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Sample records for hfmd consultation rates

  1. Modelling the effects of contaminated environments on HFMD infections in mainland China.

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    Wang, Jinyan; Xiao, Yanni; Cheke, Robert A

    2016-02-01

    Hand-foot-mouth disease (HFMD) has spread widely in mainland China increasing in prevalence in most years with serious consequences for child health. The HFMD virus can survive for a long period outside the host in suitable conditions, and hence contaminated environments may play important roles in HFMD infection. A new mathematical model was proposed and used to investigate the roles that asymptomatic individuals and contaminated environments played in HFMD dynamics. The model includes both direct transmission between susceptible and infected individuals and indirect transmission via free-living infectious unites in the environment. Theoretical analysis shows that the disease goes to extinction if the basic reproduction number is less than unity, whilst otherwise the disease persists. By fitting the proposed model to surveillance data we estimated the basic reproduction number as 1.509. Numerical simulations show that increasing the rate of virus clearance and decreasing transmission rates can delay epidemic outbreaks and weaken the severity of HFMD. Sensitivity analysis indicated that the basic reproduction number is sensitive to the transmission rate induced by asymptomatic infectious individuals and parameters associated with contaminated environments such as the indirect transmission rate, the rate of clearance and the virus shedding rates. This implies that asymptomatic infectious individuals and contaminated environments contribute substantially to new HFMD infections, and so would be targets for effective control measures.

  2. Detecting spatial-temporal clusters of HFMD from 2007 to 2011 in Shandong Province, China.

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    Yunxia Liu

    Full Text Available BACKGROUND: Hand, foot, and mouth disease (HFMD has caused major public health concerns worldwide, and has become one of the leading causes of children death. China is the most serious epidemic area with a total of 3,419,149 reported cases just from 2008 to 2010, and its different geographic areas might have different spatial epidemiology characteristics at different spatial-temporal scale levels. We conducted spatial and spatial-temporal epidemiology analysis to HFMD at county level in Shandong Province, China. METHODS: Based on the China National Disease Surveillance Reporting and Management System, the spatial-temporal database of HFMD from 2007 to 2011 was built. The global autocorrelation statistic (Moran's I was first used to detect the spatial autocorrelation of HFMD cases in each year. Purely Spatial scan statistics combined with Space-time scan statistic were used to detect epidemic clusters. RESULTS: The annual average incidence rate was 93.70 per 100,000 in Shandong Province. Most HFMD cases (93.94% were aged within 0-5 years old with an average male-to-female sex ratio 1.71, and the incidence seasonal peak was between April and July. The dominant pathogen was EV71 (47.35%, and CoxA16 (26.59%. HFMD had positive spatial autocorrelation at medium spatial scale level (county level with higher Moran's I from 0.31 to 0.62 (P<0.001. Seven spatial-temporal clusters were detected from 2007 to 2011 in the landscape of the whole Shandong, with EV71 or CoxA16 as the dominant pathogen for most hotspots areas. CONCLUSIONS: The spatial-temporal clusters of HFMD wandered around the whole Shandong Province during 2007 to 2011, with EV71 or CoxA16 as the dominant pathogen. These findings suggested that a real-time spatial-temporal surveillance system should be established for identifying high incidence region and conducting prevention to HFMD timely.

  3. The development and application of the two real-time RT-PCR assays to detect the pathogen of HFMD.

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    Aili Cui

    Full Text Available Large-scale Hand, Foot, and Mouth Disease (HFMD outbreaks have frequently occurred in China since 2008, affecting more than one million children and causing several hundred children deaths every year. The pathogens of HFMD are mainly human enteroviruses (HEVs. Among them, human enterovirus 71 (HEV71 and coxsackievirus A16 (CVA16 are the most common pathogens of HFMD. However, other HEVs could also cause HFMD. To rapidly detect HEV71 and CVA16, and ensure detection of all HEVs causing HFMD, two real-time hybridization probe-based RT-PCR assays were developed in this study. One is a multiplex real-time RT-PCR assay, which was developed to detect and differentiate HEV71 specifically from CVA16 directly from clinical specimens within 1-2 h, and the other is a broad-spectrum real-time RT-PCR assay, which targeted almost all HEVs. The experiments confirmed that the two assays have high sensitivity and specificity, and the sensitivity was up to 0.1 TCID50/ml for detection of HEVs, HEV71, and CVA16, respectively. A total of 213 clinical specimens were simultaneously detected by three kinds of assays, including the two real-time RT-PCR assays, direct conventional RT-PCR assay, and virus isolation assay on human rhabdomyosarcoma cells (RD cells. The total positive rate of both HEV71 and CVA16 was 69.48% with real-time RT-PCR assay, 47.42% with RT-PCR assay, and 34.58% with virus isolation assay. One HFMD clinical specimen was positive for HEV, but negative for HEV71 or CVA16, which was identified as Echovirus 11 (Echo11 by virus isolation, RT-PCR, and sequencing for the VP1 gene. The two real-time RT-PCR assays had been applied in 31 provincial HFMD labs to detect the pathogens of HFMD, which has contributed to the rapid identification of the pathogens in the early stages of HFMD outbreaks, and helped to clarify the etiologic agents of HFMD in China.

  4. Matched comparison of GP and consultant rating of electronic discharge summaries.

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    Stainkey, Lesley; Pain, Tilley; McNichol, Margaret; Hack, John; Roberts, Lynden

    2010-01-01

    Queensland Health is implementing a state-wide system to electronically generate and distribute discharge summaries. Previously, general practitioners (GPs) have indicated that the quality of the discharge summary does not support clinical handover. While the electronic system will address some issues (e.g. legibility and timeliness), the quality of the discharge summary content is predominantly independent of method of generation. As discharge summaries are usually generated by interns, we proposed that improvement in the quality of the summary may be achieved through education. This project aimed to compare the perceptions of hospital-based consultant educators and recipient GPs regarding discharge summary content and quality. The discharge summary and audit tool were sent to the recipient GP (n=134) and a hospital consultant (n=14) for satisfaction rating, using a 5- point Likert scale for questions relating to diagnosis, the listing of clinical management, medication, pathology, investigations, and recommendations to GP. Sampling was performed by selecting up to 10 discharge summaries completed by each first-year intern (n=36) in 2009, during the second, third and fourth rotations at the Townsville Hospital until a total of 403 was reached. Matched responses were compared using the Kappa statistic. The response rate was 93% (n=375) and 63% (n=254) for consultants and GPs respectively. Results from this study demonstrated that GPs were more satisfied with discharge summaries than were consultants. An anomaly occurred in three questions where, despite the majority of GPs rating satisfied or very satisfied, a small but proportionally greater number of GPs were very dissatisfied when compared with consultants. Poor or fair agreement between GPs and consultants was demonstrated in medications, pathology results, investigations and recommendations to GP, with GPs rating higher satisfaction in all questions. Lower consultant satisfaction ratings compared with GP

  5. High medical consultation rates of lead workers after industrial dispute over lead effects

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    Araki, S.; Murata, K.; Yanagihara, S.; Ushio, K.

    1982-02-01

    Medical consultation rates were compared between a group of lead workers and two groups of non-lead workers in a newspaper company where a serious industrial dispute took place over health effects of lead three years before this study. The comparison was also made within the group of lead workers. Maximal blood lead concentrations (PbBs) ranged from 0.1 ..mu..mol/kg to 3.6 ..mu..mol/kg with an average of 1.3 ..mu..mol/kg in the past three years. The consultation rate of lead workers was significantly higher than that of both the non-lead workers, when the number of workers who consulted physicians or dentists once or more for a year per 100 workers was compared. Disease-specific consultation rates were also higher in lead workers for seven categories of diseases and injuries such as hypertensive disease and peptic ulcers. When lead workers were divided into three groups by PbB or erythrocytes delta-aminolevulinic acid dehydratase (ALAD) levels, however, no significantly high rate was found in the higher PbB groups nor lower ALAD groups in terms of general and disease-specific consultation rates. It was concluded that the industrial dispute might have been a major cause of the high consultation rate of lead workers.

  6. High medical consultation rates of lead workers after industrial dispute over lead effects

    Energy Technology Data Exchange (ETDEWEB)

    Araki, S.; Murata, K.; Yanagihara, S.; Ushio, K.

    1982-02-01

    Medical consultation rates were compared between a group of lead workers (346 males) and two groups of non-lead workers (317 and 329 males) in a newspaper company where a serious industrial dispute took place over health effects of lead three years before this study. The comparison was also made within the group of lead workers. Maximal blood lead concentrations (PbBs) ranged from 0.1 mumol/kg to 3.6 mumol/kg (74 microgram/100 g) with an average of 1.3 mumol/kg in the past three years. Ages averaged 35 years in lead workers, and 34 and 30 years in non-lead workers, the ranges being 19-55 years in all. The consultation rate of lead workers was significantly higher than that of both the non-lead workers (P less than 0.001), when the number of workers who consulted physicians or dentists once or more for a year per 100 workers (general consultation rate) was compared. Disease-specific consultation rates were also higher in lead workers for seven categories of diseases and injuries such as hypertensive disease and peptic ulcers. When lead workers were divided into three groups by PbB or erythrocytes delta-aminolevulinic acid dehydratase (ALAD) levels, however, no significantly high rate was found in the higher PhB groups not lower ALAD groups in terms of general and disease-specific consultation rates. It was concluded that the industrial dispute might have been a major cause of the high consultation rate of lead workers.

  7. Striking variations in consultation rates with general practice reveal family influence

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    Spreeuwenberg Peter

    2007-01-01

    Full Text Available Abstract Background The reasons why patients decide to consult a general practitioner vary enormously. While there may be individual reasons for this variation, the family context has a significant and unique influence upon the frequency of individuals' visits. The objective of this study was to explore which family factors can explain the differences between strikingly high, and correspondingly low, family consultation rates in families with children aged up to 21. Methods Data were used from the second Dutch national survey of general practice. This survey extracted from the medical records of 96 practices in the Netherlands, information on all consultations with patients during 2001. We defined, through multilevel analysis, two groups of families. These had respectively, predominantly high, and low, contact frequencies due to a significant family influence upon the frequency of the individual's first contacts. Binomial logistic regression analyses were used to analyse which of the family factors, related to shared circumstances and socialisation conditions, can explain the differences in consultation rates between the two groups of families. Results In almost 3% of all families, individual consultation rates decrease significantly due to family influence. In 11% of the families, individual consultation rates significantly increase due to family influence. While taking into account the health status of family members, family factors can explain family consultation rates. These factors include circumstances such as their economic status and number of children, as well as socialisation conditions such as specific health knowledge and family beliefs. The chance of significant low frequencies of contact due to family influences increases significantly with factors such as, paid employment of parents in the health care sector, low expectations of general practitioners' care for minor ailments and a western cultural background. Conclusion Family

  8. The combined effect of cancer and chronic diseases on general practitioner consultation rates.

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    Heins, M.J.; Korevaar, J.C.; Donker, G.A.; Rijken, P.M.; Schellevis, F.G.

    2015-01-01

    Aim: More than two-thirds of cancer patients have one or more chronic diseases besides cancer. The purpose of this study was to get detailed insight into the combined effect of cancer and chronic diseases on general practitioner (GP) consultation rates. Methods: From the NIVEL Primary Care Database

  9. Seroprevalence of human enterovirus 71 and coxsackievirus A16 in Guangdong, China, in pre- and post-2010 HFMD epidemic period.

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    Wei Li

    Full Text Available BACKGROUND: Human Enterovirus 71 and Coxsackie A16 have caused many outbreaks in the last decade in mainland China, resulting in thousands of fatal cases. Seroepidemiology which provides important information to document population immunity is rare in China. METHODOLOGY/PRINCIPAL FINDINGS: A cross sectional study of Enterovirus 71 (EV71 and Coxsackie A16 (CA16 seroprevalence was carried out in Guangdong, China, pre- and post- the 2010 hand, foot and mouth disease (HFMD epidemic period. The levels of EV71 and CA16 specific antibodies were evaluated by a microneutralization test and the geometric mean titer (GMT was calculated and compared. Our results indicated frequent infection by EV71 and CA16 in Guangdong before the 2010 epidemic. Only EV71 neutralizing antibody but not CA16 seroprevalence was significantly increased after the 2010 HFMD epidemic. Children less than 3 years old especially those aged 2 years showed the lowest positive rates for EV71 and CA16 NA before epidemic and the most significantly increased EV71 seroprevalence after epidemic. CA16 GMT values declined after the 2010 epidemic. CONCLUSIONS: These results indicate EV71 was the major pathogen of HFMD in Guangdong during the 2010 epidemic. The infection occurs largely in children less than 3 years, who should have first priority to receive an EV71 vaccine.

  10. Perceptions of Contractors and Consultants Toward Application of Greenship Rating Tools on Apartment Buildings in Surabaya

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    Herry Pintardi Chandra

    2014-04-01

    Full Text Available During the last ten years, the growth of apartment buildings in Surabaya has encountered the bitter experience of global warming, resource depletion, energy scarcity, and other environmental impacts. We cannot avoid them, but we can minimize the negative impacts of global warming. The green building concept is one of the methods to minimize the environmental impact. It takes into account principles of sustainable development in planning, construction, operation, and maintenance. Greenship Rating Tools is used to evaluate and calculate green achievements, prior to green building certification. The aim of this research is to represent the perceptions of contractors and consultants toward application of Greenship Rating Tools on apartment buildings in Surabaya. Based on the data obtained from a questionnaires survey carried out to 41 respondents, the mean value ranking method is used to evaluate the main factors of Greenship. These factors are Appropriate Site Development, Energy Efficiency and Conservation, Water Conservation, Material Resource and Cycle, Indoor Health and Comfort, and Building Environmental Management. In general, the results of this research show that there are a number of differences between perceptions of contractors and consultants toward application of Greenship Rating Tools on apartment buildings in Surabaya. According to the contractors’ perception, Visual Comfort is a factor that would easily to be applied, whilst consultants’ is Landscape. On the other hand, there are factors that would difficult to be applied. Based on contractors’ perceptiom is Climate Change, while consultants’ perception is Renewal Energy. In summary, Greenship Rating Tools can be applied on contractors’ and consultants’ perceptions, whilst there are some variables which can not be applied.

  11. 75 FR 16452 - Consulting Gasca & Associates, LLC; Supplemental Notice That Initial Market-Based Rate Filing...

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    2010-04-01

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Consulting Gasca & Associates, LLC; Supplemental Notice That Initial Market... supplemental notice in the above-referenced proceeding of Consulting Gasca & Associates, LLC's application for...

  12. Antibiotic prescribing in relation to diagnoses and consultation rates in Belgium, the Netherlands and Sweden: use of European quality indicators

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    Tyrstrup, Mia; van der Velden, Alike; Engstrom, Sven; Goderis, Geert; Molstad, Sigvard; Verheij, Theo; Coenen, Samuel; Adriaenssens, Niels

    2017-01-01

    Objective To assess the quality of antibiotic prescribing in primary care in Belgium, the Netherlands and Sweden using European disease-specific antibiotic prescribing quality indicators (APQI) and taking into account the threshold to consult and national guidelines. Design A retrospective observational database study. Setting Routine primary health care registration networks in Belgium, the Netherlands and Sweden. Subjects All consultations for one of seven acute infections [upper respiratory tract infection (URTI), sinusitis, tonsillitis, otitis media, bronchitis, pneumonia and cystitis] and the antibiotic prescriptions in 2012 corresponding to these diagnoses. Main outcome measures Consultation incidences for these diagnoses and APQI values (a) the percentages of patients receiving an antibiotic per diagnosis, (b) the percentages prescribed first-choice antibiotics and (c) the percentages prescribed quinolones. Results The consultation incidence for respiratory tract infection was much higher in Belgium than in the Netherlands and Sweden. Most of the prescribing percentage indicators (a) were outside the recommended ranges, with Belgium deviating the most for URTI and bronchitis, Sweden for tonsillitis and the Netherlands for cystitis. The Netherlands and Sweden prescribed the recommended antibiotics (b) to a higher degree and the prescribing of quinolones exceeded the proposed range for most diagnoses (c) in Belgium. The interpretation of APQI was found to be dependent on the consultation incidences. High consultation incidences were associated with high antibiotic prescription rates. Taking into account the recommended treatments from national guidelines improved the results of the APQI values for sinusitis in the Netherlands and cystitis in Sweden. Conclusion Quality assessment using European disease-specific APQI was feasible and their inter-country comparison can identify opportunities for quality improvement. Their interpretation, however, should take

  13. Antibiotic prescribing in relation to diagnoses and consultation rates in Belgium, the Netherlands and Sweden: use of European quality indicators.

    Science.gov (United States)

    Tyrstrup, Mia; van der Velden, Alike; Engstrom, Sven; Goderis, Geert; Molstad, Sigvard; Verheij, Theo; Coenen, Samuel; Adriaenssens, Niels

    2017-03-01

    To assess the quality of antibiotic prescribing in primary care in Belgium, the Netherlands and Sweden using European disease-specific antibiotic prescribing quality indicators (APQI) and taking into account the threshold to consult and national guidelines. A retrospective observational database study. Routine primary health care registration networks in Belgium, the Netherlands and Sweden. All consultations for one of seven acute infections [upper respiratory tract infection (URTI), sinusitis, tonsillitis, otitis media, bronchitis, pneumonia and cystitis] and the antibiotic prescriptions in 2012 corresponding to these diagnoses. Consultation incidences for these diagnoses and APQI values (a) the percentages of patients receiving an antibiotic per diagnosis, (b) the percentages prescribed first-choice antibiotics and (c) the percentages prescribed quinolones. The consultation incidence for respiratory tract infection was much higher in Belgium than in the Netherlands and Sweden. Most of the prescribing percentage indicators (a) were outside the recommended ranges, with Belgium deviating the most for URTI and bronchitis, Sweden for tonsillitis and the Netherlands for cystitis. The Netherlands and Sweden prescribed the recommended antibiotics (b) to a higher degree and the prescribing of quinolones exceeded the proposed range for most diagnoses (c) in Belgium. The interpretation of APQI was found to be dependent on the consultation incidences. High consultation incidences were associated with high antibiotic prescription rates. Taking into account the recommended treatments from national guidelines improved the results of the APQI values for sinusitis in the Netherlands and cystitis in Sweden. Quality assessment using European disease-specific APQI was feasible and their inter-country comparison can identify opportunities for quality improvement. Their interpretation, however, should take consultation incidences and national guidelines into account. Differences in

  14. Striking variations in consultation rates with general practice reveal family influence.

    NARCIS (Netherlands)

    Cardol, M.; Dijk, L. van; Bosch, W.J.H.M. van den; Spreeuwenberg, P.; Bakker, D.H. de; Groenewegen, P.P.

    2007-01-01

    BACKGROUND: The reasons why patients decide to consult a general practitioner vary enormously. While there may be individual reasons for this variation, the family context has a significant and unique influence upon the frequency of individuals' visits. The objective of this study was to explore

  15. Striking variations in consultation rates with general practice reveal family influence.

    NARCIS (Netherlands)

    Cardol, M.; Dijk, L. van; Bosch, W.J.H.M. van den; Spreeuwenberg, P.; Bakker, D.H. de; Groenewegen, P.P.

    2007-01-01

    BACKGROUND: The reasons why patients decide to consult a general practitioner vary enormously. While there may be individual reasons for this variation, the family context has a significant and unique influence upon the frequency of individuals' visits. The objective of this study was to explore whi

  16. Striking variations in consultation rates with general practice reveal family influence

    NARCIS (Netherlands)

    Cardol, Mieke; Dijk, Liset van; Bosch, Wil J.H.M. van den; Spreeuwenberg, Peter; Bakker, Dinny H. de; Groenewegen, Peter P.

    2007-01-01

    Background: The reasons why patients decide to consult a general practitioner vary enormously. While there may be individual reasons for this variation, the family context has a significant and unique influence upon the frequency of individuals' visits. The objective of this study was to explore whi

  17. The effect of the full moon on general practice consultation rates.

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    Neal, R D; Colledge, M

    2000-12-01

    The effect of the full moon on human behaviour, the so-called 'Transylvania hypothesis', has fascinated the public and occupied the mind of researchers for centuries. The aim of the present study was to determine whether or not there was any change in general practice consultation patterns around the time of the full moon. We analysed data from the fourth national morbidity study of general practice. The data set was split into two groups and analysed separately: consultations on ordinary weekdays and consultations on weekends and bank holidays. The data were split randomly into two equal sets, one for model building and one for model validation. The lunar cycle effect was assumed to be sinusoidal, on the grounds that any effect would be maximal at the time of the full moon and decline to the new moon, following a cosine curve (with a period of 29.54 days, the mean length of a lunar cycle). There was a statistically significant, but small, effect associated with the lunar cycle of 1.8% of the mean value [95% confidence interval (CI) 0.9-2.7%]. This equates to an average difference between the two extremes during the cycle of 3.6%. For this data set, this accounts for 190 (95% CI 95-285) more consultations on days at the peak of the cycle compared with those at the bottom of the cycle, or, put another way, about three consultations per practice. We can speculate neither as to what the nature of these moon-related problems may be, nor as to the mechanisms underpinning such behaviour. However, we have confirmed that it does not seem to be related to anxiety and depression.

  18. Primary care consultation rates among people with and without severe mental illness: a UK cohort study using the Clinical Practice Research Datalink

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    Kontopantelis, Evangelos; Olier, Ivan; Planner, Claire; Reeves, David; Ashcroft, Darren M; Gask, Linda; Doran, Tim; Reilly, Siobhan

    2015-01-01

    Objectives Little is known about service utilisation by patients with severe mental illness (SMI) in UK primary care. We examined their consultation rate patterns and whether they were impacted by the introduction of the Quality and Outcomes Framework (QOF), in 2004. Design Retrospective cohort study using individual patient data collected from 2000 to 2012. Setting 627 general practices contributing to the Clinical Practice Research Datalink, a large UK primary care database. Participants SMI cases (346 551) matched to 5 individuals without SMI (1 732 755) on age, gender and general practice. Outcome measures Consultation rates were calculated for both groups, across 3 types: face-to-face (primary outcome), telephone and other (not only consultations but including administrative tasks). Poisson regression analyses were used to identify predictors of consultation rates and calculate adjusted consultation rates. Interrupted time-series analysis was used to quantify the effect of the QOF. Results Over the study period, face-to-face consultations in primary care remained relatively stable in the matched control group (between 4.5 and 4.9 per annum) but increased for people with SMI (8.8–10.9). Women and older patients consulted more frequently in the SMI and the matched control groups, across all 3 consultation types. Following the introduction of the QOF, there was an increase in the annual trend of face-to-face consultation for people with SMI (average increase of 0.19 consultations per patient per year, 95% CI 0.02 to 0.36), which was not observed for the control group (estimates across groups statistically different, p=0.022). Conclusions The introduction of the QOF was associated with increases in the frequency of monitoring and in the average number of reported comorbidities for patients with SMI. This suggests that the QOF scheme successfully incentivised practices to improve their monitoring of the mental and physical health of this group of patients

  19. An Automated Recording Method in Clinical Consultation to Rate the Limp in Lower Limb Osteoarthritis

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    Barrois, R.; Gregory, Th.; Oudre, L.; Moreau, Th.; Truong, Ch.; Aram Pulini, A.; Vienne, A.; Labourdette, Ch.; Vayatis, N.; Buffat, S.; Yelnik, A.; de Waele, C.; Laporte, S.; Vidal, P. P.; Ricard, D.

    2016-01-01

    For diagnosis and follow up, it is important to be able to quantify limp in an objective, and precise way adapted to daily clinical consultation. The purpose of this exploratory study was to determine if an inertial sensor-based method could provide simple features that correlate with the severity of lower limb osteoarthritis evaluated by the WOMAC index without the use of step detection in the signal processing. Forty-eight patients with lower limb osteoarthritis formed two severity groups separated by the median of the WOMAC index (G1, G2). Twelve asymptomatic age-matched control subjects formed the control group (G0). Subjects were asked to walk straight 10 meters forward and 10 meters back at self-selected walking speeds with inertial measurement units (IMU) (3-D accelerometers, 3-D gyroscopes and 3-D magnetometers) attached on the head, the lower back (L3-L4) and both feet. Sixty parameters corresponding to the mean and the root mean square (RMS) of the recorded signals on the various sensors (head, lower back and feet), in the various axes, in the various frames were computed. Parameters were defined as discriminating when they showed statistical differences between the three groups. In total, four parameters were found discriminating: mean and RMS of the norm of the acceleration in the horizontal plane for contralateral and ipsilateral foot in the doctor’s office frame. No discriminating parameter was found on the head or the lower back. No discriminating parameter was found in the sensor linked frames. This study showed that two IMUs placed on both feet and a step detection free signal processing method could be an objective and quantitative complement to the clinical examination of the physician in everyday practice. Our method provides new automatically computed parameters that could be used for the comprehension of lower limb osteoarthritis. It may not only be used in medical consultation to score patients but also to monitor the evolution of their

  20. A Hand-Foot-and-Mouth Disease Model with Periodic Transmission Rate in Wenzhou, China

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    Yeting Zhu

    2014-01-01

    Full Text Available We establish an SEIQRS epidemic model with periodic transmission rate to investigate the spread of seasonal HFMD in Wenzhou. The value of this study lies in two aspects. Mathematically, we show that the global dynamics of the HFMD model can be governed by its reproduction number R0; if R01, the model has at least one positive periodic solution and is uniformly persistent, which indicates that HFMD becomes an endemic disease. Epidemiologically, based on the statistical data of HFMD in Wenzhou, we find that the HFMD becomes an endemic disease and will break out in Wenzhou. One of the most interesting findings is that, for controlling the HFMD spread, we must increase the quarantined rate or decrease the treatment cycle.

  1. Satisfaction rates with the current Special Type Consultation (STC) reimbursement scheme among General Practitioners – A Mixed Methods Study.

