastal Engineering in Denmark

DEFF Research Database (Denmark)

Burcharth, H. F.

2000-01-01

Codes of practice for building and civil engineering works have been produced since 1893 by the "Danish Society of Engineers". Among the early codes are: Reinforces concrete structures (1908, 1943), calculation of reinforced concrete structures in harbour works (1926), Harbour Works (1927), Steel...... structures (1941). The codes were based on the principle of allowable stresses. However, already in 1948 a Danish consulting engineer used a partial safety factor concept for a power station design in order to secure satisfactory safety. The concept was in fact old as it was used by Gerber in his design...

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.

Fire-safety engineering and performance-based codes

DEFF Research Database (Denmark)

Sørensen, Lars Schiøtt

project administrators, etc. The book deals with the following topics: • Historical presentation on the subject of fire • Legislation and building project administration • European fire standardization • Passive and active fire protection • Performance-based Codes • Fire-safety Engineering • Fundamental......Fire-safety Engineering is written as a textbook for Engineering students at universities and other institutions of higher education that teach in the area of fire. The book can also be used as a work of reference for consulting engineers, Building product manufacturers, contractors, building...... thermodynamics • Heat exchange during the fire process • Skin burns • Burning rate, energy release rate and design fires • Proposal to Risk-based design fires • Proposal to a Fire scale • Material ignition and flame spread • Fire dynamics in buildings • Combustion products and toxic gases • Smoke inhalation...

International telemedicine consultations for neurodevelopmental disabilities.

Science.gov (United States)

Pearl, Phillip L; Sable, Craig; Evans, Sarah; Knight, Joseph; Cunningham, Parker; Lotrecchiano, Gaetano R; Gropman, Andrea; Stuart, Sheela; Glass, Penny; Conway, Anne; Ramadan, Issam; Paiva, Tania; Batshaw, Mark L; Packer, Roger J

2014-06-01

A telemedicine program was developed between the Children's National Medical Center (CNMC) in Washington, DC, and the Sheikh Khalifa Bin Zayed Foundation in the United Arab Emirates (UAE). A needs assessment and a curriculum of on-site training conferences were devised preparatory to an ongoing telemedicine consultation program for children with neurodevelopmental disabilities in the underserved eastern region of the UAE. Weekly telemedicine consultations are provided by a multidisciplinary faculty. Patients are presented in the UAE with their therapists and families. Real-time (video over Internet protocol; average connection, 768 kilobits/s) telemedicine conferences are held weekly following previews of medical records. A full consultation report follows each telemedicine session. Between February 29, 2012 and June 26, 2013, 48 weekly 1-h live interactive telemedicine consultations were conducted on 48 patients (28 males, 20 females; age range, 8 months-22 years; median age, 5.4 years). The primary diagnoses were cerebral palsy, neurogenetic disorders, autism, neuromuscular disorders, congenital anomalies, global developmental delay, systemic disease, and epilepsy. Common comorbidities were cognitive impairment, communication disorders, and behavioral disorders. Specific recommendations included imaging and DNA studies, antiseizure management, spasticity management including botulinum toxin protocols, and specific therapy modalities including taping techniques, customized body vests, and speech/language and behavioral therapy. Improved outcomes reported were in clinician satisfaction, achievement of therapy goals for patients, and requests for ongoing sessions. Weekly telemedicine sessions coupled with triannual training conferences were successfully implemented in a clinical program dedicated to patients with neurodevelopmental disabilities by the Center for Neuroscience at CNMC and the UAE government. International consultations in neurodevelopmental

Consultation: Creating School-Based Interventions. Second Edition.

Science.gov (United States)

Dinkmeyer, Don, Jr.; Carlson, Jon

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

29 CFR 1903.10 - Consultation with employees.

Science.gov (United States)

2010-07-01

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

Expectation Levels in Dictionary Consultation and Compilation ...

African Journals Online (AJOL)

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

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.

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

OpenAIRE

Reviakin, Y; Sukhanov, A

1999-01-01

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

Technology for reducing aircraft engine pollution

Science.gov (United States)

Rudey, R. A.; Kempke, E. E., Jr.

1975-01-01

Programs have been initiated by NASA to develop and demonstrate advanced technology for reducing aircraft gas turbine and piston engine pollutant emissions. These programs encompass engines currently in use for a wide variety of aircraft from widebody-jets to general aviation. Emission goals for these programs are consistent with the established EPA standards. Full-scale engine demonstrations of the most promising pollutant reduction techniques are planned within the next three years. Preliminary tests of advanced technology gas turbine engine combustors indicate that significant reductions in all major pollutant emissions should be attainable in present generation aircraft engines without adverse effects on fuel consumption. Fundamental-type programs are yielding results which indicate that future generation gas turbine aircraft engines may be able to utilize extremely low pollutant emission combustion systems.

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

Science.gov (United States)

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

2016-01-29

Remote video consultations between clinician and patient are technically possible and increasingly acceptable. They are being introduced in some settings alongside (and occasionally replacing) face-to-face or telephone consultations. To explore the advantages and limitations of video consultations, we will conduct in-depth qualitative studies of real consultations (microlevel) embedded in an organisational case study (mesolevel), taking account of national context (macrolevel). The study is based in 2 contrasting clinical settings (diabetes and cancer) in a National Health Service (NHS) acute trust in London, UK. Main data sources are: microlevel--audio, video and screen capture to produce rich multimodal data on 45 remote consultations; mesolevel--interviews, ethnographic observations and analysis of documents within the trust; macrolevel--key informant interviews of national-level stakeholders and document analysis. Data will be analysed and synthesised using a sociotechnical framework developed from structuration theory. City Road and Hampstead NHS Research Ethics Committee, 9 December 2014, reference 14/LO/1883. We plan outputs for 5 main audiences: (1) academics: research publications and conference presentations; (2) service providers: standard operating procedures, provisional operational guidance and key safety issues; (3) professional bodies and defence societies: summary of relevant findings to inform guidance to members; (4) policymakers: summary of key findings; (5) patients and carers: 'what to expect in your virtual consultation'. The research literature on video consultations is sparse. Such consultations offer potential advantages to patients (who are spared the cost and inconvenience of travel) and the healthcare system (eg, they may be more cost-effective), but fears have been expressed that they may be clinically risky and/or less acceptable to patients or staff, and they bring significant technical, logistical and regulatory challenges. We

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

Science.gov (United States)

Gottlieb, C; Christiansen, I; Von Segebaden, C; Wiksten-Almströmer, M

1998-08-05

As adolescence is a critical period of development, and as boys are less inclined than girls to approach the school facility for adolescent counselling, segregated consulting hours were introduced for boys to attract those with problems. The frequency of consultations by boys increased by 25 per cent, and 70 per cent of the boys reported a preference for the segregated consulting hours; 75 per cent appreciated the absence of girls from the waiting room; and of the 42 per cent with special preferences regarding the gender of the staff encountered, half reported preferring a man. Most of the boys presented with defined problems, though many revealed other problems, often relating to sexuality, in the course of consultation. The availability of segregated consulting hours for boys with adolescent problems is important, and often the only way to reach young boys who need help.

An empirical study of multidimensional fidelity of COMPASS consultation.

Science.gov (United States)

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

2018-06-01

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

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.

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

Science.gov (United States)

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

2016-01-01

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

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

Science.gov (United States)

Fiester, Autumn

2015-01-01

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

The Next Frontier in Family Business: Career Consulting.

Science.gov (United States)

Haid, Richard L.

1995-01-01

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

Building Interpersonal Relationships as a Key to Effective Speaking Center Consultations

Science.gov (United States)

Ward, Kiya; Schwartzman, Roy

2009-01-01

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

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

Science.gov (United States)

Mendoza, Danielle W.

1993-01-01

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

Ubiquitous consultation tool for decentral knowledge workers

OpenAIRE

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

2003-01-01

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

Interventions before consultations for helping patients address their information needs.

Science.gov (United States)

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

2007-07-18

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

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.

