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Sample records for management consulting assistance

  1. Consultant management estimating tool.

    2012-04-01

    The New York State Department of Transportation (NYSDOT) Consultant Management Bureaus primary responsibilities are to negotiate staffing hours/resources with : engineering design consultants, and to monitor the consultant's costs. Currently the C...

  2. [PREDICTORS OF WEIGHT LOSS AND FAT IN THE DIETARY MANAGEMENT: SEX, AGE, BMI AND CONSULTING ASSISTANCE].

    Reig García-Galbis, Manuel; Rizo Baeza, Mercedes; Cortés Castell, Ernesto

    2015-09-01

    WL%: percentage of weight loss; % FL: percentage fat loss; PNLWF: patients who lose weight or fat; PLWF: patients who lose weight and fat. assess whether the% WL and FL% in the dietary treatment was affected by gender, age, BMI and assistance to the query. 4,700 consultations, 670 patients (BMI ≥25), in the south-east of Spain (2006-12). Balanced and hypo-caloric diet was used. Two types of patients: PNLWF and PLWF (91.9%). in PLWF, men and those attending a greater number of occasions to the consultation have shown a greater loss against women (%FL: 23.0 vs 14.3%, p = 0.000; %WL: 7.7 vs 6.6%, p = 0.020), and those who attend less frequently (%FL: 19.1 vs 7.3%, p = 0.000; %WL: 7.8 vs 2.9%, p = 0.000). Multinomial regression analysis (PNLWF / PLWF) indicates that only attend more than one and a half to the consultation is a factor in the loss, OR 8.3 (IC 95% 4.5-15.1; p = 0.000). the body fat measurement provides additional information lost weight; Most patients attend more than six weeks, obtained a high %FL; attendance is a predictor of loss; the %FL indicates that the dietary management plays a major role in the resolution of this pathology; It is recommended to design practical schemes of action process nutritionists according to the IMCI and variable. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  3. Client Perceptions of Occupational Health and Safety Management System Assistance Provided by OSHA On-Site Consultation: Results of a Survey of Colorado Small Business Consultation Clients.

    Autenrieth, Daniel A; Brazile, William J; Gilkey, David P; Reynolds, Stephen J; June, Cathy; Sandfort, Del

    2015-01-01

    The Occupational Safety and Health Administration (OSHA) On-Site Consultation Service provides assistance establishing occupational health and safety management systems (OHSMS) to small businesses. The Safety and Health Program Assessment Worksheet (Revised OSHA Form 33) is the instrument used by consultants to assess an organization's OHSMS and provide feedback on how to improve a system. A survey was developed to determine the usefulness of the Revised OSHA Form 33 from the perspective of Colorado OSHA consultation clients. One hundred and seven clients who had received consultation services within a six-year period responded to the survey. The vast majority of respondents indicated that the Revised OSHA Form 33 accurately reflected their OHSMS and that information provided on the Revised OSHA Form 33 was helpful for improving their systems. Specific outcomes reported by the respondents included increased safety awareness, reduced injuries, and improved morale. The results indicate that the OHSMS assistance provided by OSHA consultation is beneficial for clients and that the Revised OSHA Form 33 can be an effective tool for assessing and communicating OHSMS results to business management. Detailed comments and suggestions provided on the Revised OSHA Form 33 are helpful for clients to improve their OHSMS.

  4. Ethics in Management Consulting

    Carlo Vallini

    2007-01-01

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

  5. Effects of Using Licensed Practical Nurses to Assist with Telephone Consultation Management

    Wiley, Jennifer L

    2006-01-01

    .... The study compared means of pre- and post-implementation provider overall job satisfaction, provider satisfaction with the telephone consult process, average daily hours providers spent on telephone...

  6. Academic Development for Careers in Management Consulting

    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…

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

    Hartley, Jeanette

    2017-01-01

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

  8. Advantages and disadvantages of interdisciplinary consultation in the prescription of assistive technologies for mobility limitations.

    de Laat, Fred A; van Heerebeek, Bart; van Netten, Jaap J

    2018-03-28

    To explore the advantages and disadvantages experienced by professionals in interdisciplinary consultation involving the user, prescriber and technician in the prescription of assistive technologies for mobility limitations. Cross-sectional study. Prescribers (N = 39) and orthopaedic technicians (N = 50), who were regularly involved in an interdisciplinary consultation completed a questionnaire about advantages and disadvantages of the interdisciplinary consultation. Advantages of the interdisciplinary consultation were mentioned within all CanMEDS areas of medical practice, including better and quicker prescription of the assistive technology, shared knowledge of medical diagnosis and device possibilities, shared decision making of the device prescription and clear communication rules. Disadvantages were mentioned in the CanMEDS areas management and collaboration, including planning problems (financial) reimbursement of this type of consultation, and time efficiency. On a 10-point scale, mean (standard deviation) rates of interdisciplinary consultations were 7.9 (0.6) according to prescribers, and 7.8 (0.9) by technicians. All participants wanted to continue the interdisciplinary consultation. Prescribers and technicians in the field of assistive technologies for walking mobility limitations appreciate an interdisciplinary consultation. Advantages are found in all CanMEDS areas, whereas disadvantages only concern coordination. It should be encouraged to realize this kind of consultation in all situations where such technologies are prescribed. Implications for rehabilitation Interdisciplinary consultation involving the user, prescriber and technician to prescribe assistive technologies for mobility limitations has many advantages in all CanMEDS areas of medical practice, and few disadvantages, related to management and collaboration only. The disadvantages of interdisciplinary consultation, such as (financial) reimbursement by health insurance companies

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

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

    2017-01-01

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

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

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

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

    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. Standardization Versus Innovation In Management Consultancy

    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.

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

    Kreutzer, Markus; Menz, Markus

    2012-01-01

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

  14. From Research Assistant to Professional Research Assistance: Research Consulting as a Form of Research Practice

    Dawn E. Pollon

    2013-01-01

    Full Text Available Research assistantships have long been viewed as an extension of the formal education process, a form of apprenticeship, and a pathway into the professional practice of research in institutional settings. However, there are other contexts in which researchers practice research. This self-study documents the formative role research assistantships played in the authors’ development as professional research consultants. Four professional research consultants who held research assistant positions during their master’s and doctoral studies describe the contributions of their research assistantship experiences to the advancement of their knowledge, skills, and passion for research and subsequently to their career decisions. Professional research consulting is identified as a natural extension of research assistant roles and a potential career path. The article enhances current understandings about the ways research assistantships contribute to the development of researchers, and specifically to the development of professional research consultants. The analysis will be of interest to students contemplating entering into research assistantships, current research assistants, current research assistant supervisors, academic staff looking to improve their research productivity, and department chairs.

  15. SOME REFLECTIONS UPON MANAGEMENT CONSULTING AS PROFESSIONAL SERVICES

    Tomescu Ada; Botezat Elena

    2008-01-01

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

  16. Capturing the competence of management consulting work

    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

  17. Managing outpatient consultations: from referral to discharge.

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

    2017-08-01

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

  18. Nurse consultants 10 years on: an insight to the role for nurse managers.

    Mullen, Chris; Gavin-Daley, Ann; Kilgannon, Helen; Swift, Juliette

    2011-09-01

    To evaluate the Non-Medical Consultant role in the North West of England. The objective was to identify the current number of Non-Medical Consultants, what they do and the impact of the role in practice. The Non-Medical Consultant role for nursing and midwifery was introduced in the UK in 2000 to provide better outcomes for patients by improving service and quality; strengthening clinical leadership; and providing a new career opportunity to help retain experienced and expert professionals in practice. A combined qualitative and quantitative design was adopted. This included desktop review of previous studies, a survey questionnaire to current consultants, focus group meetings with Non-Medical Consultants, sponsors and champions. The role is effective, flexible, responsive and outward facing both internal to the organization and externally on a local, regional and national basis. A key challenge for the Non-Medical Consultants was organizational understanding of the role. The small size of the Non-Medical Consultant workforce can limit individual organizations experience of establishing and supporting the role. Effective Non-Medical Consultants lead, drive and support quality improvement, increased productivity and service effectiveness. Other impacts include sharing and promoting best practice with colleagues, income generation and financial savings through service redesign and/or staff skill mix changes. Managerial issues identified may assist Nurse Managers seeking to introduce new consultant roles and/or support, and retain existing consultants to reach their full potential. 2011 Blackwell Publishing Ltd.

  19. Palliative medicine consultation for preparedness planning in patients receiving left ventricular assist devices as destination therapy.

    Swetz, Keith M; Freeman, Monica R; AbouEzzeddine, Omar F; Carter, Kari A; Boilson, Barry A; Ottenberg, Abigale L; Park, Soon J; Mueller, Paul S

    2011-06-01

    To assess the benefit of proactive palliative medicine consultation for delineation of goals of care and quality-of-life preferences before implantation of left ventricular assist devices as destination therapy (DT). We retrospectively reviewed the cases of patients who received DT between January 15, 2009, and January 1, 2010. Of 19 patients identified, 13 (68%) received proactive palliative medicine consultation. Median time of palliative medicine consultation was 1 day before DT implantation (range, 5 days before to 16 days after). Thirteen patients (68%) completed advance directives. The DT implantation team and families reported that preimplantation discussions and goals of care planning made postoperative care more clear and that adverse events were handled more effectively. Currently, palliative medicine involvement in patients receiving DT is viewed as routine by cardiac care specialists. Proactive palliative medicine consultation for patients being considered for or being treated with DT improves advance care planning and thus contributes to better overall care of these patients. Our experience highlights focused advance care planning, thorough exploration of goals of care, and expert symptom management and end-of-life care when appropriate.

  20. THE IMPORTANCE OF CONSULTING IN CONTEMPORARY BUSINESS MANAGEMENT

    Svetlana Vukotić; Jugoslav Aničić; Radovan Vukotić

    2017-01-01

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

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

    Driftmann, Christian; Josipovic, Neven

    2015-01-01

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

  2. Managing Employee Assistance Programmes.

    Schmidenberg, Olive C.; Cordery, John L.

    1990-01-01

    Interviews with 20 branch managers and 20 accountants in an Australian bank determined factors influencing the success of an employee assistance program (EAP). It was found that policies requiring supervisors to act against normal managerial practice doom EAPs to failure. Organizational analysis to integrate the EAP within existing organizational…

  3. Organizational design approaches in management consulting

    Visscher, Klaasjan; Visscher-Voerman, Irene

    2010-01-01

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

  4. Delivering an MBA Management Consulting Experience

    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.

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

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

    2010-03-01

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

  6. Determinants of Management Innovation in the Ghanaian Construction Consulting Sector

    De-Graft Owusu-Manu

    2015-03-01

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

  7. 44 CFR 204.23 - Processing a request for a fire management assistance declaration.

    2010-10-01

    ... management assistance declaration. The Principal Advisor may consult with State agencies, usually emergency... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Processing a request for a fire management assistance declaration. 204.23 Section 204.23 Emergency Management and Assistance...

  8. Guidelines for Management Consulting Programs for Small-Scale Enterprise. Appropriate Technologies for Development. Manual M-14.

    Vaughan, Gary L.

    This manual is designed to assist management consultants in working with small-scale entrepreneurs in developing countries. Addressed in an overview of the small-scale enterprise (SSE) are: the role of the SSE in third world development, problems of SSEs, and target firms. The second chapter deals with various forms of management assistance to…

  9. THE IMPORTANCE OF CONSULTING IN CONTEMPORARY BUSINESS MANAGEMENT

    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.

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

    Maria HERMEL STĂNESCU

    2014-04-01

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

  11. Data Management Consulting at the Johns Hopkins University

    Varvel, Virgil E., Jr.; Shen, Yi

    2013-01-01

    As research data complexity and quantity grows and funding agency requirements for data management are articulated, there is a growing need for data management services (DMS). Within these services, one important role emerging is that of data management consultant (DMC). Roles were analyzed that these professionals play through case study analysis…

  12. Consultations

    IDRC CRDI

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

  13. The interactions of Canadian ethics consultants with health care managers and governing boards during times of crisis.