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    Kiely, A

    2017-03-01

    The Special Type Consultation (STC) scheme is a fee-for-service reimbursement scheme for General Practitioners (GPs) in Ireland. Introduced in 1989, the scheme includes specified patient services involving the application of a learned skill, e.g. suturing. This study aims to establish the extent to which GPs believe this scheme is appropriate for current General Practice. This is an embedded mixed-methods study combining quantitative data on GPs working experience of and qualitative data on GPs attitudes towards the scheme. Data were collected by means of an anonymous postal questionnaire. The response rate was 60.4% (n=159.) Twenty-nine percent (n=46) disagreed and 65% (n=104) strongly disagreed that the current list of special items is satisfactory. Two overriding themes were identified: economics and advancement of the STC process. This study demonstrates an overwhelming consensus among GPs that the current STC scheme is outdated and in urgent need of revision to reflect modern General Practice.

  2. Spatio-Temporal Distribution and Hotspots of Hand, Foot and Mouth Disease (HFMD in Northern Thailand

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    Ratchaphon Samphutthanon

    2013-12-01

    Full Text Available Hand, Foot and Mouth Disease (HFMD is an emerging viral disease, and at present, there are no antiviral drugs or vaccines available to control it. Outbreaks have persisted for the past 10 years, particularly in northern Thailand. This study aimed to elucidate the phenomenon of HFMD outbreaks from 2003 to 2012 using general statistics and spatial-temporal analysis employing a GIS-based method. The spatial analysis examined data at the village level to create a map representing the distribution pattern, mean center, standard deviation ellipse and hotspots for each outbreak. A temporal analysis was used to analyze the correlation between monthly case data and meteorological factors. The results indicate that the disease can occur at any time of the year, but appears to peak in the rainy and cold seasons. The distribution of outbreaks exhibited a clustered pattern. Most mean centers and standard deviation ellipses occurred in similar areas. The linear directional mean values of the outbreaks were oriented toward the south. When separated by season, it was found that there was a significant correlation with the direction of the southwest monsoon at the same time. An autocorrelation analysis revealed that hotspots tended to increase even when patient cases subsided. In particular, a new hotspot was found in the recent year in Mae Hong Son province.

  3. Using an autologistic regression model to identify spatial risk factors and spatial risk patterns of hand, foot and mouth disease (HFMD) in Mainland China.

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    Bo, Yan-Chen; Song, Chao; Wang, Jin-Feng; Li, Xiao-Wen

    2014-04-14

    There have been large-scale outbreaks of hand, foot and mouth disease (HFMD) in Mainland China over the last decade. These events varied greatly across the country. It is necessary to identify the spatial risk factors and spatial distribution patterns of HFMD for public health control and prevention. Climate risk factors associated with HFMD occurrence have been recognized. However, few studies discussed the socio-economic determinants of HFMD risk at a space scale. HFMD records in Mainland China in May 2008 were collected. Both climate and socio-economic factors were selected as potential risk exposures of HFMD. Odds ratio (OR) was used to identify the spatial risk factors. A spatial autologistic regression model was employed to get OR values of each exposures and model the spatial distribution patterns of HFMD risk. Results showed that both climate and socio-economic variables were spatial risk factors for HFMD transmission in Mainland China. The statistically significant risk factors are monthly average precipitation (OR = 1.4354), monthly average temperature (OR = 1.379), monthly average wind speed (OR = 1.186), the number of industrial enterprises above designated size (OR = 17.699), the population density (OR = 1.953), and the proportion of student population (OR = 1.286). The spatial autologistic regression model has a good goodness of fit (ROC = 0.817) and prediction accuracy (Correct ratio = 78.45%) of HFMD occurrence. The autologistic regression model also reduces the contribution of the residual term in the ordinary logistic regression model significantly, from 17.25 to 1.25 for the odds ratio. Based on the prediction results of the spatial model, we obtained a map of the probability of HFMD occurrence that shows the spatial distribution pattern and local epidemic risk over Mainland China. The autologistic regression model was used to identify spatial risk factors and model spatial risk patterns of HFMD. HFMD occurrences were found to be spatially

  4. Individual Consultations

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    Ian Walkinshaw

    2015-09-01

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

  5. 重症手足口病156例临床分析%The clinical analysis of 156 cases of HFMD in Shaanxi area in 2010

    Institute of Scientific and Technical Information of China (English)

    史艳平; 李小青; 韩静枫; 李丹; 豆玉凤

    2011-01-01

    Objective : To analyze the clinical features of HFMD in 2010 in Shaanxi area and study the causes of the disease and the facts to get affected and seek out the effective treatments.Methods:Are reviewing the records of 156 children patients with serious conditioris hospitalized by our hospital from Shaanxi area during 2010.4-2010were analysed.10.Results : We used rRT-PCR to examine the 156 cases of severely sick children finding 75.2% of them got affected by EV71; Including skin rash the typical clinical features mostly happened to patients bellow 3 years old, who often suffered from continuous fever, fatigue, easy to be frightened,uncontrolled shaking.Part of them also appeared increasing breathing rate and peripheraL circulation disturbance, white cell and CRP increasing in peripheral blood and high level of blood sugar.After treatment of releasing intracranial pressure and large amount of IVIG injection and hormonal drugs, 119 patients cured from hospital with 29 cases suffered from aftereffects of disorder of body motions and 8 cases of death.Conclusion : the severe cases of HFMD in Shaanxi area are mostly caused by EV71 affection and all have the damage of nerve system.An early use of IVIG and glucocorticoid can effectively prevent the disease from developing.When damage appears on nerve system, we need pay attention to pulmonary edcma and damage to heart.An early stage of treatment such as mechanical ventilation and active improvement of circuLation can help thereafter.%目的:分析2010年陕西地区重症手足口病(HFMD)的临床特点,探讨其病原、高危因素及有效治疗方法.方法:对156例重症HFMD患儿的临床资料进行回顾性分析.结果:156例重症HFMD,EV71感染占75.2%.临床特点:皮疹,持续发热,精神差、易惊,嗜睡,肢体抖动,部分伴呼吸心率增快,末梢循环不良;外周血中白细胞及CRP升高,高血糖.积极给予降颅压、静脉用丙种球蛋白冲击,激素等对症治疗,临床痊愈出院119

  6. Situational Consultation

    Science.gov (United States)

    Rimehaug, Tormod; Helmersberg, Ingunn

    2010-01-01

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

  7. Antibiotic prescribing in relation to diagnoses and consultation rates in Belgium, the Netherlands and Sweden : use of European quality indicators

    NARCIS (Netherlands)

    Tyrstrup, Mia; van der Velden, Alike|info:eu-repo/dai/nl/20448295X; Engstrom, Sven; Goderis, Geert; Molstad, Sigvard; Verheij, Theo|info:eu-repo/dai/nl/126027668; Coenen, Samuel; Adriaenssens, Niels

    2017-01-01

    OBJECTIVE: To assess the quality of antibiotic prescribing in primary care in Belgium, the Netherlands and Sweden using European disease-specific antibiotic prescribing quality indicators (APQI) and taking into account the threshold to consult and national guidelines. DESIGN: A retrospective observa

  8. [Bioclimatic consultation].

    Science.gov (United States)

    Cordes, H; Reinke, R

    1975-01-23

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

  9. epidemiological analysis of HFMD in Liujiang County of Guangxi Province in 2011%2011年广西省柳江县手足口病流行病学分析

    Institute of Scientific and Technical Information of China (English)

    韦雪玲

    2013-01-01

    [Objective]To analyze the epidemiological characteristics of hand-foot-mouth disease (HFMD) in Liujiang County of Guangxi Province,and provide scientific evidence for developing control measures and strategies.[Methods] Descriptive epidemiological study was applied to analyze the epidemic data of HFMD from disease surveillance information reporting system in Liujiang County in 2011.[Results] A total of 2 321 HFMD cases were reported in 2011,with 3 severe cases and no death case.One thousand four hundred and eighty seven (64.07%) HFMD cases were reported from April to June.Two thousand one hundred and thirty five (91.99%) HFMD cases were reported in children aged 0-3 years.Chi-square test showed significant difference of incidence was observed between age groups(P <0.01).Most cases were scattered children (1 799 cases,77.51%),followed by preschool children (509 cases,21.93%).The incidence was significantly different between occupations by Chi-square test(P <0.01).The incidence among preschool children and scattered children was significantly higher than that among primary school students.Clinical manifestations were mainly fever and herpes in hands,feet and mouth,with the digestive tract symptoms such as nausea,vomiting and poor appetite; the EV71 detectable rate of severe cases was 100%.[Conclusion] The HFMD occurred mainly in the scattered children under 3 years,more frequently in spring and summer.The rural areas in which the health condition is poor must be taken as key control points.The scattered children living in rural areas are the HFMD high risk group.In future,HFMD control should be strengthened on key areas and key populations.To reduce the occurrence of death or severe cases,control and prevention should be strengthen in epidemic season,as well as the HFMD etiology monitoring in children under 3 years.%目的 分析广西省柳江县手足口病的流行病学情况,为制定手足口病预防控制措施和

  10. Prevention of HFMD cross infections in pediatric clinic%儿科门诊手足口病交叉感染的预防

    Institute of Scientific and Technical Information of China (English)

    王荣兰; 卓燕芳; 车春; 谢霞梅; 许声波; 蔡岳

    2016-01-01

    目的:探讨儿科门诊手足口病交叉感染的临床护理方案,为降低患儿感染率提供临床参考依据。方法分析2013年8月-2014年12月医院收治的180例手足口病患儿临床资料,给予患儿家属健康教育指导,了解患儿家属对疾病、家庭护理知识的了解,并对患儿家属进行护理干预,干预后再对患儿家属进行上述调查,分析其对疾病相关知识及疾病护理的掌握率,数据采用SPSS 17.0软件进行统计分析。结果手足口病患儿多发于3~6月份,1~3岁患儿为多发人群;护理干预前后患儿家属对疾病发病原因、临床症状、传播途径、疾病传染性增强时段、临床治疗原则和常用治疗药物了解情况差异有统计学意义(P<0.05)。结论给予儿科门诊手足口病患儿家属一定护理知识,有利于减少患儿交叉感染,缓解患儿家属情绪,可有效促进患儿疾病康复。%OBJECTIVE To investigate the clinical care programs of HFMD cross‐infections in pediatric clinic ,and to provide clinical evidence for reducing infection rate .METHODS The clinical data of 180 children with hand ,foot and mouth disease in our hospital from Aug .2013 to Dec .2014 were analyzed .Parents of the children were given a certain nursing health education of basic knowledge of hand ,foot and mouth disease .Then the parents knowl‐edge of the disease and the house care were investigated ,and at the same time nursing care was intervened in par‐ent caring .After the intervention ,the parents knowledge of the disease was investigated again ,and their knowl‐edge of the disease and the house care were statistically analyzed by software of SPSS 17 .0 .RESULTS HFMD mainly occurred from Mar .to Jun ,and one‐year and three‐year old children were susceptible population .The mastery of knowledge of parents nursing care for their children showed that before and after the treatment ,their understanding of

  11. The clinical significance of serum creatine kinase isoenzyme MB and troponin I for judging the myocardial injury of hand foot mouth disease (HFMD)children%CK-MB 及 cTnI 检测对手足口病患儿心肌损害的临床意义

    Institute of Scientific and Technical Information of China (English)

    汤淑斌; 庞伟斌

    2015-01-01

    目的:探讨血清肌酸激酶同工酶(CK-MB)及肌钙蛋白 I(cTnI)检测对手足口病(HFMD)患儿心肌损害的临床意义。方法选择2012年7月至2013年6月期间在我院住院的80例手足口病患儿为 HFMD 组;50例健康体检儿童为对照组,比较分析两组 CK-MB 及 cTnI 水平。结果手足口病患儿 CK-MB 水平为38.10±19.50 U/L,cT-nI 水平为0.2±0.07μg/L,均高于对照组(14.80±10.30 U/L,0.07±0.02μg/L),差异有统计学意义(P <0.05)。HFMD 组 CK-MB 检测阳性率56.3%(45/80),明显高于 cTnI 的33.8%(27/80),差异有统计学意义(P <0.05)。经积极治疗后 CK-MB 及 cTnI 水平均明显下降,较入院时比较,差异有统计学意义(P <0.05)。结论联合检测血清CK-MB 及 cTnI 对手足口病合并心肌损害的早期诊断具有重要临床意义。%Objective To explore the clinical significance of serum creatine kinase isoenzyme MB and troponin I for judging the myocardial injury of hand foot mouth disease (HFMD)children.Methods Choose 80 HFMD patients who were hospitalized with in our college from July 2012 to June 2014 as the observation group,and selected 50 healthy check-up children as the control group.We detected and comparatively analyzed the children of the two groups in crea-tine kinase isoenzyme and troponin I difference.Results HFMD group of creatine kinase isoenzyme and troponin I tese results are greatly higher than control group,and in HFMD group the creatine kinase isoenzyme and troponin I test re-sults had significantly reduced after taking effective treatment,and in HFMD group the positive rate of creatine kinase isoenzyme was great higher than the positive rate of troponin I,all the differences were statistically significant(P <0.05).Conclusion Combined detection of serum creatine kinase isoenzyme and troponin I have the important clinical meaning for the early clinical

  12. Assessing the impact of humidex on HFMD in Guangdong Province and its variability across social-economic status and age groups

    Science.gov (United States)

    Zhang, Wangjian; Du, Zhicheng; Zhang, Dingmei; Yu, Shicheng; Huang, Yong; Hao, Yuantao

    2016-01-01

    Humidex is a meteorological index that combines the impacts of temperature and humidity, and is directly comparable with dry temperature in degrees Celsius. However, to date, no research has focused on the effect of humidex on hand, foot and mouth disease (HFMD). The current study was designed to address this research need. Case-based HFMD surveillance data and daily meteorological data collected between 2010 and 2012 was obtained from the China CDC and the National Meteorological Information Center, respectively. Distributed lag nonlinear models were applied to assess the impact of humidex on HFMD among children under 15 years oldin Guangdong, and its variability across social-economic status and age groups. We found that relative risk (RR) largely increased with humidex. Lag-specific and cumulative humidex-RR curves for children from the Pearl-River Delta Region as well as older children were more likely to show two-peak distribution patterns. One RR peak occurred at a humidex of between 15 and 20, and the other occurred between 30 and 35. This study provides a comprehensive picture of the impact of humidex on HFMD incidence in Guangdong Province. Results from the present study should be important in the development of area-and-age-targeted control programs.

  13. Integrating GIS with AHP and Fuzzy Logic to generate hand, foot and mouth disease hazard zonation (HFMD-HZ) model in Thailand

    Science.gov (United States)

    Samphutthanon, R.; Tripathi, N. K.; Ninsawat, S.; Duboz, R.

    2014-12-01

    The main objective of this research was the development of an HFMD hazard zonation (HFMD-HZ) model by applying AHP and Fuzzy Logic AHP methodologies for weighting each spatial factor such as disease incidence, socio-economic and physical factors. The outputs of AHP and FAHP were input into a Geographic Information Systems (GIS) process for spatial analysis. 14 criteria were selected for analysis as important factors: disease incidence over 10 years from 2003 to 2012, population density, road density, land use and physical features. The results showed a consistency ratio (CR) value for these main criteria of 0.075427 for AHP, the CR for FAHP results was 0.092436. As both remained below the threshold of 0.1, the CR value were acceptable. After linking to actual geospatial data (disease incidence 2013) through spatial analysis by GIS for validation, the results of the FAHP approach were found to match more accurately than those of the AHP approach. The zones with the highest hazard of HFMD outbreaks were located in two main areas in central Muang Chiang Mai district including suburbs and Muang Chiang Rai district including the vicinity. The produced hazardous maps may be useful for organizing HFMD protection plans.

  14. Molecular Epidemiological Analysis of Echovirus 19 Isolated From an Outbreak Associated With Hand, Foot, and Mouth Disease (HFMD) in Shandong Province of China

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective To elucidate the genetic characterization and molecular epidemiological features of Echovirus 19 (E19) isolates collected from an outbreak associated with hand, foot and mouth disease (HFMD) in Tai'an city of Shandong Province of China from July to September, 2003. Methods Thirty seven Echovirus 19 isolates were isolated from stool specimens and throat swabs collected during the outbreak, then major capsid (VP1) genomic sequence was determined, and phylogenetic tree was done based on the VP1 sequences among these 37 and other E19 viruses deposited in the Genbank. Also a representative strain named CHN-SD03-TN12 was selected for sequencing of 5'-untranslated regions (5'-UTR). Results The identity rate was about 98.9%-100% among all these 37 El9 viruses. The genetic relationships between these 37 E19 isolates and other strains reported were also depicted. The identity rate was about 78.4%-78.9% compared with E19 reference strain Burke. The substitutions in the sequence of 5'-UTR resulted in changes in the conjectural properties of 5'-UTR of E19 viruses.Conclusion The genetic features of E19 viruses isolated during the outbreak in Shandong Province in 2003 may be associated with a genetic and antigenic drift that changes the virulence of the Shandong isolates, but the molecular changes in Shandong E19 viruses contributing to their phenotype remain to be further illuminated. However, the sequences described in this paper substantiate the changes taken place in capsid VP1 and 5'UTR regions. These substitutions may contribute to their tropism and virulence, and play a significant role in pathogenesis and clinical manifestations of the disease.

  15. Clinical efficacy observation on treating infantile HFMD with Tanreqing injection%痰热清注射液治疗小儿手足口病的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    孙珺; 刘宏瑞; 邸顺祥

    2013-01-01

    Objective:To observe the clinical effect of Tanreqing injection on treating infantile HFMD. Methods:122 children with HFMD were randomly divided into two groups, 62 children in the treatment group, 60 children in the control group. The treatment group was given Tanreqing injection 0.3~0.5ml/kg, while the control group was injected with Vidarabine Monophosphate. To observe and record the pyretolysis time ,rash dissipated time, appetite improve time and curative effect evaluation of disease in both groups. Results:The total effective rate in the treatment group was higher than that in the control group, and the pyretolysis time and rash dissipated time were significantly shorter than those in the control group, with significant differences (P0.05). Conclusion: Tanreqing injection had definite clinical effect on treating children's HFMD, safe and effective.%  目的:观察痰热清注射液治疗小儿手足口病的临床疗效.方法:将122例手足口病患儿随机分为治疗组62例,对照组60例.治疗组给予痰热清注射液0.3~0.5ml/kg加入5%葡萄糖注射液100~200ml,静脉滴注,1次/d;对照组给予注射用单磷酸阿糖腺苷.观察并记录两组退热时间、退疹时间、食欲改善时间及疾病疗效评价.结果:治疗组总有效率高对照组,退热和退疹时间明显短对照组,比较差异均有统计学意义(P0.05).结论:痰热清注射液治疗小儿手足口病临床疗效确切,安全有效.

  16. 2010~2012年无锡市滨湖区手足口病流行特征分析%Analysis of The Epidemiological Characteristics of HFMD in Wuxi Binhu District

    Institute of Scientific and Technical Information of China (English)

    方静; 王敏芳; 陈军

    2014-01-01

    Objective:To discuss the epidemiologic feature and the influencing factor of hand-foot-and-mouth disease in order to provide scientific basis for control ing the disease. Methods:Descriptive and analytical epidemiology analysis were used for the cases of HFMD from 2010~2012 in Wuxi Binhu District.Results:A total of 4533 patients with hand-foot-mouth disease were reported from 2010 to 2012 in Liyuan Street.of whom children from 1 to 4-years-old were the majoirty,accounted for 79.00%of the total number,Men had a higher morbidity rate than women;the disease at acked throughout al the 12 months.Conclusions:There levant departments should strengthen the prevention and control ef orts of HFMD,focusing on 1 to 4-years-old children based on the HFMD epidemic characteristics.%目的:探讨手足口病流行病学特征及影响因素,为预防、控制手足口病提供科学依据。方法:采用描述性和分析性流行病学方法,对2010年~2012年无锡市滨湖区的手足口病病例进行分析。结果:2010年~2012年共报告手足口病病例4533例,以1~4岁儿童发病最多,占总病例数的79.00%,全年12个月均有发病,男性发病多于女性。结论:根据手足口病流行特征,有关部门应加强手足口病防控力度,重点对象为1~4岁儿童。

  17. Consulting in Collection Development.

    Science.gov (United States)

    Ash, Lee

    1980-01-01

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

  18. 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.

  19. Application of a New Hybrid Model with Seasonal Auto-Regressive Integrated Moving Average (ARIMA) and Nonlinear Auto-Regressive Neural Network (NARNN) in Forecasting Incidence Cases of HFMD in Shenzhen, China

    OpenAIRE

    Lijing Yu; Lingling Zhou; Li Tan; Hongbo Jiang; Ying Wang; Sheng Wei; Shaofa Nie

    2014-01-01

    BACKGROUND: Outbreaks of hand-foot-mouth disease (HFMD) have been reported for many times in Asia during the last decades. This emerging disease has drawn worldwide attention and vigilance. Nowadays, the prevention and control of HFMD has become an imperative issue in China. Early detection and response will be helpful before it happening, using modern information technology during the epidemic. METHOD: In this paper, a hybrid model combining seasonal auto-regressive integrated moving average...

  20. The Impact of Checking the Health of Adults with Intellectual Disabilities on Primary Care Consultation Rates, Health Promotion and Contact with Specialists

    Science.gov (United States)

    Felce, David; Baxter, Helen; Lowe, Kathy; Dunstan, Frank; Houston, Helen; Jones, Glyn; Grey, Jill; Felce, Janet; Kerr, Michael

    2008-01-01

    Background: Studies have found that health checking in primary care led to the identification of previously unrecognized morbidity among adults with intellectual disabilities. The aim here was to evaluate whether health checking stimulated increased consultation with the general practitioner or another member of the primary care team, increased…

  1. 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...

  2. Campaign Consultants - Client Payments

    Data.gov (United States)

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

  3. Optimizing Consulting Delivery Systems.

    Science.gov (United States)

    Spottswood, Curran

    1980-01-01

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

  4. 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.

  5. Tianjin Architects & Consulting Engineers

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

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

  6. Consulting on Academic Library Buildings.

    Science.gov (United States)

    Mason, Ellsworth

    1980-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Keme Carter

    2015-10-01

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

  8. Designing consultancy on energy

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-07-01

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

  9. Making consultations run smoothly

    DEFF Research Database (Denmark)

    Jespersen, Astrid Pernille; Jensen, Torben Elgaard

    2012-01-01

    This article investigates the skilful use of time in general practice consultations. It argues that consultation work involves social and material interactions, which are only partially conceptualized in existing medical practice literatures. As an alternative, this article employs ideas from...... the field of science and technology studies (STS), including notions of relationality, multiplicity and otherness. Through this lens, and based on extensive fieldwork, it describes the daily work of arranging time before, during and after consultations. In conclusion, it suggests that a STS...

  10. The Dream Consultant

    DEFF Research Database (Denmark)

    Muhr, Sara Louise; Kirkegaard, Line

    2013-01-01

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

  11. 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...

  12. Family Practice Consultation.

    African Journals Online (AJOL)

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

  13. Application of a new hybrid model with seasonal auto-regressive integrated moving average (ARIMA) and nonlinear auto-regressive neural network (NARNN) in forecasting incidence cases of HFMD in Shenzhen, China.

    Science.gov (United States)

    Yu, Lijing; Zhou, Lingling; Tan, Li; Jiang, Hongbo; Wang, Ying; Wei, Sheng; Nie, Shaofa

    2014-01-01

    Outbreaks of hand-foot-mouth disease (HFMD) have been reported for many times in Asia during the last decades. This emerging disease has drawn worldwide attention and vigilance. Nowadays, the prevention and control of HFMD has become an imperative issue in China. Early detection and response will be helpful before it happening, using modern information technology during the epidemic. In this paper, a hybrid model combining seasonal auto-regressive integrated moving average (ARIMA) model and nonlinear auto-regressive neural network (NARNN) is proposed to predict the expected incidence cases from December 2012 to May 2013, using the retrospective observations obtained from China Information System for Disease Control and Prevention from January 2008 to November 2012. The best-fitted hybrid model was combined with seasonal ARIMA [Formula: see text] and NARNN with 15 hidden units and 5 delays. The hybrid model makes the good forecasting performance and estimates the expected incidence cases from December 2012 to May 2013, which are respectively -965.03, -1879.58, 4138.26, 1858.17, 4061.86 and 6163.16 with an obviously increasing trend. The model proposed in this paper can predict the incidence trend of HFMD effectively, which could be helpful to policy makers. The usefulness of expected cases of HFMD perform not only in detecting outbreaks or providing probability statements, but also in providing decision makers with a probable trend of the variability of future observations that contains both historical and recent information.

  14. 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.

  15. Base rates in the SDE Plus Scheme 2014 (Dutch Renewable Energy Scheme). Concept recommendation 'for the market consultation]; Conceptadvies basisbedragen in de SDE+ 2014 [ten behoeve van de marktconsultatie

    Energy Technology Data Exchange (ETDEWEB)

    Lensink, S.M. (ed.) [ECN Policy Studies, Petten (Netherlands)

    2013-05-15

    On assignment of the Dutch Ministry of Economic Affairs, ECN and DNV KEMA have studied the cost of renewable energy production. This cost assessment for various categories is part of an advice on the subsidy base rates for the feed-in support scheme SDE+. This report contains a draft advice on the cost of projects in the Netherlands targeted for realization in 2014. The options advice covers installation technologies for the production of green gas, biogas, renewable electricity and renewable heat. This draft advice has been written to facilitate the market consultation on the 2014 base rates. The open market consultation is to be held in June 2013 [Dutch] Het Ministerie van Economische Zaken (EZ) heeft aan ECN en DNV KEMA advies gevraagd over de hoogte van de basisbedragen in het kader van de SDE+-regeling voor 2014. Evenals bij vergelijkbare onderzoeken in voorgaande jaren hebben ECN en DNV KEMA er in overleg met het ministerie voor gekozen om een conceptadvies aan de markt voor te leggen. Dit rapport betreft het conceptadvies. ECN en DNV KEMA adviseren het ministerie over de hoogte van de basisbedragen voor door het ministerie voorgeschreven categorieen. De Minister van EZ beslist over de openstelling van de SDE+-regeling in 2014, de open te stellen categorieen en de basisbedragen voor nieuwe SDE+-beschikkingen in 2014. Het proces staat beschreven in Hoofdstuk 2. Hoofdstuk 3 behandelt de prijsontwikkelingen voor elektriciteit, gas en biomassa. Hoofdstuk 4 geeft per categorie een overzicht van de technisch-economische parameters van de hernieuwbareenergieopties. Hoofdstuk 5 besluit met conclusies waarbij de vertaalslag naar basisbedragen gemaakt is aan de hand van beknopt beschreven financiele parameters.