A preliminary parametric performance assessment for the disposal of alpha-contaminated mixed low-level waste stored at the Idaho National Engineering Laboratory

International Nuclear Information System (INIS)

Smith, T.H.; Anderson, G.L.; Myers, J.

1995-01-01

A preliminary parametric performance assessment (PA) has been performed of potential waste disposal systems for alpha-contaminated mixed low-level waste (ALLW) currently stored at the Idaho National Engineering Laboratory. The radionuclide-confinement performance of treated ALLW in various final waste forms, in various disposal locations, and under various assumptions was evaluated. Compliance with performance objectives was assessed for the undisturbed waste scenario and for intrusion scenarios. Some combinations of final waste form, disposal site, and environmental transport assumptions lead to calculated does that comply with the performance objectives, while others do not. The results will help determine the optimum degree of ALLW immobilization to satisfy the performance objectives while minimizing cost

User Consultation Behaviour in Internet Dictionaries

DEFF Research Database (Denmark)

Simonsen, Henrik Køhler

2011-01-01

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

Stirling engine design manual

Science.gov (United States)

Martini, W. R.

1978-01-01

This manual is intended to serve both as an introduction to Stirling engine analysis methods and as a key to the open literature on Stirling engines. Over 800 references are listed and these are cross referenced by date of publication, author and subject. Engine analysis is treated starting from elementary principles and working through cycles analysis. Analysis methodologies are classified as first, second or third order depending upon degree of complexity and probable application; first order for preliminary engine studies, second order for performance prediction and engine optimization, and third order for detailed hardware evaluation and engine research. A few comparisons between theory and experiment are made. A second order design procedure is documented step by step with calculation sheets and a worked out example to follow. Current high power engines are briefly described and a directory of companies and individuals who are active in Stirling engine development is included. Much remains to be done. Some of the more complicated and potentially very useful design procedures are now only referred to. Future support will enable a more thorough job of comparing all available design procedures against experimental data which should soon be available.

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

Science.gov (United States)

Martín-Fernández, Jesús; Rodríguez-Martínez, Gemma; Ariza-Cardiel, Gloria; Vergel Gutierrez, M Ángeles; Hidalgo Escudero, Ana Victoria; Conde-López, Juan Francisco

2013-01-01

Different conditions in health services utilization may create situations of inequity. The objective was analyze the differences of nurse consultation utilization in primary care. Cross-sectional study, in 23 health centres in Madrid. Environmental variables, consultation characteristics, socio-demographic and health need characteristics were collected. The quality of life and satisfaction were also studied. The variables were classified according to the "behavioral model" in predisposing, enabling or need variables. Explanatory multivariate models were constructed (Generalized-Estimating-Equations). The higher income areas and aging, predisposing factors, were associated with increases of 17% (95% CI: 0.4 to 36.9%) and 11.0% per decade (95% CI: 6.2 - 16.2) in nursing consultations per year. Among enabling factors, each additional minute of consultation length was associated with an increase of 2.0% (95% CI :1.2-2, 9%) in number of nurse consultations, each new medical consultation was associated with a increase of 2.7% (95% CI: 2.1-3.2%) and the delay in getting appointment over a day, represented a decrease of 32.8% (95% CI: 19.3 to 44.1%) in the total nursing consultations. Each chronic condition, which expresses the need health, was associated with an increase in the number of visits of 4.8% (95% CI: 1.7 to 8.0%). The improved perception of quality of life was associated with a reduction of 5.4% (95% CI 1.0 to 8.7%) of the consultations. The difference of the use of primary care nurse consultations is based on health need criteria, but is also influenced by accessibility conditions.

42 CFR 493.1457 - Standard; Clinical consultant responsibilities.

Science.gov (United States)

2010-10-01

... HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Personnel for Nonwaived Testing Laboratories Performing High Complexity Testing § 493.1457 Standard; Clinical consultant... 42 Public Health 5 2010-10-01 2010-10-01 false Standard; Clinical consultant responsibilities. 493...

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)

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

OpenAIRE

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

2015-01-01

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

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

Science.gov (United States)

Choi, Kevin J; Kahmke, Russel R; Crowson, Matthew G; Puscas, Liana; Scher, Richard L; Cohen, Seth M

2017-05-01

The consultation patterns of an otolaryngology-head and neck surgery service have not previously been reported. The time, resources, and attention required to operate such a consultation service are unknown. To assess trends in otolaryngology-head and neck surgery consultations conducted in emergency departments (EDs) and inpatient services. A retrospective analysis was conducted of the medical records of patients at a quaternary care center receiving inpatient otolaryngology consultations from January 1 to December 31, 2014. Clinical evaluation and bedside and operative procedures performed by the otolaryngology-head and neck surgery service. Demographics, reason for consultation, diagnosis, bedside procedures, operative interventions, and admission variables. A total of 1491 consultations were completed for adult (1091 [73.2%]; 854 men and 637 women; mean [SD] age 50.3 [19.3] years) and pediatric (400 [26.8%]; 232 boys and 168 girls; mean [SD] age, 4.0 [5.2] years) patients. Of the 1491 consultations, 766 (51.4%) originated from inpatient teams vs 725 (48.6%) from the ED. A total of 995 of all consultations (66.7%) resulted in a bedside procedure, and 243 (16.3%) required operative intervention. Consultations regarding airway evaluation (362 [47.3%] vs 143 [19.7%]), management of epistaxis (78 [10.2%] vs 33 [4.6%]), and rhinologic evaluation (79 [10.3%] vs 18 [2.5%]) were more frequent from inpatient teams than from the ED. Consultations regarding management of head and neck infections (162 [22.3%] vs 32 [4.2%]), facial trauma (235 [32.4%] vs 16 [2.1%]), and postoperative complications (73 [10.1%] vs 2 [0.3%]) were more frequent in the ED. Of the 725 consultations performed in the ED, 212 patients (29.2%) required hospitalization. The consultation volume of an otolaryngology-head and neck surgery service requires significant time and resources. Consultations are most often for rhinologic or laryngologic issues and are reflective of the clinical setting in which

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.

The preoperative cardiology consultation: Indications and risk modification

NARCIS (Netherlands)

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

2017-01-01

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

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

Science.gov (United States)

Hayes, Marie; Stringer, Phil

2016-01-01

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

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

OpenAIRE

Chia Nan Wang; Tran Thanh Tuyen; Nguyen Nhu Ty

2014-01-01

The topic of job satisfaction has been investigated over the years. However, the environmental impact of the work of job consulting centre’s employee satisfaction is beginning to attract the attention of the researcher. Job consulting centre has become an integral part of most organizations today, play an important role in supplying-jobs services. This study aims to examine the key factors that are closely associated with job satisfaction of employees working at job consulting centre as well ...

Preliminary Results from Simulations of Temperature Oscillations in Stirling Engine Regenerator Matrices

DEFF Research Database (Denmark)

Andersen, Stig Kildegård; Carlsen, Henrik; Thomsen, Per Grove

2006-01-01

The objective of this study has been to create a Stirling engine model for studying the effects of regenerator matrix temperature oscillations on Stirling engine performance. A one-dimensional model with axial discretisation of engine components has been formulated using the control volume method...

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.

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

Science.gov (United States)

Davis, Frank M; Park, Yeo June; Grey, Scott F; Boniakowski, Anna E; Mansour, M Ashraf; Jain, Krishna M; Nypaver, Timothy; Grossman, Michael; Gurm, Hitinder; Henke, Peter K

2018-01-01

To understand statewide variation in preoperative cardiology consultation prior to major vascular surgery and to determine whether consultation was associated with differences in perioperative myocardial infarction (poMI). Medical consultation prior to major vascular surgery is obtained to reduce perioperative risk. Despite perceived benefit of preoperative consultation, evidence is lacking specifically for major vascular surgery on the effect of preoperative cardiac consultation. Patient and clinical data were obtained from a statewide vascular surgery registry between January 2012 and December 2014. Patients were risk stratified by revised cardiac risk index category and compared poMI between patients who did or did not receive a preoperative cardiology consultation. We then used logistic regression analysis to compare the rate of poMI across hospitals grouped into quartiles by rate of preoperative cardiology consultation. Our study population comprised 5191 patients undergoing open peripheral arterial bypass (n = 3037), open abdominal aortic aneurysm repair (n = 332), or endovascular aneurysm repair (n = 1822) at 29 hospitals. At the patient level, after risk-stratification by revised cardiac risk index category, there was no association between cardiac consultation and poMI. At the hospital level, preoperative cardiac consultation varied substantially between hospitals (6.9%-87.5%, P 66%) had a reduction in poMI (OR, 0.52; confidence interval: 0.28-0.98; P cardiology consultation for vascular surgery varies greatly between institutions, and does not appear to impact poMI at the patient level. However, reduction of poMI was noted at the hospitals with the highest rate of preoperative cardiology consultation as well as a variety of medical services, suggesting that other hospital culture effects play a role.