    Kaposy, Chris; Maddalena, Victor; Brunger, Fern; Pullman, Daryl; Singleton, Richard

    2017-01-01

    Health care organizations can be very complex, and are often the setting for crisis situations. In recent years, Canadian health care organizations have faced large-scale systemic medical errors, a nation-wide generic injectable drug shortage, iatrogenic infectious disease outbreaks, and myriad other crises. These situations often have an ethical component that ethics consultants may be able to address. Organizational leaders such as health care managers and governing boards have responsibilities to oversee and direct the response to crisis situations. This study investigates the nature and degree of involvement of Canadian ethics consultants in such situations. This qualitative study used semi-structured interviews with Canadian ethics consultants to investigate the nature of their interactions with upper-level managers and governing board members in health care organizations, particularly in times of organizational crisis. We used a purposive sampling technique to identify and recruit ethics consultants throughout Canada. We found variability in the interactions between ethics consultants and upper-level managers and governing boards. Some ethics consultants we interviewed did not participate in managing organizational crisis situations. Most ethics consultants reported that they had assisted in the management of some crises and that their participation was usually initiated by managers. Some ethics consultants reported the ability to bring issues to the attention of upper-level managers and indirectly to their governing boards. The interactions between managers and ethics consultants were characterized by varying degrees of collegiality. Ethics consultants reported participating in or chairing working groups, participating in incident management teams, and developing decision-making frameworks. Canadian ethics consultants tend to believe that they have valuable skills to offer in the management of organizational crisis situations. Most of the ethics consultants

  14. Game Methods of Collective Decision Making in Management Consulting.

    Prigozhin, Arkadii Il'ich

    1991-01-01

    Explores former Soviet management consultants' increased use of social psychological game methods. Identifies such games as means of involving segments of client organizations in accomplishing shared tasks. Proposes a "practical" business game, designed to shape the process of formulating new management decisions at a radical level.…

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

    of medicine: 'the psychosomatic unity of the body and ... ¹ Department of Psychiatry, Faculty of Health Sciences, University of the ... assessment, and was more likely to be managed in the medical wards for delirium, ... and ongoing interaction between mental disorders and general ..... such as hallucinations and delusions.

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

    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…

  17. Managing Resistance: An Essential Consulting Skill for Learning Disabilities Teachers.

    Friend, Marilyn; Bauwens, Jeanne

    1988-01-01

    The article explores characteristics of resistance by general educators to special education consultation programs. It offers teachers of learning disabled students strategies for managing specific types of resistance as well as a general plan for minimizing resistance as well as suggestions for evaluating the impact of resistance management…

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

    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…

  19. Implementation of a nationwide health economic consultation service to assist substance use researchers: Lessons learned.

    Murphy, Sean M; Leff, Jared A; Linas, Benjamin P; Morgan, Jake R; McCollister, Kathryn; Schackman, Bruce R

    2018-03-20

    Health economic evaluation findings assist stakeholders in improving the quality, availability, scalability, and sustainability of evidence-based services, and in maximizing the efficiency of service delivery. The Center for Health Economics of Treatment Interventions for Substance Use Disorders, HCV, and HIV (CHERISH) is a NIDA-funded multi-institutional center of excellence whose mission is to develop and disseminate health-economic research on healthcare utilization, health outcomes, and health-related behaviors that informs substance use disorder treatment policy, and HCV and HIV care of people who use substances. We designed a consultation service that is free to researchers whose work aligns with CHERISH's mission. The service includes up to six hours of consulting time. After prospective consultees submit their request online, they receive a screening call from the consultation service director, who connects them with a consultant with relevant expertise. Consultees and consultants complete web-based evaluations following the consultation; consultees also complete a six-month follow-up. We report on the status of the service from its inception in July 2015 through June 2017. We have received 28 consultation requests (54% Early Stage Investigators, 57% MD or equivalent, 28% PhD, 61% women) on projects typically related to planning a study or grant application (93%); 71% were HIV/AIDS-related. Leading topics included cost-effectiveness (43%), statistical-analysis/econometrics (36%), cost (32%), cost-benefit (21%), and quality-of-life (18%). All consultees were satisfied with their overall experience, and felt that consultation expectations and objectives were clearly defined and the consultant's expertise was matched appropriately with their needs. Results were similar for consultants, who spent a median of 3 hours on consultations. There is a need for health-economic methodological guidance among substance use, HCV, and HIV researchers. Lessons learned

  20. Job competencies for the malaysian consultant project managers

    Dr. Ilias Said

    2009-12-01

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

  1. Practice what you preach: how consultants frame management concepts as enacted practice

    Heusinkveld, S.; Visscher, Klaasjan

    2012-01-01

    To contribute to the understanding of management knowledge commodification, this research explores how management consultants frame management concepts as enacted practice. Despite the recognition of consultants as important knowledge entrepreneurs, little academic research considers how they

  2. Consultancy

    Vorm, J.K.J. van der

    2014-01-01

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

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

    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

  4. Psychiatric consultation with regard to requests for euthanasia or physician-assisted suicide

    Groenewoud, JH; van der Heide, A; Tholen, AJ; Schudel, WJ; Hengeveld, MW; Onwuteaka-Philipsen, BD; van der Maas, PJ; van der Wal, G

    2004-01-01

    The objective of this article is to describe the practice of psychiatric consultation with regard to explicit requests for euthanasia or physician-assisted suicide in the Netherlands. Written questionnaires were sent to an unselected sample of 673 Dutch psychiatrists, about half of all such

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

    2012-01-01

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

  6. Consultant Learning: A Model for Student-Directed Learning in Management Education.

    Kunkel, Scott W.

    2002-01-01

    Consultant learning turns the management classroom into a laboratory for free enterprise. Students determine their own grades by earning consulting fees for completing projects they design and propose. Project work becomes a portfolio for future employment. (Contains 15 references.) (SK)

  7. Routine Immunization Consultant Program in Nigeria: A Qualitative Review of a Country-Driven Management Approach for Health Systems Strengthening.

    O'Connell, Meghan; Wonodi, Chizoba

    2016-03-01

    Since 2002, the Nigerian government has deployed consultants to states to provide technical assistance for routine immunization (RI). RI consultants are expected to play a role in supportive supervision of health facility staff, capacity building, advocacy, and monitoring and evaluation. We conducted a retrospective review of the RI consultant program's strengths and weaknesses in 7 states and at the national level from June to September 2014 using semi-structured interviews and online surveys. Participants included RI consultants, RI program leaders, and implementers purposively drawn from national, state, and local government levels. Thematic analysis was used to analyze qualitative data from the interviews, which were triangulated with results from the quantitative surveys. At the time of data collection, 23 of 36 states and the federal capital territory had an RI consultant. Of the 7 states visited during the study, only 3 states had present and visibly working consultants. We conducted 84 interviews with 101 participants across the 7 states and conducted data analysis on 70 interviews (with 82 individuals) that had complete data. Among the full sample of interview respondents (N = 101), most (66%) were men with an average age of 49 years (±5.6), and the majority were technical officers (63%) but a range of other roles were also represented, including consultants (22%), directors (13%), and health workers (2%). Fifteen consultants and 44 program leaders completed the online surveys. Interview data from the 3 states with active RI consultants indicated that the consultants' main contribution was supportive supervision at the local level, particularly for collecting and using RI data for decision making. They also acted as effective advocates for RI funding. In states without an RI consultant, gaps were highlighted in data management capacity and in monitoring of RI funds. Program design strengths: the broad terms of reference and autonomy of the consultants

  8. [Requests for assisted reproduction formulated by same-sex couples consulting physicians in France].

    Jouannet, P; Spira, A

    2014-08-01

    In order to determine the characteristic features of requests for assisted reproduction formulated by same-sex couples consulting physicians in France, we conducted a study in collaboration with professional organizations, general practitioners, gynecologists and obstetricians who distributed an email questionnaire among their recruitment. In our sample, 191 physicians (71% of responders) reported that 1040 homosexual couples expressed desire to become parents in 2011-2012. Nearly all of the physicians (94%) reported that the couples sought assistance before participating in an assisted reproduction technology (ART) program in a foreign country, but 35% reported that advice was solicited concerning natural reproduction and 48.5% reported requests for advice concerning inseminations performed by the woman herself. Most of the physicians responded to all or part of the requests and 61% of those who had been consulted reported they had directly participated in preparing an ART program in a foreign country. Among the 270 physicians who participated in this study, 162 (60%) believed that ART should be assessable to homosexual couples in France, but less than half of them were in favor of reimbursement by the national health insurance fund. Although biased and non-representative, this study shows that assisted reproduction, with or without medical intervention, is a real-life phenomenon for many homosexual couples, and for many physicians, even before same-sex marriage became legal. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  9. [Terminal sedation: consultation with a second physician as is the case in euthanasia and assisted suicide].

    Ponsioen, B P; Schuurman, W H A Elink; van den Hurk, A J P M; van der Poel, B N M; Runia, E H

    2005-02-26

    In terminally-ill patients in the Netherlands deep sedation by means of a continuous subcutaneous infusion with midazolam occurs more frequently than euthanasia and assisted suicide. Deep terminal sedation is applied to relieve symptoms during the phase of dying, but in contrast to euthanasia and assisted suicide, does not hasten death. In three terminally-ill patients, a 65-year-old man suffering from pulmonary carcinoma, a 94-year-old woman with general malaise, nausea and anorexia, and a 79-year-old woman in the final stage of ovarian carcinoma, a general-practitioner advisor was consulted about an end-of-life decision--deep terminal sedation versus euthanasia or assisted suicide. The first two patients were given deep sedation until death, in both cases a day and a half later. The third patient's request for euthanasia was considered to meet the legal criteria for euthanasia. Compliance with the Dutch statutory criteria for due care in euthanasia and assisted suicide might also be helpful when deciding about terminal deep sedation, but the role and responsibility of the attending physician may differ. However, the radical effects of sedation on the terminally-ill patient and the rapid changes in the clinical situation of the patient when the decision to sedate is taken, both emphasize the need for consultation with another physician.

  10. Occupational Therapy and assistive technology: thoughts about the experience with collaborative school consulting

    Luciana Ramos Baleotti

    2017-06-01

    Full Text Available This study presents thoughts and ideas based on the experience developed in the project entitled Assistive Technology for Inclusion of Students with Physical Disorders: Resources and Procedures, in development since 2009. This project aims to help in the process of school inclusion of students with physical disorder in Early Childhood Education in the city of Marilia, Brazil, through the collaboration between Health and Education departments. Health professionals contribute through the implementation of the Assistive Technology by means of school consulting. The project has been developed in six different stages, namely: Gaining access and establishing goals for the team; Identifying the problem; Interventions/Recommendations; Implementation; Evaluation and further actions. This working model, seeks to insert occupational therapy in the school environment. This project showed the importance of occupational therapists as team members in school settings, and the importance of a collaborative work between Education and Health departments.

  11. MANAGEMENT CONSULTANCIES DISCURSIVE CONSTRUCTION OF WORK-LIFE BALANCE : A DISCOURSE ANALYSIS OF WEB PAGES

    Bergqvist, Sofie; Vestin, Mikaela

    2014-01-01

    Academics, practitioners and media agree that the topic of work-life balance is on the agenda and valued by the new business generation. Although Sweden might be considered a working friendly country, the management consultancy industry is not recognized to be the same. With an institutional perspective we will through a discourse analysis investigate the communication on Swedish management consultancies web pages in order to explore how consultancies relate to the work-life balance discourse...