  16. Sharing Expertise: Consulting

    Science.gov (United States)

    Graves, Bill

    2011-01-01

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

  17. The co-inheritance of alpha-thalassemia and sickle cell anemia is associated with better hematological indices and lower consultations rate in Cameroonian patients and could improve their survival.

    Directory of Open Access Journals (Sweden)

    Maryam Bibi Rumaney

    Full Text Available BACKGROUND: Co-inheritance of α-thalassemia was reported to be associated with a delayed age of disease onset among Cameroonian Sickle Cell Anemia (SCA patients. The present study aimed to explore the correlation between α-thalassemia, hematological indices, and clinical events in these patients. METHODS AND FINDINGS: We studied 161 Cameroonian SCA patients and 103 controls (59.1% HbAA with median ages of 17.5 and 23 years. RFLP-PCR was used to confirm SCA genotype and to describe haplotypes in the HBB-like genes cluster. Multiplex Gap-PCR was performed to investigate the 3.7 kb α-globin gene deletions. SNaPshot PCR, capillary electrophoresis and cycle sequencing were used for the genotyping of 10 SNPs in BCL11A, HMIP1/2, OR51B5/6 and HBG loci, known to influence HbF levels. Generalised linear regression models adjusted for age, sex and SNPs genotypes was used to investigate effects of α-thalassemia on clinical and hematological indices. The median rate of vaso-occlusive painful crisis and hospitalisations was two and one per year, respectively. Stroke was reported in eight cases (7.4%. Benin haplotype was the most prevalent (66.3%; n = 208 chromosomes. Among patients, 37.3% (n = 60 had at least one 3.7 kb deletion, compared to 10.9% (n = 6 among HbAA controls (p<0.001. Among patients, the median RBC count increased with the number of 3.7 kb deletions [2.6, 3.0 and 3.4 million/dl, with no, one and two deletions (p = 0.01]. The median MCV decreased with the number of 3.7 kb deletion [86, 80, and 68fl, with no, one and two deletions (p<0.0001], as well as median WBC counts [13.2, 10.5 and 9.8×109/L (p<0.0001. The co-inheritance of α-thalassemia was associated with lower consultations rate (p = 0.038. CONCLUSION: The co-inheritance of α-thalassemia and SCA is associated with improved hematological indices, and lower consultations rate in this group of patients. This could possibly improve their survival and explain the

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

    Science.gov (United States)

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

    2007-02-12

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

  19. Mentoring for new consultants.

    Science.gov (United States)

    Ackroyd, R; Adamson, K A

    2015-01-01

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

  20. Health Consultation in China

    Institute of Scientific and Technical Information of China (English)

    1995-01-01

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

  1. The Process of Psychological Consultation

    Science.gov (United States)

    Nolan, Anna; Moreland, Neil

    2014-01-01

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

  2. Management Consulting: Planning, Entry, Performance.

    Science.gov (United States)

    Cosier, Richard A.; Dalton, Dan R.

    1993-01-01

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

  3. Consulting in Electronic Commerce

    Directory of Open Access Journals (Sweden)

    Florentina Loredana Tache

    2010-10-01

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

  4. Epistemics in audiological consultations

    DEFF Research Database (Denmark)

    Egbert, Maria

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

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

    Science.gov (United States)

    Prasad-Gaur, Archna; And Others

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

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

    Science.gov (United States)

    Ingraham, Colette L.

    2017-01-01

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

  7. 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.

  8. 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....

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

    Science.gov (United States)

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

    2017-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Dendukuri Nandini

    2005-04-01

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

  11. 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.

  12. Users enlist consultants to calculate costs, savings

    Energy Technology Data Exchange (ETDEWEB)

    1982-05-24

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

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

    Science.gov (United States)

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

    2011-01-01

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

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

    Science.gov (United States)

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

    2011-12-01

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

  15. Health Education and Nursing Management of Prevention and Control of HFMD%手足口病预防和控制的健康教育和护理管理

    Institute of Scientific and Technical Information of China (English)

    王頔

    2015-01-01

    HFMD is a common childhood infectious diseases.Health education is an important measure of prevention and control of HFMD. We should take a variety of ways to carry out various forms of health education objects of missionary ac-tivity straightaway and found the children to be taken after, cut off transmission and protect vulnerable populations nursing management measures possible to avoid large-scale spread of the disease , so that children early recovery, reduce disease for children with adverse health effects, effectively prevent and control the spread and prevalence of the disease.%手足口病是儿童常见传染病,健康教育是手足口病预防和控制的重要措施。应采取多种途径对健康教育对象开展形式多样的通俗易懂的宣教活动,发现患儿后要采取控制传染源、切断传播途径和保护易感人群的护理管理措施,能够避免疾病的大范围传播,使患儿尽早痊愈,减少疾病对于患儿健康的不良影响,有效预防和控制手足口病的传播和流行。

  16. Simulated consultations: a sociolinguistic perspective

    National Research Council Canada - National Science Library

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

    2016-01-01

    .... Equally important, but less researched, is the question of how far consultations with simulated patients reflect real clinical encounters--for which sociolinguistics, defined as the study of language...

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

    Science.gov (United States)

    Gazdag, Gábor; Sebestyén, Gábor

    2005-09-01

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

  18. 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…

  19. Communication Consulting as Persuasion: Issues and Implications.

    Science.gov (United States)

    Ross, Roseanna G.

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

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

    Science.gov (United States)

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

    2017-08-01

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

  1. Perceived incivility during emergency department phone consultations.

    Science.gov (United States)

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

    2016-06-01

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

  2. Narrative and Structure in Consultation

    Science.gov (United States)

    Hadley, David

    2012-01-01

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

  3. Gamification in a Consulting Company

    NARCIS (Netherlands)

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

    2014-01-01

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

  4. [Remote medical consultations in gerontology].

    Science.gov (United States)

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

    2012-01-01

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

  5. Gamification in a Consulting Company

    NARCIS (Netherlands)

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

    2014-01-01

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

  6. 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.

  7. 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…

  8. 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…

  9. 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

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

    Science.gov (United States)

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

    2005-10-01

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

  11. Enterovirus 71 infection induced HFMD related to IL-6 and IL-13 level%IL-6和 IL-13与 EV71型肠道病毒感染手足口病患者发病的相关性

    Institute of Scientific and Technical Information of China (English)

    陈清

    2015-01-01

    Objective To study the clinical significance of interleukin (IL)-6 and IL-13 levels in serum of hand,foot,and mouth disease (HFMD)caused by enterovirus 71,and carries on the preliminary discussion on serum IL-6 and IL-13 cell origin. Methods Serum levels of IL-6 and IL-13 in HFMD and healthy control were detected by enzyme linked immunosorbent assay (ELISA),serum IL-6 and IL-13 levels among different severity of HFMD were compared.Serum IL-6 and IL-13 levels in HFMD after treatment were also detected.The secretion of IL-6 by monocyte and the secretion of IL-13 by T cells in peripheral blood mononuclear cells (PBMC)were detected by Flow Cytometry (FCM).Monocyte and T cells from health individual were treated with EV71,and the secretion of IL-6 by monocyte and the secretion of IL-13 by T cells were detected by FCM too.Results Serum levels of IL-6 and IL-13 were (79.63±29.45)pg/mL and (36.45±1 5.13)pg/mL respectively in HFMD,and serum levels of IL-6 and IL-13 were (27.26±7.82)pg/mL and (13.46±3.14)pg/mL respectively in health control,serum IL-6 and IL-13 levels in HFMD were significantly higher than that of healthy subjects (P < 0.01 ),and the mean serum IL-6 and IL-13 levels of HFMD were increased with the severity of the disease (P <0.01).After treatment,serum levels of IL-6 and IL-13 were (48.23 ±23.14) pg/mL and (23.25±9.63)pg/mL respectively,when compared with before treatment,serum levels of IL-6 and IL-13 were signifi-cantly decreased (P <0.01).The secretion ability of IL-6 by monocyte and the secretion of IL-13 by T cells in HFMD were signifi-cantly higher than that of healthy subjects.After infection by EV71,the secretion ability of IL-6 by monocyte and the secretion of IL-13 by T cells were significantly increased.Conclusion Infection of EV71 probably by increase the secretion ability of IL-6 by monocyte and the secretion of IL-13 by T cells,resulted in elevated of serum IL-6 and IL-13 levels,which involved in the occurrence and development of HFMD

  12. CURBSIDE CONSULTATION IN HIP ARTHROPLASTY

    OpenAIRE

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

    2009-01-01

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

  13. 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…

  14. Core Competencies for Training Effective School Consultants

    Science.gov (United States)

    Burkhouse, Katie Lynn Sutton

    2012-01-01

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

  15. Special Education Teacher Consultant: Idealism versus Realism.

    Science.gov (United States)

    Haight, Sherrel Lee

    1984-01-01

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

  16. Observed Consultation: Confidence and Accuracy of Assessors

    Science.gov (United States)

    Tweed, Mike; Ingham, Christopher

    2010-01-01

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

  17. Observed Consultation: Confidence and Accuracy of Assessors

    Science.gov (United States)

    Tweed, Mike; Ingham, Christopher

    2010-01-01

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

  18. 手足口病重症患儿营养素水平与病情的相关性分析%Correlation of nutrient levels and state of severe cases with HFMD

    Institute of Scientific and Technical Information of China (English)

    王晓波; 杜潘艳; 赵玉萍; 王宝林; 高翠红; 张双

    2016-01-01

    目的:探讨手足口病患儿外周血中营养素前白蛋白(PA)、纤维连接蛋白(FN)、视黄醇结合蛋白(RBP)、C-反应蛋白( CRP)、微量元素铁、锌及维生素D( VitD)水平与病情的相关性。方法:采用免疫比浊法检测PA、FN、RBP和CRP水平;采用火焰原子吸收法检测全血微量元素铁、锌水平;采用电化学发光法检测VitD水平。结果:重症组与普通组、对照组比较,PA、FN、RBP、铁、锌及VitD水平均低,CRP水平升高(P<0.05);普通组与对照组比较,PA、FN和RBP水平均降低,CRP水平升高( P<0.05);铁、锌及VitD水平在普通组和对照组间无统计学意义( P>0.05)。重症恢复期PA、FN、RBP、铁、锌及VitD水平均高于急性期( P<0.01),但仍低于对照组( P<0.05);恢复期CRP水平与对照组无统计学意义( P>0.05)。 PA、FN和RBP水平与手足口病病情呈显著负相关( P<0.05);而CRP与病情呈显著正相关( P<0.05);铁、锌、VitD水平与病情呈低度负相关( P<0.05)。结论:手足口病重症病例存在营养缺乏,临床应对其进行营养状态动态评估并适量补充营养。%Objective:To detect the levels of PA,FN,RBP,CRP,Iron,Zinc,VitD in peripheral blood of children with HFMD and to explore the relationship between them and the disease .Methods:The levels of PA,FN,RBP and CRP were detected by immune turbidimetric assay;and the levels of Iron and Zinc were detected by flame atomic absorption spectrometry ;while the levels of VitD were detected by electro chemilumin escence .Results:The levels of PA,FN,RBP,Iron,Zinc and VitD in the severe group were lower than those in other groups ,while the levels of CRP were higher than those in other groups ( P0.05 ) .The levels of PA,FN,RBP,Fe,Zn and VitD in the convalescence were higher than those in the acute phase of the severe cases (P0.05).There were

  19. Harnessing competence and confidence: Dimensions in education and development for advanced and consultant practice

    Energy Technology Data Exchange (ETDEWEB)

    Price, Richard C. [School of Health and Emergency Professions, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB (United Kingdom)], E-mail: r.c.price@herts.ac.uk; Edwards, Hazel M. [School of Health and Emergency Professions, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB (United Kingdom)

    2008-12-15

    Consultant and advanced practice are relatively new concepts in radiography. There is evidence to show that as the career progression framework is being adopted the numbers of consultant and advanced practitioners in radiography are growing with the latter growing at a faster rate. The article considers the concept of advanced and consultant practice and the education requirements to support development. Preparation for an advanced practice role begins at the practitioner stage. Masters' level programmes are available to support the development of advanced practice. Education needs to be flexible as new advanced practice roles emerge. It is necessary to take practitioners beyond a defined modality to include leadership and people skills. These are essential for those aspiring to become consultants. Consultants require a high level of clinical knowledge for expert practice but also strategic vision and interpersonal intelligence to facilitate leadership and practice innovation. A model for developing leadership skills for consultants focussing on competence, confidence and capacity is proposed.

  20. 喜炎平注射液治疗手足口病合并肺炎的疗效观察%To Observe the Clinical Effects of Xiyanping Injection on Hand-foot-mouth disease(HFMD) Complicated Pneumonia

    Institute of Scientific and Technical Information of China (English)

    张洪涛; 毕英花; 徐辉; 程庚哲

    2013-01-01

    Objective To observe the clinical effects of Xiyanping injection on pneumonia caused by Hand -foot-mouth disease(HFMD).Method TO review 158 HFMD patients with pneumonia;There are 100 cases injected Xiyanping and 58 cases not injected.Compare the former with the latter on the time of fever,deflorescence, white blood cells,myocardial enzyme and Pulmonary shadow fading,and the number of severe cases.Result There was a significant difference in fever length(days),Bleb subsidizing length(days),white cells keep in normal days,Pulmonary shadow fading days,and the incidence of severe cases between the treatment group and control group.Conclusion Xiyanping injection is exactly safe and reliable for curing pneumonia ,and can shorten the length of stay and reduce the incidence of severe pneumoni-a.%目的:观察喜炎平注射液对手足口病引起的肺炎临床疗效。方法回顾分析158例手足口病合并肺炎患者中100例应用喜炎平注射液和58例未用喜炎平治疗后,发热、皮疹消退、白细胞、心肌酶、肺部阴影消退时间,重症病例发生人数进行对比。结果治疗组与对照组在发热天数、疱疹消退天数、白细胞正常天数、心肌酶正常天数、肺阴影消退天数、重症发生率等方面差异有统计学意义。结论喜炎平注射液治疗肺炎疗效确切安全、可靠,可缩短治愈时间,减少重症肺炎发生。

  1. Tips for telephone and electronic medical consultation.

    Science.gov (United States)

    Gupta, Sailesh G

    2013-11-01

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

  2. 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

  3. 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

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

    Science.gov (United States)

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

    2017-01-05

    validated tool to assess the effects of a training intervention on paediatric residents' history-taking and case management skills. It reported no difference compared to no intervention, but authors did not report any quantitative analyses and could not supply additional data. We rated this study as being at high risk of bias. Based on GRADE, we assessed the certainty of the evidence as very low, and consequently it is uncertain whether this intervention improves clinicians' telephone skills.We did not find any study assessing the effect of training interventions for improving clinicians' telephone communication skills on patient primary outcomes (health outcomes measured by validated tools or biomedical markers or patient behaviours, patient morbidity or mortality, patient satisfaction, urgency assessment accuracy or adverse events). Telephone consultation skills are part of a wider set of remote consulting skills whose importance is growing as more and more medical care is delivered from a distance with the support of information technology. Nevertheless, no evidence specifically coming from telephone consultation studies is available, and the training of clinicians at the moment has to be guided by studies and models based on face-to-face communication, which do not consider the differences between these two communicative dimensions. There is an urgent need for more research assessing the effect of different training interventions on clinicians' telephone consultation skills and their effect on patient outcomes.

  5. Development and implementation of a proactive geriatrics consultation model in collaboration with hospitalists.

    Science.gov (United States)

    Sennour, Youcef; Counsell, Steven R; Jones, Jerrlyn; Weiner, Michael

    2009-11-01

    Acutely ill hospitalized older adults often experience a decline in function that may be preventable using a proactive, interdisciplinary, patient-centered approach. Hospitalists are treating an increasing number of these patients. A collaborative geriatrics consultation model to prevent functional decline and improve care for older patients with geriatrics syndromes was developed and implemented in partnership with a large hospitalist group in a community teaching hospital. A team of a geriatrician and a geriatrics nurse practitioner led the new consultation service. The team assisted with identifying cases, provided consultation early in the hospital stay, focused its evaluation on functional and psychosocial issues, and assisted in clinical management to optimize implementation of recommendations. In the first 4 years, the consultation service conducted 1,538 consultations in patients with a mean age of 81 (range 56-103). The most frequent geriatrics diagnoses were gait instability, delirium, and depression; recommendations usually included consulting physical therapy, increasing activity, and changing medications. The number of referrals and referring physicians grew steadily each year. Twenty-eight of 34 (82%) of the referring hospitalists completed a Web-based satisfaction questionnaire. All responding hospitalists agreed that proactive geriatrics consultation helped them provide better care; 96% rated the service as excellent. Analysis of hospital administrative data revealed a lower length of stay index and lower hospital costs in patients receiving a geriatrics consultation. The Proactive Geriatrics Consultation Service represents a promising model of collaboration between hospitalists and geriatricians for improving care of hospitalized older adults.

  6. Annual consultation prevalence of regional musculoskeletal problems in primary care: an observational study

    Science.gov (United States)

    2010-01-01

    Background Regional musculoskeletal pain such as back or shoulder pain are commonly reported symptoms in the community. The extent of consultation to primary care with such problems is unknown as a variety of labels may be used to record such consultations. The objective was to classify musculoskeletal morbidity codes used in routine primary care by body region, and to determine the annual consultation prevalence of regional musculoskeletal problems. Methods Musculoskeletal codes within the Read morbidity Code system were identified and grouped by relevant body region by four GPs. Consultations with these codes were then extracted from the recorded consultations at twelve general practices contributing to a general practice consultation database (CiPCA). Annual consultation prevalence per 10,000 registered persons for the year 2006 was determined, stratified by age and gender, for problems in individual regions and for problems affecting multiple regions. Results 5,908 musculoskeletal codes were grouped into regions. One in seven of all recorded consultations were for a musculoskeletal problem. The back was the most common individual region recorded (591 people consulting per 10,000 registered persons), followed by the knee (324/10,000). In children, the foot was the most common region. Different age and gender trends were apparent across body regions although women generally had higher consultation rates. The annual consultation-based prevalence for problems encompassing more than one region was 556 people consulting per 10,000 registered persons and increased in older people and in females. Conclusions There is an extensive and varied regional musculoskeletal workload in primary care. Musculoskeletal problems are a major constituent of general practice. The output from this study can be used as a resource for planning future studies. PMID:20598124

  7. The inverse care law revisited: impact of disadvantaged location on accessing longer GP consultation times.

    Science.gov (United States)

    Furler, John S; Harris, Elizabeth; Chondros, Patty; Powell Davies, P Gawaine; Harris, Mark F; Young, Doris Y L

    2002-07-15

    To compare the rate of provision of longer consultations per head of population across practice locations categorised by socioeconomic status. Retrospective analysis of Medicare data for all consultations for all general practitioners in Australia for the 1998-99 and 1999-2000 financial years, grouped by postcode of practice location. Postcodes were categorised by the Socio-Economic Indexes for Areas, Index of Relative Socio-Economic Disadvantage score. Number of consultations and number of brief, standard, long and prolonged consultations per capita in each postcode grouping. The absolute number of long plus prolonged consultations showed no trend across postcode groups, but the rate ratio per person was significantly higher in more advantaged postcode areas. This represents an example of care provision in inverse relationship to need. Despite higher rates of chronic disease and lower rates of preventive care uptake, patients in low socioeconomic status areas receive longer GP consultations at a lower rate than patients in more advantaged areas. Possible strategies to overcome this inverse care provision include increased numbers of GPs in disadvantaged communities, removal of financial disincentives to longer consultations, and strengthening health promotion and community health services in disadvantaged areas.

  8. CURBSIDE CONSULTATION IN HIP ARTHROPLASTY

    Directory of Open Access Journals (Sweden)

    Scott M. Sporer

    2009-03-01

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

  9. Integrating corpus consultation in language studies

    OpenAIRE

    Angela Chambers

    2005-01-01

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

  10. Psychoimmunology Consultation - A Study on Comorbidity

    Directory of Open Access Journals (Sweden)

    Mariana Marinho

    2017-03-01

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

  11. Managing your engineering consultants: Steps for simultaneously improving operations, project implementation, and your bottom line

    Energy Technology Data Exchange (ETDEWEB)

    Kirchen, E.R.; Perilloux, B.L. [Albert-Garaudy and Associates, Inc., Metairie, LA (United States)

    1997-12-31

    The domestic oil and gas industry has responded to depleting reserves and increasing operating costs by downsizing the overhead required to maintain production and processing facilities. For many companies this downsizing has resulted in a reduced in-house engineering staff and a greater reliance on consulting engineering services. To get the most benefit from consulting engineering companies, the partnership between consultants and the oil and gas company needs to be carefully considered. Unfortunately, these partnerships are often developed at the home office with visionary goals in mind, only to be implemented reluctantly on a local level. A better strategy is to implement partnering tools on the local level and allow these partnerships to develop naturally, and at times, uniquely, at each location. The following such tools detailed in this paper are: manpower leveraging -- using field-trained consulting engineers to address project design/implementation and field/construction support so that the operating company`s engineers may focus on management and detailed development of high-return projects; enhanced project scope and design review -- developing and reviewing project scope(s) and preliminary engineering designs to minimize engineering/construction costs as well as optimize the operability and constructability of the project; and consulting rate standardization -- understanding and structuring the consultant`s rates so that neither side is exploited and so that the project is staffed in the interest of project execution and not maximum profits for the consultant.

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

    Science.gov (United States)

    Lister, E D; Pirrotta, S

    1996-11-01

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

  13. Diagnoses, Requests and Timing of 503 Psychiatric Consultations in Two General Hospitals

    Directory of Open Access Journals (Sweden)

    Elahe Sahimi Izadian

    2012-01-01

    Full Text Available The high comorbidity of medical and psychiatric diagnoses in the general hospital population requires collaboration between various medical fields to provide comprehensive health care. This study aims to find the rate of psychiatric consultations, their timing and overall diagnostic trend in comparison to previous studies. Tehran University of Medical Sciences has got an active psychiatric consultation-liaison service which includes services provided by four faculty psychiatrists (two full-time and two part-time. This study was done in two general hospitals by simple sampling in available cases. For each consultation, a board-certified faculty psychiatrist conducted a clinical evaluation based on DSM-IV-TR. Other than psychiatric diagnoses, socio-demographic variables, relative consultation rates, reasons for referral, medical diagnoses and the time stay after admission were assessed. Among 503 patients who were visited by the consultation-liaison service, there were 54.3% female with mean age of 39.8 years. In 90.1% of consultations, at least one DSM-IV-TR diagnosis was made. The most frequent diagnosis groups were mood disorder (43.5%, adjustment disorder (10.9% and cognitive disorder (7.6%. In about 10.9% of the consultations, multiple psychiatric diagnoses were made. The mean length of hospital stay before the consultation was 12.56 days (range=1-90, SD=13. Based on our findings, the mood and cognitive disorders still remain major foci of consultation-liaison practice in general hospitals; however our findings showed high rate of adjustment disorders diagnosis and ambiguous request for psychiatric consultation which need more interdisciplinary interaction.

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

    Science.gov (United States)

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

    2012-05-01

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

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

    Science.gov (United States)

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

    2004-01-01

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

  16. The application of time series analysis in modeling and predicting the influenza-like illness consultation rate in Huangpu District of Shanghai%用时间序列分析对黄浦区流感样病例就诊百分比建模并评价预测效果

    Institute of Scientific and Technical Information of China (English)

    沈福杰; 王怡珺; 张焕珠; 毛宇明; 孙海燕

    2016-01-01

    Objective To explore the feasibility for modeling and forecasting outpatient consulta-tionrate of influenza-like illness ( ILI ) in Huangpu District of Shanghai . Methods ILI consultation rates from the first week of 2011 to the 52 th week of 2014 were collected through the National Influenza Surveillance Information System .SAS 9.3 was used to establish an optimal ARIMA model of ILI data .The forecasting ability of the ARIMA model was afterwards evaluated by using data from the first to the sixth week in 2015 . Results ARIMA ( 1 ,0 ,0 ) was identified as the final model in fitting outpatient vising rate of ILI with stable and white noise residual .Model validation showed that the real outpatient-visiting rate of ILI all fell in the 95%confidence interval of the predictive values . Conclusion ARIMA (1,0, 0 ) could be used in the forecast of ILI consultation rates in Huangpu District of Shanghai .%目的:利用时间序列分析对黄浦区流感样病例( ILI)就诊百分比建模并评价预测效果。方法通过国家流感监测信息系统收集黄浦区2011年第1周—2014年第52周的ILI就诊百分比,利用SAS 9.3软件对数据建立最优ARIMA模型,利用2015年第1周—第6周的ILI就诊百分比对已建立的ARIMA模型进行预测效果评价。结果对ILI就诊百分比预处理发现序列为平稳非白噪声序列,最终建模为ARIMA(1,0,0),模型残差为白噪声序列,真实值均在预测值95%可信区间内。结论 ARIMA(1,0,0)模型可用于黄浦区ILI就诊百分比的预测。

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

    Science.gov (United States)

    Spencer, Gregory P.