Addressing Cultural Responsiveness in Consultation: An Empirical Demonstration

Science.gov (United States)

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

2017-01-01

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

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

OpenAIRE

RUBLE, LISA; BIRDWHISTELL, JESSIE; TOLAND, MICHAEL D.; MCGREW, JOHN H.

2011-01-01

The significant increase in the numbers of students with autism combined with the need for better trained teachers (National Research Council, 2001) call for research on the effectiveness of alternative methods, such as consultation, that have the potential to improve service delivery. Data from 2 randomized controlled single-blind trials indicate that an autism-specific consultation planning framework known as the collaborative model for promoting competence and success (COMPASS) is effectiv...

Participation in Written Government Consultations in Denmark and the UK

DEFF Research Database (Denmark)

Rasmussen, Anne

2015-01-01

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

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

Science.gov (United States)

Walsh, Cian; Ryan, Patrick; Flynn, Daniel

2018-01-01

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

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

Science.gov (United States)

Schein, Edgar H.

1978-01-01

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

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

Science.gov (United States)

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

2010-03-01

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

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.

42 CFR 431.105 - Consultation to medical facilities.

Science.gov (United States)

2010-10-01

... State agencies furnish consultative services to hospitals, nursing homes, home health agencies, clinics... 42 Public Health 4 2010-10-01 2010-10-01 false Consultation to medical facilities. 431.105 Section 431.105 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...

Malpractice and the Communication Consultant: A Proactive Approach.

Science.gov (United States)

Montgomery, Daniel J.; And Others

1995-01-01

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

Murjottelu-Interdisciplinary Training Campaign for Industrial Design and Engineering Students

Science.gov (United States)

Itkonen, Maija; Ekman, Kalevi Edvard; Kojo, Inka

2009-01-01

Today's growing business competition demands that design and technology must be seamlessly integrated. Designers should be employed increasingly as in-house in the industry, in addition to entrepreneurship and consultancy employment. How to realise this aim? Industry training is a tradition in engineering studies, but that is rarely the case in…

An overview of the NASA rotary engine research program

Science.gov (United States)

Meng, P. R.; Hady, W. F.

1984-01-01

A brief overview and technical highlights of the research efforts and studies on rotary engines over the last several years at the NASA Lewis Research Center are presented. The test results obtained from turbocharged rotary engines and preliminary results from a high performance single rotor engine were discussed. Combustion modeling studies of the rotary engine and the use of a Laser Doppler Velocimeter to confirm the studies were examined. An in-house program in which a turbocharged rotary engine was installed in a Cessna Skymaster for ground test studies was reviewed. Details are presented on single rotor stratified charge rotary engine research efforts, both in-house and on contract.

High Pressure Reverse Flow APS Engine

Science.gov (United States)

Senneff, J. M.

1972-01-01

A design and test demonstration effort was undertaken to evaluate the concept of the reverse flow engine for the APS engine application. The 1500 lb (6672 N) thrust engine was designed to operate on gaseous hydrogen and gaseous oxygen propellants at a mixture ratio of 4 and to achieve the objective performance of 435 sec (4266 Nsec/kg) specific impulse. Superimposed durability requirements called for a million-cycle capability with 50 hours duration. The program was undertaken as a series of tasks including the initial preliminary design, design of critical test components and finally, the design and demonstration of an altitude engine which could be used interchangeably to examine operating parameters as well as to demonstrate the capability of the concept. The program results are reported with data to indicate that all of the program objectives were met or exceeded within the course of testing on the program. The analysis effort undertaken is also reported in detail and supplemented with test data in some cases where prior definitions could not be made. The results are contained of these analyses as well as the test results conducted throughout the course of the program. Finally, the test data and analytical results were combined to allow recommendations for a flight weight design. This preliminary design effort is also detailed.

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

Science.gov (United States)

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

2016-02-01

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

Offshore petroleum engineering task force report

International Nuclear Information System (INIS)

Ruelokke, M.

1999-05-01

The Offshore Petroleum Engineering Task Force was established in July 1998 in response to concerns about Newfoundland and Labrador's share of offshore petroleum engineering activity, with the aim of determining the current capability of the local sector, the demand for such companies and individuals until the year 2010, their capability to grow over that time-frame, and requirements in order to achieve that growth. The report summarizes the analysis undertaken by the Task Force as well as the conclusions it reached and associated recommendations. Section two provides an overview of the offshore engineering activity, including its origins, structure, and key success factors, and its also provides a profile of the industry, internationally, in Canada and in Newfoundland. Section three presents an analysis of the future demand for offshore engineering in Newfoundland until 2010, based on three development scenarios. Section four based on a Consulting Engineers of Newfoundland and Labrador (CENL) survey, establishes the present offshore engineering capacity and capabilities within the province. Section five examines current education and training programs and their ability to respond to future demands. Section six summarizes the conclusions of the analysis and presents recommendations designed to facilitate and promote the development of the local offshore engineering industry. 6 figs

Engineering in the energy sector. The single market and the engineering sector

International Nuclear Information System (INIS)

Garcia Rodrigues, A.

1993-01-01

Projects with large infrastructures, particularly those in the field of energy, provide a strong boost to certain industrial sectors in the country. In the case of Spain, the policy of direct management 'by components' of these projects - hydroelectric power plants, petrochemical plants, thermoelectric plants and nuclear power plants - adopted by the electric utility owners has furthered not only the local equipment manufacturing industry but also the engineering sector. At present, with full implementation of the Single Market in sight, it is particularly interesting for Spain to continue building up a powerful engineering sector, increasing its size and usefulness, and extending its traditional areas of action to other technologies, more on the lines of engineering and consulting firms in the USA than in the rest of Europe. The intention is to endow our equipment and construction companies with the skills necessary to enable them to compete with large European conglomerates in their respective sectors. The structure of these conglomerates usually contains engineering capabilities which are not habitual in our industry. Examples are given, showing how this model has been used to compete and win awards for important international projects. A specific analysis has been made of the position of Spanish engineering and industry in nuclear power generation projects in the former Soviet Union and East European countries, in which large investments are expected to be made. (author)

20 CFR 416.1016 - Medical or psychological consultants.

Science.gov (United States)

2010-04-01

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

RE-1000 free-piston Stirling engine update

Science.gov (United States)

Schreiber, J. G.

1985-01-01

A free piston Stirling engine was tested. The tests performed over the past several years on the single cylinder engine were designed to investigate the dynamics of a free piston Stirling engine. The data are intended to be used primarily for computer code validation. The tests designed to investigate the sensitivity of the engine performance to variations in working space pressure, heater and cooler temperatures, regenerator porosity, power piston mass and displacer dynamics were completed. In addition, some data were recorded with alternate working fluids. A novel resonant balance system for the engine was also tested. Some preliminary test results of the tests performed are presented along with an outline of future tests to be run with the engine coupled to a hydraulic output unit. A description of the hydraulic output unit is given.

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.

How lead consultants approach educational change in postgraduate medical education.

Science.gov (United States)

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

2012-04-01

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

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

Science.gov (United States)

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

2016-02-12

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

Development of a tissue-engineered human oral mucosa equivalent based on an acellular allogeneic dermal matrix: a preliminary report of clinical application to burn wounds.