  12. A TOTAL QUALITY MANAGEMENT APPROACH TO CIVIL ENGINEERING CONSULTING

    G.A.L. Ambrose

    2012-01-01

    Full Text Available

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

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

  13. Technical assistance contractor Management Plan

    1993-09-01

    The Technical Assistance Contractor (TAC) for the Uranium Mill Tailings Remedial Action (UMTRA) Project comprises Jacobs Engineering Group Inc. (JEG) and its major teaming partners [Roy F. Weston, Inc. (RFW), Sergent, Hauskins ampersand Beckwith Agra, Inc. (SHB Agra), and Geraghty ampersand Miller, Inc. (G ampersand M)]. The first three companies have worked together effectively on the UMTRA Project for more than 10 years. With the initiation of the UMTRA Groundwater Project in April 1991, a need arose to increase the TAC's groundwater technical breadth and depth, so G ampersand M was brought in to augment the team's capabilities. The TAC contract's scope is to provide technical, analytical, environmental, engineering, design, inspection, and management support services to the US Department of Energy (DOE) for both surface and groundwater projects. The TAC team continues to support the DOE in completing surface remedial actions and initiating groundwater remediation work for start-up, characterization, design, construction oversight, and remedial operations. A key feature of the TAC's management approach is the extensive set of communication systems implemented for the UMTRA Project. These systems assist all functional disciplines in performing UMTRA Project tasks associated with management, technical support, administrative support, and financial/project controls

  14. CURBSIDE CONSULTATION IN FRACTURE MANAGEMENT: 49 CLINICAL QUESTIONS

    Walter W. Virkus

    2008-12-01

    displaced bimalleolar fracture in insulin dependant middle aged woman; Man-agement of calcaneal fractures; Fixation technic for a displaced talar neck fracture in a patient in ER; Indica-tions for surgical treatment of metatarsal fractures; Bone grafting in acute fractures; Management of a nonunion of plated midshaft tibia fracture; Management of a child with a twisted ankle and normal x-rays; Assessment of com-partment syndrome in foot.The Section III is about “GENERAL FRACTURE CARE” including: Management of multiple orthopedic injuries and damage control orthopedics; Bone stimula-tion in nonunion; Indications for locking plates; Fractures requiring anatomic reduction.AUDIENCE: Mainly trauma fellows and practicing or-thopedists are the targeted audience of the book, but not only the basic knowledge for the orthopedic residents but also the expert advices for complicated and controversial cases pointing experienced surgeons widen the spectrum of audience. Also non-physician personnel may benefit the basic knowledge from brief answers given in a casual format.ASSESMENT: “Curbside Consultation in Fracture Man-agement:49 Clinical Questions” offering practical, brief, evidence based answers to frequently asked questions especially those have been often left controversial related with the treatment of fractures of upper and lower extrem-ity, pelvic fractures is a useful resource mainly for resi-dents, fellows and junior orthopedists. Casual format that mimics a “curbside” dialog of colleagues and also the rich illustrations by images and diagrams makes the advanced knowledge in the text easier to understand and learn. Questions are carefully chosen from a wide spectrum of subjects related to fracture management to form a unique reference including high and low energy trauma fractures, pediatric fractures, fractures in elderly, multiple orthope-dic injury, and general fracture care. Assessment of frac-tures and diagnostic approach, postoperative care and

  15. Fault Management Assistant (FMA), Phase I

    National Aeronautics and Space Administration — S&K Aerospace (SKA) proposes to develop the Fault Management Assistant (FMA) to aid project managers and fault management engineers in developing better and more...

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

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

    2014-12-01

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

  17. Selling Academies: Local Democracy and the Management of "Consultation"

    Hatcher, Richard

    2008-01-01

    Academies (state schools owned and run by private sponsors on a non-profit basis) are a key element in Labour's education agenda. Proposals to set up Academies, in most cases by taking over existing schools, have provoked local campaigns of opposition in many areas. Replacing a Local Authority with an Academy entails a process of consultation.…

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

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

    2014-07-01

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

  19. Program Management Assistance Group: AFSC’s Internal Consultants

    1977-11-01

    acquisition activity reviews. Subsequently, since PMAG’s effectiveness is difficult, if not impossible, to measure due to, the confidentiality of its...implications. While the PMAG field review results would be very interesting and illuminating in terms of PMAG’s effectiveness and value, these examples are...December 1975, the new Commander of AFSC, General William J. Evans, wrote his commanders and directors of AFSC’s divisions, centers, SAMSO, AFETR and

  20. Strategic Management Accounting in the Knowledge Economy : Interplay between Control and Strategy in IT Consultancy

    Scott, Gustav; Gyllenstedt, Felix

    2008-01-01

    In today’s world information and knowledge is the most valuable asset and an increasing number of people are working with selling their specialized knowledge. In this knowledge economy professional services are increasing in importance and consultants play an increasingly important role. This master thesis investigates the interplay between management control and the strategizing process in IT-Consultancy firms. With the purpose of gaining an understanding on how management control systems ar...

  1. Tapping into the Forest Management Assistance Programs

    John L. Greene; Terry K. Haines

    1998-01-01

    Use of federal and state forest management assistance programs can enable nonindustial private forest owners to reduce their management expenses and practice better stewardship. This paper summarizes six federal and twelve state assistance programs available to owners in the North Central states. It also describes how to calculate the amount of a government...

  2. Evolution of External Consultant Involvement in Human Resource Management in Eastern Europe (1990-2007

    József Poór

    2015-03-01

    Full Text Available This paper aims to analyze the evolution of Human Resources (HR consulting in transitional economies of Eastern Europe (EE from the political changes till the economic crisis (2008. This article provides insights into the specific socio-economic environment and HR practice of the region.  Following Markham's model (1999 we analyze specific characteristics of four typical ways of external consultant involvement: informative-becnhmarking, design, change and organizational learning consulting.  in this region. In general, before the political changes at the end of the 1980's, in most EE countries , consulting service was redendered by sector  research institutes, controlled by the state or by the different minsitries. Consulting approach in EE countries  were predominant similar to the school of scientific management. HR consulting hardly existed that time. Since changes in the regime's consulting linked to privatization, firm restructuring, and development has been developing significantly in all countries of the region. HR consulting underwent a significant development in the region.

  3. Climate Change Risk Management Consulting: The opportunity for an independent business practice

    Ciccozzi, R.

    2009-04-01

    The Paper outlines the main questions to be addressed with reference to the actual demand of climate change risk management consulting, in the financial services. Moreover, the Project shall also try to investigate if the Catastrophe Modelling Industry can start and manage a business practice specialised on climate change risk exposures. In this context, the Paper aims at testing the possibility to build a sound business case, based upon typical MBA course analysis tools, such as PEST(LE), SWOT, etc. Specific references to the tools to be used and to other contribution from academic literature and general documentation are also discussed in the body of the Paper and listed at the end. The analysis shall also focus on the core competencies required for an independent climate change risk management consulting business practice, with the purpose to outline a valid definition of how to achieve competitive advantage in climate change risk management consulting.

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

    Kirchen, E.R.; Perilloux, B.L.

    1997-01-01

    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

  5. Function of Management Consultation in Implementation of ERP Project

    2002-01-01

    ERP(enterprise resource planning) is a huge and com pl ex system engineering which costs a great lot of fund and manpower. It is a refo rm in the enterprise management mode, management idea and management method whi ch needs mass fund import, with long period, full of risk, hard to perform and can't show its effects at once. The essence of the enterprise performing in ERP system is to run a "management engineering", which involves integration of opera tion process. The integration will touch business ...

  6. Managing the consultation with patients with medically unexplained symptoms: a grounded theory study of supervisors and registrars in general practice.

    Stone, Louise

    2014-12-05

    Patients with medically unexplained symptoms (MUS) commonly present in general practice. They often experience significant disability and have difficulty accessing appropriate care. Many feel frustrated and helpless. Doctors also describe feeling frustrated and helpless when managing these patients. These shared negative feelings can have a detrimental effect on the therapeutic relationship and on clinical outcomes. The aim of this study was to explore how novice and experienced GPs manage patients with MUS and how these skills are taught and learned in GP training. A constructivist grounded theory study with 24 general practice registrars and supervisors in GP training practices across Australia. Registrars lacked a framework for managing patients with MUS. Some described negative feelings towards patients that were uncomfortable and confronting. Registrars also were uncertain about their clinical role: where their professional responsibilities began and ended. Supervisors utilised a range of strategies to address the practical, interpersonal and therapeutic challenges associated with the care of these patients. Negative feelings and a lack of diagnostic language and frameworks may prevent registrars from managing these patients effectively. Some of these negative feelings, such as frustration, shame and helplessness, are shared between doctors and patients. Registrars need assistance to identify and manage these difficult feelings so that consultations are more effective. The care of these patients also raises issues of professional identity, roles and responsibilities. Supervisors can assist their registrars by proactively sharing models of the consultation, strategies for managing their own feelings and frustrations, and ways of understanding and managing the therapeutic relationship in this difficult area of practice.

  7. Consultations for the management of radiophysics and radiation processes

    Martinez, D.; Melchor, M.; Candela, F.; Camara, A.

    2011-01-01

    In the services of Radio Physics and Radiation Hospital has implemented an electronic patient data management, both of the treatment plan and the medical history of radiotherapy, so that we can exploit the advantages it brings to automate the analysis.

  8. The service of strategic consultancy in information systems management

    Zunilka Limonta Favier

    2013-07-01

    Full Text Available We present a service that enables the design, management, innovation and implementation of information systems in academic, service, economic etc. which is intended as advice to entities that require attending to their needs whether external or internal. They offer some recommendations to improve the work in information systems and management. This paper shows how to provide differentiated services according to the characteristics of each institution.

  9. Early geriatric consultation increases adherence to TQIP Geriatric Trauma Management Guidelines.

    Southerland, Lauren T; Gure, Tanya R; Ruter, Daniel I; Li, Michael M; Evans, David C

    2017-08-01

    The American College of Surgeons' Trauma Quality Improvement Program (TQIP) Geriatric Trauma Management Guidelines recommend geriatric consultation for injured older adults. However it is not known how or whether geriatric consultation improves compliance to these quality measures. This study is a retrospective chart review of our institutional trauma databank. Adherence to quality measures was compared before and after implementation of specific triggers for geriatric consultation. Secondary analyses evaluated adherence by service: trauma service (Trauma) or a trauma service with early geriatric consultation (GeriTrauma). The average age of the 245 patients was 76.7 years, 47% were women, and mean Injury Severity Score was 9.5 (SD ±8.1). Implementation of the GeriTrauma collaborative increased geriatric consultation rates from 2% to 48% but had minimal effect on overall adherence to TQIP quality measures. A secondary analysis comparing those in the post implementation group who received geriatric consultation (n = 94) to those who did not (n = 103) demonstrated higher rates of delirium diagnosis (36.2% vs 14.6%, P quality indicators is needed. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. VACUUM ASSISTED CLOSURE IN DIABETIC FOOT MANAGEMENT

    Moganakannan; `Prema; Arun Sundara Rajan

    2014-01-01

    Comparision of vacuum assisted closure vs conventional dressing in management of diabetic foot patients. 30 patients were taken in that 15 underwent vacuum therapy and remaining 15 underwent conventional dressing.They were analysed by the development of granulation tissue and wound healing.The study showed Vac therapy is the best modality for management of diabetic foot patients.

  11. Fifteen minute consultation: Practical pain management in paediatric palliative care.

    Harrop, Emily Jane; Brombley, Karen; Boyce, Katherine

    2017-10-01

    Pain and distress in the paediatric palliative care population can be very difficult to manage. Clinical scenarios range from the acute management of cancer-related pain at the end of life to the ongoing long-term support of children with complex multimodal pain related to progressive neurological conditions. Understanding the child's underlying condition, possible causes of pain and their preferred mode of communication are important to the delivery of holistic care. Modification of environmental factors, basic care consideration and non-pharmacological measures have a large role to play, alongside conventional analgesics. Medication may also need to be delivered by novel routes such as transdermal patches, continuous subcutaneous infusion of multiple drugs or transmucosal breakthrough analgesic doses. Two cases are used to illustrate approaches to these clinical problems. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. Do longer consultations improve the management of psychological problems in general practice? A systematic literature review

    Hutton Catherine

    2007-05-01

    Full Text Available Abstract Background Psychological problems present a huge burden of illness in our community and GPs are the main providers of care. There is evidence that longer consultations in general practice are associated with improved quality of care; but this needs to be balanced against the fact that doctor time is a limited resource and longer consultations may lead to reduced access to health care. The aim of this research was to conduct a systematic literature review to determine whether management of psychological problems in general practice is associated with an increased consultation length and to explore whether longer consultations are associated with better health outcomes for patients with psychological problems. Methods A search was conducted on Medline (Ovid databases up to7 June 2006. The following search terms, were used: general practice or primary health care (free text or family practice (MeSH AND consultation length or duration (free text or time factors (MeSH AND depression or psychological problems or depressed (free text. A similar search was done in Web of Science, Pubmed, Google Scholar, and Cochrane Library and no other papers were found. Studies were included if they contained data comparing consultation length and management or detection of psychological problems in a general practice or primary health care setting. The studies were read and categories developed to enable systematic data extraction and synthesis. Results 29 papers met the inclusion criteria. Consultations with a recorded diagnosis of a psychological problem were reported to be longer than those with no recorded psychological diagnosis. It is not clear if this is related to the extra time or the consultation style. GPs reported that time pressure is a major barrier to treating depression. There was some evidence that increased consultation length is associated with more accurate diagnosis of psychological problems. Conclusion Further research is needed to

  13. Tilting the Balance: A Management Consultant's Prescription for Changing the Equilibrium between Central Office and Schools

    Ouchi, William G.

    2004-01-01

    During the past 30 years, the author has served as a management consultant to companies that wanted to achieve revolutionary change to become more successful. He has worked with companies as small as 100 employees and as large as General Motors, IBM and Amgen, the world's largest biotechnology company. More recently he has worked (as a pro bono…

  14. Teaching Management: A Field Guide for Professors, Consultants, and Corporate Trainers

    Clawson, James G. S.; Haskins, Mark E.