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

  18. Consulting Careers: A Profile of Three Occupations

    Science.gov (United States)

    Mullins, John

    2011-01-01

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

  19. The Consulting Challenge: A Case Competition

    Science.gov (United States)

    Sachau, Daniel A.; Naas, Patricia A.

    2010-01-01

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

  20. Capturing the Competence of Management Consulting Work

    Science.gov (United States)

    Visscher, Klaasjan

    2006-01-01

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

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

    Science.gov (United States)

    Spencer, Gregory P.

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

  2. How to Hire a Search Consultant.

    Science.gov (United States)

    Lester, Virginia L.

    1993-01-01

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

  3. Patient expectations from consultation with family physician.

    NARCIS (Netherlands)

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

    2006-01-01

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

  4. 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…

  5. Capturing the competence of management consulting work

    NARCIS (Netherlands)

    Visscher, Klaasjan

    2006-01-01

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

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

    Science.gov (United States)

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

    2016-11-01

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

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

    Science.gov (United States)

    Pringle, M; Robins, S; Brown, G

    1986-01-01

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

  8. Analysis on results of Coxsackie virus nucleic acid detection in HFMD patients%手足口病患者柯萨奇病毒核酸检测结果分析

    Institute of Scientific and Technical Information of China (English)

    王武琦; 苏国生; 韦善求

    2015-01-01

    目的:探讨手足口病患者柯萨奇病毒核酸检测的临床应用价值。方法利用实时荧光聚合酶链反应技术,以 EV71/CA16基因组编码区的高度保守区为靶区域,设定特异性引物及荧光探针,通过一步法 RT‐PCR 扩增对 EV71 RNA/CA16 RNA 进行检测。结果在428份患者标本中,EV71‐RNA 阳性136份,CA16‐RNA 阳性6份,其中有1例患者既是 EV71‐RNA 咽拭子和肛拭子均阳性又是 CA16‐RNA 咽拭子阳性。而有40例(80份标本)患者 EV71‐RNA 咽拭子和肛拭子均阳性,46份 EV71‐RNA 单独肛拭子阳性,10份 EV71‐RNA 单独咽拭子阳性。在6份 CA16‐RNA 阳性患者标本中,4份为肛拭子阳性,2份为咽拭子阳性。结论手足口病患者柯萨奇核酸检测对重症患者判断预后有重要的指导意义,对指导临床合理制订治疗方案有重要的参考价值,值得推广应用。%Objective To investigate the clinical application value of Coxsackie virus nucleic acid detection in the patients with hand‐foot‐mouth disease(HFMD) .Methods The real‐time fluorescent PCR technology was adopt‐ed ,with a highly conserved region of EV71/CA16 genomic coding regionas the target area ,the specific primers and fluorescent probes were set ,EV71 RNA /CA16 RNA was detected by the one‐step method of RT‐PCR amplification . Results In 428 patients samples ,136 cases were EV71‐RNA positive ,6 cases were CA16‐RNA positive ,including 1 case of EV71‐RNA positive in throat swabs and anal swabs and CA16‐RNA positive in throat swab .And there were 40 cases (80 specimens) of EV71‐RNA positive in swabs and anal swabs ,46 cases of single EV71‐RNA positive in a‐nal swab ,10 cases of single EV71‐RNA positive in throat swabs .In 6 cases of CA16‐RNA positive specimens ,4 cases were positive in anal swab ,two cases were positive in throat swab .Conclusion The Coxsackie nucleic acid testing in HFMD patients has an important

  9. 56例重症手足口病患儿的护理%56 Nursing Cases of Severe HFMD Patients

    Institute of Scientific and Technical Information of China (English)

    李艳

    2014-01-01

    Objective: To investigate the ef ect of nursing in 56 children with severe hand foot and mouth disease, sum up experience. Methods: in our hospital in 2008 March -2010 year in October there were 989 cases of children with hand foot and mouth disease, of which 56 cases were severe, the care of al patients, to observe the ef ect of nursing. Results: the success rate of 98%, less adverse reaction, before discharge review of al children, pale, heart rate, heart rhythm awareness, blood pressure and other conditions were normal, mental status improved, good nursing ef ect. Conclusion: pay at ention to the symptoms observed in children with severe hand foot and mouth disease, detect changes in condition, good nursing care of the complications, active prevention and treatment of adverse reaction of drug rehabilitation, is of great significance to strengthen disinfection and isolation and vaccination of health education and nursing measures for patients with severe hand foot and mouth.%目的:探讨对56例重症手足口病患儿的护理效果,总结经验。方法选取我院2008年3月~2010年10月共收治手足口病患儿989例,其中重症56例,对所有患儿进行护理照料,观察其护理效果。结果抢救成功率98%,不良反应较少,出院前复查所有患儿意识、面色、心率、心律、血压等情况均恢复正常,精神状况好转,护理效果较好。结论注重观察重症手足口病患儿的系统症状,发现病情变化,做好并发症的护理,积极预防并处理好药物的不良反应,加强消毒隔离以及预防接种的健康宣教等护理措施对于重症手足口患儿的康复具有重要意义。

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

    Science.gov (United States)

    Dave, Anish

    2009-01-01

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

  11. 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…

  12. Reliability and accuracy of dermatologists' clinic-based and digital image consultations.

    Science.gov (United States)

    Whited, J D; Hall, R P; Simel, D L; Foy, M E; Stechuchak, K M; Drugge, R J; Grichnik, J M; Myers, S A; Horner, R D

    1999-11-01

    Telemedicine technology holds great promise for dermatologic health care delivery. However, the clinical outcomes of digital image consultations (teledermatology) must be compared with traditional clinic-based consultations. Our purpose was to assess and compare the reliability and accuracy of dermatologists' diagnoses and management recommendations for clinic-based and digital image consultations. One hundred sixty-eight lesions found among 129 patients were independently examined by 2 clinic-based dermatologists and 3 different digital image dermatologist consultants. The reliability and accuracy of the examiners' diagnoses and the reliability of their management recommendations were compared. Proportion agreement among clinic-based examiners for their single most likely diagnosis was 0. 54 (95% confidence interval [CI], 0.46-0.61) and was 0.92 (95% CI, 0. 88-0.96) when ratings included differential diagnoses. Digital image consultants provided diagnoses that were comparably reliable to the clinic-based examiners. Agreement on management recommendations was variable. Digital image and clinic-based consultants displayed similar diagnostic accuracy. Digital image consultations result in reliable and accurate diagnostic outcomes when compared with traditional clinic-based consultations.

  13. CONSULTATION ON UPDATED METHODOLOGY FOR ...

    Science.gov (United States)

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

  14. The Consultation of the Puericulture.

    Directory of Open Access Journals (Sweden)

    Rotardo Rafael Navarro Ruíz

    2010-06-01

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

  15. 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.

  16. Practical guidance for charting ethics consultations.

    Science.gov (United States)

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

    2014-03-01

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

  17. INTEGRATING CORPUS CONSULTATION IN LANGUAGE STUDIES

    Directory of Open Access Journals (Sweden)

    Angela Chambers

    2005-05-01

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

  18. 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.

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

    Science.gov (United States)

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

    2012-01-01

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

  20. 24 CFR 91.100 - Consultation; local governments.

    Science.gov (United States)

    2010-04-01

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

  1. Bladder Pain Syndrome International Consultation on Incontinence

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  2. Consulting Informs Best Practice in Academia

    Directory of Open Access Journals (Sweden)

    Risa Blair

    2015-10-01

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

  3. Three Obstacles to Improving Academic Consultation.

    Science.gov (United States)

    Kremer, John F.

    1980-01-01

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

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

    Science.gov (United States)

    Soudan, Corinne

    2014-10-01

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

  5. Ethics consultation: a dangerous, antidemocratic charlatanry?

    Science.gov (United States)

    Lilje, Christian

    1993-01-01

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

  6. 265 Statistical Consulting and the African Universities

    African Journals Online (AJOL)

    User

    2011-07-21

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

  7. ACF 2012 Reponse to Tribal Consultation Testimony

    Data.gov (United States)

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

  8. Bladder Pain Syndrome International Consultation on Incontinence

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  9. Supporting Group Communication Among UX Consultants

    OpenAIRE

    Feldt, Tommy

    2015-01-01

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

  10. Using Language Consultants in Communicative Language Teaching

    OpenAIRE

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

    2016-01-01

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

  11. 应用健康信念模型分析社会心理因素与手足口病预防行为的关系%Application of health belief model (HBM) in relationship of socio-psychological factors and hand-foot-mouth disease (HFMD) prevention behaviors

    Institute of Scientific and Technical Information of China (English)

    王蕊; 康晓平; 张丽平

    2012-01-01

    目的 应用健康信念模型(HBM)分析社会心理因素与手足口病预防行为的关系.方法 采用分层抽样方法对天津市塘沽地区幼儿园中530名婴幼儿家长进行问卷调查,采用SPSS 13.0进行统计分析,对原有的HBM进行校正,应用结构方程方法进行分析.结果 对手足口病知觉到严重性和到易感性有较强信念的人为46.92%和30.82%.手足口病相关知识得分低的人群的预防行为得分低于手足口病相关知识得分高的人群,差异有统计学意义(x2 =8.24,P<0.05).结构方程分析结果显示,户籍(t=-1.962)、手足口病相关知识(t =2.020)和知觉到障碍(t=-22.220)对预防手足口病预防行为有直接效应;家庭月收入(t=2.872)和手足口病相关知识(t=1.990)对预防行为有间接效应;手足口病相关知识(t=2.866)和知觉到障碍(t=-22.220)对预防行为有总效应,均有统计学意义(P<0.05).结论 校正后的健康信念模型能够成功地解释社会心理因素与手足口病预防行为的关系.良好的个人预防行为可以通过健康教育的形式,建立健康信念来实现.%Objective To use health belief model (HBM) for analysis of socio-psychological factors associated with hand-foot-mouth disease ( HFMD) prevention behaviors. Methods 530 parents or guardians of children were randomly selected for questionnaire survey from Tanggu District, Tianjin. The SPSS 13. 0 software was used for statistical a-nalysis. The original HBM model was corrected, and structural equation methods was used for influencing factors statistical analysis. Results The perceived severity and susceptibility by HFMD model were 46. 92% and 30. 82%. Parents with low knowledge scores had lower behaviors score than those with higher knowledge score, and the differences were statistically significant (x2= 8. 24, P < 0. 05 ). Structural equation analysis results showed that household registration (t = - 1. 962 ) , knowledge (t =2. 020) and perceived

  12. VP4基因鉴定非EV71非CoxA16手足口病病原体漏检的研究%Research on undetection of non-EV71 and non-CoxA16 related HFMD pathogens identified by using VP4 gene

    Institute of Scientific and Technical Information of China (English)

    木朝宇; 庄晓亮; 赵俊; 陈敬贤; 王明丽

    2014-01-01

    Objective To investigate the accuracy of PCR for detection of non-EV71 and non-CoxA16 by using u-niversal primers with VP4 gene of HEV. Methods When identified by VP4 gene of EV71 and CoxA16 unrelated HFMD, two isolates of Sabin-1 were found(such as Fy-01and Fy-02). They were identified by co-primers such as EVP4/Q8 and specific primers of VP1 gene. Results Fy-01 isolates were appeared with an unusual frayment and identified as CoxA10 after being sequenced and the selected independent clones were sequenced and blasted in GenBank. It proved that both Sabin-1 and CoxA10 existed. Conclusion Clinical diagnosis of EV71 and CoxA16 unrelated HFMD,when identifying the type of HFMD pathogen only by using the amplification product of VP4 gene after being sequenced directly is not enough, especially HFMD with mixed infections caused by enterovirus.%目的探讨肠道病毒VP4基因通用引物PCR诊断非肠道病毒71型( EV71)非柯萨奇病毒A组16型( CoxA16)手足口病( HFMD)病毒方案的准确性。方法通过肠道病毒VP4基因通用引物PCR鉴定阜阳地区非EV71非CoxA16 HFMD病毒时,显示两例病毒分离株为Sabin-1(命名为Fy-01和Fy-02株)。分别采用引物EVP4/Q8和VP1特异性引物对Fy-01和Fy-02分离株进行鉴定。结果采用VP4基因PCR扩增产物测序证实,两例病毒分离株为Sabin-1,而采用EVP4/Q8引物PCR扩增Fy-01分离株却存在异常的扩增条带,PCR扩增产物测序结果为柯萨奇病毒A组10型( Cox-A10);将VP4基因PCR产物制备成克隆载体挑选多个单克隆测序结果显示,Fy-01分离株既存在Sabin-1 VP4基因,又存在CoxA10 VP4基因,证实为两种毒株混合感染。结论临床诊断为非EV71非CoxA16 HFMD的病例,如病原学诊断仅采用VP4基因PCR产物测序,特别是针对多种肠道病毒混合感染引起的HFMD,其结果并不完全可靠。

  13. Osteoporosis screening and treatment among veterans with recent fracture after implementation of an electronic consult service.

    Science.gov (United States)

    Lee, Richard H; Lyles, Kenneth W; Pearson, Megan; Barnard, Karen; Colón-Emeric, Cathleen

    2014-06-01

    Fewer than 24% of Veterans received appropriate evaluation and/or treatment for osteoporosis within 6 months of an index fracture. An electronic consult (E-consult) service was implemented at three Veterans Affairs Medical Centers to facilitate the identification of and recommend management for patients with recent fracture. The E-consult service used clinical encounter data based on ICD9 diagnosis codes to prospectively identify patients with potential osteoporotic fractures. Eligible patients' medical records were reviewed by a metabolic bone specialist, and an E-consult note was sent to the patient's primary provider with specific recommendations for further management. Recommendations were initiated at the provider's discretion. Between 2011 and 2013, the E-consult service identified 444 eligible patients with a low-trauma fracture who were not already on treatment. One hundred twenty-nine (29.1%) consults recommended immediate bisphosphonate treatment, and 258 (58.1%) recommended bone density assessments. Primary providers responded by prescribing bisphosphonates in 74 patients (57.4%) and by ordering bone density testing in 183 (70.9%) patients. At the facility level, prior to implementation of the E-consult service, the rate of osteoporosis treatment following a fracture was 4.8% for bisphosphonates and 21.3% for calcium/vitamin D. After implementation, the treatment rate increased to 7.3% for bisphosphonates (p = 0.02) and 35.2% for calcium/vitamin D (p E-consult service modestly improved the rate of osteoporosis treatment among patients with a recent fracture. These results suggest that a program with direct patient interaction is probably required to substantially improve treatment rates.

  14. Nurse consultants: organizational influences on role achievement.

    Science.gov (United States)

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

    2006-03-01

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

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

    Science.gov (United States)

    Burdette, Paula J.; Crockett, Jean B.

    1999-01-01

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

  16. 41 CFR 102-78.30 - Who are consulting parties?

    Science.gov (United States)

    2010-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Dojeiji Suzan

    2007-05-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

  19. Web-based consultation between general practitioners and nephrologists: a cluster randomized controlled trial.

    Science.gov (United States)

    van Gelder, Vincent A; Scherpbier-de Haan, Nynke D; van Berkel, Saskia; Akkermans, Reinier P; de Grauw, Inge S; Adang, Eddy M; Assendelft, Pim J; de Grauw, Wim J C; Biermans, Marion C J; Wetzels, Jack F M

    2017-08-01

    Consultation of a nephrologist is important in aligning care for patients with chronic kidney disease (CKD) at the primary-secondary care interface. However, current consultation methods come with practical difficulties that can lead to postponed consultation or patient referral instead. This study aimed to investigate whether a web-based consultation platform, telenephrology, led to a lower referral rate of indicated patients. Furthermore, we assessed consultation rate, quality of care, costs and general practitioner (GPs') experiences with telenephrology. Cluster randomized controlled trial with 47 general practices in the Netherlands was randomized to access to telenephrology or to enhanced usual care. A total of 3004 CKD patients aged 18 years or older who were under primary care were included (intervention group n = 1277, control group n = 1727) and 2693 completed the trial. All practices participated in a CKD management course and were given an overview of their CKD patients. The referral rates amounted to 2.3% (n = 29) in the intervention group and 3.0% (n = 52) in the control group, which was a non-significant difference, OR 0.61; 95% CI 0.31 to 1.23. The intervention group's consultation rate was 6.3% (n = 81) against 5.0% (n = 87) (OR 2.00; 95% CI 0.75-5.33). We found no difference in quality of care or costs. The majority of GPs had a positive opinion about telenephrology. The data in our study do not allow for conclusions on the effect of telenephrology on the rate of patient referrals and provider-to-provider consultations, compared to conventional methods. It was positively evaluated by GPs and was non-inferior in terms of quality of care and costs.

  20. 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…

  1. Consulting as a Strategy for Knowledge Transfer

    Science.gov (United States)

    Jacobson, Nora; Butterill, Dale; Goering, Paula

    2005-01-01

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

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

    Science.gov (United States)

    2016-01-01

    Background Many markets have traditionally been dominated by a few best-selling products, and this is also the case for the health care industry. However, we do not know whether the market will be more or less concentrated when health care services are delivered online (known as E-consultation), nor do we know how to reduce the concentration of the E-consultation market. Objective The aim of this study was to investigate the concentration of the E-consultation market and how to reduce its concentration through information disclosure mechanisms (online reputation and self-representation). Methods We employed a secondary data econometric analysis using transaction data obtained from an E-consultation Website (haodf.com) for three diseases (infantile pneumonia, diabetes, and pancreatic cancer) from 2008 to 2015. We included 2439 doctors in the analysis. Results The E-consultation market largely follows the 20/80 principle, namely that approximately 80% of orders are fulfilled by nearly 20% of doctors. This is much higher than the offline health care market. Meanwhile, the market served by doctors with strong online reputations (beta=0.207, P<.001) or strong online self-representation (beta=0.386, P<.001) is less concentrated. Conclusions When health care services are delivered online, the market will be more concentrated (known as the “Superstar” effect), indicating poor service efficiency for society as a whole. To reduce market concentration, E-consultation websites should provide important design elements such as ratings of doctors (user feedback), articles contributed by doctors, and free consultation services (online representation). A possible and important way to reduce the market concentration of the E-consultation market is to accumulate enough highly rated or highly self-represented doctors. PMID:27793793

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

    Science.gov (United States)

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

    2016-01-01

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

  4. 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

  5. Moral mediation in interpreted health care consultations.

    Science.gov (United States)

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

    2013-12-01

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

  6. Reducing the time before consulting with symptoms of lung cancer: a randomised controlled trial in primary care.

    Science.gov (United States)

    Smith, Sarah; Fielding, Shona; Murchie, Peter; Johnston, Marie; Wyke, Sally; Powell, Rachael; Devereux, Graham; Nicolson, Marianne; Macleod, Una; Wilson, Phil; Ritchie, Lewis; Lee, Amanda J; Campbell, Neil C

    2013-01-01

    Most individuals with lung cancer have symptoms for several months before presenting to their GP. Earlier consulting may improve survival. To evaluate whether a theory-based primary care intervention increased timely consulting of individuals with symptoms of lung cancer. Open randomised controlled trial comparing intervention with usual care in two general practices in north-east Scotland. Smokers and ex-smokers aged ≥55 years were randomised to receive a behavioural intervention or usual care. The intervention comprised a single nurse consultation at participants' general practice and a self-help manual. The main outcomes were consultations within target times for individuals with new chest symptoms (≤3 days haemoptysis, ≤3 weeks other symptoms) in the year after the intervention commenced, and intentions about consulting with chest symptoms at 1 and 6 months. Two hundred and twelve participants were randomised and 206 completed the trial. The consultation rate for new chest symptoms in the intervention group was 1.19 (95% confidence interval [CI] = 0.92 to 1.53; P = 0.18) times higher than in the usual-care group and the proportion of consultations within the target time was 1.11 (95% CI = 0.41 to 3.03; P = 0.83) times higher. One month after the intervention commenced, the intervention group reported intending to consult with chest symptoms 31 days (95% CI = 7 to 54; P = 0.012) earlier than the usual care group, and at 6 months this was 25 days (95% CI = 1.5 to 48; P = 0.037) earlier. Behavioural intervention in primary care shortened the time individuals at high risk of lung disease intended to take before consulting with new chest symptoms (the secondary outcome of the study), but increases in consultation rates and the proportions of consultations within target times were not statistically significant.

  7. EV71感染手足口病患儿临床表现与甘露糖结合凝集素表达及基因多态性相关性研究%Analysis on the relationship between the human EV71 associated HFMD children's clinical manifestation and the genetic polymorphism and serum concentration of mannan binding lectin

    Institute of Scientific and Technical Information of China (English)

    何勇; 沈南平; 吉山宝; 吴晓波; 徐惠良

    2012-01-01

    Objective To explore the relationship between the genetic polymorphism and serum concentration of mannan binding lectin (MBL)and the clinical manifestation of the hand-foot-mouth disease (HFMD) children infection by human enterovirus 71 (HEV71).Methods One hundred and thirty-eight children diagnosed as HFMD infected by HEV71 (including 80 mild cases and 58 severe cases) and 40 healthy,symptom-free children were investigated.The concentrations of serum MBL were measured in 40 healthy controls,80 mild HFMD cases and 56 severe HFMD cases at both acute and convalescent phases by a sandwich enzyme immunoassay with a human MBL ELISA kit.And the genomic DNA of all cases were extracted from blood according to standard phenol-chloroform procedure.Six SNPs in the MBL gene(-550G/C,-221G/C and +4C/T of the promoter,CGT52TGT,GGC54GAC,and GGA57GAA of the exon 1) were analyzed by a sequencing-based typing method.Results The MBL serum level of the severe HFMD circulatory respiratory failure group in acute phase was significantly increased compared with severe HFMD encephalitis group,the mild cases and the control,but in the convalescence phase it significantly decreased compared with them.The frequencis of type B/B mutation (+230 of the exon 1),type P/P mutation (+4C/T of the promoter),and type H/H mutation (-550G/C of the promoter) were a significant difference among mild group,severe group and the control(P=0.006,0.043,0.028,respectively).The frequencies of LYPB/LYPB genotype and HYPA/HYPA genotype were a significant difference among mild group,severe groupand the control (P=0.028,0.014,respectively).Conclusion Low MBL protein level as a result genetic polymorphism seems to be correlative with clinical manifestation of HFMD disease.The MBL gene mutation and low MBI.protein level may be used as one of the evaluation method of HFMD severeity.%目的 探讨EV71感染的普通手足口病患儿和重症患儿的临床表现差异与甘露糖结合凝集素(MBL)血清水平、基

  8. IT Consultants in Acquisition IT Integration

    DEFF Research Database (Denmark)

    Henningsson, Stefan; Øhrgaard, Christian

    2016-01-01

    ’s IT following a corporate acquisition, presents a difficult but crucial IT challenge for the many acquiring organizations. Through a comparative case study of four acquirers, theoretically grounded in the resource-based view of the firm, it is analyzed how acquirers draw on external consultants to realize...... model, depicting the use of external consultants in acquisition IT integration, contributes to the literature on acquisition IT integration by providing an explanation for IT-based value creation in acquisition that is rooted in the external of the acquirer. In addition to adding to the limited...

  9. 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.

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

    Science.gov (United States)

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

    2014-01-01

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

  11. 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.

  12. Lung cancer physicians' referral practices for palliative care consultation.

    Science.gov (United States)

    Smith, C B; Nelson, J E; Berman, A R; Powell, C A; Fleischman, J; Salazar-Schicchi, J; Wisnivesky, J P

    2012-02-01

    Integration of palliative care with standard oncologic care improves quality of life and survival of lung cancer patients. We surveyed physicians to identify factors influencing their decisions for referral to palliative care. We provided a self-administered questionnaire to physicians caring for lung cancer patients at five medical centers. The questionnaire asked about practices and views with respect to palliative care referral. We used multiple regression analysis to identify predictors of low referral rates (consultation. Multivariate analysis, controlling for provider characteristics, found that low referral rates were associated with physicians' concerns that palliative care referral would alarm patients and families [odds ratio (OR) 0.45, 95% confidence interval (CI) 0.21-0.98], while the belief that palliative care specialists have more time to discuss complex issues (OR 3.07, 95% CI 1.56-6.02) was associated with higher rates of referral. Although palliative care consultation is increasingly available and recommended throughout the trajectory of lung cancer, our data indicate it is underutilized. Understanding factors influencing decisions to refer can be used to improve integration of palliative care as part of lung cancer management.

  13. Sustainability of a proactive geriatric trauma consultation service.

    Science.gov (United States)

    Wong, Camilla L; Al Atia, Raghda; McFarlan, Amanda; Lee, Holly Y; Valiaveettil, Christina; Haas, Barbara

    2017-02-01

    Proactive geriatric trauma consultation service (GTCS) models have been associated with better delivery of geriatric care and functional outcomes. Whether such collaborative models can be improved and sustained remains uncertain. We describe the sustainability and process improvements of an inpatient GTCS. We assessed workflow using interviews and surveys to identify opportunities to optimize the referral process for the GTCS. Sustainability of the service was assessed via a prospective case series (July 2012-December 2013). Study data were derived from a review of the medical record and trauma registry database. Metrics to determine sustainability included volume of cases, staffing levels, rate of adherence to recommendations, geriatric-specific clinical outcomes, trauma quality indicators, consultation requests and discharge destination. Through process changes, we were able to ensure every eligible patient was referred for a comprehensive geriatric assessment. Compared with the implementation phase, volume of assessments increased and recommendation adherence rates were maintained. Delirium and/or dementia were the most common geriatric issue addressed. The rate of adherence to recommendations made by the GTCS team was 88.2%. Only 1.4% of patients were discharged to a nursing home. Workflow assessment is a useful means to optimize the referral process for comprehensive geriatric assessment. Sustainability of a GTCS was shown by volume, staffing and recommendation adherence.