Science.gov (United States)

Iida, Takuya; Takami, Yoshihiro; Yamaguchi, Ryo; Shimazaki, Shuji; Harii, Kiyonori

2005-01-01

Tissue-engineered skin equivalents composed of epidermal and dermal components have been widely investigated for coverage of full-thickness skin defects. We developed a tissue-engineered oral mucosa equivalent based on an acellular allogeneic dermal matrix and investigated its characteristics. We also tried and assessed its preliminary clinical application. Human oral mucosal keratinocytes were separated from a piece of oral mucosa and cultured in a chemically-defined medium. The keratinocytes were seeded on to the acellular allogeneic dermal matrix and cultured. Histologically, the mucosa equivalent had a well-stratified epithelial layer. Immunohistochemical study showed that it was similar to normal oral mucosa. We applied this equivalent in one case with an extensive burn wound. The equivalent was transplanted three weeks after the harvest of the patient's oral mucosa and about 30% of the graft finally survived. We conclude that this new oral mucosa equivalent could become a therapeutic option for the treatment of extensive burns.

Preliminary construction of a service provider--informed domestic violence research agenda.

Science.gov (United States)

Murray, Christine E; Welch, Metoka L

2010-12-01

This article presents the results of a statewide survey of domestic violence (DV) service providers that focused on the needs, background characteristics, and opinions of service providers related to research. The survey included an examination of service providers' motivation for working in the field, research background and training, and perceptions of research as well as the topics they believe are important for researchers to study, the resources they consult to learn about DV, and their suggestions to help researchers learn more about the nature of their work. The results are integrated into a preliminary agenda for future DV research that accounts for the needs and insight of service providers.

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

Science.gov (United States)

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

2014-03-06

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

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.

A systems engineering primer for every engineer and scientist

International Nuclear Information System (INIS)

Edwards, William R.

2001-01-01

The Systems Engineering (SE) staff at LBNL has generated the following artifacts to assist projects with implementing a systems approach: (1) The present document that focuses on the what, why, and when of SE. It also provides a simple case-study to illustrate several SE tasks. (2) A web site with primary emphasis on the project life-cycle and workflow, (http://www-eng.LBNL.gov/Systems/index.html). It includes: SE guidelines and principles; A list of in-house tools; Templates; Case studies with ''how to'' examples; and Links to useful SE material. These sources are living documents to be updated as necessary. The viewpoint adopted in this document is that what LBNL engineers and scientists need is a set of principles and guiding practices for developing R and D systems rather than a ''cookbook''. There are many excellent ''how to'' resources such as the ''INCOSE Systems Engineering Handbook'' to guide those in search of more details. The SE staff is another resource available to consult and support projects. This document specifies SE principles and activities that are applicable to all LBNL projects independent of their specific differences. Each project should tailor the SE implementation to meet its individual needs and culture including project-specific resources, procedures, products, and tools

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

NARCIS (Netherlands)

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

2009-01-01

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

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.

The pattern and impact of infectious diseases consultation on antimicrobial prescription

Directory of Open Access Journals (Sweden)

Jaffar A Al-Tawfiq

2013-01-01

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

Experience base for Radioactive Waste Thermal Processing Systems: A preliminary survey

International Nuclear Information System (INIS)

Mayberry, J.; Geimer, R.; Gillins, R.; Steverson, E.M.; Dalton, D.; Anderson, G.L.

1992-04-01

In the process of considering thermal technologies for potential treatment of the Idaho National Engineering Laboratory mixed transuranic contaminated wastes, a preliminary survey of the experience base available from Radioactive Waste Thermal Processing Systems is reported. A list of known commercial radioactive waste facilities in the United States and some international thermal treatment facilities are provided. Survey focus is upon the US Department of Energy thermal treatment facilities. A brief facility description and a preliminary summary of facility status, and problems experienced is provided for a selected subset of the DOE facilities

Engineering systems reliability, safety, and maintenance an integrated approach

CERN Document Server

Dhillon, B S

2017-01-01

Today, engineering systems are an important element of the world economy and each year billions of dollars are spent to develop, manufacture, operate, and maintain various types of engineering systems around the globe. Many of these systems are highly sophisticated and contain millions of parts. For example, a Boeing jumbo 747 is made up of approximately 4.5 million parts including fasteners. Needless to say, reliability, safety, and maintenance of systems such as this have become more important than ever before.　 Global competition and other factors are forcing manufacturers to produce highly reliable, safe, and maintainable engineering products. Therefore, there is a definite need for the reliability, safety, and maintenance professionals to work closely during design and other phases. Engineering Systems Reliability, Safety, and Maintenance: An Integrated Approach eliminates the need to consult many different and diverse sources in the hunt for the information required to design better engineering syste...

10 CFR 51.40 - Consultation with NRC staff.

Science.gov (United States)

2010-01-01

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

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

Science.gov (United States)

Jones, Mavis; Einsiedel, Edna

2011-09-01

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

A Home-Based Palliative Care Consult Service for Veterans.

Science.gov (United States)

Golden, Adam G; Antoni, Charles; Gammonley, Denise

2016-11-01

We describe the development and implementation of a home-based palliative care consult service for Veterans with advanced illness. A retrospective chart review was performed on 73 Veterans who received a home-based palliative care consult. Nearly one-third were 80 years of age or older, and nearly one-third had a palliative diagnosis of cancer. The most common interventions of the consult team included discussion of advance directives, completion of a "do not resuscitate" form, reduction/stoppage of at least 1 medication, explanation of diagnosis, referral to home-based primary care program, referral to hospice, and assessment/support for caregiver stress. The home-based consult service was therefore able to address clinical and psychosocial issues that can demonstrate a direct benefit to Veterans, families, and referring clinicians. © The Author(s) 2015.

A Qualitative Study of Televideo Consultations for COPD Patients

DEFF Research Database (Denmark)

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

2015-01-01

. The patients’ assessments of the service must be understood in relation to the routines and strategies developed to handle the array of problems related to a life affected by chronic illness. Keywords: COPD patients, televideo consultations, telemedicine, coping strategies, security, control.......This article presents results from a small qualitative study investigating COPD patients' experiences with televideo consultations at home as a supplement to conventional control and treatment. The research question is: what are the experiences and preferences of COPD patients related to discharge...... from hospital with televideo consultations? The study shows that the patients' assessments of the effectiveness and value of the televideo consultations in their everyday lives are based on tough cost-benefit calculation of the extent to which the intervention makes their lives easier or more difficult...

The role of a consultant breast radiographer: A description and a reflection

International Nuclear Information System (INIS)

Kelly, Judith; Hogg, Peter; Henwood, Suzanne

2008-01-01

Consultant radiographers are a relatively new concept within the British healthcare system, with them being first established in 2003. Consultant radiographer job roles are broad and include advanced clinical activities (often being similar in nature to those delivered by medical practitioners, e.g. radiologists), professional leadership, teaching and education and service improvement. Given their relative novelty almost no literature exists to describe in detail specific roles of consultant breast radiographers. Consequently, in this article we use a case study approach to describe and reflect critically upon the role of one consultant breast radiographer. The article commences with a general introduction about consultant radiographers; it then progresses to outline the context in which the case study of the breast consultant radiographer sits. Through description and reflective commentary we take the reader through the role of the consultant breast radiographer to highlight where the role has had perceived value and also to highlight where the role has been particularly challenging for the post holder. As a consequence of the case study approach taken, the article is written partly in the first person (taken from interview comments made by the consultant breast radiographer) and partly in the third person. The final element of the article is a reflective commentary given by the consultant radiographer regarding her feelings about her first few years as a consultant breast radiographer

Rotating Liner Engine: Improving Efficiency of Heavy Duty Diesels by Significant Friction Reduction, and Extending the Life of Heavy Duty Engines.