    2006-01-01

    How can every management class be a dynamic, unforgettable experience? This much-needed book distills over half a century of the authors' combined experience as university professors, consultants, and advisors to corporate training departments. In a lively, hands-on fashion, it describes the fundamental elements in every learning situation,…

  15. Management Consulting and International Business Support for SMEs: Need and Obstacles

    Mughan, Terry; Lloyd-Reason, Lester; Zimmerman, Carsten

    2004-01-01

    This paper explores the challenges involved in the development of coordinated management consulting services for small and medium-sized international companies in the East of England. This paper synthesises the findings of recently published quantitative and qualitative research to identify the characteristics of small to medium-sized enterprises…

  16. Implementing Experiential Action Learning in International Management Education: The Global Business Strategic (GLOBUSTRAT) Consulting Program

    Kamath, Shyam; Agrawal, Jagdish; Krickx, Guido

    2008-01-01

    This paper discusses the theoretical foundations and implementation challenges and outcomes of a unique "hands-on" global consulting program that is integrated into an international EMBA program for mid-career and senior American and European managers. It details the challenges for the integration of experiential action learning, double-loop…

  17. The impact of the strategic factor in knowledge management projects in the consulting industry

    Marta Mas-Machuca

    2008-10-01

    Full Text Available The projects of Knowledge Management in the consulting industry have become a necessity to obtain sustainable competitive advantages. Between all the factors that influence in the success of a Knowledge Management project, the strategic ones have a decisive weight according to existing literature. Although many studies raise the issue of strategy’s influence on Knowledge Management success, few have measured them. This paper aims to identify the elements that configure the strategic dimension and measure its contribution in order to maximize the profit. The research methodology is based on a Structural Equation Model to validate the hypothesis. The findings highlight the huge influence of strategy in Knowledge Management project’s success in the consultancy industry.

  18. [Toxicological consultation data management system based on experience of Pomeranian Center of Toxicology].

    Kabata, Piotr Maciej; Waldman, Wojciech; Sein Anand, Jacek

    2015-01-01

    In this paper the structure of poisonings is described, based on the material collected from tele-toxicology consults by the Pomeranian Center of Toxicology in Gdańsk and harvested from its Electronic Poison Information Management System. In addition, we analyzed conclusions drawn from a 27-month operation of the system. Data were harvested from the Electronic Poison Information Management System developed in 2012 and used by the Pomeranian Center of Toxicology since then. The research was based on 2550 tele-toxicology consults between January 1 and December 31, 2014. Subsequently the data were electronically cleaned and presented using R programming language. The Pomeranian voivodeship was the prevalent localisation of calls (N = 1879; 73.7%). Most of the calls came from emergency rooms (N = 1495; 58.63%). In the case of 1396 (54.7%) patients the time-lag between intoxication and the consult was less than 6 h. There were no differences in the age distribution between genders. Mean age was 26.3 years. Young people predominated among intoxicated individuals. The majority of intoxications were incidental (N = 888; 34.8%) or suicidal (N = 814; 31.9%) and the most of them took place in the patient's home. Information about Poison Control Center consultations access should be better spread among medical service providers. The extent of poison information collected by Polish Poison Control Centers should be limited and unified. This should contribute to the increased percentage of properly documented consultations. Additional duties stemming from the need of digital archiving of consults provided, require the involvement of additional staff, leading to the increased operation costs incurred by Poison Control Centers. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  19. TADS and Technical Assistance: Readings on System Design, Needs Assessment, Consultation, and Evaluation.

    Trohanis, Pascal L., Ed.

    The document reviews the technical assistance process used by TADS (Technical Assistance Development System), a project to provide support to HCEEP (Handicapped Children's Early Education Program) demonstration projects serving young handicapped children and their families. Chapter 1, by P. Trohanis, focuses on a number of questions that people…

  20. Value Creation through IT-supported Knowledge Management? The Utilisation of a Knowledge Management System in a Global Consulting Company

    Karlheinz Kautz

    2003-01-01

    Full Text Available Although many consulting companies have introduced IT-supported knowledge-management systems, and proponents of the literature continue to advocate knowledge management as a key to competitive advantage in consultancies, many knowledge management systems have fallen short of expectation in companies that have adopted them. However, empirical studies regarding the performance implications of these systems are missing. This paper reports such an empirical, explorative study identifying the extent as well as impediments of the utilization of an IT-supported knowledge management system in a large, global consulting company. The main findings are that the majority of the IT users are not familiar with the knowledge management framework of the company; still the knowledge management system is used by 3/4 of all respondents, but mainly to search for general information, much less to participate in competence networks to develop shared knowledge assets. The knowledge management system is not used as the primary repository and communication media for knowledge assets. The limited use is explained by the practitioners as being caused by lack of time and their perception of the system as a slow and poorly structured technical infrastructure. These and other findings are discussed with regard to the current understanding of knowledge management as presented by the literature, and important issues with regard to future research integrating individual, organisational, technical and economical perspectives of knowledge management are raised.

  1. The impact of a standardized consultation form for facial trauma on billing and evaluation and management levels.

    Levesque, Andre Y; Tauber, David M; Lee, Johnson C; Rodriguez-Feliz, Jose R; Chao, Jerome D

    2014-02-01

    Facial trauma is among the most frequent consultations encountered by plastic surgeons. Unfortunately, the reimbursement from these consultations can be low, and qualified plastic surgeons may exclude facial trauma from their practice. An audit of our records found insufficient documentation to justify higher evaluation and management (EM) levels of service resulting in lower reimbursement. Utilizing a standardized consultation form can improve documentation resulting in higher billing and EM levels. A facial trauma consultation form was developed in conjunction with the billing department. Three plastic surgery residents completed 30 consultations without the aid of the consult form followed by 30 consultations with the aid of the form. The EM levels and billing data for each consultation were obtained from the billing department for analysis. The 2 groups were compared using χ2 analysis and t tests to determine statistical significance. Using our standardized consultation form, the mean EM level increased from 2.97 to 3.60 (P = 0.002). In addition, the mean billed amount increased from $391 to $501 per consult (P = 0.051) representing a 28% increase in billing. In our institution, the development and implementation of a facial trauma consultation form has resulted in more complete documentation and a subsequent increase in EM level and billed services.

  2. Outpatient dermatology consultation impacts the diagnosis and management of pediatric oncology patients: A retrospective study.

    Song, Hannah; Robinson, Sarah N; Huang, Jennifer T

    2017-11-01

    The impact of dermatology consultation on the care of children with oncologic conditions is unknown. To review outpatient dermatology visits and the resulting impact on diagnosis and management of pediatric oncology patients. Retrospective review of pediatric oncology patients with outpatient dermatology visits at a tertiary care center from 2008 to 2015. The most common dermatologic diagnoses in 516 patients were skin infections (21.3%) and nonmalignant skin eruptions (33.4%). A diagnosis of significant impact (ie, malignancy, adverse cutaneous drug reaction, graft-versus-host disease, varicella-zoster virus, or herpes simplex virus infection), was made at the dermatology clinic in 14.7% of visits. Consultation resulted in a change in diagnosis in 59.8% of patients, change in dermatologic management in 72.4% of patients, and change in management of noncutaneous issues in 12.4% of patients. The use of electronic medical records, the nongeneralizable study population, and the retrospective design represent potential limitations. Outpatient dermatology consultation can affect the care of pediatric oncology patients with respect to diagnosis and treatment of skin conditions and management of nondermatologic issues. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  3. Extent and types of management consulting services to SMEs in Vojvodina

    Dragan Dukić

    2013-11-01

    Full Text Available Growth and development of small and medium enterprises depends on many external and internal factors, as well as the volume, type and quality of support available to them. This paper highlights the importance of management knowledge and skills in small business, and the importance of management consulting in their acquisition and development. We have researched and analyzed the extent to management consulting (MC services, separately in the micro, small and medium enterprises. In addition, we learn which types of MC services are most commonly used by companies of different sizes. In that way, we provided qualitative and quantitative data for each group of enterprises, both in the type and volume of services used. It is observed that micro-enterprises use a small amount  MC services, and those of more general type. With the growth of the enterprises, comes an increase in scope, and sophistication of services used. The results may be useful both for small and medium enterprises, as well as for institutional and private providers of management consulting services.

  4. Managing spine surgery referrals: The consultation of neurosurgery and its nuances.

    Debono, B; Sabatier, P; Koudsie, A; Buffenoir, K; Hamel, O

    2017-09-01

    Spinal disorders, particularly low back pain, are among the most common reasons for general practitioner (GP) consultation and can sometimes be a source of professional friction. Despite their frequency and published guidelines, many patients are still mistakenly referred by their GP to specialists for spinal surgery consultation which can create colleague relationship problems, suboptimal or unnessary delayed care, as well as the financial implications for patients. To assess the management of GP lumbar spine referrals made to 4 neurosurgeons from 3 neurosurgical teams specialized in spinal surgery. All patient's medical records relating to 672 primary consultants over a period of two months (January and February 2015) at three institutions were retrospectively reviewed. Medical referral letters, clinical evidence and imaging data were analyzed and the patients were classified according the accuracy of surgical assessment. The final decisions of the surgeons were also considered. Of the 672 patients analyzed, 198 (29.5%) were considered unsuitable for surgical assessment: no spinal pathology=10.6%, no surgical conditions=35.4%, suboptimal medical treatment=31.3%, suboptimal radiology=18.2% and asymptomatic patients=4.5%. Unnecessary referrals to our consultation centers highlight the gap between the reason for the consultation and the indications for spinal surgery. Compliance with the guidelines, the creation of effective multidisciplinary teams, as well as the "hands on" involvement of surgeons in primary and continuing education of physicians are the best basis for a reduction in inappropriate referrals and effective patient care management. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  5. Project Management Consultancy (PMC) procurement approach: Supplier's evaluation and selection dilemma

    Nawi, Mohd Nasrun Mohd; Azimi, Mohd Azrulfitri; Pozin, Mohd Affendi Ahmad; Osman, Wan Nadri; Anuar, Herman Shah

    2016-08-01

    Project Management Consultancy (PMC) is part of the management oriented procurement method in which a sole consultant is hired by the client to deal with the contactors in place of the client. Appointing contractors in this method or approach looks to be interesting as client could play a pivotal role in evaluating and selecting the supplier/contractor for the work package. In some cases, client gives the authority for the PMC to hire the supplier/contractor of their choice while in some cases the client is the one who made the decision. This research paper seeks to investigate the dilemma arises from this situation and for the purpose of this research, a real case study was studied to assess the impacts of such dilemma to the performance of the project. Recommendations on how to tackle the dilemma will also be addressed in the later part of this research paper.

  6. Identifying predictors of work engagement: An example from a management consultancy company

    Persson, Andreas

    2010-01-01

    Empirical evidence suggests work engagement to be of crucial importance for business critical aspects such as work performance and employee retention. When building a strategy for enhancing engagement in the workplace, identifying its predictors becomes important. Therefore, the aim of this study was to identify predictors related to work engagement. The study was conducted in a management consultancy company, through analyzing their employee survey. Results indicated satisfaction with leader...

  7. Arbiters of Effectiveness and Efficiency: The Frames and Strategies of Management Consulting Firms in US Higher Education Reform

    McClure, Kevin R.

    2017-01-01

    A growing number of public colleges and universities in the United States have hired management consulting firms to help develop strategies aimed at increasing institutional effectiveness and efficiency. The purpose of this paper is to explore the frames and strategies of consultants in US public higher education reform efforts. Drawing upon a…

  8. Workplace Violence: Practical Considerations for Mental Health Professionals in Consultation, Assessment, and Management of Risk.

    Saragoza, Philip; White, Stephen G

    2016-12-01

    Workplace predatory violence has been the focus of increased study over the past 30 years, leading to a more sophisticated understanding of the factors that contribute to it, and important considerations for its assessment and management. Risk assessment professionals involved in workplace violence consultations should be mindful of issues specific to the workplace context and the principles of threat assessment to provide a more precise opinion of risk, to inform and enhance critical decisions regarding the employment status of the individual of concern, security measures, possible treatment options, and other management responses, while being mindful of the employee's certain rights. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Directives Relatives a l'Elaboration de Programmes de Conseil en Gestion pour Petites Entreprises (Guidelines for Management Consulting Programs for Small-Scale Enterprise). Appropriate Technologies for Development. Peace Corps Information Collection & Exchange Manual Series No. M-29.

    Vaughan, Gary L.