  14. Negotiating the Dance: Consulting with Adoptive Systems.

    Science.gov (United States)

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

    2002-01-01

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

  15. Delivering an MBA Management Consulting Experience

    Science.gov (United States)

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

    2017-01-01

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

  16. School Neuropsychology Consultation in Neurodevelopmental Disorders

    Science.gov (United States)

    Decker, Scott L.

    2008-01-01

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

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

    Science.gov (United States)

    Kirby, David A.

    2003-01-01

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

  18. Individualizing Language Strategies Using CONSULT-I.

    Science.gov (United States)

    Newman, Anabel P.; Metz, Elizabeth

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

  19. 76 FR 55678 - Tribal Consultation Policy

    Science.gov (United States)

    2011-09-08

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

  20. The Writing Consultation: Developing Academic Writing Practices

    Science.gov (United States)

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

    2008-01-01

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

  1. IT Consultants in Acquisition IT Integration

    DEFF Research Database (Denmark)

    Henningsson, Stefan; Øhrgaard, Christian

    2016-01-01

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

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

    African Journals Online (AJOL)

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

  3. 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.

  4. 77 FR 19020 - Tribal Consultation Meeting

    Science.gov (United States)

    2012-03-29

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

  5. 29 CFR 1691.12 - Interagency consultation.

    Science.gov (United States)

    2010-07-01

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

  6. Teacher Utilization of Instructional Consultation Teams

    Science.gov (United States)

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

    2014-01-01

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

  7. 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.

  8. The Role of the Organisational Development Consultant

    Science.gov (United States)

    Simmons, Mike

    1972-01-01

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

  9. Viburnum “terugloopziekte” : Consultancy onderzoek

    NARCIS (Netherlands)

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

    2012-01-01

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

  10. The Writing Consultation: Developing Academic Writing Practices

    Science.gov (United States)

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

    2008-01-01

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

  11. School Neuropsychology Consultation in Neurodevelopmental Disorders

    Science.gov (United States)

    Decker, Scott L.

    2008-01-01

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

  12. Psychiatric consultation of patients with hyperemesis gravidarum.

    Science.gov (United States)

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

    2009-04-01

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

  13. 34 CFR 200.63 - Consultation.

    Science.gov (United States)

    2010-07-01

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

  14. Consultation in university-based and community-based infectious disease practices: a prospective study.

    Science.gov (United States)

    Sexton, D J; Corey, G R; Ingram, C W; Morris, V M; Haywood, H B

    1995-02-01

    Infectious disease physicians in university and community practices completed a standard data form following each of 1,366 inpatient consultations during a 7-month period. The rate of consultation was higher in the university practice than in the community practice (3.4 vs. 1.8 per 100 discharges, respectively). Known or suspected bacterial pathogens accounted for more than half of all consultations in both practice groups. The three organ systems most commonly affected by infection were pulmonary (20% in university practice vs. 19% in community practice), skin and soft tissue (13% in university practice vs. 20% in community practice), and musculoskeletal (12% in university practice vs. 16% in community practice). Bloodstream infection, pneumonia, unexplained fever, osteomyelitis, urinary tract infection, and cellulitis were the six most common disease processes that led to consultation in both practice groups. The percentage of patients with noninfectious diseases and the percentage for whom a change in antimicrobial therapy was advised was nearly identical in both practice settings. Physicians in private practice performed more consultations on weekends (20% vs. 11% in university practices, P consultants in community practices are nearly identical to those of their colleagues in university-based practices.

  15. The 5Cs of Consultation: Training Medical Students to Communicate Effectively in the Emergency Department.

    Science.gov (United States)

    Kessler, Chad S; Tadisina, Kashyap Komarraju; Saks, Mark; Franzen, Doug; Woods, Rob; Banh, Kenny V; Bounds, Richard; Smith, Michael; Deiorio, Nicole; Schwartz, Alan

    2015-11-01

    Effective communication is critical for health care professionals, particularly in the Emergency Department (ED). However, currently, there is no standardized consultation model that is consistently practiced by physicians or used for training medical graduates. Recently, the 5Cs of Consultation model (Contact, Communicate, Core Question, Collaborate, and Close the Loop) has been studied in Emergency Medicine residents using simulated consultation scenarios. Using an experimental design, we aimed to evaluate the efficacy of the 5Cs consultation model in a novel learner population (medical students) and in a "real time and real world" clinical setting. A prospective, randomized, controlled study was conducted at eight large, academic, urban, tertiary-care medical centers (U.S. and Canada). Intervention involved two experimental groups (asynchronous and live training) compared to a baseline control group. All participants placed up to four consult phone calls. A senior physician observed and assessed each call using a preapproved 5Cs checklist and a Global Rating Scale (GRS). Participants who received training (asynchronous or live) scored significantly higher on the 5Cs checklist total and GRS than the control group. Both training methods (asynchronous and live) were equally effective. Importantly, learning gains were sustained as students' 5Cs checklist total and GRS scores remained consistently higher at their second, third, and fourth consult (relative to their first consult). At posttest, all participants reported feeling more confident and competent in relaying patient information. Medical students can be trained to use the 5Cs model in a timely, inexpensive, and convenient manner and increase effectiveness of physician consultations originating from the ED. Published by Elsevier Inc.

  16. [Motives of requirement for health care consultations and factors associated to mortality due to poisoning].

    Science.gov (United States)

    Villa-Manzano, Alberto Iram; Lamas-Flores, Sofía; Méndez-Cervantes, Diana; Villa-Manzano, Rebeca; Cabrera-Pivaral, Carlos E; Rojo-Contreras, Wendoline

    2009-01-01

    The poisoning is a public health problem. This problem requires continuous evaluation to decrease it. Our objective was to identify causes of requirement for health care consults and factors associated to mortality due to poisoning. We assessed the requirements for health care consults during one year and the outcomes of these consultations in a center of toxicology. Odds ratios (OR) were used as risk estimator. There were 3116 consultations due to poisons. From these 79% required hospitalization. The identified causes were: be bite and wound inflected by poisonous animals in 57 % (44 % of these were due to scorpions); medications in 15 %; agrochemicals in 5 % and in 4 % prohibit substances (marihuana or cocaine). A poisoning caused by suicidal attempt was observed in 28 %. Mortality rate was 3/1000, and the mortality rate for suicidal attempt was 0.7 % meaning an OR = 6 (95 % CI = 1.3 to 31) compared with the overall mortality rate. The most frequent cause of mortality was organophosphorates poisoning (OR = 30, 95 % CI = 2.86-759). The poisoning secondary to animals represented the most frequent cause for consultation. The suicidal attempt and organophosphorates intoxication were associated with higher mortality.

  17. The Statistical Consulting Center for Astronomy (SCCA)

    Science.gov (United States)

    Akritas, Michael

    2001-01-01

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

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

    Science.gov (United States)

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

    2017-04-01

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

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

    Science.gov (United States)

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

    2009-02-01

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

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

    DEFF Research Database (Denmark)

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

    Introduction In order to give patients possibility to listen to their consultation again, we have designed a system which gives the patients access to digital audio recordings of their consultations. An Interactive Voice Response platform enables the audio recording and gives the patients access...... to replay their consultation. The intervention is evaluated in a randomised controlled trial with 5.460 patients in order to determine whether providing patients with digital audio recording of the consultation affects the patients overall perception of their consultation. In addition to this primary...... objective we want to investigate if replay of the consultations improves the patients’ recall of the information given. Methods Interviews are carried out with 40 patients whose consultations have been audio recorded. Patients are divided into two groups, those who have listened to their consultation...

  1. Consultants and organization concepts; tracing routes of reception

    NARCIS (Netherlands)

    Heusinkveld, Stefan; Benders, Jos

    2001-01-01

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

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

    NARCIS (Netherlands)

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

    2012-01-01

    CONTEXT: Consultants in charge of postgraduate medical education (PGME) in hospital departments ('lead consultants') are responsible for the implementation of educational change. Although difficulties in innovating in medical education are described in the literature, little is known about how lead

  3. 75 FR 72838 - Notice of Tribal Consultations; Schedule Update

    Science.gov (United States)

    2010-11-26

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

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

    NARCIS (Netherlands)

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

    2012-01-01

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

  5. The Role of Design Consultants in Innovation Strategy Decisionmaking

    NARCIS (Netherlands)

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

    2013-01-01

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

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

    NARCIS (Netherlands)

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

    2012-01-01

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

  7. The Application of Cognitive Dissonance Theory to Consultation.

    Science.gov (United States)

    Hughes, Jan N.

    1983-01-01

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

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

    African Journals Online (AJOL)

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

  9. 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)

  10. Consultant supported ERP implementation – a learning opportunity?

    OpenAIRE

    2005-01-01

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

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

    OpenAIRE

    Lemus Aguilar, Isaac; Hidalgo Nuchera, Antonio

    2015-01-01

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

  12. What to listen for in the consultation

    DEFF Research Database (Denmark)

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

    2014-01-01

    scale (CES-D). RESULTS: Among the qualitative themes, only the percentage of words spent on talking about 'Acceptance-based psychological coping' was related to symptoms. In regression models controlling for age, education and time since diagnosis, a stronger focus on acceptance-based coping predicted......OBJECTIVE: To analyze whether qualitative themes in breast cancer patients' self-presentations predicted symptoms of psychological distress and depression in order to improve the consultation process. METHODS: Ninety-seven breast cancer patients gave unstructured, 10-min self......-presentations at their first consultation in a clinical registered trial (CRT identifier: NCT00990977). Self-presentations were categorized thematically and the most prevalent themes investigated as predictors for scores on the symptom check-list 90-revised (SCL-90-R) and the center for epidemiological studies depression...

  13. Consulting as a Strategy for Knowledge Transfer

    OpenAIRE

    Jacobson, Nora; Butterill, Dale; Goering, Paula

    2005-01-01

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

  14. ACCOUNTING A CONSULTANT IN THE MANAGEMENT PROCESS

    Directory of Open Access Journals (Sweden)

    VIRAG NICOLAE PAUL

    2012-05-01

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

  15. Republic of Kazakhstan; 2013 Article IV Consultation

    OpenAIRE

    International Monetary Fund

    2013-01-01

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

  16. Internship at Taylor Fry Consulting Actuaries

    OpenAIRE

    Kierkels, Bram Joseph Johannes

    2013-01-01

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

  17. Virtual slides: application in pulmonary pathology consultations.

    Directory of Open Access Journals (Sweden)

    Michał Wojciechowski

    2008-02-01

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

  18. Multilocation teleradiology system for emergency triage consultation

    Science.gov (United States)

    Herron, John M.; Yonas, Howard

    1996-05-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  20. 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…

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

    Science.gov (United States)

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

    2015-01-01

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

  2. Teaching Evaluation: A Student-Run Consulting Firm

    Science.gov (United States)

    Cundiff, Nicole; Nadler, Joel; Scribner, Shauna

    2011-01-01

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

  3. 5 CFR 2426.13 - Obligation to consult.

    Science.gov (United States)

    2010-01-01

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

  4. 5 CFR 2426.3 - Obligation to consult.

    Science.gov (United States)

    2010-01-01

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

  5. 29 CFR 779.515 - Regulations should be consulted.

    Science.gov (United States)

    2010-07-01

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

  6. 15 CFR 200.103 - Consulting and advisory services.

    Science.gov (United States)

    2010-01-01

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

  7. 45 CFR 400.57 - Planning and consultation process.

    Science.gov (United States)

    2010-10-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  10. A Rational-Emotive Therapy Approach to Consultation

    Science.gov (United States)

    Forman, Susan G.; Forman, Bruce D.

    1978-01-01

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

  11. 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.

  12. The Development of Behaviorally Based Public School Consultation Services

    Science.gov (United States)

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

    2005-01-01

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

  13. The clinical value of cortical,β-endorphins and some cytokines in HFMD children%手足口病患儿皮质醇β-内啡肽和部分细胞因子监测价值

    Institute of Scientific and Technical Information of China (English)

    张婷

    2015-01-01

    目的:明确手足口病患儿皮质醇、β‐内啡肽和部分细胞因子监测的临床价值。方法选取2011年1~6月该院收治的手足口病患儿(普通组30例、重型组30例)及健康儿童(对照组30例),比较皮质醇、β‐内啡肽、白细胞介素10(IL‐10)、白细胞介素13(IL‐13)、γ干扰素(IFN‐γ)及肿瘤坏死因子‐α(TNF‐α)水平,并对其治疗前后各项指标水平进行对比。结果与对照组比较,普通组与重型组的皮质醇、β‐内啡肽、IL‐10、IL‐13、IFN‐γ及TNF‐α水平均有所升高,组间比较,差异有统计学意义(P<0.05)。随着病情的加重,皮质醇、β‐内啡肽及细胞因子水平逐渐增加,且重型组与普通组的各项指标差异有统计学意义( P<0.05)。普通组患儿治疗后,皮质醇、β‐内啡肽、IL‐10、IL‐13、IFN‐γ及T N F‐α水平下降,接近对照组。重型组患儿治疗后,皮质醇、β‐内啡肽、IL‐10、IL‐13、IFN‐γ及TNF‐α水平升高。两组患儿治疗前后皮质醇、β‐内啡肽及细胞因子水平组内比较,差异有统计学意义(P<0.05)。结论血清皮质醇、β‐内啡肽及部分细胞因子水平对手足口病的病情判断及治疗具有重要的临床价值。%Objective To explore the clinical value of cortical ,β‐endorphins and some cytokines in HFMD chil‐dren .Methods From Jan 2011 to June 2011 in our hospital ,30 severe cases of hand ,foot and mouth disease(heavy group) ,30 Slight symptoms cases of hand ,foot and mouth disease(general group) and 30 healthy children were col‐lected ,cortical ,β‐endorphins ,IL‐10 ,IL‐13 ,IFN‐γand TNF‐αlevels in the three groups were compared ,and those val‐ue of patients before and after treatment were compared ,too .Results Compared with the level of cortical ,β‐endor‐phins ,IL‐10 ,IL‐13 ,IFN‐γ and TNF‐α in the control group ,those

  14. 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.

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

    Science.gov (United States)

    Ontario Ministry of Community and Social Services, Toronto.

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

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

    Science.gov (United States)

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

    2007-09-01

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

  17. Why are hospital doctors not referring to Consultation-Liaison Psychiatry? - a systemic review.

    Science.gov (United States)

    Chen, Kai Yang; Evans, Rebecca; Larkins, Sarah

    2016-11-09

    Consultation-Liaison Psychiatry (CLP) is a subspecialty of psychiatry that provides care to inpatients under non-psychiatric care. Despite evidence of benefits of CLP for inpatients with psychiatric comorbidities, referral rates from hospital doctors remain low. This review aims to understand barriers to CLP inpatient referral as described in the literature. We searched on Medline, PsychINFO, CINAHL and SCOPUS, using MESH and the following keywords: 1) Consultation-Liaison Psychiatry, Consultation Liaison Psychiatry, Consultation Psychiatry, Liaison Psychiatry, Hospital Psychiatry, Psychosomatic Medicine, the 2) Referral, Consultation, Consultancy and 3) Inpatient, Hospitalized patient, Hospitalized patient. We considered papers published between 1 Jan 1965 and 30 Sep 2015 and all articles written in English that contribute to understanding of barriers to CLP referral were included. Thirty-five eligible articles were found and they were grouped thematically into three categories: (1) Systemic factors; (2) Referrer factors; (3) Patient factors. Systemic factors that improves referrals include a dedicated CLP service, active CLP consultant and collaborative screening of patients. Referrer factors that increases referrals include doctors of internal medicine specialty and comfortable with CLP. Patients more likely to be referred tend to be young, has psychiatric history, live in an urban setting or has functional psychosis. This is the first systematic review that examines factors that influence CLP inpatient referrals. Although there is research in this area, it is of limited quality. Education could be provided to hospital doctors to better recognise mental illness. Collaborative screening of vulnerable groups could prevent inpatients from missing out on psychiatric care. CLP clinicians should use the knowledge gained in this review to provide quality engagement with referrers.

  18. Translating Evidence to Facilitate Shared Decision Making: Development and Usability of a Consult Decision Aid Prototype.

    Science.gov (United States)

    Stacey, Dawn; Légaré, France; Lyddiatt, Anne; Giguere, Anik M C; Yoganathan, Manosila; Saarimaki, Anton; Pardo, Jordi Pardo; Rader, Tamara; Tugwell, Peter

    2016-12-01

    The purpose of this study was to translate evidence from Cochrane Reviews into a format that can be used to facilitate shared decision making during the consultation, namely patient decision aids. A systematic development process (a) established a stakeholder committee; (b) developed a prototype according to the International Patient Decision Aid Standards; (c) applied the prototype to a Cochrane Review and used an interview-guided survey to evaluate acceptability/usability; (d) created 12 consult decision aids; and (e) used a Delphi process to reach consensus on considerations for creating a consult decision aid. The 1-page prototype includes (a) a title specifying the decision; (b) information on the health condition, options, benefits/harms with probabilities; (c) an explicit values clarification exercise; and (d) questions to screen for decisional conflict. Hyperlinks provide additional information on definitions, probabilities presented graphically, and references. Fourteen Cochrane Consumer Network members and Cochrane Editorial Unit staff participated. Thirteen reported that it would help patient/clinician discussions and were willing to use and/or recommend it. Seven indicated the right amount of information, six not enough, and one too much. Changes to the prototype were more links to definitions, more white space, and details on GRADE evidence ratings. Creating 12 consult decision aids took about 4 h each. We identified ten considerations when selecting Cochrane Reviews for creating consult decision aids. Using a systematic process, we developed a consult decision aid prototype to be populated with evidence from Cochrane Reviews. It was acceptable and easy to apply. Future studies will evaluate implementation of consult decision aids.

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

    Science.gov (United States)

    Félix, Sylvie; Bonvin, Raphaël; Bischoff, Thomas

    2010-05-19

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

  20. Citation Analysis as a Tool to Measure the Impact of Individual Research Consultations

    Science.gov (United States)

    Reinsfelder, Thomas L.

    2012-01-01

    This study sought to determine the degree to which individual research consultations with a librarian can improve the work of undergraduate students. Citation analysis was used to evaluate the quality of sources selected on draft papers before meeting with a librarian and on final papers after meeting with a librarian. The rating scale presented…

  1. Overweight and obesitas: effect on GP consultation and the use of medication.

    NARCIS (Netherlands)

    Dijk, L. van; Otters, H.; Schuit, J.

    2004-01-01

    Background: Most research on health consequences of obesitas examined differences in occurrences of specific health problems such as diabetes mellitus and coronary heart disease and related use of care, rather than investigating differences in the use of care in general, such as rate GP consultation

  2. Expression of Toll-like receptor 4 and nuclear factor-κB in patients with critically severe HFMD and the effects of esmolol intervention%Toll样受体4和核因子-κB 在危重型手足口病中的表达及艾司洛尔的干预作用

    Institute of Scientific and Technical Information of China (English)

    朱磊; 齐共健; 席晓莹; 张虹; 张蕊; 李卫华

    2015-01-01

    目的:探讨Toll样受体4(TLR4)和核因子-κB(NF-κB)在危重型手足口病(HFMD)中的表达,观察艾司洛尔的干预作用。方法选择2014年5月至2015年5月收治于我院重症监护室的52例危重型HFMD患儿为研究对象,采用随机数字表分为A组及B组,每组各26例。 A组予常规治疗,B组加用艾司洛尔治疗。另选取同期感染科收治的30例普通型HFMD作为疾病对照组,门诊健康体检30例儿童为健康对照组。比较3组儿童TLR4、NF-κB及TNF-α、IL-6的表达情况。治疗24 h、72 h及5 d后比较危重型HFMD患儿2亚组TLR4、NF-κB及TNF-α、IL-6的表达情况。结果(1)危重型HFMD患儿TLR4、NF-κB及TNF-α、IL-6的表达显著高于疾病对照组和健康对照组( P<0.01)。(2)治疗前危重型HFMD患儿2亚组间TLR4、NF-κB及TNF-α、IL-6的表达差异均无统计学意义( P均>0.05);与治疗前相比较,治疗后24 h、72 h及5 d两组危重型HFMD患儿TLR4、NF-κB及TNF-α、IL-6的表达均显著降低,差异有统计学意义(P均<0.05)。与常规治疗组(A组)相比较,B组患儿治疗24 h及72 h后NF-κB及TNF-α、IL-6的表达进一步降低,差异有统计学意义(P均<0.05),而TLR4的表达差异无统计学意义,治疗5 d后2组患儿上述指标差异均无统计学意义( P均>0.05)。结论 TLR4/NF-κB/促炎因子信号通路可能参与了危重型HFMD的病理生理过程,艾司洛尔能一定程度上抑制NF-κB表达,减少炎性因子生成,减轻炎性反应。%Objective To investigate the expression of Toll-like receptor 4 ( TLR4 ) and nuclear factor-κB ( NF-κB) in patients with critically severe hand, foot and mouth disease ( HFMD) and to evaluate the effects of esmolol intervention on those patients.Methods Fifty-two hospitalized children with critically severe HFMD in the Intensive Care Unit of Xuzhou Children′s Hospital were enrolled in

  3. SOME INDICATORS OF CONSULTATIVE SERVICES DEVELOPMENT IN SERBIA

    Directory of Open Access Journals (Sweden)

    Vesna PARAUSIC

    2012-01-01

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

  4. SOME REFLECTIONS UPON MANAGEMENT CONSULTING AS PROFESSIONAL SERVICES

    Directory of Open Access Journals (Sweden)

    Botezat Elena

    2008-05-01

    Full Text Available Management consulting helping organizations improve their performance, primarily through the thorough analysis of existing business problems and development of plans for improvement. There is probably no activity about which the opinions are so divided as management consulting. The purpose of this paper is to make some reflections upon what role play the consulting management services as professional service to the firms and how offering these services affects the offering and delivery of other services of the firms. The study is based on an office documentation research within consulting firms and resources. The approach tries to be critical and reflective, examines different consulting roles by developing a typology. The purpose is to aware of these professional services young business people. The FAQ of this service are: “How to choose the best consultant?” and “Why did fail consultant?”.

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

    Directory of Open Access Journals (Sweden)

    Singh JS

    2015-10-01

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

  6. Predictive Factors for Medical Consultation for Sore Throat in Adults with Recurrent Pharyngotonsillitis

    Directory of Open Access Journals (Sweden)

    T. Koskenkorva

    2016-01-01

    Full Text Available Objects. To seek patient- and episode-related factors that associate with medical consultation for acute sore throat because these factors may affect the patient being referred to specialist care and tonsillectomy for recurrent pharyngotonsillitis. Methods. In a secondary analysis of two prior randomised controlled trials, sore throat episodes and medical visits were explored among 156 adult patients referred for tonsillectomy because of recurrent pharyngotonsillitis. Results. The 156 patients (104 females, mean age of 26 years suffered from 208 acute pharyngotonsillitis episodes during 5-6 months of follow-up. Forty (25% patients visited a physician, and female gender (adjusted hazard ratio, HR, 3.3; 95% confidence interval 1.4–8.0 and finding of chronically infected tonsils (HR 2.7; 1.2–6.1 were associated with medical consultation. Thirty-six (17% episodes led to medical consultation during the first 7 days of symptoms. Presence of severe throat pain was related to medical visit (HR 4.3; 1.0–18.5. Conclusions. Even among patients with recurrent pharyngotonsillitis, the acute sore throat episodes were usually mild and only few resulted in medical consultation, with female gender, chronically infected tonsils, and having severe throat pain increasing the consultation rate.

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

    Science.gov (United States)

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

    2011-07-01

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

  8. Trends in doctor consultations, antibiotic prescription, and specialist referrals for otitis media in children : 1995-2003

    NARCIS (Netherlands)

    Plasschaert, Astrid I O; Rovers, Maroeska M; Schilder, Anne G M; Verheij, Theo J M; Hak, Eelko

    2006-01-01

    BACKGROUND: Reported trends regarding the incidence of otitis media and antibiotic prescription rates are inconsistent. OBJECTIVE: Our goal was to assess changes in incidence of consultation rates, antibiotic prescription, and referral rates for otitis media in children over the years 1995-2003. MET

  9. Trends in doctor consultations, antibiotic prescription, and specialist referrals for otitis media in children : 1995-2003

    NARCIS (Netherlands)

    Plasschaert, Astrid I O; Rovers, Maroeska M; Schilder, Anne G M; Verheij, Theo J M; Hak, Eelko

    BACKGROUND: Reported trends regarding the incidence of otitis media and antibiotic prescription rates are inconsistent. OBJECTIVE: Our goal was to assess changes in incidence of consultation rates, antibiotic prescription, and referral rates for otitis media in children over the years 1995-2003.

  10. Addressing poverty as risk for disease: recommendations from CDC's consultation on microenterprise as HIV prevention.

    Science.gov (United States)

    Stratford, Dale; Mizuno, Yuko; Williams, Kim; Courtenay-Quirk, Cari; O'leary, Ann

    2008-01-01

    In March 2006, the Centers for Disease Control and Prevention (CDC) convened a consultation meeting to explore microenterprise as a potential human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) prevention intervention. The impulse to link microenterprise with HIV/AIDS prevention was driven by the fact that poverty is a significant factor contributing to the risk for infection. Because increasingly high rates of HIV infection are occurring among women, particularly among poor African American women in the southern United States, we focused the consultation on microenterprise as an intervention among that population. In the international arena, income generated by microenterprise has contributed to improving family and community health outcomes. This article summarizes the contributions made to the consultation by participants from the diverse fields of microenterprise, microfinance, women's studies, and public health. The article ends with recommendations for HIV/AIDS prevention and, by implication, addressing other public health challenges, through the development of multifaceted intervention approaches.