Energy Technology Data Exchange (ETDEWEB)

Dardalis, Dimitrios

2013-12-31

This report describes the work on converting a 4 cylinder Cummins ISB engine into a single cylinder Rotating Liner Engine functioning prototype that can be used to measure the friction benefits of rotating the cylinder liner in a high pressure compression ignition engine. A similar baseline engine was also prepared, and preliminary testing was done. Even though the fabrication of the single cylinder prototype was behind schedule due to machine shop delays, the fundamental soundness of the design elements are proven, and the engine has successfully functioned. However, the testing approach of the two engines, as envisioned by the original proposal, proved impossible due to torsional vibration resonance caused by the single active piston. A new approach for proper testing has been proposed,

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

International Nuclear Information System (INIS)

2010-09-01

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

Consultation and IBA negotiations in wind projects

Energy Technology Data Exchange (ETDEWEB)

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

2011-07-01

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

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

OpenAIRE

2012-01-01

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

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

Science.gov (United States)

Johnston, Donna L; Murto, Kimmo; Kurzawa, Julia; Liddy, Clare; Keely, Erin; Lai, Lillian

2017-10-01

Electronic consultations (eConsult) allow for communication between primary care providers and specialists in an asynchronous manner. This study examined provider satisfaction, topics of interest, and efficiency of eConsult in pediatric hematology/oncology in Ottawa, Canada. We conducted a cross-sectional assessment of all eConsult cases directed to pediatric hematology/oncology specialists using the Champlain BASE (Building Access to Specialists through eConsultation) eConsult service from June 1, 2014 to May 31, 2016. There were 1064 eConsults to pediatrics during the study timeperiod and pediatric hematology/oncology consults accounted for 8% (85). During the same study timeperiod, 524 consults were seen in the pediatric hematology/oncology clinic. The majority of the eConsults were for hematology (90.5%) in contrast to oncology topics (9.5%). The most common topics were anemia, hemoglobinopathy, bleeding disorder, and thrombotic state. Primary care providers rated the eConsult service very highly, and their comments were very positive. The eConsult service resulted in deferral of 40% of consults originally contemplated to require a face-to-face specialist visit. This study showed successful implementation and use of the eConsult service for pediatric hematology/oncology and resulted in avoidance of a large number of face-to-face consultation. The common topics identified areas for continuing medical education.

Optimal Pricing Strategy in Marketing Research Consulting.

OpenAIRE

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

1994-01-01

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

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...

Industrial Buying Behavior Related to Human Resource Consulting Services

DEFF Research Database (Denmark)

Grünbaum, Niels Nolsøe; Hollensen, Svend; Kahle, Lynn

2013-01-01

The purpose of this article is to extend the understanding of the industrial buying process in connection with purchasing professional business (B2B) services, specifically human resource (HR) consulting services. Early B2B buying-behavior literature strongly emphasizes the rational aspects...... of buying behavior in B2B services. Based on a comprehensive exploratory study of Danish companies’ purchases of HR consulting services, the authors provide insights into the factors that determine how Danish companies choose a consulting services supplier. Five hypotheses are developed based...

Can audio recording of outpatient consultations improve patient outcome?

DEFF Research Database (Denmark)

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

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

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

Consulting communities: a renewable energy toolkit

Energy Technology Data Exchange (ETDEWEB)

Hinshelwood, E.; McCallum, D.

2001-07-01

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

Cost and consultation patterns of abdominal pain in Uruguayan children.

Science.gov (United States)

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

2008-02-01

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

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

DEFF Research Database (Denmark)

Sørensen, Lene Bjerg; Broberg, Ole

2012-01-01

ergonomics into engineering design processes and how different factors either promote or limit the integration. Based on a grounded theory approach a model illustrating these factors is developed and different hypotheses about how these factors either promote and/or limit the integration of ergonomics...

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

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

Science.gov (United States)

Parker, J Clint

2018-06-01

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

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

OpenAIRE

Greenhill, Nicola H.

2010-01-01

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

Ship Design and Construction. An Integrated University Course

DEFF Research Database (Denmark)

Andersen, Poul; Jensen, Jørgen Juncher

1996-01-01

This paper describes an integrated course in design and construction of merchant ships taught at the Department of Naval Architecture andOffshore Engineering, the Technical University of Denmark. During the course, the students make a preliminary design of a ship of selected type and also design...... its engine room. The teaching combines lectures with laboratory work at the drawing tables and computer terminals. During the summer holiday, sea time on board ships of the relevant types are offered. Experienced naval architects from shipyards and ship consultancies give lectures and instructions...

Human-factors engineering-control-room design review: Shoreham Nuclear Power Station. Draft audit report

International Nuclear Information System (INIS)

Peterson, L.R.; Preston-Smith, J.; Savage, J.W.; Rousseau, W.F.

1981-01-01

A human factors engineering preliminary design review of the Shoreham control room was performed at the site on March 30 through April 3, 1981. This design review was carried out by a team from the Human Factors Engineering Branch, Division of Human Factors Safety. This report was prepared on the basis of the HFEB's review of the applicant's Preliminary Design Assessment and the human factors engineering design review/audit performed at the site. The presented sections are numbered to conform to the guidelines of the draft version of NUREG-0700. They summarize the teams's observations of the control room design and layout, and of the control room operators' interface with the control room environment

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

Science.gov (United States)

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

2011-01-01

The significant increase in the numbers of students with autism combined with the need for better trained teachers (National Research Council, 2001) call for research on the effectiveness of alternative methods, such as consultation, that have the potential to improve service delivery. Data from 2 randomized controlled single-blind trials indicate that an autism-specific consultation planning framework known as the collaborative model for promoting competence and success (COMPASS) is effective in increasing child Individual Education Programs (IEP) outcomes (Ruble, Dal-rymple, & McGrew, 2010; Ruble, McGrew, & Toland, 2011). In this study, we describe the verbal interactions, defined as speech acts and speech act exchanges that take place during COMPASS consultation, and examine the associations between speech exchanges and child outcomes. We applied the Psychosocial Processes Coding Scheme (Leaper, 1991) to code speech acts. Speech act exchanges were overwhelmingly affiliative, failed to show statistically significant relationships with child IEP outcomes and teacher adherence, but did correlate positively with IEP quality.

Inside the fitness for work consultation: a qualitative study.

Science.gov (United States)

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

2009-08-01

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

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

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

Preliminary radiological assessments of low-level waste repositories

International Nuclear Information System (INIS)

Nancarrow, D.J.; Sumerling, T.J.; Ashton, J.

1988-06-01

Preliminary assessments of the post-closure radiological impact from the disposal of low-level radioactive wastes in shallow engineered facilities at four sites are presented. This provides a framework to practice and refine a methodology that could be used, on behalf of the Department, for independent assessment of any similar proposal from Nirex. Information and methodological improvements that would be required are identified. (author)

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

Science.gov (United States)

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

2014-01-01

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

The role of assessment packages for diagnostic consultations

DEFF Research Database (Denmark)

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

2015-01-01

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

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

Science.gov (United States)

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

1980-12-01

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

CIVIL ENGINEERING TECHNOLOGY CONSULTANTS' WORKSHOP, REPORT OF PROCEEDINGS (ATLANTA, MAY 17-20, 1967).

Science.gov (United States)

DOBROVOLNY, JERRY S.

THIS REPORT ATTEMPTS TO SHOW ADMINISTRATORS OF JUNIOR COLLEGES, TECHNICAL INSTITUTES, AND GOVERNMENT OR INDUSTRIAL TRAINING PROGRAMS CERTAIN CRITICAL PROBLEMS IN THE TRAINING OF CIVIL ENGINEERING TECHNICIANS. THE PHILOSOPHY OF TECHNICAL EDUCATION REQUIRES ATTENTION AS DOES THE IDENTIFICATION OF STUDENTS WHO CAN BENEFIT FROM AND SUCCESSFULLY…

Liquid xenon detector engineering

International Nuclear Information System (INIS)

Chen, E.; Chen, M.; Gaudreau, M.P.J.; Montgomery, D.B.; Pelly, J.D.; Shotkin, S.; Sullivan, J.D.; Sumorok, K.; Yan, X.; Zhang, X.; Lebedenko, V.