    Written in French, this manual is designed to assist management consultants in working with small-scale entrepreneurs in developing countries. Addressed in an overview of the small-scale enterprise (SSE) are the role of the SSE in Third World development, problems of SSEs, and target firms. The second chapter deals with various forms of management…

  10. Pautas para Programas de Asesoramiento Gestional para Microempresas (Guidelines for Management Consulting Programs for Small-Scale Enterprise). Appropriate Technologies for Development. Peace Corps Information Collection & Exchange Manual Series No. M-27.

    Vaughan, Gary L.

    Written in Spanish, this manual is designed to assist management consultants in working with small-scale entrepreneurs in developing countries. Addressed in an overview of the small-scale enterprise (SSE) are the role of the SSE in Third World development, problems of SSEs, and target firms. The second chapter deals with various forms of…

  11. Computer-assisted power plant management

    Boettcher, D.

    1990-01-01

    Operating a power plant and keeping it operational is ensured by a multiplicity of technical management subtasks which are cross referenced and based on an extensive inventory of descriptive and operational plant data. These data stocks are still registered in an isolated mode and managed and updated manually. This is a labor intensive, error prone procedure. In this situation, the introduction of a computer-assisted plant management system, whose core is a data-base of assured quality common to all activities, and which contains standardized processing aids fully planned for the subtasks occurring in the plant, is likely to achieve a considerable improvement in the quality of plant management and to relieve the staff of administrative activities. (orig.) [de

  12. Trauma surgeon becomes consultant: evaluation of a protocol for management of intermediate-level trauma patients.

    Fallon, Sara C; Delemos, David; Christopher, Daniel; Frost, Mary; Wesson, David E; Naik-Mathuria, Bindi

    2014-01-01

    At our level 1 pediatric trauma center, 9-54 intermediate-level ("level 2") trauma activations are received per month. Previously, the surgery team was required to respond to and assume responsibility for all patients who had "level 2" trauma activations. In 8/2011, we implemented a protocol where the emergency room (ER) physician primarily manages these patients with trauma consultation for surgical evaluation or admission. The purpose of this study was to prospectively evaluate the effects of the new protocol to ensure that patient safety and quality of care were maintained. We compared outcomes of patients treated PRE-implementation (10/2010-7/2011) and POST-implementation (9/2011-5/2012), including surgeon consultation rate, utilization of imaging and laboratory testing, ER length of stay, admission rate, and missed injuries or readmissions. Statistical analysis included chi-square and Student's t-test. We identified 472 patients: 179 in the PRE and 293 in the POST period. The populations had similar baseline clinical characteristics. The surgical consultation rate in the POST period was only 42%, with no missed injuries or readmissions. The ER length of stay did not change. However, in the POST period there were significant decreases in the admission rate (73% to 44%) and the mean number of CT scans (1.4 to 1), radiographs (2.4 to 1.7), and laboratory tests (5.1 to 3.3) ordered in the emergency room (all p<0.001). Intermediate-level pediatric trauma patients can be efficiently and safely managed by pediatric emergency room physicians, with surgical consultation only as needed. The protocol change improved resource utilization by decreasing testing and admissions and streamlining resident utilization in an era of reduced duty hours. © 2014.

  13. Improving health research governance and management in the Western Pacific: a WHO expert consultation.

    Rani, Manju; Bekedam, Hendrik; Buckley, Brian S

    2011-11-01

    Repeated calls have been made in recent decades to increase investments in health research, especially in low- and middle-income countries (LMIC). However, the perceived low relevance and quality of health research, poor visibility of outputs, and difficulties in tracking current levels of and returns on investments have undermined efforts to advocate for additional investments in these countries. Some of these issues emanate from inadequate governance and management systems for health research at the national level, which are ineffective in tracking and steering the research portfolio and investments, ensuring quality, and facilitating access to research outputs. In spite of this, the value, necessity, and cost of performing health research management and governance functions are not well appreciated, especially in LMIC. To address this, the World Health Organization (WHO) Regional Office for the Western Pacific organized an expert consultation in August 2011, involving experts from 14 of its developed and developing member states and from leading research organizations such as the Wellcome Trust. The consultation identified essential health research governance and management functions that must be performed by appropriate organizational entities to maximize returns on health research investments. In addition, three specific areas for intervention were considered: (1) prospective research registration in publicly accessible national health research registries; (2) systematic health research data archiving and wider access; and (3) national research ethics systems. A consensus was reached on the need to invest more in essential health research and management functions, including establishing publicly accessible web-based national health research registries for prospective registration of health research, setting up systems to archive and share health research data, and improving the governance of research ethics committees. The consultation also concluded that the

  14. Occupational therapy consultation for case managers in community mental health: exploring strategies to improve job satisfaction and self-efficacy.

    Chapleau, Ann; Seroczynski, A D; Meyers, Susan; Lamb, Kristen; Haynes, Susan

    2011-01-01

    The purpose of this study was 2-fold: (1) to examine to what extent case managers' job satisfaction and self-efficacy were impacted by the addition of an occupational therapy consultation model and (2) to identify factors that both positively and negatively impacted the occupational therapy consultation services. The study was conducted at a mental health community support program in a local homeless center. In a 2-year study, a mixed-methods design was used to study changes over time in job satisfaction and perceived self-efficacy among 14 case managers who received ongoing occupational therapy consultation. Job satisfaction and self-efficacy data were obtained using standardized questionnaires. Qualitative data related to factors impacting the consultation program were obtained using open-ended written questions, focus groups, and individual interviews. Statistically significant differences in job satisfaction and perceptions of self-efficacy were found 18 months into the study, when case managers were more actively seeking occupational therapy consultation services and were reporting improved client outcomes from occupational therapy intervention. In addition, themes related to both positive and negative factors impacting the occupational therapy consultation program were identified and provided useful data for development of future consultation services. IMPLICATION FOR CASE MANAGEMENT PRACTICE: Results suggest that ongoing training and professional support for case managers who are paraprofessionals and/or new to mental health practice may improve job satisfaction and efficacy. Occupational therapy consultation may be helpful in developing services for health promotion, including self-care management, cognitive assessments, activity-based programming, and home safety evaluation and modification. In addition, new graduates and paraprofessional case managers working with clients who are high utilizers of services may benefit from smaller caseloads and support

  15. Psychiatric consultations and the management of associated comorbid medical conditions in a regional referral hospital

    Nkokone S Z Tema

    2015-05-01

    Full Text Available Background. Psychiatrists are often called upon to evaluate patients with a medical condition and psychiatric symptoms, either as a complication thereof or initial presenting symptoms. There are often grey areas with regard to neuropsychiatric disorders in which psychiatrists and specialists from other clinical disciplines would need to co-manage or share ideas on the comprehensive treatment of a presenting patient. Objectives. This study was undertaken to provide a demographic and clinical profile of all patients consulted by the consultation-liaison psychiatry (CLP service at the Helen Joseph Hospital (HJH in Johannesburg, and to describe the clinical management of patients admitted with a diagnosis of a mental disorder associated with a comorbid medical condition, including delirium, dementia and a mood or psychotic disorder due to a general medical condition. Methods. A retrospective record review of all patients referred to the HJH CLP team over a 6-month period. Results. A total of 884 routine and emergency consultations were done for 662 patients (males n=305; females n=357 between the ages of 13 and 90 years who were referred from various other clinical departments. The most common documented reason for referral was a request for assessment (n=182; 27.5%, which consisted of mental state assessment, reconsultation and assessing capacity. A total of 63 patients (10.0% of cases consulted were admitted to either the medical or psychiatric wards with a confirmed diagnosis of delirium, dementia and/or a mood or psychotic disorder due to a general medical condition (although admission wards were identified in 55 files only. The medical wards admitted the majority (n=37; 67.3% mostly for delirium (n=28; 50.9%. HIV was identified as the most common systemic aetiological factor (n=23; 67.7%. Conclusion. In this study, a female patient between 31 and 45 years of age was slightly more likely to be referred to the HJH CLP service for assessment, and

  16. Technical assistance contractor Management Plan. Final [report

    1993-09-01

    The Technical Assistance Contractor (TAC) for the Uranium Mill Tailings Remedial Action (UMTRA) Project comprises Jacobs Engineering Group Inc. (JEG) and its major teaming partners [Roy F. Weston, Inc. (RFW), Sergent, Hauskins & Beckwith Agra, Inc. (SHB Agra), and Geraghty & Miller, Inc. (G&M)]. The first three companies have worked together effectively on the UMTRA Project for more than 10 years. With the initiation of the UMTRA Groundwater Project in April 1991, a need arose to increase the TAC`s groundwater technical breadth and depth, so G&M was brought in to augment the team`s capabilities. The TAC contract`s scope is to provide technical, analytical, environmental, engineering, design, inspection, and management support services to the US Department of Energy (DOE) for both surface and groundwater projects. The TAC team continues to support the DOE in completing surface remedial actions and initiating groundwater remediation work for start-up, characterization, design, construction oversight, and remedial operations. A key feature of the TAC`s management approach is the extensive set of communication systems implemented for the UMTRA Project. These systems assist all functional disciplines in performing UMTRA Project tasks associated with management, technical support, administrative support, and financial/project controls.

  17. Using Communication Consultants to Rightsize Successfully.

    Tudor, Thomas R.; Sleeth, Randall G.

    1997-01-01

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

  18. The (non)sense of organizational change : An Essai about universal management hypes, sick consultancy metaphors, and healthy organization theories

    Sorge, A; van Witteloostuijn, A

    The global business world is infected by a virus that induces a permanent need for organizational change, which is fed by the management consultancy industry. The nature of the organizational change hype changes colour frequently, through the emergence of new universal management fashions. An urge

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

    Barker, Randolph T.; Gower, Kim

    2009-01-01

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

  20. Technical Assistance Contractor management plan. Revision 1

    1995-08-01

    The Technical Assistance Contractor (TAC) for the Uranium Mill Tailings Remedial Action (UMTRA) Project comprises Jacobs Engineering Group Inc. (JEG) as the prime contractor and three teaming partner subcontractors: Roy F. Weston, Inc. (RFW), AGRA Earth and Environmental, Inc. (AGRA), and Geraghty and Miller, Inc. (G and M). The TAC contract's scope is to provide technical, analytical, environmental, engineering, design, inspection, and management support services to the US Department of Energy (DOE) for both Surface and Ground Water Projects. The TAC team supports the DOE in completing surface remedial action and initiating ground water remediation work for start-up, characterization, compliance planning, design, construction oversight, and remedial operations. The TAC provides the DOE UMTRA Project Team with a dedicated management, scientific, and technical resource base in Albuquerque, New Mexico, which is supplemented by corporate resources. A carefully developed and maintained staff of technical experts is available to assess, analyze, develop, and execute cost-effective solutions to the demanding technical and institutional problems presented by the UMTRA Project

  1. Technical Assistance Contractor management plan. Revision 1

    NONE

    1995-08-01

    The Technical Assistance Contractor (TAC) for the Uranium Mill Tailings Remedial Action (UMTRA) Project comprises Jacobs Engineering Group Inc. (JEG) as the prime contractor and three teaming partner subcontractors: Roy F. Weston, Inc. (RFW), AGRA Earth and Environmental, Inc. (AGRA), and Geraghty and Miller, Inc. (G and M). The TAC contract`s scope is to provide technical, analytical, environmental, engineering, design, inspection, and management support services to the US Department of Energy (DOE) for both Surface and Ground Water Projects. The TAC team supports the DOE in completing surface remedial action and initiating ground water remediation work for start-up, characterization, compliance planning, design, construction oversight, and remedial operations. The TAC provides the DOE UMTRA Project Team with a dedicated management, scientific, and technical resource base in Albuquerque, New Mexico, which is supplemented by corporate resources. A carefully developed and maintained staff of technical experts is available to assess, analyze, develop, and execute cost-effective solutions to the demanding technical and institutional problems presented by the UMTRA Project.

  2. The expert assistant in accident management

    Goddard, A.J.H.; Cannell, R.J.