  11. Visualising conversation structure across time: insights into effective doctor-patient consultations.

    Science.gov (United States)

    Angus, Daniel; Watson, Bernadette; Smith, Andrew; Gallois, Cindy; Wiles, Janet

    2012-01-01

    Effective communication between healthcare professionals and patients is critical to patients' health outcomes. The doctor/patient dialogue has been extensively researched from different perspectives, with findings emphasising a range of behaviours that lead to effective communication. Much research involves self-reports, however, so that behavioural engagement cannot be disentangled from patients' ratings of effectiveness. In this study we used a highly efficient and time economic automated computer visualisation measurement technique called Discursis to analyse conversational behaviour in consultations. Discursis automatically builds an internal language model from a transcript, mines the transcript for its conceptual content, and generates an interactive visual account of the discourse. The resultant visual account of the whole consultation can be analysed for patterns of engagement between interactants. The findings from this study show that Discursis is effective at highlighting a range of consultation techniques, including communication accommodation, engagement and repetition.

  12. Consultation of traditional bone setters instead of doctors: is it a sociocultural and educational or social insurance problem?

    Science.gov (United States)

    Gölge, Umut Hatay; Kaymaz, Burak; Kömürcü, Erkam; Eroğlu, Mehmet; Göksel, Ferdi; Nusran, Gürdal

    2015-04-01

    Patients consulting bone setters is common in the eastern and south-eastern regions of Turkey. The reasons for consulting bone setters instead of qualified doctors remains unclear. We investigated the characteristics of such patients who consult traditional bone setters after trauma prior to admission to hospital. In the study, 3,422 of 14,080 patients were investigated admitted to hospital between January 2012 and February 2013 with trauma or sequelae of such who were previously treated by bone setters. The characteristics of these patients and the main reasons for consultation of bone setters instead of doctors were recorded. Most of the patients consulting bone setters were found to be young adults or children. Generally speaking, the poorly educated prefer bone setters despite having social insurance. The most common reason (29.3%) was a general preference and secondarily (27.1%) the fear of being disabled after medical treatment. However, the most common cause of patients' consultation at hospital subsequently was due to complications of treatment (46.8%); indeed the complication rate after bone setters' intervention was found to be 54.8%. Although improvements have occurred in the access to and utilisation of healthcare services, consultation by patients of bone setters seems to be a sociocultural and educational issue rather than a problem of lack of medical insurance. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  13. Distance from practice moderates the relationship between patient management involving nurse telephone triage consulting and patient satisfaction with care.

    Science.gov (United States)

    Calitri, Raff; Warren, Fiona C; Wheeler, Benedict; Chaplin, Katherine; Fletcher, Emily; Murdoch, Jamie; Richards, Suzanne; Taylor, Rod S; Varley, Anna; Campbell, John

    2015-07-01

    The ESTEEM trial was a randomised-controlled trial of telephone triage consultations in general practice. We conducted exploratory analyses on data from 9154 patients from 42 UK general practices who returned a questionnaire containing self-reported ratings of satisfaction with care following a request for a same-day consultation. Mode of care was identified through case notes review. There were seven main types: a GP face-to-face consultation, GP or nurse telephone triage consultation with no subsequent same day care, or a GP or nurse telephone triage consultation with a subsequent face-to-face consultation with a GP or a nurse. We investigated the contribution of mode of care to patient satisfaction and distance between the patient׳s home and the practice as a potential moderating factor. There was no overall association between patient satisfaction and distance from practice. However, patients managed by a nurse telephone consultation showed lowest levels of satisfaction, and satisfaction for this group of patients increased the further they lived from the practice. There was no association between any of the other modes of management and distance from practice. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  14. Risk communication in the clinical consultation.

    Science.gov (United States)

    Thomson, Richard; Edwards, Adrian; Grey, Jenny

    2005-01-01

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

  15. Pharmaceutical consultation in UAE community pharmacies

    Directory of Open Access Journals (Sweden)

    N M Hamoudi

    2011-01-01

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

  16. The duty to consult and legal obligations

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-07-01

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

  17. Pharmaceutical Consultation in UAE Community Pharmacies.

    Science.gov (United States)

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

    2011-07-01

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

  18. Client/consultant model services agreement

    CERN Document Server

    International Federation of Consulting Engineers

    2006-01-01

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

  19. Preliminary Data from an Advanced Dementia Consult Service: Integrating Research, Education, and Clinical Expertise

    Science.gov (United States)

    Catic, Angela G.; Mitchell, Susan L.

    2013-01-01

    Hospitalized patients with advanced dementia often receive care that is of limited clinical benefit and inconsistent with preferences. We designed an Advanced Dementia Consult Service and conducted a pre and post pilot study to evaluate it in a Boston hospital. Consults were conducted by geriatricians and palliative care nurse practitioner. They consisted of structured consultation, counseling and provision of an information booklet to the family, and post-discharge follow-up with the family and primary care providers. Patients > 65 admitted with advanced dementia were identified and consults were solicited using pop-ups programmed into the computerized provider order entry (POE) system. In the initial 3-month period, patients received usual care (N=24). In the subsequent 3-month period, consults were provided to patients for whom it was requested (N=5). Data were obtained from the electronic medical record and proxies interviews (admission, 1-month post-discharge). The patients’ mean age in the combined sample (N=29) was 85.4, 58.6% were from nursing homes, and 86.2% of their proxies stated comfort was the goal of care. Nonetheless, their hospitalizations were characterized by high rates of intravenous antibiotics (86.2%), > 5 venipunctures (44.8%), and radiological exams (96.6%). Acknowledging the small sample size, there were trends towards better outcomes in the intervention group including: higher proxy knowledge of the disease, greater communication between proxies and providers, more advance care planning, lower re-hospitalization rates, and fewer feeding tube insertions after discharge. Targeted consultation for advanced dementia is feasible and may promote greater engagement of proxies and goal-directed care for patients after discharge. PMID:24219202

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

    Directory of Open Access Journals (Sweden)

    Jennifer B McCormick

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

  1. 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.

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

    Science.gov (United States)

    Krajewski, Katherine M.; Giardino, Angela A.; Braschi-Amirfarzan, Marta; Ramaiya, Nikhil H.

    2017-01-01

    The purpose of the article is to describe the various radiology consultation models in the Era of Precision Medicine. Since the inception of our specialty, radiologists have served as consultants to physicians of various disciplines. A variety of radiology consultation services have been described in the literature, including clinical decision support, patient-centric, subspecialty interpretation, and/or some combination of these. In oncology care in particular, case complexity often merits open dialogue with clinical providers. To explore the utility and impact of radiology consultation services in the academic setting, this article will further describe existing consultation models and the circumstances that precipitated their development. The hybrid model successful at our tertiary cancer center is discussed. In addition, the contributions of a consultant radiologist in breast cancer care are reviewed as the archetype of radiology consultation services provided to oncology practitioners. PMID:28096715

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-01-15

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

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

    Directory of Open Access Journals (Sweden)

    Annelies Lucas EM

    2012-07-01

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

  5. Outreach surgical consulting services in North East Victoria.

    Science.gov (United States)

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

    2013-12-01

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

  6. 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.

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

    Keiley, Margaret K.; Piercy, Fred P.

    1999-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  10. The development and validation of the Interpersonal Support in Physical Activity Consultations Observational Tool.

    Science.gov (United States)

    Rouse, Peter C; Duda, Joan L; Ntoumanis, Nikos; Jolly, Kate; Williams, Geoffrey C

    2016-01-01

    This study describes the development and psychometric characteristics of an observational instrument that examines four aspects of interpersonal support (or lack of) provided during physical activity (PA) promotion consultations (i.e., Autonomy Support, Involvement, Structure and Interpersonal Control), as identified by Self-determination Theory (SDT). The reliability and validity of the Interpersonal Support in Physical Activity Consultations Observational Tool (ISPACOT) were examined within an exploratory randomised control trial. Recorded consultations (N = 42) conducted by qualified PA advisors (N = 14) at 13 leisure centres across the West Midlands (UK) were rated. Intra-class correlation coefficients (ICC) indicated moderate to high inter-rater reliability for overall interpersonal support (0.80), and the Autonomy Support (0.74), Involvement (0.73) and Structure (0.91) dimensions, but low reliability for Interpersonal Control (0.35). The advisors, who conducted PA promotion consultations that were rated as low in their interpersonally supportive features, were perceived by their clients as being less supportive (F(1,10) = 5.0, p validity of the ISPACOT.

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

    OpenAIRE

    2015-01-01

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

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

    OpenAIRE

    Francisca Bertilia Chaves Costa; Thelma Leite de Araújo

    2012-01-01

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

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

    OpenAIRE

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

    2012-01-01

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

  14. Consultations in primary care for symptoms attributed to electromagnetic fields – a survey among general practitioners

    Directory of Open Access Journals (Sweden)

    Röösli Martin

    2006-10-01

    Full Text Available Abstract Background Five percent of the Swiss population attribute symptoms to electromagnetic fields (EMF. General practitioners (GPs might play a key role in recognising an emerging health risk, since they are the first to observe and follow up persons who attribute symptoms to EMF. It is unclear to what extent EMFs have become an issue in general practice and which experiences GPs report from the consultations. Methods We conducted telephone interviews in a random sample of GPs in Switzerland in order to assess the frequency of consultations in primary care due to EMF and the GPs' experience with these patients. Results 342 general practitioners were interviewed, corresponding to a response rate of 28.2%. 69% of the GPs reported at least one consultation due to EMF, but GPs with a certificate in complementary medicine were much more likely to report EMF consultations. The median of EMF consultation numbers within one year was three. An overview of the most recent EMF-related consultation per GP yielded sleep disorders, headaches and fatigue as the most often reported symptoms and mobile phone base stations, power lines and the own use of mobile phones as the main EMF sources suspected to be associated to symptoms. GPs judged the association between EMF and the symptoms to be plausible in 54% of the cases. There was no combination of symptoms and EMF sources that was remarkably and consistently judged to be a plausible cause of the symptoms. Conclusion In our survey, GPs often judged the association between the health problems and the suspected exposure to be plausible. This plausibility assessment seems to be based on grounds of preventive positions in a situation of scientific uncertainty. More research effort is needed to obtain more insight on a potential association between long term EMF exposure and unspecific symptoms.

  15. Does the presence of medical students affect quality in general practice consultations?

    Science.gov (United States)

    Price, Richard; Spencer, John; Walker, Jeremy

    2008-04-01

    Previous studies have suggested that the patient's experience of a consultation with a doctor is not affected by the presence of medical students. However, no study has looked at the effect of student presence on conventional UK general practice consultations. This study aimed to measure the quality of the consultation as experienced by patients when students are present, to explore patients' attitudes to the presence of medical students, and to look at the relationships between these factors. We conducted a cross-sectional questionnaire study in general practices in north-east England. General practitioners (GPs) from practices teaching fourth and final year students administered questionnaires to patients who were seen in either teaching or non-teaching consultations. The questionnaire comprised previously validated measures of empathy and enablement as measures of quality, attitudinal statements regarding the presence of students, a scale rating pertaining to the patient's degree of acquaintance with the doctor, and items on demographic data. Results showed no significant differences in enablement scores between the 2 groups. Consultations with student presence last longer. Empathy scores were significantly lower in the 'student present' group, but the size of the difference was small. Attitudinal statements regarding the presence of students showed a high proportion of positive responses, and some groupings of negative ones. Further analysis demonstrated some significant links between attitudinal statements and enablement and empathy scores. The quality of general practice consultations was not adversely affected by medical student presence. However, significant numbers of patients who agreed to be seen with a student present were resistant to the student's presence.

  16. Utilization of a consultation liaison psychiatry service in a general hospital.

    Science.gov (United States)

    Gobar, A H; Collins, J L; Mathura, C B

    1987-05-01

    This retrospective study was conducted in response to a need to evaluate the overall utilization rates of the psychiatric consultation liaison service by nonpsychiatric units within Howard University Hospital, which deals almost exclusively with a black, inner-city population. The study covers a three-year period (July 1982 to July 1985). During this time only 815 patients (2 percent) were referred for psychiatric evaluation out of the total number of hospital admissions (40,000 patients).Patient characteristics and general attitudes appear to have had a major role in this low ratio of referrals, particularly a lack of awareness and bias against psychiatry. This latter finding is in disparity with other published reports. Diagnostically, depression, organic mental disorders (acute), and substance abuse (mainly PCP) constituted the greater bulk of the patients seen by the consultation liaison psychiatry service. The review of a random sample of psychiatric inpatients (n = 100) revealed that in 50 percent of the cases there was a coexisting physical illness or abnormality.The role of mental health education and the liaison function needs to be emphasized. It is suggested that efforts should be directed toward a wider acceptance and utilization of consultation liaison psychiatry by primary care physicians in general hospitals. The factors listed by physicians and patients that may account for the observed underutilization of consultation liaison services are discussed. The results of 20 interviews and the reasons given by referring physicians as to whether or not they will seek consultation from the consultation liaison services are also reviewed.

  17. Evaluation of the impact of a consultation in a secure setting.

    Science.gov (United States)

    Blumenthal, Stephen; Ruszczynski, Stanley; Richards, Rachel; Brown, Matthew

    2011-10-01

    Organisational consultation is widespread in the National Health Service (NHS), but little is known about its impact. To evaluate the impact of a psychodynamically informed consultation to a high-security hospital ward.  This prospective study compared measures before and after the consultation with similarly timed measures on a comparison ward in the hospital, matched for patient characteristics, but not exposed to the consultation. The intention was to compare the consultation with 'treatment as usual', but the study became a comparison of interventions after a programme to facilitate staff-patient communication was instituted by management on the comparison ward. Measures included the Ward Atmosphere Scale (WAS) and an index of burnout. Interactions between staff and patients were observed and rated for content and quality.  Most scales on two of three dimensions of the WAS improved on both wards, as did the quality of staff-patient contact. Change at the levels of behaviour and attitude strengthens confidence that a shift occurred in a positive direction.  The overall importance of professional supportive attention to staff in such settings was established. Although there was little evidence here for a distinct advantage of one intervention style, the results were encouraging for the consultation, because ward atmosphere and staff-patient interaction were not a direct target for change. Further study is needed to test the possibility that specific interventions may carry specific advantage in other settings or with other patient groups. The nature and quality of institutional support for such research itself needs strengthening. In this case, the institutions' intention to assist was robust, but real understanding and/or sustained ability to facilitate it is lacking. This problem is hardly unique to this setting. 2011 John Wiley & Sons, Ltd.

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

    Science.gov (United States)

    Swank, Otto H

    2010-03-01

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

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

    Science.gov (United States)

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

    2014-12-01

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

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

    Science.gov (United States)

    Jannings, W; Maynard, C

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

  1. Asynchronous Remote Medical Consultation for Ghana

    CERN Document Server

    Luk, Rowena; Aoki, Paul M

    2008-01-01

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

  2. Cap and trade offsets regulation - consultation paper

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-07-01

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

  3. 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.

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

    Science.gov (United States)

    1996-01-01

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

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

    Science.gov (United States)

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

    1996-08-01

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

  6. Perinatal depression screening in healthy start: an evaluation of the acceptability of technical assistance consultation.

    Science.gov (United States)

    Segre, Lisa S; O'Hara, Michael W; Fisher, Sheehan D

    2013-08-01

    In 2001, Healthy Start was required to screen for maternal depression. To support this mandate, technical assistance (TA) consultations were provided to eleven programs. Participant evaluations assessed TA recipients' views, a foundational level of program evaluation. Staff evaluated TA presentations immediately; and directors assessed its helpfulness in a 6-month and a 5-year follow-up. Staff believed their knowledge increased significantly; the majority rated TA presentations as "useful" to "very useful." Most directors rated TA as "useful" or "very useful" in achieving TA goals, reported having "few" or "no" obstacles in screening, and rated staff as "willing" or "very willing" to screen. A range of educational programs have been developed to assist the implementation of maternal depression screening. The current evaluation indicates that diverse types of programs held positive views of TA consultation and believed it was effective. The success of the method argues for further development.

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2014-02-01

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

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

    Science.gov (United States)

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

    2015-09-01

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

  10. The impact of a diagnostic decision support system on the consultation: perceptions of GPs and patients.

    Science.gov (United States)

    Porat, Talya; Delaney, Brendan; Kostopoulou, Olga

    2017-06-02

    Clinical decision support systems (DSS) aimed at supporting diagnosis are not widely used. This is mainly due to usability issues and lack of integration into clinical work and the electronic health record (EHR). In this study we examined the usability and acceptability of a diagnostic DSS prototype integrated with the EHR and in comparison with the EHR alone. Thirty-four General Practitioners (GPs) consulted with 6 standardised patients (SPs) using only their EHR system (baseline session); on another day, they consulted with 6 different but matched for difficulty SPs, using the EHR with the integrated DSS prototype (DSS session). GPs were interviewed twice (at the end of each session), and completed the Post-Study System Usability Questionnaire at the end of the DSS session. The SPs completed the Consultation Satisfaction Questionnaire after each consultation. The majority of GPs (74%) found the DSS useful: it helped them consider more diagnoses and ask more targeted questions. They considered three user interface features to be the most useful: (1) integration with the EHR; (2) suggested diagnoses to consider at the start of the consultation and; (3) the checklist of symptoms and signs in relation to each suggested diagnosis. There were also criticisms: half of the GPs felt that the DSS changed their consultation style, by requiring them to code symptoms and signs while interacting with the patient. SPs sometimes commented that GPs were looking at their computer more than at them; this comment was made more often in the DSS session (15%) than in the baseline session (3%). Nevertheless, SP ratings on the satisfaction questionnaire did not differ between the two sessions. To use the DSS effectively, GPs would need to adapt their consultation style, so that they code more information during rather than at the end of the consultation. This presents a potential barrier to adoption. Training GPs to use the system in a patient-centred way, as well as improvement of the

  11. The effect of using an interactive booklet on childhood respiratory tract infections in consultations: Study protocol for a cluster randomised controlled trial in primary care

    Directory of Open Access Journals (Sweden)

    Nuttall Jacqueline

    2008-04-01

    Full Text Available Abstract Background Respiratory tract infections in children result in more primary care consultations than any other acute condition, and are the most common reason for prescribing antibiotics (which are largely unnecessary. About a fifth of children consult again for the same illness episode. Providing parents with written information on respiratory tract infections may result in a reduction in re-consultation rates and antibiotic prescribing for these illnesses. Asking clinicians to provide and discuss the information during the consultation may enhance effectiveness. This paper outlines the protocol for a study designed to evaluate the use of a booklet on respiratory tract infections in children within primary care consultations. Methods/Design This will be a cluster randomised controlled trial. General practices will be randomised to provide parents consulting because their child has an acute respiratory tract infection with either an interactive booklet, or usual care. The booklet provides information on the expected duration of their child's illness, the likely benefits of various treatment options, signs and symptoms that should prompt re-consultation, and symptomatic treatment advice. It has been designed for use within the consultation and aims to enhance communication through the use of specific prompts. Clinicians randomised to using the interactive booklet will receive online training in its use. Outcomes will be assessed via a telephone interview with the parent two weeks after first consulting. The primary outcome will be the proportion of children who re-consult for the same illness episode. Secondary outcomes include: antibiotic use, parental satisfaction and enablement, and illness costs. Consultation rates for respiratory tract infections for the subsequent year will be assessed by a review of practice notes. Discussion Previous studies in adults and children have shown that educational interventions can result in reductions

  12. Cross-sectional evaluation of a longitudinal consultation skills course at a new UK medical school

    Directory of Open Access Journals (Sweden)

    Kemmy Julie

    2011-08-01

    Full Text Available Abstract Background Good communication is a crucial element of good clinical care, and it is important to provide appropriate consultation skills teaching in undergraduate medical training to ensure that doctors have the necessary skills to communicate effectively with patients and other key stakeholders. This article aims to provide research evidence of the acceptability of a longitudinal consultation skills strand in an undergraduate medical course, as assessed by a cross-sectional evaluation of students' perceptions of their teaching and learning experiences. Methods A structured questionnaire was used to collect student views. The questionnaire comprised two parts: 16 closed questions to evaluate content and process of teaching and 5 open-ended questions. Questionnaires were completed at the end of each consultation skills session across all year groups during the 2006-7 academic year (5 sessions in Year 1, 3 in Year 2, 3 in Year 3, 10 in Year 4 and 10 in Year 5. 2519 questionnaires were returned in total. Results Students rated Tutor Facilitation most favourably, followed by Teaching, then Practice & Feedback, with suitability of the Rooms being most poorly rated. All years listed the following as important aspects they had learnt during the session: • how to structure the consultation • importance of patient-centredness • aspects of professionalism (including recognising own limits, being prepared, generally acting professionally. All years also noted that the sessions had increased their confidence, particularly through practice. Conclusions Our results suggest that a longitudinal and integrated approach to teaching consultation skills using a well structured model such as Calgary-Cambridge, facilitates and consolidates learning of desired process skills, increases student confidence, encourages integration of process and content, and reinforces appreciation of patient-centredness and professionalism.

  13. 45 CFR 98.12 - Coordination and consultation.

    Science.gov (United States)

    2010-10-01

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

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

    NARCIS (Netherlands)

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

    2009-01-01

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

  15. 48 CFR 3437.270 - Consulting services reporting clause.

    Science.gov (United States)

    2010-10-01

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

  16. 48 CFR 1552.211-78 - Management consulting services.

    Science.gov (United States)

    2010-10-01

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

  17. 48 CFR 3437.271 - Services of consultants clause.

    Science.gov (United States)

    2010-10-01

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

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

    Science.gov (United States)

    1995-01-01

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

  19. The social identity of hospital consultants as managers.

    Science.gov (United States)

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

    2010-01-01

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

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

    Science.gov (United States)

    Serrano-Velarde, Kathia

    2010-01-01

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

  1. 76 FR 81527 - Notice of Tribal Consultations; Schedule Update

    Science.gov (United States)

    2011-12-28

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

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

    DEFF Research Database (Denmark)

    Rasmussen, Anne

    2015-01-01

    5,000 responses to consultations in Denmark and the UK in the first half of 2008. It shows that participation is highly conditional upon system-and actor-level characteristics in practice. Our findings indicate that, even if liberal democracies have adopted similar procedures for actor consultation...

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

    Science.gov (United States)

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

    2015-01-01

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

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  5. 22 CFR 61.6 - Consultation with subject matter specialists.

    Science.gov (United States)

    2010-04-01

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

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

    Science.gov (United States)

    Ibrahim, Farah A.

    2015-01-01

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

  7. A Model for Psychiatric Consultation in Systemic Therapy.

    Science.gov (United States)

    Griffith, James L.; And Others

    1991-01-01

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

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

    Science.gov (United States)

    Newman, Daniel S.

    2012-01-01

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

  9. Colonial connections and consulting engineers 1850-1914

    DEFF Research Database (Denmark)

    Andersen, Casper

    2011-01-01

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

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

    NARCIS (Netherlands)

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

    2008-01-01

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

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

    NARCIS (Netherlands)

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

    2008-01-01

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

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

    NARCIS (Netherlands)

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

    2008-01-01

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

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

    NARCIS (Netherlands)

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

    2009-01-01

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

  14. Structuring a written examination to assess ASBH health care ethics consultation core knowledge competencies.

    Science.gov (United States)

    White, Bruce D; Jankowski, Jane B; Shelton, Wayne N

    2014-01-01

    As clinical ethics consultants move toward professionalization, the process of certifying individual consultants or accrediting programs will be discussed and debated. With certification, some entity must be established or ordained to oversee the standards and procedures. If the process evolves like other professions, it seems plausible that it will eventually include a written examination to evaluate the core knowledge competencies that individual practitioners should possess to meet peer practice standards. The American Society for Bioethics and Humanities (ASBH) has published core knowledge competencies for many years that are accepted by experts as the prevailing standard. Probably any written examination will be based upon the ASBH core knowledge competencies. However, much remains to be done before any examination may be offered. In particular, it seems likely that a recognized examining board must create and validate examination questions and structure the examination so as to establish meaningful, defensible parameters after dealing with such challenging questions as: Should the certifying examination be multiple choice or short-answer essay? How should the test be graded? What should the pass rate be? How may the examination be best administered? To advance the field of health care ethics consultation, thought leaders should start to focus on the written examination possibilities, to date unaddressed carefully in the literature. Examination models-both objective and written-must be explored as a viable strategy about how the field of health care ethics consultations can grow toward professionalization.

  15. The Missing Evaluation at the End of GP’s Consultation

    Directory of Open Access Journals (Sweden)

    Maisa Kuusela

    2013-01-01

    Full Text Available Evaluation at the end of a consultation is an element of a successful encounter. The doctor should inquire if patient’s expectations were fulfilled and sum up the information given, the examinations performed, and the decisions made with the patient. This way the patient would be fully aware of what has been decided and that the problems and expectations of the patient had been taken into account. Twenty consultations of four general practitioners (GPs in Finland were videotaped. The doctors were men and women, two of them had a long experience and two were trainees in general practice. The data (videotapes, questionnaires, and interviews were analysed by multiple research methods with investigator and methodological triangulation. MAAS-Global Rating List was used as an assessment tool. The evaluation of the consultation was often missing or having shortages; only one-third was assessed to be better than doubtful. The assessments done by experienced GPs and the medical student were similar. According to the result of this study as well as the information in the current literature, doctors in all periods of their career should repeatedly be reminded about the importance of the evaluation at the end of the consultation.

  16. [Strategy on the recruitment of free community medical-consultation in acupuncture clinical trials].