1991-01-01

The design, engineering constraints and R and D status of a 15 m 3 precision liquid xenon, electromagnetic calorimeter for the Superconducting Super Collider are discussed in this paper. Several prototype liquid xenon detectors have been built, and preliminary results are described. The design of a conical 7 cell by 7 cell detector capable of measuring fully contained high energy electron showers is described in detail

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

Directory of Open Access Journals (Sweden)

Lester Barry M

2008-02-01

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

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

Science.gov (United States)

Wang, George Sam; Monte, Andrew; Hatten, Benjamin; Brent, Jeffrey; Buchanan, Jennie; Heard, Kennon J

2015-05-01

Currently, only 10% of board-certified medical toxicologists are pediatricians. Yet over half of poison center calls involve children toxicology consultation is not common at children's hospitals. In collaboration with executive staff from Department of Pediatrics and Emergency Medicine, regional poison center, and our toxicology fellowship, we established a toxicology consulting service at our tertiary-care children's hospital. There were 139 consultations, and the service generated 13 consultations in the first month; median of 11 consultations per month thereafter (range 8-16). The service increased pediatric cases seen by the fellowship program from 30 to 94. The transition to a consult service required a culture change. Historically, call center advice was the mainstay of consulting practice and the medical staff was not accustomed to the availability of bedside medical toxicology consultations. However, after promotion of the service and full attending and fellowship coverage, consultations increased. In collaboration with toxicologists from different departments, a consultation service can be rapidly established. The service filled a clinical need that was disproportionately utilized for high acuity patients, immediately utilized by the medical staff and provided a robust pediatric population for the toxicology fellowship.

An open-source, mobile-friendly search engine for public medical knowledge.

Science.gov (United States)

Samwald, Matthias; Hanbury, Allan

2014-01-01

The World Wide Web has become an important source of information for medical practitioners. To complement the capabilities of currently available web search engines we developed FindMeEvidence, an open-source, mobile-friendly medical search engine. In a preliminary evaluation, the quality of results from FindMeEvidence proved to be competitive with those from TRIP Database, an established, closed-source search engine for evidence-based medicine.

[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.

Determinants of Management Innovation in the Ghanaian Construction Consulting Sector

Directory of Open Access Journals (Sweden)

De-Graft Owusu-Manu

2015-03-01

Full Text Available Determinants of management innovation (MI within the Ghanaian construction consulting sector are examined. A sample of 70 consulting firms is surveyed using self-administered questionnaires. Data are analysed using descriptive statistics and factor analysis. Findings indicate that determinants of MI were interwoven among seven principal factors viz: community and market demands; financial and business management practices; human resource policies; creativity and organizational strategies; corporate social responsibility; prevailing conditions; and competitive leverage. The study adds to the discourse on evolution of innovation within the global consulting sector generally, while providing reference for practitioners and academics in the field with respect to MI determinants more specifically. It is envisaged that practitioners who adopt these findings in the construction consultancy sector would enhance their ability to provide innovative services to clients. Study recommendations include that future research should explore how innovation is diffused within consulting enterprises’ value chains. Paper Type: Research article

Telemedicine Consultations in Oral and Maxillofacial Surgery: A Follow-Up Study.

Science.gov (United States)

Wood, Eric W; Strauss, Robert A; Janus, Charles; Carrico, Caroline K

2016-02-01

The purpose of this study was to follow up on the previous study in evaluating the efficiency and reliability of telemedicine consultations for preoperative assessment of patients. A retrospective study of 335 patients over a 6-year period was performed to evaluate success rates of telemedicine consultations in adequately assessing patients for surgical treatment under anesthesia. Success or failure of the telemedicine consultation was measured by the ability to triage patients appropriately for the hospital operating room versus the clinic, to provide an accurate diagnosis and treatment plan, and to provide a sufficient medical and physical assessment for planned anesthesia. Data gathered from the average distance traveled and data from a previous telemedicine study performed by the National Institute of Justice were used to estimate the cost savings of using telemedicine consultations over the 6-year period. Practitioners performing the consultation were successful 92.2% of the time in using the data collected to make a diagnosis and treatment plan. Patients were triaged correctly 99.6% of the time for the clinic or hospital operating room. Most patients (98.0%) were given sufficient medical and physical assessment and were able to undergo surgery with anesthesia as planned at the clinic appointment immediately after telemedicine consultation. Most patients (95.9%) were given an accurate diagnosis and treatment plan. The estimated amount saved by providing consultation by telemedicine and eliminating in-office consultation was substantial at $134,640. This study confirms the findings from previous studies that telemedicine consultations are as reliable as those performed by traditional methods. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Preliminary results on performance testing of a turbocharged rotary combustion engine

Science.gov (United States)

Meng, P. R.; Rice, W. J.; Schock, H. J.; Pringle, D. P.

1982-01-01

The performance of a turbocharged rotary engine at power levels above 75 kW (100 hp) was studied. A twin rotor turbocharged Mazda engine was tested at speeds of 3000 to 6000 rpm and boost pressures to 7 psi. The NASA developed combustion diagnostic instrumentation was used to quantify indicated and pumping mean effect pressures, peak pressure, and face to face variability on a cycle by cycle basis. Results of this testing showed that a 5900 rpm a 36 percent increase in power was obtained by operating the engine in the turbocharged configuration. When operating with lean carburetor jets at 105 hp (78.3 kW) and 4000 rpm, a brake specific fuel consumption of 0.45 lbm/lb-hr was measured.

Evaluation of the Effect of Consultant Characteristics on Telemedicine Diagnosis and Treatment

Directory of Open Access Journals (Sweden)

Ann B. Bynum

2011-01-01

Full Text Available This study examined teleconsultants' specialty, practice setting, type of employment, years and training in telemedicine to evaluate the effect of these characteristics on diagnoses and treatment. A postuse survey was conducted during 1998–2003 (n=454 consultations in the University of Arkansas for Medical Sciences' Rural Hospital, Telehealth Project. There were 61 consultants who conducted the teleconsultations. The teleconsultants established a diagnosis in 121 consultations and reported a change in diagnoses in 29 consultations. The consultants established a treatment plan in 219 consultations and reported a change in the treatment plan in 100 consultations. Dermatologists were significantly more likely to establish (P<.01 and change (P=.005 the diagnosis and to establish a treatment plan (P=.03, when compared to all other specialties. Teleconsultants who were self-employed were significantly more likely to change the treatment plan (P=.012. The findings suggest that teleconsultants' characteristics can affect diagnoses and treatment in telemedicine.

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.

76 FR 28446 - Policy on Consultation With Indian Tribes

Science.gov (United States)

2011-05-17

.... Consultation promotes an enhanced form of communication that emphasizes trust, respect, and shared... consultation process, ensure continuity, and demonstrate commitment to the process. Communication will be open... access to traditional areas of cultural or religious importance on Federally managed lands; 2. The...

Examining engineering costs for development of highway projects.

Science.gov (United States)

2012-12-01

The Texas Department of Transportation (TxDOT) commissioned a research team at Texas State University-San Marcos Department of Accounting to analyze the cost of projects by determining the cost of a preliminary engineering hour necessary to develop h...

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.

Implementing national nuclear safety plan at the preliminary stage of nuclear power project development

International Nuclear Information System (INIS)

Xue Yabin; Cui Shaozhang; Pan Fengguo; Zhang Lizhen; Shi Yonggang

2014-01-01

This study discusses the importance of nuclear power project design and engineering methods at the preliminary stage of its development on nuclear power plant's operational safety from the professional view. Specifically, we share our understanding of national nuclear safety plan's requirement on new reactor accident probability, technology, site selection, as well as building and improving nuclear safety culture and strengthening public participation, with a focus on plan's implications on preliminary stage of nuclear power project development. Last, we introduce China Huaneng Group's work on nuclear power project preliminary development and the experience accumulated during the process. By analyzing the siting philosophy of nuclear power plant and the necessity of building nuclear safety culture at the preliminary stage of nuclear power project development, this study explicates how to fully implement the nuclear safety plan's requirements at the preliminary stage of nuclear power project development. (authors)

Patients' reflections on communication in the second-opinion hematology-oncology consultation.