    1990-01-01

    In the event of a nuclear accident in proximity to an urban area, the consequences resulting from the complex processes of environmental transport of radioactivity would require complex countermeasures. Emphasis has been placed on either modelling the potential effects of such an event on the population, or on attempting to predict the geographical evolution of the release. Less emphasis has been placed on the development of accident management aids with a in-built data acquisition capability. Given the problems of predicting the evolution of an accidental release of activity, more emphasis should be placed on the development of small regional systems specifically engineered to acquire and display environmental data in the most efficaceous form possible. A wealth of information can be obtained from appropriately-sited outstations which can aid those responsible for countermeasures in their decision making processes. The substantial volume of data which would arrive within the duration and during the aftermath of an accident requires skilled interpretation under conditions of considerable stress. It is necessary that a management aid notonly presents these data in a rapidly assimilable form, but is capable of making intelligent decisions of its own, on such matters as information display priority and the polling frequency of outstations. The requirement is for an expert assistant. The XERSES accident management aid has been designed with the foregoing features in mind. Intended for covering regions up to approximately 100 kms square, it links with between 1 and 64 outstations supplying a variety of environmental data. Under quiescent conditions the system will operate unattended, raising alarms remotely only when detecting abnormal conditions. Under emergency conditions, the system automatically adjusts such operating parameters as data acquisition rate

  3. Postpartum consultation: Occurrence, requirements and expectations

    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.

  4. Nutritional screening and dietitian consultation rates in a geriatric evaluation and management unit.

    Dent, Elsa; Wright, Olivia; Hoogendijk, Emiel O; Hubbard, Ruth E

    2018-02-01

    Nutritional screening may not always lead to intervention. The present study aimed to determine: (i) the rate of nutritional screening in hospitalised older adults; (ii) whether nutritional screening led to dietitian consultation and (iii) factors associated with malnutrition. In this prospective study of patients aged ≥70 years admitted to a Geriatric Evaluation and Management Unit (GEMU), malnutrition was screened for using the Mini Nutritional Assessment Short Form (MNA-SF) and identified using the Mini Nutritional Assessment (MNA). Of the 172 patients participating in the study, 53 (30.8%) patients were malnourished, and 84 (48.8%) were at risk of malnutrition. Mean (SD) age was 85.2 (6.4 years), with 131 patients (76.2%) female. Nutritional screening was performed for all patients; however, it was incomplete in 59 (34.3%) because of omission of the anthropometric measurement. Overall, 62 (36.0%) of the total number of patients were seen by the dietitian, which included 26 (49%) of malnourished patients, 27 (32%) of at-risk patients and 9 (26%) of the well-nourished patients. No patients lost >1% of body weight during GEMU stay. Malnourished patients were more likely to be frail, have poor appetite, depression, and have lower levels of: albumin, cognition, physical function, grip strength and quality of life. The full benefits of nutritional screening by MNA-SF may not be realised if it does not result in malnourished patients receiving a dietitian consultation. However, it is possible that enrichment of the foodservice with high protein/high-energy options minimised patient weight loss in the GEMU. © 2017 Dietitians Association of Australia.

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

    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

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

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

    2010-01-01

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

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

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

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

  8. Management consulting. Ein neuer Weg der angewandten Sozial- und Wirtschaftsgeographie - Legoland Deutschland = Management consulting. The new way of applied social- and economic geography – LEGOLAND Germany

    Klaus Kellner

    2006-01-01

    Full Text Available The decision of the LEGO group, to build itsfourth LEGOLAND amusement park in the Bavarian Swabian district Günzburg, has created a challenging situation for the regional politicians. With the help of the new consulting approach "Municipal Profiling", the future oriented development of the Günzburg district, was firstly clearly planned and secondly consequently enforced. The motto for the future oriented development of the district is: "District Günzburg - The Family And Children Region."

  9. Feasibility and impact of a computer-guided consultation on guideline-based management of COPD in general practice.

    Angus, Robert M; Thompson, Elizabeth B; Davies, Lisa; Trusdale, Ann; Hodgson, Chris; McKnight, Eddie; Davies, Andrew; Pearson, Mike G

    2012-12-01

    Applying guidelines is a universal challenge that is often not met. Intelligent software systems that facilitate real-time management during a clinical interaction may offer a solution. To determine if the use of a computer-guided consultation that facilitates the National Institute for Health and Clinical Excellence-based chronic obstructive pulmonary disease (COPD) guidance and prompts clinical decision-making is feasible in primary care and to assess its impact on diagnosis and management in reviews of COPD patients. Practice nurses, one-third of whom had no specific respiratory training, undertook a computer-guided review in the usual consulting room setting using a laptop computer with the screen visible to them and to the patient. A total of 293 patients (mean (SD) age 69.7 (10.1) years, 163 (55.6%) male) with a diagnosis of COPD were randomly selected from GP databases in 16 practices and assessed. Of 236 patients who had spirometry, 45 (19%) did not have airflow obstruction and the guided clinical history changed the primary diagnosis from COPD in a further 24 patients. In the 191 patients with confirmed COPD, the consultations prompted management changes including 169 recommendations for altered prescribing of inhalers (addition or discontinuation, inhaler dose or device). In addition, 47% of the 55 current smokers were referred for smoking cessation support, 12 (6%) for oxygen assessment, and 47 (24%) for pulmonary rehabilitation. Computer-guided consultations are practicable in general practice. Primary care COPD databases were confirmed to contain a significant proportion of incorrectly assigned patients. They resulted in interventions and the rationalisation of prescribing in line with recommendations. Only in 22 (12%) of those fully assessed was no management change suggested. The introduction of a computer-guided consultation offers the prospect of comprehensive guideline quality management.

  10. Consultancy to dairy farmers relating to animal health and herd health management on small- and medium-sized farms.

    Pothmann, H; Nechanitzky, K; Sturmlechner, F; Drillich, M

    2014-02-01

    The objectives of this study were to obtain information about animal health challenges for dairy farmers of small- and medium-sized herds and about the fields in which consultancy services should be improved. The hyperlink to an internet-based survey was sent to 9,021 farmers in Austria. The survey included questions about the participants and their farms, about who is consulting with the farmers with regard to animal health, feeding, sire selection, construction of barns and animal husbandry, about animal health issues farmers find most challenging, and about their demands for improved consultancy services. The questionnaire was completed anonymously. Analyses were stratified by milk yield (categorized) and whether farmers worked full-time or part-time. The overall response rate was 11.3% (n=1,018). The majority of farms kept less than 20 cows (54.0%) or 20 to 50 cows (40.1%). With regard to animal health, the veterinarian was the most important consultant for the majority of farmers (84.6%). On issues related to feeding, sire selection, and stable construction, the veterinarian was seen as a less important consultant than specialists in these fields (20.4, 11.6, and 7.9% suggested the veterinarian as an important consultant in these areas). The survey indicated that reproductive disorders, udder disease, poor conception rate, lameness, and calf diarrhea represent the most important challenges to farmers. Of these, concerns about calf diarrhea were affected by milk yield of the herds and management. More high- than low-yielding farms (11.7 vs. 6.4%) and more full-time than part-time managed herds (9.6 vs.4.3%) regarded calf diarrhea as an important problem. Farmers would welcome improved consultancy with regard to fertility, feeding, and sire selection. The results indicated which animal health issues farmers find particularly challenging and displayed which areas farmers require improved consultancy services. Veterinarians and organizations offering consultancy

  11. Managers as consultants:The hybridity and tensions of neo-bureaucratic management

    Sturdy, Andrew J; Wright, Christopher; Wylie, Nick

    2016-01-01

    The nature and extent of changes in management remain subject to debate, especially around the notion of post-bureaucracy. Most research concedes that, partly in response to critiques of bureaucracy, some change has occurred, but towards hybrid or neo-bureaucratic practices which retain core elements of bureaucratic organisation. However, both the mechanisms through which these changes have occurred and their outcomes have received less attention. This paper addresses these issues by focusing...

  12. Radiotracer and sealed source techniques for sediment management. Report of the consultants meeting

    2008-01-01

    Radioisotopes as tracers and sealed sources have been a useful and often irreplaceable tool for sediment transport studies. Gamma scattering and transmission gauges are used for sediment monitoring. Computational fluid dynamics (CFD) modelling is now an essential tool for the management of the natural systems and are increasingly used to study the fate and behaviour of particulates and contaminants. Radiotracer techniques are often employed to validate CFD models to enhance confidence in the predictive value of the models. Experimental tracing and numerical modelling are complementary methods of studying complex systems. During the last few decades, many radiotracer studies for the investigation of sediment transport in natural systems have been conducted worldwide, and various techniques for tracing and monitoring sediment have been developed by individual tracer groups. However, the developed techniques and methods for sediment tracing have not been compiled yet as a technical document, which is essential for the preservation of the knowledge and transfer of the technology to developing countries. Standard procedures or guidelines for the tracer experiments, which are vital for the reliability of the experiments and the acceptance of end-users, have not been established by the international tracer community either. The use of radiotracers in sediment transport studies demands the additional attention of the community to further develop these techniques and to ensure their transfer to developing countries. The Consultants' Meeting on 'Radiotracer and sealed source techniques for sediment management' was convened at the headquarters of the International Atomic Energy Agency (IAEA) in Vienna, Austria, from 21 to 25 April 2008. Experts from Argentina, Brazil, France, India, Republic of Korea and United Kingdom have been invited to discuss the current status of the tracer and nucleonic gauge technologies as applied for sediment transport investigations and to evaluate

  13. Radiotracer and sealed source techniques for sediment management. Report of the consultants meeting

    NONE

    2008-07-01

    Radioisotopes as tracers and sealed sources have been a useful and often irreplaceable tool for sediment transport studies. Gamma scattering and transmission gauges are used for sediment monitoring. Computational fluid dynamics (CFD) modelling is now an essential tool for the management of the natural systems and are increasingly used to study the fate and behaviour of particulates and contaminants. Radiotracer techniques are often employed to validate CFD models to enhance confidence in the predictive value of the models. Experimental tracing and numerical modelling are complementary methods of studying complex systems. During the last few decades, many radiotracer studies for the investigation of sediment transport in natural systems have been conducted worldwide, and various techniques for tracing and monitoring sediment have been developed by individual tracer groups. However, the developed techniques and methods for sediment tracing have not been compiled yet as a technical document, which is essential for the preservation of the knowledge and transfer of the technology to developing countries. Standard procedures or guidelines for the tracer experiments, which are vital for the reliability of the experiments and the acceptance of end-users, have not been established by the international tracer community either. The use of radiotracers in sediment transport studies demands the additional attention of the community to further develop these techniques and to ensure their transfer to developing countries. The Consultants' Meeting on 'Radiotracer and sealed source techniques for sediment management' was convened at the headquarters of the International Atomic Energy Agency (IAEA) in Vienna, Austria, from 21 to 25 April 2008. Experts from Argentina, Brazil, France, India, Republic of Korea and United Kingdom have been invited to discuss the current status of the tracer and nucleonic gauge technologies as applied for sediment transport investigations and to evaluate

  14. The Contemporary Consultant

    Olson, Thomas; Poulfelt, Flemming; Greiner, Larry

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

  15. Information Management and Employee Assistance Program Imperatives.

    Bickerton, Richard

    1987-01-01

    The ALMACA Clearinghouse for Employee Assistance Program (EAP) Information collects and disseminates EAP-specific data to provide subscribers with information to maintain their own competence and to improve upon the understanding and use of EAP practices and procedures. (JOW)

  16. Can Knowledge Management Become Global? - Consulting Engineering Companies in the Knowledge Economy

    Koch, Christian

    2004-01-01

    The paper presents different strategies for consulting engineering companies in the emergent global economy. It is a common assumption that players can obtain market gain through cross border mergers, acquisitions, or strategic alliances in synchronisation with internal organisation. Many big...

  17. Manager's assistant systems for space system planning

    Bewley, William L.; Burnard, Robert; Edwards, Gary E.; Shoop, James

    1992-01-01

    This paper describes a class of knowledge-based 'assistant' systems for space system planning. Derived from technology produced for the DARPA/USAF Pilot's Associate program, these assistant systems help the human planner by doing the bookkeeping to maintain plan data and executing the procedures and heuristics currently used by the human planner to define, assess, diagnose, and revise plans. Intelligent systems for Space Station Freedom assembly sequence planning and Advanced Launch System modeling will be presented as examples. Ongoing NASA-funded work on a framework supporting the development of such tools will also be described.

  18. The Assistant Manager - a Key Factor of the Managerial Team

    Lecturer Ph. D. Niculina Vargolici

    2009-05-01

    Full Text Available The new economic context, marked by the crisis and by radical transformations of the labor market, generates the need for more and more sophisticated skills for the assistant manager. That is because the efficiency of the secretarial activity implies both strategic skills and complex abilities, starting from knowledge about the specific activity of the company/institution where the person works as assistant manager, to connected areas such as: management, marketing, human resources, brand communication, company’s culture etc. Whether the manager changes his job together with the “boss”, or the boss is changed and he is bond to adapt to new conditions, a strong team spirit between the manager and his assistant is one of the most important elements that contribute to the productivity and efficiency of the both. The loyalty to the boss and to the company where he works, his adaptation capacity, his competence and his professionalism make the today’s assistant manager a key factor of the managerial team. The essence of the assistant manager job consists in making more efficient the managerial activities, namely, to make it respond to the expectations expressed or not of the manager, or even to anticipate them.