    Science.gov (United States)

    Fan, Hailong; Zhao, Ling; Li, Juan; Lv, Junling; Zhang, Linglin; Leng, Junyan; Zhang, Jie; Li, Dehua; Liang, Fanrong

    2016-04-01

    The difficulty in the participant recruitment is the common question in acupuncture clinical trial study. The existing recruitment of clinical trial is most applicable for the clinical trial of medicines. Because the intervention of acupuncture clinical trial is different from that of medicines, characterized as the specialties in "theory, principle, acupoints, technique", it is very necessary to develop the strategy on the participant recruitment in acupuncture clinical trial. The free community medical consultation is one of the important means of recruitment. In the paper, by taking the participant recruitment of acupuncture clinical trial on chronic stable angina pectoris as the example, the discussion is given on the strategy on the recruitment of free community medical consultation in the aspects of feasible investigation of recruitment approach, recruitment plan, participant screening, etc. The revisiting after the free community medical consultation is the important approach to the improvement of successful recruitment. This strategy on the recruitment of free community medical consultation is highly practical and improves the successful rate and compliance of the participant recruitment. Hence, this strategy deserves to be promoted.

  17. Development of a teledermatopathology consultation system using virtual slides

    Directory of Open Access Journals (Sweden)

    Nakayama Ikunori

    2012-12-01

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

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

    Science.gov (United States)

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

    2014-05-01

    To optimize psychiatric consultation service epidemiological information is needed. We compared data on gender, age and diagnoses of patients in the consultation service to psychiatric inpatients. In psychiatric consultation service patients are older (56.6 vs. 44.9 years, p < 0.05) and males are older than females (58.8 vs. 54.4 years, p < 0.05). For male patients, the psychiatric consultation service is contacted more often in cases of organic disorders, for females in adjustment disorders (p < 0.05). The diagnostic spectrum in psychiatric consultation service is different for males and females with relevance for diagnostic and therapeutic procedures. © Georg Thieme Verlag KG Stuttgart · New York.

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

    Directory of Open Access Journals (Sweden)

    M Seyedmajidi

    2013-09-01

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

  20. Clinical supervision by consultants in teaching hospitals.

    Science.gov (United States)

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

    2009-08-17

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

  1. Concertation rather than Consultation or Negotiation!

    CERN Multimedia

    Staff Association

    2017-01-01

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

  2. Telemedicine-based physician consultation results in more patients treated and released by ambulance personnel

    DEFF Research Database (Denmark)

    Raaber, Nikolaj; Bøtker, Morten T; Riddervold, Ingunn S

    2016-01-01

    . In the intervention period, the EMCC was manned 24/7 with physicians experienced in emergency care. Eligible participants included all patients with nonurgent conditions receiving an ambulance after a medical emergency call. Ambulance personnel assessed patients and subsequently performed a telephone consultation...... a physician at the EMCC and ambulance personnel and noncritically ill 1-1-2 patients results in an increased rate of patients treated and released with high satisfaction. The approach does not seem to compromise patient safety....

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

    Science.gov (United States)

    Reiner, Bruce

    2008-10-01

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

  4. Implementation of an Arranged Preventive Consultation in Danish General Practice

    DEFF Research Database (Denmark)

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

    Background: In 2006 an arranged preventive consultation (0106-service) was implemented in Danish general practice. The purpose of the consultation is an attempt to improve the systematic prevention of the main chronic lifestyle diseases. Aim: This study examines the GP's experiences with the arra...... interaction between the GP/nurse and the patient, and therefore the GPs/nurses can in some respects experience it as difficult to apply the theoretical guidelines of the new consultation to their daily work with the patients.......Background: In 2006 an arranged preventive consultation (0106-service) was implemented in Danish general practice. The purpose of the consultation is an attempt to improve the systematic prevention of the main chronic lifestyle diseases. Aim: This study examines the GP's experiences...... with the arranged preventive consultation with focus on facilitators and barriers in the implementation of the consultation. Material & Method: Semi-structured interviews with 10 GPs and nurses in general practice. Results & Conclusions: Economically lucrative services are not an isolated motivation for the GPs...

  5. 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.

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

    Science.gov (United States)

    Agich, George J

    2003-12-01

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

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

    Science.gov (United States)

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

    2008-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Porcheret Mark

    2013-01-01

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

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

    Science.gov (United States)

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

    2013-01-16

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

  10. The role of marketing in the modern local consulting

    Directory of Open Access Journals (Sweden)

    Bezpalova Anna

    2016-02-01

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

  11. Standardization In The Field Of Management Consulting Services

    Directory of Open Access Journals (Sweden)

    Ciumara Tudor

    2009-12-01

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

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

    Science.gov (United States)

    Keely, Erin; Dojeiji, Suzan; Myers, Kathryn

    2002-11-01

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

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

    Science.gov (United States)

    Creel, Eileen L; Robinson, Jennifer C

    2010-11-01

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

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

    Science.gov (United States)

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

    2012-08-01

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

  15. Digital audio recordings improve the outcomes of patient consultations

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  16. Digital audio recordings improve the outcomes of patient consultations

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  17. Teaching medical students consultation skills using e-learning

    DEFF Research Database (Denmark)

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

    2015-01-01

    Teaching consultation skills to medical students using e-learning. Introduction: We have been teaching Family Medicine at the University of Copenhagen for more than twenty years. We wish to develop a method to evaluate the current teaching of consultation skills and the effect of new interventions...... general practice consultations. 1. Levenstein JH, McCracken EC, McWhinney IR, Stewart MA, Brown JB. The patient-centred clinical method. A model for the doctor-patient interaction in family medicine. Fam Pract. 1986 Mar; 3(1):24-30. 2. Warnecke E, Pearson S. Medical students' perceptions of using e-learning...

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

    Science.gov (United States)

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

    2015-11-01

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

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

    Science.gov (United States)

    Weise, Kathryn L; Daly, Barbara J

    2014-01-01

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

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

    Science.gov (United States)

    2011-05-25

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

  1. The Evaluation of Psychiatry Consultation Requested in a University Hospital

    Directory of Open Access Journals (Sweden)

    Hasan Mayda

    2016-01-01

    Full Text Available Aim: The objective of our study was to evaluate the socio-demegraphic data, psychiatric diagnosis according to Diagnostic and Statistical Manuel of Mental disorder (DSV-IV of patients, referral rates of medical and surgical clinics and reasons for referrals in inpatients who were requested psychiatry consultationb Material and Method: This study was conducted in Afyonkarahisar, in a 530 bed university hospital. For a period of six months, a retrospective data was collected from 124 inpatients who were requested psychiatric consultations. Psychiatric diagnoses were based on DSM-IV. Results: Ižndicated that mean age of patients are 50.1±19.7%u2019di. Seventy (56.5% patients were female and 54 (43.5% of patients were male. The most frequent referral clinics were internal medicine (24.2%, followed by neurology (14.5% and physical medicine (14.5% and rehabilitation (11.3% The most frequent reasons for referral were depressive symptoms (21.8% somatic complaint (17.7%, agitation and non-compliance to treatment (16.1% and suicidal attempted (10.5%. Psychopathology was determined in majority of patients (86.3%. Regarding the psychiatric diagnosis, adjustment disorders (21 % were the most common. Discussion: The interaction between psychiatry and other medical clinical is important because of psychiatric disorders are more commonly seen among medical and surgical inpatients.

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

    DEFF Research Database (Denmark)

    Thorsen, Hanne; Witt, Klaus; Malterud, Kirsti

    2001-01-01

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

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

    DEFF Research Database (Denmark)

    Larsen, Jan-Helge; Risør, Ole

    1997-01-01

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

  4. Inconsistency of residents' communication performance in challenging consultations

    NARCIS (Netherlands)

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

    2013-01-01

    Objective: Communication performance inaonsistency between consultations is usually regarded as a measurement error that jeopardizes the reliability of assessments. However, inconsistency is an important phenomenon, since it indicates that physicians' communication may be below standard in some cons

  5. A Qualitative Study of Televideo Consultations for COPD Patients

    DEFF Research Database (Denmark)

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

    2015-01-01

    . In public the expectations are high that digital mediation between clients' everyday lives and the health care system can strengthen patients' abilities regarding their self-management. Nonetheless, the study shows that patients have a number of reservations concerning televideo consultations at home......This article presents results from a small qualitative study investigating COPD patients' experiences with televideo consultations at home as a supplement to conventional control and treatment. The research question is: what are the experiences and preferences of COPD patients related to discharge...... from hospital with televideo consultations? The study shows that the patients' assessments of the effectiveness and value of the televideo consultations in their everyday lives are based on tough cost-benefit calculation of the extent to which the intervention makes their lives easier or more difficult...

  6. Mutual construction and reconstruction in client-consultant interaction

    DEFF Research Database (Denmark)

    Smith, Irene Skovgaard

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

  7. The role of assessment packages for diagnostic consultations

    DEFF Research Database (Denmark)

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

    2015-01-01

    and content. Assessment packages are widely used in an increasing number of medical specialities; however, there is a lack of knowledge about how packaged assessment influences the interaction between doctor and patient. In this study, we investigate the final consultation in assessment packages, which......This article reports a conversation analysis of assessment package consultations. Healthcare delivery packages belong to a highly structured mode of healthcare delivery, in which specific courses of healthcare interventions related to assessment and treatment are predefined, both as to timing...... is when the final clarification of the patient's symptoms takes place. The primary data of the study were eight audio recordings of consultations, and the secondary data were ethnographic field descriptions. In most consultations, packaged assessment was a resource as it provided fast and efficient...

  8. MARKETING CONSULTANCY IN AGROTOURISM ALONG THE ROMANIAN WEB SITES

    Directory of Open Access Journals (Sweden)

    NEGRUŢ CONSTANTIN

    2012-05-01

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

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

    CERN Multimedia

    Ignacio Reguero, IT Department

    2016-01-01

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

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

    LENUS (Irish Health Repository)

    O'Malley, N T

    2011-12-01

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

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

    Science.gov (United States)

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

    2013-10-01

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

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

    DEFF Research Database (Denmark)

    Broberg, Ole

    2004-01-01

    In carrying out consultancy the Danish occupational health services (OHS) are supposed to support and develop the capabilities of enterprises to manage work environment issues. This may be interpreted in a learning perspective: As part of the process consultancy the OHS consultants have to put...... processes in client enter-prises. Specifically the learning perspective will be touched upon. The research programme included four cases in different client enterprises: 1) New tech-nology in a logistic department of a brewery, 2) new pharmaceutical process facility, 3) design of a new catering centre...... on reduc-ing the work loads of delivery and warehouse personnel. In facilitating learning processes, deliberately or by incidence, the OHS consultants used different boundary objects. An example: In order to involve users in the design process it was better making a walk-through in a new catering centre...

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

    African Journals Online (AJOL)

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

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

    NARCIS (Netherlands)

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

    2010-01-01

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

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

    Science.gov (United States)

    Leigh, H

    1987-01-01

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

  16. 42 CFR 431.105 - Consultation to medical facilities.

    Science.gov (United States)

    2010-10-01

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

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

    African Journals Online (AJOL)

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

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

    Science.gov (United States)

    1991-01-01

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

  19. Concepts Needed by Managerial Personnel in Automated Offices as Perceived by Office Systems Consultants and Collegiate Business Faculty.

    Science.gov (United States)

    Graves, Charlotte K.

    1985-01-01

    Office systems consultants, office administration faculty, and other collegiate business faculty (management, marketing, accounting, and finance) were asked to rate the importance of 42 concepts needed by managerial personnel in automated offices. Also, business faculty were asked to indicate which concepts were currently being taught in courses…

  20. Conjoint Consultation Using Self-Administered Manual and Videotape Parent-Teacher Training: Effects on Children's Behavioral Difficulties.

    Science.gov (United States)

    Kratochwill, Thomas R.; Elliott, Stephen N.; Loitz, Pamela Ann; Sladeczek, Ingrid; Carlson, John S.

    2003-01-01

    Research compared effectiveness of two different approaches of conjoint consultation using a manual versus a videotape series as the main components of training parents and teachers to treat children's behavioral difficulties. Parent and teacher reports characterized students as meeting their overall behavior goals; and reported high rates of…

  1. Using a smartphone-based self-management platform to support medication adherence and clinical consultation in Parkinson's disease

    NARCIS (Netherlands)

    Lakshminarayana, R.; Wang, D.; Burn, D.; Chaudhuri, K.R.; Galtrey, C.; Guzman, N.V.; Hellman, B.; Ben, J.; Pal, S.; Stamford, J.; Steiger, M.; Stott, R.W.; Teo, J.; Barker, R.A.; Wang, E.; Bloem, B.R.; Eijk, M. van; Rochester, L.; Williams, A.

    2017-01-01

    The progressive nature of Parkinson's disease, its complex treatment regimens and the high rates of comorbid conditions make self-management and treatment adherence a challenge. Clinicians have limited face-to-face consultation time with Parkinson's disease patients, making it difficult to

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

    Directory of Open Access Journals (Sweden)

    Mai T. Nguyen

    2014-04-01

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

  3. Aspects of statistical consulting not taught by acedemia

    DEFF Research Database (Denmark)

    Kenett, R.; Thyregod, Poul

    2006-01-01

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

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

    Science.gov (United States)

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

    2015-12-01

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

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

    OpenAIRE

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

    2010-01-01

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

  6. A Feasibility Study for Establishing a Sustainability Consulting Firm

    OpenAIRE

    Mathieu, Susan F.

    2011-01-01

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

  7. Tools for Project Management, Workshops and Consulting A Must-Have Compendium of Essential Tools and Techniques

    CERN Document Server

    Andler, Nicolai

    2012-01-01

    Typically today's tasks in management and consulting include project management, running workshops and strategic work - all complex activities, which require a multitude of skills and competencies. This standard work, which is also well accepted amongst consultants, gives you a reference or cookbook-style access to the most important tools, including a rating of each tool in terms of applicability, ease of use and effectiveness.In his book, Nicolai Andler presents about 120 of such tools, grouped into task-specific categories entitled Define Situation, Gather Information, Information Consolida

  8. 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.

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

    Directory of Open Access Journals (Sweden)

    Damien Giurco

    2011-10-01

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

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

    Science.gov (United States)

    Ali, Nasreen; Atkin, Karl; Neal, Richard

    2006-11-01

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

  11. 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.

  12. Communication skills for behaviour change in dietetic consultations.

    Science.gov (United States)

    Whitehead, K; Langley-Evans, S C; Tischler, V; Swift, J A

    2009-12-01

    Both the UK's National Health Service (NHS) and the National Institute of health and Clinical Excellence (NICE) have recommended increased training for health professionals in communication skills. There is evidence to suggest that communication skills are important in helping people to change health-related behaviour, which is a key role for dietitians. This study investigated the views of UK dietitians about their training needs and experience in relation to communication skills in dietetic practice. In October 2007, a cross-sectional survey was mailed to all British Dietetic Association members (n = 6013). The survey gathered quantitative data and free-text comments to ascertain the level, type and effect of communication skills training received by dietitians at both the pre- and post-registration level. There were 1158 respondents; a response rate of 19.3%. Ninety-eight percent (n = 1117) rated communication skills as either very or extremely important in client consultations. Post-registration training had been undertaken by 73% (n = 904). Of these, over 90% of respondents perceived that post-registration training had led to improvements in their relationships with patients, their confidence in client interviews and their ability to cope with challenging clients. However, 248 (21.4%) felt time keeping in interviews had worsened. Lack of time for client interviews was also the most commonly identified barrier (19%, n = 216) to implementing the skills. This study has explored an important and under-researched area. Respondents strongly endorsed the importance of good communication skills and the benefits of post-registration training in this area. Some felt that good communication was time consuming but others felt that time management had improved. Further research and training is required to support the implementation of these skills into dietetic practice.

  13. Evidence-based surgical training in orthopaedics: how many arthroscopies of the knee are needed to achieve consultant level performance?

    Science.gov (United States)

    Price, A J; Erturan, G; Akhtar, K; Judge, A; Alvand, A; Rees, J L

    2015-10-01

    Despite being one of the most common orthopaedic operations, it is still not known how many arthroscopies of the knee must be performed during training in order to develop the skills required to become a Consultant. A total of 54 subjects were divided into five groups according to clinical experience: Novices (n = 10), Junior trainees (n = 10), Registrars (n = 18), Fellows (n = 10) and Consultants (n = 6). After viewing an instructional presentation, each subject performed a simple diagnostic arthroscopy of the knee on a simulator with visualisation and probing of ten anatomical landmarks. Performance was assessed using a validated global rating scale (GRS). Comparisons were made against clinical experience measured by the number of arthroscopies which had been undertaken, and ROC curve analysis was used to determine the number of procedures needed to perform at the level of the Consultants. There were marked differences between the groups. There was significant improvement in performance with increasing experience (p < 0.05). ROC curve analysis identified that approximately 170 procedures were required to achieve the level of skills of a Consultant. We suggest that this approach to identify what represents the level of surgical skills of a Consultant should be used more widely so that standards of training are maintained through the development of an evidenced-based curriculum. ©2015 The British Editorial Society of Bone & Joint Surgery.

  14. A comparison of general medical and clinical ethics consultations: what can we learn from each other?

    Science.gov (United States)

    Geppert, Cynthia M A; Shelton, Wayne N

    2012-04-01

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

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

    OpenAIRE

    Kohlsdorf,Marina; Costa Junior,Áderson Luiz

    2015-01-01

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

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

    OpenAIRE

    Alex Boulton

    2012-01-01

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

  17. 景德镇市两例重症EV71手足口病毒VP1区基因型分析%Analysis of the VP1 region genotype of enterovirus 71 isolated from two severe HFMD patients in Jingdezhen City

    Institute of Scientific and Technical Information of China (English)

    胡芹; 涂智杰; 吴集才; 魏建萍; 张敏; 曹健

    2013-01-01

    目的:分析2011年景德镇地区两例临床症状不同的EV71手足口重症病例病毒株的分子生物学特征。方法采集2例临床症状不同的手足口病重症患者咽拭子标本,进行病毒分离和逆转录-聚合酶链反应(RT-PCR),并将其与GenBank已上传的其他EV71病毒株的VP1区进行相关生物信息学分析。结果两例临床症状不同的重症病例都由EV71病毒引起,他们都同属于C4a亚型,通过氨基酸序列比对发现它们在四个氨基酸的位点上存在变异引起不同临床症状,其中有神经症状的患儿出现第19位丙氨酸由缬氨酸取代(A→V),第106位酪氨酸由苯丙氨酸取代(Y→F);无神经症状的患儿出现第19位丙氨酸由半胱氨酸取代(A→C),第38位精氨酸由谷氨酰胺取代(R→Q),第293位丙氨酸由丝氨酸取代(A→S)。结论 EV71病毒是引起手足口重症病例的主要病原,临床症状的差异性主要体现在有无神经系统症状,通过基因分析发现不同位点氨基酸的突变可能成为临床症状差异性形成的生物学基础。%Objective To analyze the molecular characterization of two enterovirus 71 (EV71) strains isolated from two severe hand foot mouth disease (HFMD) patients with different clinical symptoms in Jingdezhen City in 2011. Methods Throat swab specimens were collected from the two patients and EV71 were isolated for reverse transcription-polymerase chain reaction (RT-PCR) analysis. The differences of VP1 region genotype between the isolated virus and virus in GenBank were analyzed. Results Both patients with different severe clinical symptoms were caused by EV71 C4a subtype. Using amino acid sequence alignment, we found that there were four mutated amino acids and they would cause the different clinical symptoms. In EV71 isolated from pa-tient with neurologic symptoms, the 19th amino acid alanine was replaced by valine (A→V), the 106th amino acid tyrosine was re-placed by

  18. Epidemic Features and Etiology of HFMD in Yinchuan in Year 2008/2009%银川市2008-2009年手足口病流行特征及病原学监测分析

    Institute of Scientific and Technical Information of China (English)

    雷静; 范晓宇; 胡皓; 张嫣平; 李萍; 杨嵘

    2011-01-01

    models. Results A sample of 363 finished the survey, response rate were 92.3%. The detection rate of the mental disorders is 54. 8%. The detection rate of the Hui ethnicity was 38.1% , lower than the rate of the Han ethnicity 61. 9% (P 0. 05). The total score and the item score of other 8 factors in SCL -90 from inpatients showed different significantly in Chinese norms; The analysis of logistic showed that the primary influence factors of the mental healthy of inpatients were Hui ethnicity ( OR = 3. 0), the family members large ( OR = 1. 2 ) , income of inpatients influenced strongly by disease ( OR = 1.1). Conclusion The problems of mental health of inpatients with chronic hepatitis B is Outstanding and the main impact factors are social factors.

  19. 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.

  20. The Hannover Consultation Liaison model: some empirical findings.

    Science.gov (United States)

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

    1985-01-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

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

    NARCIS (Netherlands)

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

    2000-01-01

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

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

    NARCIS (Netherlands)

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

    2009-01-01

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

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

    Science.gov (United States)

    Rosenfield, Sylvia

    2014-01-01

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

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

    Science.gov (United States)

    Sulla, Nancy

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

  6. Incidence and outcomes of intraoperative vascular surgery consultations.

    Science.gov (United States)

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

    2015-07-01

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

  7. Impact of a new palliative care consultation team on opioid prescription in a University Hospital

    Science.gov (United States)

    Centeno, Carlos; Portela, María Angustias; Noguera, Antonio; Idoate, Antonio; Rubiales, Álvaro Sanz

    2009-01-01

    Background There are no validated measuring tools to gauge the effectiveness of a Hospital Palliative Care Consultation Team (PCCT). One way would be to consider its effect on the consumption of opioids expressed in total amounts and different formulations administered. We perform this study to evaluate the impact of a hospital PCCT on the trends of opioid prescription in a University Hospital. Methods A seven year retrospective study on opioid prescription was carried out in the Clínica Universidad de Navarra. The period includes three years before and three years after the PCCT was implemented. Prescription was analysed calculating yearly the Defined Daily Dose (DDD) adjusted to 1000 hospital stays (DDD/1000HS). Indicators considered were the proportion of patients treated using opioids compared to the total estimated in need of treatment (rate of effectiveness) and the proportion of patients potentially requiring opioids but not treated who were incorporated into the treatment group (rate of improvement). Results From 2001 to 2007, total opioid prescription was low in non-oncology Departments (range: 69–110 DDD/1000HS) while parenteral morphine and fentanyl did not register any changes. In the same period of time, total opioid prescription increased in the Oncology Department from 240 to 558 DDD/1000HS. The rate of effectiveness in the three years prior to the implantation of the consultation team was 64% and in the three following years rose to 87%. The rate of improvement prior to the palliative care consultation team was 43% and in the three following years was 64%. A change in opioid prescription was registered after the implementation of the PCCT resulting in an increase in the prescription of parenteral morphine and methadone and a decrease in transdermal fentanyl. Conclusion Implementation of a PCCT in a University Hospital is associated with a higher and more adequate use of opioids. PMID:19149875

  8. Consultation behaviour of doctor-shopping patients and factors that reduce shopping.

    Science.gov (United States)

    Ohira, Yoshiyuki; Ikusaka, Masatomi; Noda, Kazutaka; Tsukamoto, Tomoko; Takada, Toshihiko; Miyahara, Masahito; Funakoshi, Hiraku; Basugi, Ayako; Keira, Katsunori; Uehara, Takanori

    2012-04-01

    To investigate the subsequent behaviour of doctor-shopping patients (defined as those attending multiple hospitals for the same complaint) who consulted our department and factors related to cessation of doctor shopping. Patients who presented without referral to the Department of General Medicine at Chiba University Hospital in Japan (our department) completed a questionnaire at their first visit. A follow-up questionnaire was also sent to them in order to assess doctor shopping after 3 months. Then items in the questionnaires were investigated for significant differences between patients who continued or stopped doctor shopping. Logistic regression analysis was performed with items showing a significant difference between patients who stopped doctor shopping and those who continued it, in order to identify independent determinants of the cessation of shopping. A total of 978 patients who presented spontaneously to our department consented to this study, and 929 patients (95.0%) completed questionnaires correctly. Among them, 203 patients (21.9%) were identified as doctor shoppers. The follow-up survey was completed correctly by 138 patients (68.0%). Among them, 25 patients (18.1%) were found to have continued doctor shopping, which was a significantly lower rate than before (P shopping: 'confirmation of the diagnosis' (odds ratio: 8.12, 95% confidence interval: 1.46-45.26), and 'satisfaction with consultation' (odds ratio: 2.07, 95% confidence interval: 1.42-3.01). Doctor shopping decreased significantly after patients consulted our department, with 'confirmation of the diagnosis' and 'satisfaction with consultation' being identified as contributing factors. © 2010 Blackwell Publishing Ltd.

  9. Investigating the quality of video consultations performed using fourth generation (4G) mobile telecommunications.

    Science.gov (United States)

    Caffery, Liam J; Smith, Anthony C

    2015-09-01

    The use of fourth-generation (4G) mobile telecommunications to provide real-time video consultations were investigated in this study with the aims of determining if 4G is a suitable telecommunications technology; and secondly, to identify if variation in perceived audio and video quality were due to underlying network performance. Three patient end-points that used 4G Internet connections were evaluated. Consulting clinicians recorded their perception of audio and video quality using the International Telecommunications Union scales during clinics with these patient end-points. These scores were used to calculate a mean opinion score (MOS). The network performance metrics were obtained for each session and the relationships between these metrics and the session's quality scores were tested. Clinicians scored the quality of 50 hours of video consultations, involving 36 clinic sessions. The MOS for audio was 4.1 ± 0.62 and the MOS for video was 4.4 ± 0.22. Image impairment and effort to listen were also rated favourably. There was no correlation between audio or video quality and the network metrics of packet loss or jitter. These findings suggest that 4G networks are an appropriate telecommunication technology to deliver real-time video consultations. Variations in quality scores observed during this study were not explained by the packet loss and jitter in the underlying network. Before establishing a telemedicine service, the performance of the 4G network should be assessed at the location of the proposed service. This is due to known variability in performance of 4G networks. © The Author(s) 2015.

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

    Science.gov (United States)

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

    1996-01-01

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

  11. [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.

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

    Science.gov (United States)

    Maylor, Miles

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

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

    Science.gov (United States)

    Currie, Jane

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

  14. 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.