Science.gov (United States)

Goldman, Roberta E; Sullivan, Amy; Back, Anthony L; Alexander, Stewart C; Matsuyama, Robin K; Lee, Stephanie J

2009-07-01

The nature of communication between patients and their second-opinion hematology consultants may be very different in these one-time consultations than for those that are within long-term relationships. This study explored patients' perceptions of their second-opinion hematology-oncology consultation to investigate physician-patient communication in malignant disease at a critical juncture in cancer patients' care and decision-making. In-depth telephone interviews with a subset of 20 patients from a larger study, following their subspecialty hematology consultations. Most patients wanted to contribute to the consultation agenda, but were unable to do so. Patients sought expert and honest advice delivered with empathy, though most did not expect the consultant to directly address their emotions. They wanted the physician to apply his/her knowledge to the specifics of their individual cases, and were disappointed and distrustful when physicians cited only general prognostic statistics. In contrast, physicians' consideration of the unique elements of patients' cases, and demonstrations of empathy and respect made patients' feel positively about the encounter, regardless of the prognosis. Patients provided concrete recommendations for physician and patient behaviors to enhance the consultation. Consideration of these recommendations may result in more effective communication and increased patient satisfaction with medical visits.

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

Science.gov (United States)

Nagamatsu, Yasuko

2011-09-01

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

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.

Preliminary Results on the Influence of Engineered Artificial Mucus Layer on Phonation

Science.gov (United States)

Döllinger, Michael; Gröhn, Franziska; Berry, David A.; Eysholdt, Ulrich; Luegmair, Georg

2014-01-01

Purpose: Previous studies have confirmed the influence of dehydration and an altered mucus (e.g., due to pathologies) on phonation. However, the underlying reasons for these influences are not fully understood. This study was a preliminary inquiry into the influences of mucus architecture and concentration on vocal fold oscillation. Method: Two…

Improving teaching on the basis of student evaluation: integrative teaching consultation.

Science.gov (United States)

Wibbecke, Gerald; Kahmann, Janine; Pignotti, Tanja; Altenberger, Leander; Kadmon, Martina

2015-01-01

Due to the development of medical education in the past decade the role of teachers has changed and requires higher didactic competence. Student evaluation of teaching alone does not lead to considerable improvement of teaching quality. We present the concept of "Integrative Teaching Consultation", which comprises both the teacher's reflection and own objectives to improve their teaching as well as data from students ratings. Teachers in collaboration with a teaching consultant reflect on their teaching ability and set themselves improvement goals. Then the consultant himself observes a teaching session and subsequently analyses the respective student evaluation in order to give meaningful feedback to the teacher. The combination of student feedback with professional consultation elements can initiate and maintain improvements in teaching. Teaching consultation complements existing faculty development programs and increases the benefit of student evaluations.

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.

[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.

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.

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

Science.gov (United States)

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

2012-01-01

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

Computer Supported Argument Visualisation: Modelling in Consultative Democracy Around Wicked Problems

Science.gov (United States)

Ohl, Ricky

In this case study, computer supported argument visualisation has been applied to the analysis and representation of the draft South East Queensland Regional Plan Consultation discourse, demonstrating how argument mapping can help deliver the transparency and accountability required in participatory democracy. Consultative democracy for regional planning falls into a category of problems known as “wicked problems”. Inherent in this environment is heterogeneous viewpoints, agendas and voices, built on disparate and often contradictory logic. An argument ontology and notation that was designed specifically to deal with consultative urban planning around wicked problems is the Issue Based Information System (IBIS) and IBIS notation (Rittel & Webber, 1984). The software used for argument visualisation in this case was Compendium, a derivative of IBIS. The high volume of stakeholders and discourse heterogeneity in this environment calls for a unique approach to argument mapping. The map design model developed from this research has been titled a “Consultation Map”. The design incorporates the IBIS ontology within a hybrid of mapping approaches, amalgamating elements from concept, dialogue, argument, debate, thematic and tree-mapping. The consultation maps developed from the draft South East Queensland Regional Plan Consultation provide a transparent visual record to give evidence of the themes of citizen issues within the consultation discourse. The consultation maps also link the elicited discourse themes to related policies from the SEQ Regional Plan providing explicit evidence of SEQ Regional Plan policy-decisions matching citizen concerns. The final consultation map in the series provides explicit links between SEQ Regional Plan policy items and monitoring activities reporting on the ongoing implementation of the SEQ Regional Plan. This map provides updatable evidence of and accountability for SEQ Regional Plan policy implementation and developments.

High-Value Consults: A Curriculum to Promote Point-of-Care, Evidence-Based Recommendations.

Science.gov (United States)

Nandiwada, Deepa Rani; Kohli, Amar; McNamara, Megan; Smith, Kenneth J; Zimmer, Shanta; McNeil, Melissa; Spagnoletti, Carla; Rubio, Doris; Berlacher, Kathryn

2017-10-01

In an era when value-based care is paramount, teaching trainees to explicitly communicate the evidence behind recommendations fosters high-value care (HVC) in the consultation process. To implement an HVC consult curriculum highlighting the need for clear consult questions, evidence-based recommendations to improve consult teaching, clinical decision-making, and the educational value of consults. A pilot curriculum was implemented for residents on cardiology consult electives utilizing faculty and fellows as evidence-based medicine (EBM) coaches. The curriculum included an online module, an EBM teaching point template, EBM presentations on rounds, and "coach" feedback on notes. A total of 15 residents and 4 fellows on cardiology consults participated, and 87% (13 of 15) of residents on consults felt the curriculum was educationally valuable. A total of 80% (72 of 90) of residents on general medicine rotations responded to the survey, and 25 of 72 residents (35%) had a consult with the EBM template. General medicine teams felt the EBM teaching points affected clinical decision-making (48%, 12 of 25) and favored dissemination of the curriculum (90%, 72 of 80). Checklist-guided chart review showed a 22% improvement in evidence-based summaries behind recommendations (7 of 36 precurriculum to 70 of 146 charts postcurriculum, P  = .015). The HVC consult curriculum during a cardiology elective was perceived by residents to influence clinical decision-making and evidence-based recommendations, and was found to be educationally valuable on both parties in the consult process.

Measuring the barriers against seeking consultation for urinary incontinence among Middle Eastern women.

Science.gov (United States)

El-Azab, Ahmed S; Shaaban, Omar M

2010-01-27

Existing questionnaires to assess barriers against consultation for urinary incontinence (UI) are not appropriate for use in the Middle East culture. The aim of this study was to explore barriers against seeking help for UI and introducing a questionnaire that assess these barriers among those women. This is important before proceeding to any educational programs or having interval clinical audits to help incontinent women. 1- Screening for UI. Women - aged 20 years and older, attending the outpatient Urology and Gynaecology clinics were invited to participate and interviewed by a research nurse. The UDI-6 was administered to assess the presence and type of UI. Women with UI as their chief complaint were excluded. 2- Interviewing study subjects for possible barriers. Subjects who had UI - as determined by the UDI-6-were first asked an open question "what prevented you from seeking medical consultation for urine leakage?"." They were then asked the proposed questions to assess possible barriers. We developed a preliminary questionnaire based on a review of reasons for not seeking incontinence care from the literature and the response of UI sufferers to the open question in this study. The questionnaire was modified many times to reach this final form. 3- Pilot Study to assess characteristics of the questionnaire. Validity and reliability of the final version of the questionnaire were assessed in a small pilot study including 36 women who completed questionnaire at initial visit and again after 2 weeks. Of the 1231 subjects who agreed to participate in the study, 348 reported having UI. About 80% of incontinent women have never sought medical advice. Factors significantly associated with seeking help were husband encouragement, prayer affection and having severe UI. Common barriers were embarrassment and assuming UI as a normal part of aging. A pilot study included 36 women to assess the psychometric properties of the questionnaire after modifying it. The number of

Preliminary design package for solar hot water system

Energy Technology Data Exchange (ETDEWEB)

Fogle, Val; Aspinwall, David B.