  19. Working with boundaries in systems psychodynamic consulting

    Henk Struwig

    2012-03-01

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

  20. An Examination of Assistant Professors' Project Management Practices

    Alpert, Shannon Atkinson; Hartshorne, Richard

    2013-01-01

    Purpose: The purpose of this research was to identify factors that influence the use of project management in higher education research projects by investigating the project management practices of assistant professors. Design/methodology/approach: Using a grounded theory approach that included in-depth, semi-structured interviews with 22…

  1. Impacts of stakeholder consultation in the FSC certification process on sustainable forest management in South Africa

    Cousins, CC

    2000-01-01

    Full Text Available This research was done so as to understand key issues in the stakeholder consultation process undertaken as a component of the process of forest certification under the Forest Stewardship Council FSC), and to understand the nature of the impacts...

  2. The Role of the Team in Managing Telephone Consultation in Dialectical Behavior Therapy: Three Case Examples

    Koons, Cedar R.

    2011-01-01

    Standard, outpatient Dialectical Behavior Therapy (DBT) includes the provision of intersession telephone contact between the therapist and the client to reduce suicidal crisis behaviors, enhance skills generalization, and reduce alienation and conflict in the therapeutic relationship. Therapists providing telephone consultation need the help of…

  3. Enhancing Inter-Firm Networks and Interorganizational Strategies. Research in Management Consulting Series.

    Buono, Anthony F., Ed.

    This book contain papers 13 papers on enhancing inter-firm networks, including by intervening in mergers and acquisitions and developing strategic alliances and partnerships. The following papers are included: "Introduction" (Anthony F. Buono); "Making Mergers and Acquisitions Work: A Guide to Consulting Interventions" (Mitchell Lee Marks);…

  4. Managing International Consulting Projects and International Business Courses Using Virtual Teams

    Prachyl, Cheryl; Quintanilla, Hector; Gutiérrez, Luis Antonio

    2011-01-01

    The Instituto Tecnologico y de Estudios Superiores de Monterrey and Texas Wesleyan University used technology based courses to enhance internationalization of their curricula. These courses required students to use computer technology as the distance communication medium and to complete an applied international consulting project as part of each…

  5. 44 CFR 204.25 - FEMA-State agreement for fire management assistance grant program.

    2010-10-01

    ... GRANT PROGRAM Declaration Process § 204.25 FEMA-State agreement for fire management assistance grant... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false FEMA-State agreement for fire management assistance grant program. 204.25 Section 204.25 Emergency Management and Assistance FEDERAL...

  6. Report of the Norway-FAO Expert Consultation on the Management of Shared Fish Stocks: Bergen, Norway, 7-10 October 2002

    2002-01-01

    The Norway-FAO Expert Consultation was held in recongnition of the fact that the management of shared fishery resources remains one of the great challenges on the way towards achieving long-term sustainable fisheries...

  7. Consultation Models Revisited

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

    2006-01-01

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

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

    Lakshminarayana, Rashmi; Wang, Duolao; Burn, David; Chaudhuri, K Ray; Galtrey, Clare; Guzman, Natalie Valle; Hellman, Bruce; Ben James; Pal, Suvankar; Stamford, Jon; Steiger, Malcolm; Stott, R W; Teo, James; Barker, Roger A; Wang, Emma; Bloem, Bastiaan R; van der Eijk, Martijn; Rochester, Lynn; Williams, Adrian

    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 comprehensively address non-adherence. Here we share the results from a multi-centre (seven centres) randomised controlled trial conducted in England and Scotland to assess the impact of using a smartphone-based Parkinson's tracker app to promote patient self-management, enhance treatment adherence and quality of clinical consultation. Eligible Parkinson's disease patients were randomised using a 1:1 ratio according to a computer-generated random sequence, stratified by centre and using blocks of variable size, to intervention Parkinson's Tracker App or control (Treatment as Usual). Primary outcome was the self-reported score of adherence to treatment (Morisky medication adherence scale -8) at 16 weeks. Secondary outcomes were Quality of Life (Parkinson's disease questionnaire -39), quality of consultation for Parkinson's disease patients ( Patient-centred questionnaire for Parkinson's disease ), impact on non-motor symptoms (Non-motor symptoms questionnaire), depression and anxiety (Hospital anxiety and depression scale) and beliefs about medication (Beliefs about Medication Questionnaire) at 16 weeks. Primary and secondary endpoints were analysed using a generalised linear model with treatment as the fixed effect and baseline measurement as the covariate. 158 patients completed the study (Parkinson's tracker app = 68 and TAU = 90). At 16 weeks Parkinson's tracker app significantly improved adherence, compared to treatment as usual (mean difference: 0.39, 95%CI 0.04-0.74; p  = 0.0304) with no confounding effects of gender, number of comorbidities and age. Among secondary outcomes, Parkinson's tracker app significantly improved patients' perception of quality of

  9. Chronic disease management: time for consultant physicians to take more leadership in system redesign.

    Brand, C; Scott, I; Greenberg, P; Sargious, P

    2007-09-01

    There is a need for system redesign to meet the needs of individuals with chronic disease. New models of chronic disease care include team-based paradigms that focus on continuous and patient-centred care. In such models the roles of providers and patients must change. In this article we focus on new roles for consultant physicians, as well as barriers and incentives to these roles.

  10. An overview of the management consulting firms of the Spanish company in China: company profile and success and failure factors

    A. Niñerola

    2016-03-01

    Full Text Available This article explores the vision of Management Consulting Firms (MCF specialized in internationalization processes of Spanish companies in China. The main objective is to shed light on a process full of uncertainty as is international expansion into emerging markets on the point of view of the advisors of that process. First, it is analyzed whether there is a Spanish company profile that is internationalized toward China in terms of sector of activity, size and experience in international business. And second, with their client’s experiences, success and failure factors in the internationalization process are studied. To achieve those objectives in depth interviews were held with partners and managers of six Management Consulting Firms with Spanish clients in their portfolio. As a result it is concluded that the sectors where the Spanish company has invested are several, the size of the company is important to undertake an implementation process in China and its international experience as well. Eight key factors were found relevant to invest in China successfully.  Five factors are related with their resources (humans and financials and the other three are related with their strategy. The main reasons of failure are also discussed. The article provides an outside perspective on the reasons why an internationalization process is successful and other fails.

  11. Management councils and regulation: public assistance in times of transition

    Carla Cecília Rodrigues Almeida

    2009-10-01

    Full Text Available This article analyzes the role of municipal public assistance councils in the regulation of civil society organizations classified as social welfare organizations. We draw attention to the importance that these councils have for the operationalization of the more general principles governing the country’s social welfare/public assistance policies. Focusing on the regulatory role that management councils’ take on, we seek to understand, on the one hand, the wider institutional environment to which they belong and, on the other, their power to remodel a particular type of associativism which until very recently was identified and identified itself as philanthropical. Keywords: municipal councils, social welfare, Sistema Único de Assistência Social, regulation, public assistance entities.

  12. [The significance of dermatologic management in computer-assisted occupational dermatology consultation].

    Rakoski, J; Borelli, S

    1989-01-15

    At our occupational outpatient clinic, 230 patients were treated for about 15 months. With the help of a standardized questionary, we registered all the data regarding the relevant substances the patients contacted during their work as well as their various jobs since they left school. The patients were repeatedly seen and trained in procedures of skin care and skin protection. If required, we took steps to find new jobs for them within their employing company; this was done in cooperation with the trade cooperative association according to the dermatological insurance consultanship. If these proceedings did not work out, the patient had to change his profession altogether. All data were computerized. As an example for this computer-based documentation we present the data of barbers.

  13. Executive Assistant – Risk Management and Internal Audit / Office of ...

    Under the supervision of the Director, Risk Management and Internal Audit, the ... filing system which includes ensuring all information related to RMIA's activities is ... Maintains reliable accounting/budgeting records of fees and expenditures ... The Executive Assistant's responsibilites have a direct impact on Director's and ...

  14. Leading or Managing? Assistant Regional Directors, School Performance, in Queensland

    Bloxham, Ray; Ehrich, Lisa C.; Iyer, Radha

    2015-01-01

    Purpose: Education reform aimed at achieving improved student learning is a demanding challenge for leaders and managers at all levels of education across the globe. In 2010, the position of Assistant Regional Directors, School Performance (ARD-SP), was established to positively impact upon student learning across public schools in Queensland,…

  15. Employee Assistance Programmes: The Emperor's New Clothes of Stress Management?

    Arthur, Andrew R.

    2000-01-01

    Discusses the employee assistance program (EAP), a benefit increasingly provided by United Kingdom employers that claims to reduce the effects of stress on individuals and organizations, provide a management tool to improve workplace performance and productivity, and respond to critical incidents. Describes EAPs, their history, development and…

  16. Management consulting. Ein neuer Weg der angewandten Sozial- und Wirtschaftsgeographie - Legoland Deutschland

    Klaus Kellner

    2006-12-01

    Full Text Available The decision of the LEGO group, to build its fourth LEGOLAND amusement park in the Bavarian Swabian district Günzburg, has created a challenging situation for the regional politicians. With the help of the new consulting approach “Municipal Profiling,” the future oriented development of the Günzburg district, was firstly clearly planned and secondly consequently enforced. The motto for the future oriented development of the district is: “District Günzburg – The Family And Children Region.”

  17. The BCG (Boston Consulting Group) matrix for management of periodic publications

    Serrano Gallardo, Mª del Pilar; Arroyo Gordo, Mª Pilar; Giménez Maroto, Ana Mª

    2005-01-01

    El marketing documental se ha de encargar de satisfacer las necesidades informativas de los usuarios de forma rentable para ellos y para el centro; para ello se ha de partir de un conjunto de herramientas técnicas que se conocen como el Marketing - Mix, y que abarcan el Producto, el Precio, la Distribución y la Comunicación. Dentro de las herramientas destinadas al producto se encuentra la matriz BCG (Boston Consulting Group), que está orientada a gestión, sobre la base de la situación del pr...

  18. An overview of knowledge management (KM) issues for implementation in consultant firms in Malaysian construction industry

    Othman, Azlan; Ismail, Syuhaida; Yahya, Khairulzan

    2017-12-01

    In the past few years, there has been a growing interest in treating knowledge as a significant organisational resource. Thus, effective development and implementation of KM requires a foundation in several rich literatures. As a preparation for the competitive industrial nation, KM is an important countenance that should be the point of convergence for the industry players. This paper wishes to draw the attention on the current situation of KM practice, focusing on consultant firms in Malaysian construction industry. Questionnaires were distributed to about 200 respondents working in the industry, with the objective of appraising the KM implementation amongst consultant firms working in construction industry in Malaysia. This paper also gives the overview on KM definition, process, understanding and challenges in construction industry, besides the critical success factor of KM implementation. The literature is restricted on the recent KM study of 17 years research from 2000 to 2017. Finally, this paper proposes the conceptual ideas of relationship between KM process, KM understanding and KM challenges with critical success factor of KM implementation.

  19. Accompanied consultations in occupational health.

    Hobson, J; Hobson, H; Sharp, R

    2016-04-01

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

  20. Patient contributions during primary care consultations for hypertension after self-reporting via a mobile phone self-management support system.