  15. Interventions to influence consulting and antibiotic use for acute respiratory tract infections in children: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Talley Andrews

    Full Text Available BACKGROUND: Respiratory tract infections (RTIs are common in children and generally self-limiting, yet often result in consultations to primary care. Frequent consultations divert resources from care for potentially more serious conditions and increase the opportunity for antibiotic overuse. Overuse of antibiotics is associated with adverse effects and antimicrobial resistance, and has been shown to influence how patients seek care in ensuing illness episodes. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a systematic review and meta-analysis to assess the effectiveness of interventions directed towards parents or caregivers which were designed to influence consulting and antibiotic use for respiratory tract infections (RTIs in children in primary care. Main outcomes were parental consulting rate, parental knowledge, and proportion of children subsequently consuming antibiotics. Of 5,714 references, 23 studies (representing 20 interventions met inclusion criteria. Materials designed to engage children in addition to parents were effective in modifying parental knowledge and behaviour, resulting in reductions in consulting rates ranging from 13 to 40%. Providing parents with delayed prescriptions significantly decreased reported antibiotic use (Risk Ratio (RR 0.46 (0.40, 0.54; moreover, a delayed or no prescribing approach did not diminish parental satisfaction. CONCLUSIONS: IN ORDER TO BE MOST EFFECTIVE, INTERVENTIONS TO INFLUENCE PARENTAL CONSULTING AND ANTIBIOTIC USE SHOULD: engage children, occur prior to an illness episode, employ delayed prescribing, and provide guidance on specific symptoms. These results support the wider implementation of interventions to reduce inappropriate antibiotic use in children.

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

    OpenAIRE

    2016-01-01

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

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

    OpenAIRE

    Hackett, William S.; McInerney, John Francis

    1984-01-01

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

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

    OpenAIRE

    Verba Veronika A.

    2013-01-01

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

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

    OpenAIRE

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

    2014-01-01

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

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

    OpenAIRE

    2005-01-01

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

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

    OpenAIRE

    2001-01-01

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

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

    DEFF Research Database (Denmark)

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

    different departments: Orthopedics, Urology, Internal Medicine and Pediatrics. A total of 5,460 patients will be included from the outpatient clinics. All patients randomized to an intervention group are offered audio recording of their consultation. An Interactive Voice Response platform enables an audio......Introduction Information provided in an outpatient consultation concerns medication, diagnostic tests, treatment and rehabilitation which is crucial knowledge in regards of patient compliance, decision making and general patient satisfaction. Despite good communication skills among clinicians...... the communication is challenged by the fact that patients tend to forget or misunderstand a great deal of the information given. The primary objective of this study is to investigate the effects of providing patients with an audio recording of the consultation. Methods A randomized controlled trial involving four...

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

    Science.gov (United States)

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

    1997-01-01

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

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

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  5. Colonial connections and consulting engineers 1850-1914

    DEFF Research Database (Denmark)

    Andersen, Casper

    2011-01-01

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

  6. Standard psychological consultations and follow up for women at increased risk of hereditary breast cancer considering prophylactic mastectomy

    Directory of Open Access Journals (Sweden)

    Tan Murly BM

    2009-03-01

    Full Text Available Abstract Background Women at increased (genetic risk of breast cancer have to weigh the personal pros and cons of prophylactic mastectomy (PM as an option to reduce their cancer risk. So far, no routine referral to a psychologist has been investigated for women considering PM. Aim of this study was to asses: 1 the acceptance of the offer of a standard psychological consultation as part of pre-surgical decision-making in high-risk women, 2 reasons for PM and reasons for postponing it, 3 the need for additional psychological interventions, and factors associated, and 4 the frequency of psychiatric/psychological treatment history. Methods During a 30 months period, women at high risk considering PM were offered a psychological consultation. The content of these, and follow-up, consultations were analyzed. Results Most women (70 out of 73 accepted the psychological consultation, and 81% proceeded with PM. Main reasons for undergoing PM were to reduce anxiety about cancer, and to reduce the cancer risk. Uncertainty about surgery and the need for further information were the reasons given most frequently for postponing PM. Additional psychological support was given to 31% before and 14% after PM. The uptake of additional support was significantly higher in women with a BRCA1/2 mutation. A history of psychiatric/psychological treatment was present in 36%, mainly consisting of depression and grief after death of a mother. Conclusion The uptake-rate of the standard psychological consultation indicates a high level of acceptability of this service for women deciding about PM. Since anxiety is one of the main reasons for considering PM, and depression and grief were present in a third, a standard consultation with a psychologist for high-risk women considering PM may be indicated. This may help them arrive at an informed decision, to detect and manage psychological distress, and to plan psychological support services.

  7. Effect of sociodemographic factors on surgical consultations and hip or knee replacements among patients with osteoarthritis in British Columbia, Canada.

    Science.gov (United States)

    Rahman, M Mushfiqur; Kopec, Jacek A; Sayre, Eric C; Greidanus, Nelson V; Aghajanian, Jaafar; Anis, Aslam H; Cibere, Jolanda; Jordan, Joanne M; Badley, Elizabeth M

    2011-03-01

    To quantify the effect of demographic variables and socioeconomic status (SES) on surgical consultation and total joint arthroplasty (TJA) rates among patients with osteoarthritis (OA), using population-based administrative data. A cohort study was conducted in British Columbia using population data from 1991 to 2004. From April 1996 to March 1998, we documented 34,420 new patients with OA and these patients were followed to March 2004 for their first surgical consultation and TJA. Effects of age, sex, and SES were evaluated by Cox proportional hazards models after adjusting for comorbidities and pain medication used. During a mean 5.5-year followup period, 7475 patients with OA had their first surgical consultations and 2814 patients received TJA within a 6-year mean followup period. Crude hazards ratio (HR) for men compared to women was 1.25 (95% CI 1.20-1.31) for surgical consultation and was 1.14 (95% CI 1.06-1.23) for TJA. The interaction between sex and SES was significant. Stratified analysis showed among men an HR of 1.42 (95% CI 1.27-1.58) and 1.52 (95% CI 1.26-1.83) for surgical consultations and TJA, respectively, for the highest SES compared with the lowest SES quintiles. Similarly significant results were observed among women. Differential access to the healthcare system exists among patients with OA. Women with OA were less likely than men to see an orthopedic surgeon as well as to obtain TJA. Patients with higher SES consulted orthopedic surgeons more frequently and received more TJA than those with the lowest SES.

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

    Directory of Open Access Journals (Sweden)

    Leonid Davidovich Gitelman

    2017-03-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

  10. 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.

  11. Consultation of medical narratives in the electronic medical record.

    Science.gov (United States)

    Tange, H J

    1999-12-01

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

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

    Science.gov (United States)

    van der

    2001-01-01

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

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

    Science.gov (United States)

    Fiester, Autumn

    2015-01-01

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

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

    Science.gov (United States)

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

    2005-04-01

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

  15. Development of a telepresence robot for medical consultation

    Science.gov (United States)

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

    2017-02-01

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

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

    DEFF Research Database (Denmark)

    Broberg, Ole

    2004-01-01

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

  17. A Marketing Study into Consumer Needs for Consulting Services

    Directory of Open Access Journals (Sweden)

    Marya V. Shendo

    2016-03-01

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

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

    Science.gov (United States)

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

    1983-10-01

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

  19. 提高院内会诊质量的管理举措%The management approaches to enhance the quality of hospital consultation

    Institute of Scientific and Technical Information of China (English)

    霍霄鲲; 刘小乡; 郑超; 刘建寨; 王刚; 曹秀堂

    2013-01-01

      目的:分析院内会诊管理现状,针对发现的问题提出应对策略,完善会诊管理制度,提高会诊质量。方法:提取医院会诊系统中的会诊记录,分析会诊按时完成率,对会诊申请及完成集中的科室进行重点分析与调查。结果:2011年1月-2012年5月会诊按时完成率逐月稳步提升,2012年5月已达到86%,但距98%的目标尚有较大距离;完成会诊的前10位科室完成量占全院的59.81%,申请会诊的前10位科室申请量占全院的63.8%,并且有6个科室重叠,说明申请与完成会诊的科室较为集中;会诊系统中有8.6%未完成的会诊。结论:应采取集中会诊、会诊质量互评、加大网络监控力度等措施,进一步提高会诊按时完成率。%  Objectives:To analyze the current status of consultation management and to seek the solutions of the problems which can improve the management system of consultation and the quality of consultation. Methods:The consultation record from the hospital consultation system were sampled and the on-time rate of the consultation were analyzed. The departments which have large numbers of consultation applications or completion were carried out key point investigation and analysis. Results:The on-time rate of consultation increases month by month, which reaches 86%by May 2012, but it is still far from the goal of 98%. The top-10 departments which complete the consultation take up 59.81%of the total amount of completion. The top-1o departments which apply for the consultation take up 63.8%of the total number of applications. There are 6 departments in both of the top-10 lists, which shows that the departments which apply for and complete the consultation are relatively concentrated. There are 8.6% unfinished consultations in the consultation system. Conclusion: Suggestions such as centered consultation, peer consultation quality evaluation and enhancing the network control and

  20. Colleague and patient appraisal of consultant psychiatrists and the effects of patient detention on appraisal scores.

    Science.gov (United States)

    Heneghan, Miranda; Chaplin, Robert

    2016-08-01

    Aims and method This paper aims to review colleague and patient feedback from the 10-year period of the operation of the Royal College of Psychiatrists' 360-degree appraisal system, specifically: (1) examine the overall distribution of ratings; (2) examine the effect of working primarily with detained patients on patient feedback, represented by forensic psychiatrists; and (3) look for a relationship between colleague and patient ratings. Results Data were analysed for 977 participating psychiatrists. Both colleagues and patients rated psychiatrists overall with high scores. Less than 1% were identified as low scorers, although there was no relationship between those identified by colleagues or patients. Colleague and patient feedback scores varied little between subspecialties including forensic consultants. Clinical implications Psychiatrists in all subspecialties obtained high scores from colleagues and staff. Working with detained patients appeared to have little effect on patient ratings.

  1. Bosnia and Herzegovina; Staff Report for the 2001 Article IV Consultation

    OpenAIRE

    International Monetary Fund

    2002-01-01

    This 2001 Article IV Consultation highlights that after several years of double-digit growth rates, real GDP for Bosnia and Herzegovina increased by about 5.5 percent in 2001. The growth slowdown was particularly marked in the Republika Srpska, where output grew by just 2 percent. The slowdown—which is partly owing to lower aid-financed reconstruction spending—marks the end of the post-war economic rebound. Industrial production is still less than half its pre-war level and measured unemp...

  2. Analysis of Drug Consultation in Our Hospital%我院593例药物咨询分析

    Institute of Scientific and Technical Information of China (English)

    刘辽; 贾萍

    2012-01-01

    Objective To improve the quality of clinical pharmacy service. Methods The medical records of drug consultation from April 2010 to April 2011 in our hospital were statistically analyzed for probing into the characteristics of drug consultation. Results A-mong 593 cases of drug consultants,the top 3 places were the outpatients (67.45% ),the patients by telephone consultation ( 10.46% ) and physicians ( 10. 12% ). The commonly consulted problems included medication for special populations,usage and dosage of drugs,adverse drug reactions and drug interactions,etc. In the total reply of drug consultation,the timely response rate,the response rate by accessing to information and the non - response rate were 90. 73%, 8. 77% and 0. 84% ,respectively. Conclusion Drug consultation can not only promote rational drug use,but also conducive to the improvement of clinical pharmacists own quality.%目的 提高临床药学服务质量.方法 对医院2010年4月至2011年4月的药物咨询情况进行分析,探讨药物咨询的特点.结果 593例药物咨询者中,列前3位的分别为门诊患者(67.45%)、通过电话咨询的患者(10.46%)、医师(10.12%);咨询的常见问题包括特殊人群用药、药物的用法用量、药品不良反应和药物相互作用等;药物咨询答复中,及时答复、查阅资料后答复、未答复分别占90.73%,8.77%,0.84%.结论进行药物咨询,一方面可促进合理用药;另一方面也有利于临床药师自身素质的提高.

  3. Genetic characteristics of the VP1 gene of enterovirus 71 strains in the City of Xiangyang, Hubei Province during a HFMD epidemic in 2011%2011年湖北省襄阳市手足口病主要病原EV71型病毒VP1基因特征分析

    Institute of Scientific and Technical Information of China (English)

    戴莹; 李静; 雷亚克; 杨朝晖; 霍细香

    2013-01-01

    Objective The genetic characteristics of the YP1 gene and phylogeny of enterovirus type 71 (EV71) strains were analyzed to investigate the genetic background of EY71 that caused a HFMD epidemic in the City of Xiangyang. Hubei Province. Methods VP 1 of EV71 strains from Xiangyang in 2011 was sequenced and its homology and phylogeny were analyzed. Results The full-length VP 1 region of Xiangyang EV71 strains was 891 bp. Nuclcotide and amino acid identity were 96. 5% -99.1% and 98. 1%-100%. respectively. Phylogenetic analysis based on the complete VP1 sequence also indicated that the Xiangyang EV71 strains belonged to the same subgenotype, C4a. Conclusion The genotype of Xiangyang EV71 strains belonged to the CM a subgenotype. There was no obvious antigenic drift or variation.%目的 调查2011年襄阳市手足口病主要病原EV71的基因型特征,分析和探讨该型病毒的VP1基因变异和分子进化特点. 方法 对2011年襄阳市流行株EV71进行VP1区核苷酸序列测定和同源性比较及遗传进化分析.结果 2011年襄阳市手足口病EV71病毒的VPI区核苷酸序列全长均为891 bp,与对照EV71毒株核苷酸序列同源性为96.5%~99.1%,编码蛋白氨基酸序列同源性为98.1%~100%.VP l区基因遗传进化分析显示,该中EV71病毒属于C4a基因亚型. 结论 2011年襄阳市手足口病疫情主要病原EV71病毒均属于C4a基因亚型,未产生明显的抗原漂移及变异.

  4. Consultations with Women Treated for Breast Cancer

    Directory of Open Access Journals (Sweden)

    Moyez Jiwa

    2011-01-01

    Full Text Available Background. Health professionals, including general practitioners involved in followup of breast cancer patients, need to systematically assess opportunities to offer patients support with ongoing or new problems. Methods. A self-administered needs assessment questionnaire was developed with reference to a multidisciplinary team. Short, evidence-based, readable questions were emphasized, and questions were tested for face validity. The questions flowed across three domains: physical, social, and psychological. Content validity and user friendliness were assessed. Results. A final set of 30 questions was rated as easy to read and comprehend (Flesch Reading Ease score 65.8 and Flesch-Kincaid Grade Level 6.9. When piloted with twenty-one patients the self-administered questionnaire detected 121 items of unmet need encompassing all three domains. Conclusions. This self-administered questionnaire has the potential to assist in the holistic assessment of breast cancer patient after treatment. The clinical value of the self-administered questionnaire will need to be further tested before it can be widely adopted.

  5. A Behavior Modification Approach to Elementary School Consultation.

    Science.gov (United States)

    Callister, Sheldon L.

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

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

    NARCIS (Netherlands)

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

    2009-01-01

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

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

    Science.gov (United States)

    2010-05-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

    Iltis, Ana S; Sheehan, Mark

    2016-08-01

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

  10. Consulting Psychiatry within an Integrated Primary Care Model

    Science.gov (United States)

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

    2014-01-01

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

  11. State S&T Plan Consultation Tops CASAD Priorities

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

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

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

    Science.gov (United States)

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

    2008-01-01

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

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

    Science.gov (United States)

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

    2015-09-01

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

  14. Spatial information in public consultation within environmental impact assessments

    NARCIS (Netherlands)

    Mwenda, A.N.

    2015-01-01

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

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

    Science.gov (United States)

    Newman, Anabel; And Others

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

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

    Science.gov (United States)

    Newman, Anabel; And Others

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

  17. 14 CFR 1261.403 - Consultation with appropriate officials; negotiation.

    Science.gov (United States)

    2010-01-01

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

  18. Consulting Young Children about Barriers and Supports to Learning

    Science.gov (United States)

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

    2014-01-01

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

  19. 42 CFR 493.1411 - Standard; Technical consultant qualifications.

    Science.gov (United States)

    2010-10-01

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

  20. Industrial Buying Behavior Related to Human Resource Consulting Services

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  1. 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...

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

    Science.gov (United States)

    Muther, Richard S.; And Others

    1989-01-01

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

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

    Science.gov (United States)

    Hall, Georgia G.; Starkman, Monica N.

    1979-01-01

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

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

    Science.gov (United States)

    Pastoors, Katja

    2007-01-01

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

  5. Spatial information in public consultation within environmental impact assessments

    NARCIS (Netherlands)

    Mwenda, A.N.

    2015-01-01

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

  6. 24 CFR 971.9 - Tenant and local government consultation.

    Science.gov (United States)

    2010-04-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

    DeCandido, Graceanne A.

    2000-01-01

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

  9. 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...

  10. Industrial Buying Behavior Related to Human Resource Consulting Services

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  11. HRC's SHP Consultation Mission in Rwanda

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

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

  12. 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.

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

    Science.gov (United States)

    Clark, Thomas

    2009-01-01

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

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

    Science.gov (United States)

    Higher Education Funding Council for England, Bristol.

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

  15. 41 CFR 101-1.107 - Agency consultation regarding FPMR.

    Science.gov (United States)

    2010-07-01

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

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

    African Journals Online (AJOL)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-07-01

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

  18. Vascular Neurology Nurse Practitioner Provision of Telemedicine Consultations

    Directory of Open Access Journals (Sweden)

    Bart M. Demaerschalk

    2010-01-01

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

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

    Science.gov (United States)

    McCarthy, Martha M.; Sorenson, Gail Paulus

    1993-01-01

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

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

    Science.gov (United States)

    Bell, Reginald L.

    2007-01-01

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

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

    Science.gov (United States)

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

    2006-01-01

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

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

    Science.gov (United States)

    Higher Education Funding Council for England, Bristol.

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

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

    Science.gov (United States)

    Serpieri, Roberto; Grimaldi, Emiliano; Vatrella, Sandra

    2015-01-01

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

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

    Science.gov (United States)

    Rothwell, William J.

    1983-01-01

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

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

    Science.gov (United States)

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

    2016-06-01

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

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

    Science.gov (United States)

    Higher Education Funding Council for England, Bristol.

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

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

    NARCIS (Netherlands)

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

    2003-01-01

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

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

    Science.gov (United States)

    Bowes, Debra

    2013-03-01

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

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

    Science.gov (United States)

    Burgess, Michael M

    2004-01-01

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

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

    Science.gov (United States)

    Rothwell, William J.

    1983-01-01

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

  11. 36 CFR 1270.50 - Consultation with law enforcement agencies.

    Science.gov (United States)

    2010-07-01

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

  12. Consultation with First Nations stakeholders : an Alberta perspective

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-07-01

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

  13. 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…

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

    NARCIS (Netherlands)

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

    2010-01-01

    Background: The increasing prevalence of chronic diseases and the growing understanding that lifestyle behaviour plays an essential role in improving overall health suggest a need for increased attention to lifestyle choices in the consulting room. This study aims to examine whether or not healthy a

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

    Science.gov (United States)

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

    2016-01-01

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

  16. 77 FR 31348 - Boott Hydropower, Inc.; Notice of Consulting Parties and Agenda for Section 106 Consultation Meeting

    Science.gov (United States)

    2012-05-25

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

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

    Science.gov (United States)

    Ontario Ministry of Community and Social Services, Toronto.

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

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

    Science.gov (United States)

    Wilkinson, Lee A.

    2006-01-01

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

  19. Using professional interpreters in undergraduate medical consultation skills teaching

    Directory of Open Access Journals (Sweden)

    Bansal A

    2014-11-01

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

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

    NARCIS (Netherlands)

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

    2007-01-01

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

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

    NARCIS (Netherlands)

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

    2015-01-01

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

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

    Science.gov (United States)

    Chion-Kenney, Linda

    1994-01-01

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

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

    NARCIS (Netherlands)

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

    2013-01-01

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

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

    NARCIS (Netherlands)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2012-01-01

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

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  7. 30 CFR 285.203 - With whom will MMS consult before issuance of a lease?

    Science.gov (United States)

    2010-07-01

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

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

    Science.gov (United States)

    Misra, Sara; Daly, Blánaid; Dunne, Stephen; Millar, Brian; Packer, Mark; Asimakopoulou, Koula

    2013-01-01

    Background There is a lack of information about the extent to which patients recall key facts of dental consultations. Forgetting health advice undermines adherence with such instructions and is a potential problem. This study assessed the quantity and type of information recalled in a dental consultation, dentist–patient agreement over the contents of the consultation, and the relationship of such recall with patient satisfaction. Methods Using a cross-sectional design, questionnaire data were obtained from patients recruited through a letter and presenting for a routine dental consultation. General issues discussed, specific information about oral health given, dentist-performed procedures, and agreed future actions were reported independently in writing, by patients and also by the treating dentist immediately postconsultation. Additionally, patients completed a dental visit satisfaction questionnaire. Results Responses (n = 26, 55% response rate) were content-analyzed, and data on the number and type of information that was recalled were obtained. Interrater reliability was established. Inferential testing showed differences in dentist–patient recall, dentist–patient agreement, and the association between patient recall and satisfaction. Dentists recalled more information than patients (P = 0.001). Dentists further reported giving more dental health education (P = 0.006) and discussing more future actions (P = 0.002) than patients actually remembered. Technical (eg, crowns/bridges) rather than psychosocial (eg, pain/embarrassment) issues were reported more often (P = 0.001) by both dentists and patients. Dentist–patient agreement over issues discussed and procedures performed was higher (kappa = 0.210–0.310) than dental health education agreement and agreed future actions (kappa = 0.060–0.110). There was no relationship between patient recall and patient satisfaction with the consultation (P = 0.240). Conclusion Patients do not recall as much advice

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

    Science.gov (United States)

    Misra, Sara; Daly, Blánaid; Dunne, Stephen; Millar, Brian; Packer, Mark; Asimakopoulou, Koula

    2013-01-01

    There is a lack of information about the extent to which patients recall key facts of dental consultations. Forgetting health advice undermines adherence with such instructions and is a potential problem. This study assessed the quantity and type of information recalled in a dental consultation, dentist-patient agreement over the contents of the consultation, and the relationship of such recall with patient satisfaction. Using a cross-sectional design, questionnaire data were obtained from patients recruited through a letter and presenting for a routine dental consultation. General issues discussed, specific information about oral health given, dentist-performed procedures, and agreed future actions were reported independently in writing, by patients and also by the treating dentist immediately postconsultation. Additionally, patients completed a dental visit satisfaction questionnaire. Responses (n = 26, 55% response rate) were content-analyzed, and data on the number and type of information that was recalled were obtained. Interrater reliability was established. Inferential testing showed differences in dentist-patient recall, dentist-patient agreement, and the association between patient recall and satisfaction. Dentists recalled more information than patients (P = 0.001). Dentists further reported giving more dental health education (P = 0.006) and discussing more future actions (P = 0.002) than patients actually remembered. Technical (eg, crowns/bridges) rather than psychosocial (eg, pain/embarrassment) issues were reported more often (P = 0.001) by both dentists and patients. Dentist-patient agreement over issues discussed and procedures performed was higher (kappa = 0.210-0.310) than dental health education agreement and agreed future actions (kappa = 0.060-0.110). There was no relationship between patient recall and patient satisfaction with the consultation (P = 0.240). Patients do not recall as much advice and agreed actions about future dental care as

  10. Tobacco and alcohol consumption in post-Soviet Ukraine: qualitative findings from community consultations

    Directory of Open Access Journals (Sweden)

    Salnykova, Anastasiya

    2016-12-01

    Full Text Available BACKGROUND: This study focuses on a variety of social determinants of alcohol and tobacco consumption, which have been reported as an alarming epidemic in the post-Soviet Ukraine. Authors look at the intersections of social determinants of tobacco and alcohol use in Ukraine as perceived by the study participants, and their perception of structural effects of economic and cultural transition on the prevalence of these harmful lifestyles. METHODS: This study is part of a mixed-methods research, informed by an intersectional framework, focusing on complex health and health care experiences of Ukrainians. This study uses findings from 21 community consultations in 11 regions, corresponding to Ukraine’s diverse demographics, culture, and geography. At these consultations, participants discussed their health, experiences in seeking healthcare and provided recommendations for healthcare reforms. RESULTS: The study identifies the important demographic factors like age, gender, SES, and place of residence, and how their intersections influence tobacco and alcohol consumption in Ukraine. People of lower SES have reportedly higher rates of consuming alcohol and tobacco, but younger individuals of low SES are most affected by these unhealthy lifestyles. The study also points to broader structural factors, such as stress, unemployment, poor law enforcement, poor social support, lack of health promotion, features of the built environment, and tobacco and alcohol availability, which affect the uptake of unhealthy behaviors. CONCLUSIONS: The community consultations revealed people’s perceptions about the complex nature of tobacco and alcohol consumption in the post-Soviet setting. People shared their concern about the vulnerability of certain social groups to using alcohol and tobacco, and their understanding of the detrimental effects these substances have on the health of these groups. This intersectionality-based study concludes that there is a need to

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

    OpenAIRE

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

    2005-01-01

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

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

    OpenAIRE

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

    1985-01-01

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

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

    OpenAIRE

    2016-01-01

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

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

    OpenAIRE

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

    2015-01-01

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

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

    OpenAIRE

    2014-01-01

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

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

    Science.gov (United States)

    Defoe, J R; Breed, W

    1988-01-01

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

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

    Science.gov (United States)

    Iordache, Serban

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

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

    Science.gov (United States)

    Forrest, David V

    2005-01-01

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

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

    Science.gov (United States)

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

    2012-04-01

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

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

    Science.gov (United States)

    Fosgerau, Christina Fogtmann; Davidsen, Annette Sofie

    2014-05-01

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