1977-12-01

The information necessary to evaluate the preliminary design of the Solar Engineering and Manufacturing Company's (SEMCO) solar hot water system is presented. This package includes technical information, schematics, drawings and brochures. This system, being developed by SEMCO, consists of the following subsystems: collector, storage, transport, control, auxiliary energy, and Government-furnished site data acquisition. The two units being manufactured will be installed at Loxahatchee, Florida, and Macon, Georgia.

Preliminary study of optimum ductburning turbofan engine cycle design parameters for supersonic cruising

Science.gov (United States)

Fishbach, L. H.

1978-01-01

The effect of turbofan engine overall pressure ratio, fan pressure ratio, and ductburner temperature rise on the engine weight and cruise fuel consumption for a mach 2.4 supersonic transport was investigated. Design point engines, optimized purely for the supersonic cruising portion of the flight where the bulk of the fuel is consumed, are considered. Based on constant thrust requirements at cruise, fuel consumption considerations would favor medium by pass ratio engines (1.5 to 1.8) of overall pressure ratio of about 16. Engine weight considerations favor low bypass ratio (0.6 or less) and low wverall pressure ratio (8). Combination of both effects results in bypass ratios of 0.6 to 0.8 and overall pressure ratio of 12 being the overall optimum.

A systems engineering primer for every engineer and scientist

Energy Technology Data Exchange (ETDEWEB)

Edwards, William R.

2001-12-10

The Systems Engineering (SE) staff at LBNL has generated the following artifacts to assist projects with implementing a systems approach: (1) The present document that focuses on the what, why, and when of SE. It also provides a simple case-study to illustrate several SE tasks. (2) A web site with primary emphasis on the project life-cycle and workflow, (http://www-eng.LBNL.gov/Systems/index.html). It includes: SE guidelines and principles; A list of in-house tools; Templates; Case studies with ''how to'' examples; and Links to useful SE material. These sources are living documents to be updated as necessary. The viewpoint adopted in this document is that what LBNL engineers and scientists need is a set of principles and guiding practices for developing R and D systems rather than a ''cookbook''. There are many excellent ''how to'' resources such as the ''INCOSE Systems Engineering Handbook'' to guide those in search of more details. The SE staff is another resource available to consult and support projects. This document specifies SE principles and activities that are applicable to all LBNL projects independent of their specific differences. Each project should tailor the SE implementation to meet its individual needs and culture including project-specific resources, procedures, products, and tools.

The Study of Teachers' and Parents' Needs for Psychological Consultation from School Psychologist

Directory of Open Access Journals (Sweden)

Savina E.A.,

2018-04-01

Full Text Available The present study was aimed at the investigation of teachers’ and parents’ needs in consultation with a school psychologist. Participants were 159 teachers and 292 parents from three cities in Russia. Two surveys were designed to measure teachers’ and parents’ desire to receive psychological consultation regarding behavioral, emotional, learning and interpersonal problems of students; teaching methods and relationships with colleagues (for teachers; and child-parent relationships. In addition, the participants were asked to indicate whether they received a consultation from a school psychologist in the past and their satisfaction from the consultation. The results indicated that, in general, both teachers and parents are satisfied with the consultation; however, fewer parents received such a consultation compared to teachers. Both teachers and parents are more willing to receive consultation regarding children’s behavioral and emotional problems and relationships with peers. Teachers are less motivated to receive consultation about teaching methods, students’ learning problems, and teachers’ relationships with colleagues. Parents were less interested to receive consultation about child-parent relationships. The results of this study are interpreted in terms of their alignment with standards, which regulate the school psychology profession and training.

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

Science.gov (United States)

Sibarani, Roza Marsaulina

2014-01-01

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

Consulting-Research Froblems with German and American Multinational Firms.

Science.gov (United States)

Hildebrandt, Herbert W.

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

Intellectual Humility and Morality as Consultee-Centered Consultation Epistemologies

Science.gov (United States)

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

2017-01-01

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

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

Science.gov (United States)

Ogasawara, Katsuhiko; Abe, Tamotsu

2013-01-01

We developed a tele-health consultation system that combines a sphygmomanometer with a tele-conference system. These were placed in pharmacies and the University. We selected five pharmacies to set up a consultation room; one in a local area, two in a suburban area, and the remaining two in an urban area. Nurses with more than 5 years of clinical experience were assigned as consultants. These consultants offer health consultation but do not practice medicine. Some researchers have indicated the economic viability of at-home health management systems, but nothing has been researched on the economic viability of tele-health consultation. The objective of present study was estimated Willingness to Payment (WTP) of Tele-health consultation service. The WTP was estimated by Double-Bounded Dichotomous-Choice model. We performed logistic-regression analysis to confirm factors to affect WTP. The number of the respondent was 480. Mean WTP was calculated 495 yen and the median was 367 yen. There was significant difference for factor of "annual income", "have a willingness to use this system", and "have a child/children".

[Evaluative study of nursing consultation in the basic networks of Curitiba, Brazil].

Science.gov (United States)

da Silva, Sandra Honorato; Cubas, Marcia Regina; Fedalto, Maira Aparecida; da Silva, Sandra Regina; Limas, Thaís Cristina da Costa

2010-03-01

The implementation of the electronic health record in the basic networks of Curitiba enabled an advance in the implementation of the nursing consultation and the ICNPCH, whose modeling uses the ICNP axes structure and the ICNPCH list of action. The objective of this study was to evaluate the nursing consultation from the productivity and assistance coverage perspective. The studied population was obtained from a secondary database of nursing consultations from April to June of 2005. The analysis was performed using the Datawarehouse and OLAP tool. The productivity per professional was found to be 2.5 consultations per day. Professionals use 16% of their daily work time with this activity and up to 27% of their potential per month. The ICNPCH was used in 21% of the consultations. There is a 0.08 consultation coverage per inhabitant for 6% of the population. The nursing consultation makes it possible to characterize the nurses' role in health care and a new professional position capable of affecting the construction of public politics.

Impact of prenatal ultrasound consultation on maternal anxiety

International Nuclear Information System (INIS)

Masroor, I.; Ajmal, F.; Ahmed, H.

2008-01-01

To determine whether ultrasound consultation reduces maternal anxiety and increases feto-maternal attachment ( the desire to care for the fetus and care for self). Patients coming for routine obstetric ultrasound at the Department of Radiology, Aga Khan University Hospital Karachi were recruited in the study. The study was carried out over the period of two months from January-February 2007 in which sixty patients were included in the study. Patients were randomly assigned to a standard care group or an ultrasound consultation group (30 patients in each arm). Both groups were required to fill a questionnaire before and after their ultrasound examination. The ultrasound consultation group in addition received counseling before they went in for the ultrasound regarding fetal development and maternal-fetal interaction. The two groups were then compared for difference of change in feto maternal attachment scores and change in anxiety levels regarding their pregnancies before and after the ultrasound. SPSS software (version 14) was used for compilation of the data and the statistical computations. Categorical data was compared using Chi-square test and continuous variables were analyzed with paired t-test. P value <0.05 was considered significant. A positive difference in feto-maternal attachment and reduction in anxiety levels was seen in both the groups but this difference was statistically significant in the ultrasound consultation group only. This study suggests that ultrasound examinations with prior consultation has a positive impact on patients as it strengthens bonding toward the fetus, reduces maternal anxiety and increases maternal investment in health during the pregnancy. (author)

The OHS consultant as a 'political reflective navigator' in technological change processes

DEFF Research Database (Denmark)

Broberg, Ole

2004-01-01

between different roles and mobilize different types of knowledge depending on the context; the consultant is a navigator in the sense of knowing how to navigate in the complex organization surrounding the technological change process. The competencies of a political reflective navigator are outlined...... of OHS consultants is placed on the line between an expert and a process consultant. Based on evidence from the cases and on the concepts of actor-network theory on technological development, we suggest a supplementary third role, that of the 'political reflective navigator', where the OHS consultant...... is an 'actor' who pursues a work environment agenda in a complex network in which other actors pursue other agendas such as productivity, economics, quality, etc. The consultant is political in the sense of pursuing a work environment agenda; the consultant is reflective in the sense of being able to switch...

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

Science.gov (United States)

Wilk, Adam S; Chen, Lena M