    Bengtsson, Ulrika; Kjellgren, Karin; Hallberg, Inger; Lundin, Mona; Mäkitalo, Åsa

    2018-03-01

    This paper reports on how the clinical consultation in primary care is performed under the new premises of patients' daily self-reporting and self-generation of data. The aim was to explore and describe the structure, topic initiation and patients' contributions in follow-up consultations after eight weeks of self-reporting through a mobile phone-based hypertension self-management support system. A qualitative, explorative study design was used, examining 20 audio- (n = 10) and video-recorded (n = 10) follow-up consultations in primary care hypertension management, through interaction analysis. Clinical trials registry: ClinicalTrials.gov NCT01510301. Four primary health care centers in Sweden. Patients with hypertension (n = 20) and their health care professional (n = 7). The consultations comprised three phases: opening, examination and closing. The most common topic was blood pressure (BP) put in relation to self-reported variables, for example, physical activity and stress. Topic initiation was distributed symmetrically between parties and BP talk was lifestyle-centered. The patients' contributed to the interpretation of BP values by connecting them to specific occasions, providing insights to the link between BP measurements and everyday life activities. Patients' contribution through interpretations of BP values to specific situations in their own lives brought on consultations where the patient as a person in context became salient. Further, the patients' and health care professionals' equal contribution during the consultations showed actively involved patients. The mobile phone-based self-management support system can thus be used to support patient involvement in consultations with a person-centered approach in primary care hypertension management Key points   The clinical consultation is important to provide opportunities for patients to gain understanding of factors affecting high blood pressure, and for health care professionals to

  1. Integrated soil, water and nutrient management for sustainable rice-wheat cropping systems in Asia. Report of a FAO/IAEA consultants' meeting

    2000-01-01

    A Consultants' Meeting on 'Integrated soil, water and nutrient management for sustainable rice-wheat cropping systems in Asia' was held at FAO, Rome, August 22-25, 2000. Five consultants, together with one staff from IAEA headquarters, one staff from IAEA Laboratories, Seibersdorf, five staff from FAO headquarters, two staff from FAO regional offices, one observer from ACIAR, one observer from Cornell University with expertise in crop, nutrient, soil and water management, attended the meeting. The consultants presented reviews of the situation regarding studies of water and nutrient dynamics in rice-wheat systems in South Asia. These were complemented by a paper on the development of 15 N techniques to study the contribution of N from legumes. The consultants also provided recommendations on the formulation and implementation of an FAO/IAEA Co-ordinated Research Project (CRP). Refs, figs, tabs

  2. DECENTRALIZATION, ELIGIBILITY OF AUTHORITIES AND CONSULTATION OF CITIZENS - EVIDENCE OF THE OCCURRENCE OF AUTONOMY IN LOCAL PUBLIC ADMINISTRATION MANAGEMENT

    ZAHARIA PETRONELA

    2013-04-01

    Full Text Available Being important for the proper functioning of the management activity conducted at the local public administration level, local autonomy cannot occur without the support coming from other rules of organization and functioning of local administrative system. From this perspective, in this paper we propose to analyze the content of decentralization, eligibility of authorities and consultation of citizens in solving local problems, in order to highlight how each of these principles demonstrates the efficiency of autonomy. Moving power from central public administration authorities to local authorities in the decentralization process, making authorities of administrative-territorial units eligible and the involvement of local community members in solving problems affecting them are clear evidence of the occurrence of autonomy in local public administration management.

  3. A survey of time management and particular tasks undertaken by consultant microbiologists in the UK.

    Riordan, Terry; Cartwright, Keith; Cunningham, Richard; Logan, Margaret; Wright, Paul

    2007-05-01

    Medical microbiology practice encompasses a diverse range of activities. Consultant medical microbiologists (CMMs) attribute widely differing priorities to, and spend differing proportions of time on various components of the job. To obtain a professional consensus on what are high-priority and low-priority activities, and to identify the time spent on low-priority activities. National survey. Many respondents felt that time spent on report authorisation and telephoning of results was excessive, whereas time spent on ward-based work was inadequate. Timesaving could also be achieved through better prioritisation of infection-control activities. CMMs should apportion their time at work focusing on high-priority activities identified through professional consensus.

  4. A survey of time management and particular tasks undertaken by consultant microbiologists in the UK

    Riordan, Terry; Cartwright, Keith; Cunningham, Richard; Logan, Margaret; Wright, Paul

    2007-01-01

    Background Medical microbiology practice encompasses a diverse range of activities. Consultant medical microbiologists (CMMs) attribute widely differing priorities to, and spend differing proportions of time on various components of the job. Aim To obtain a professional consensus on what are high‐priority and low‐priority activities, and to identify the time spent on low‐priority activities. Method National survey. Results Many respondents felt that time spent on report authorisation and telephoning of results was excessive, whereas time spent on ward‐based work was inadequate. Timesaving could also be achieved through better prioritisation of infection‐control activities. Conclusion CMMs should apportion their time at work focusing on high‐priority activities identified through professional consensus. PMID:16714398

  5. Postpartum Women’s Perspectives of Engaging with a Dietitian and Exercise Physiologist via Video Consultations for Weight Management: A Qualitative Evaluation

    Lisa Vincze

    2018-01-01

    Full Text Available Optimising weight status after childbirth is important. Video consultations are an unexplored opportunity to deliver real-time support to postpartum women to improve lifestyle behaviours. This study aims to provide insight into postpartum women’s perspectives of engaging with a dietitian and exercise physiologist through video consultations for tailored nutrition and exercise care. A qualitative study using individual telephone interviews (13–36 min was undertaken. 21 women (body mass index (BMI: 28.1 ± 3.8 kg/m2; age: 32.3 ± 3.0 years; parity: 1.6 ± 0.9 children who had completed the 8 week “Video-coaching to assist lifestyle (VITAL change for mums” intervention participation included up to five video consultations with a dietitian and exercise physiologist. The interviews were audiorecorded and transcribed. Thematic data analysis was conducted by an independent researcher using NVIVO11. Themes relating to the video consultation experience included feeling that they did not differ from other consultations, they were convenient, and the length of time and flexible options were appropriate; however there was a desire for increased contact frequency. The dietitian and exercise physiologist were perceived to increase the participants’ knowledge and confidence to improve health behaviours. The approach to setting realistic and tailored goals was well received. Tailored advice from a dietitian and exercise physiologist received via video consultations is acceptable for postpartum women and offers a viable alternative to in-person care.

  6. Effects of Teacher Consultation on Evidence-Based Classroom Management Strategies: Teacher and Student Behavior

    Funk, Kristin M.

    2013-01-01

    The American Psychological Association (APA) conducted the online 2005-2006 Teacher Needs Survey wherein 52% of first year teachers, 28% of teachers with two to five years of experience, and 26% of teachers with 6 to 10 years experience ranked classroom management as their greatest need. Difficulty managing student behaviors leads to higher stress…

  7. 75 FR 54591 - Notice of Agricultural Management Assistance Organic Certification Cost-Share Program

    2010-09-08

    ...] Notice of Agricultural Management Assistance Organic Certification Cost-Share Program AGENCY... Agricultural Management Assistance Organic Certification Cost-Share Program. SUMMARY: This Notice invites the... Agreement with the Agricultural Marketing Service (AMS) for the Allocation of Organic Certification Cost...

  8. A Quality Improvement System to Manage Feeding Assistance Care in Assisted-Living.

    Simmons, Sandra F; Coelho, Chris S; Sandler, Andrew; Schnelle, John F

    2018-03-01

    To describe a feasible quality improvement system to manage feeding assistance care processes in an assisted living facility (ALF) that provides dementia care and the use of these data to maintain the quality of daily care provision and prevent unintentional weight loss. Supervisory ALF staff used a standardized observational protocol to assess feeding assistance care quality during and between meals for 12 consecutive months for 53 residents receiving dementia care. Direct care staff received feedback about the quality of assistance and consistency of between-meal snack delivery for residents with low meal intake and/or weight loss. On average, 78.4% of the ALF residents consumed more than one-half of each served meal and/or received staff assistance during meals to promote consumption over the 12 months. An average of 79.7% of the residents were offered snacks between meals twice per day. The prevalence of unintentional weight loss averaged 1.3% across 12 months. A quality improvement system resulted in sustained levels of mealtime feeding assistance and between-meal snack delivery and a low prevalence of weight loss among ALF residents receiving dementia care. Given that many ALF residents receiving dementia care are likely to be at risk for low oral intake and unintentional weight loss, ALFs should implement a quality improvement system similar to that described in this project, despite the absence of regulations to do so. Copyright © 2018 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  9. Technical assistance contractor management plan: Surface and ground water

    1994-09-01

    This report presents the general management structure of the Technical Assistance Contractor (TAC) for the Uranium Mill Tailings Remedial Action (UMTRA) Project. This team is a partnership of four major private subcontractors, which teamed together, are striving to be the leader in environmental restoration of uranium mining and milling operations. It will provide a pool of experts in various aspects of the technologies necessary to accomplish this goal, available to DOE to deal with mission concerns. The report expands on goals from TAC's mission statement, which include management concerns, environment, safety, and health, quality, technical support, communications, and personnel

  10. Thrombectomy assisted by carotid stenting in acute ischemic stroke management

    Steglich-Arnholm, Henrik; Holtmannspötter, Markus; Kondziella, Daniel

    2015-01-01

    .0). Early clinical improvement was detected in 22 (46%) patients. Favorable outcome at 3 months occurred in 32 (68%) patients. Expedited patient management was associated with favorable clinical outcome. Two (4%) patients experienced symptomatic hemorrhage. Eight (17%) patients experienced stent thrombosis....... Four (9%) patients died. Thrombectomy assisted by carotid stenting seems beneficial and reasonably safe with a promising rate of favorable outcome. Nevertheless, adverse events and complications call for additional clinical investigations prior to recommendation as clinical standard. Expeditious...... patient management is central to achieve good clinical outcome....

  11. Technical assistance contractor management plan: Surface and ground water

    1994-09-01

    This report presents the general management structure of the Technical Assistance Contractor (TAC) for the Uranium Mill Tailings Remedial Action (UMTRA) Project. This team is a partnership of four major private subcontractors, which teamed together, are striving to be the leader in environmental restoration of uranium mining and milling operations. It will provide a pool of experts in various aspects of the technologies necessary to accomplish this goal, available to DOE to deal with mission concerns. The report expands on goals from TAC`s mission statement, which include management concerns, environment, safety, and health, quality, technical support, communications, and personnel.

  12. 32 CFR 700.323 - The Assistant Secretary of the Navy (Financial Management).

    2010-07-01

    ... Assistants § 700.323 The Assistant Secretary of the Navy (Financial Management). The Assistant Secretary of the Navy (Financial Management) is the Comptroller of the Navy, and is responsible for all matters related to the financial management of the Department of the Navy, including: (a) Budgeting; (b...

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

    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…

  14. From information and consultation to citizen influence and power. 10-Year Evolution in Public involvement in Radioactive Waste Management

    2010-09-01

    The OECD/NEA Forum on Stakeholder Confidence (FSC) was created in 2000 to promote the sharing of international experience in addressing the societal dimension of radioactive waste management. It explores means of ensuring an effective dialogue amongst all stakeholders and to strengthen confidence in decision-making processes. The working definition given to the term 'stakeholder' is: Any actor - institution, group or individual - with an interest or with a role to play in the process. The FSC has documented a wealth of experience through topical sessions and studies and, in particular, through its many national workshops and community visits. The present flyer highlights the growing stakeholder empowerment in radioactive waste management observed since the inception of the Forum ten years ago. Important changes have taken place in citizen participation for radioactive waste management in the past decade: a shift from information and consultation towards citizen influence and power, and a shift from overt conflict or resigned acceptance to volunteering and collaboration by local communities. Overall, there is recognition of the legitimacy of community empowerment measures and socio-economic benefits, and there exist now a great variety of administrative formats for collaboration. New ideals and bases for collaboration have also emerged. These are: mutual learning, adding value to the host community/region, and sustainable development

  15. Strategy-oriented display concept to assist severe accident management

    Jeong, Kwangsub; Ha, Jaejoo

    2000-01-01

    The Critical Function Monitoring System (CFMS) is a typical Safety Parameter Display System (SPDS) to assist the operation of Korean Standard Nuclear Power Plants during normal and emergency operation, and SPDS for severe accident is being developed in Korea. When the existing CFMS is used under a severe accident situation, some problems are expected from: (1) different design basis, i.e. prevention of core melt vs. protection of radiation release to environment, (2) different parameters for decision-making, and (3) different domain and depth of information to restore the plant. To resolve the above problems, a concept, 'Strategy-Oriented Information Display' concept, for displaying information for severe accident management is developed in this paper. Whereas the existing SPDS structure is based on the critical safety function, the developed concept is based on the severe accident management strategy. The display for each strategy includes the plant parameters to check the status of plant and component with the logical or graphical views necessary for executing the strategy. As the application of the proposed concept, KAERI is developing a display system, the prototype severe accident SPDS, Severe Accident Management Display System (SAMDIS), to assist plant personnel for executing Korean Severe Accident Management Guidelines. CFMS is developed for a general display suitable to all situations with various displays. On the contrary, SAMDIS provides all the relevant information on one screen based on the proposed concept. The SAMDIS screen shows more extensive area than CFMS and thus plant personnel can recognize the overall plant status at a glance. This concept is quite effective when used with severe accident management guidelines because of the relatively macroscopic characteristics of a severe accident management strategy. (author)

  16. Management and conservation of tropical acid soils for sustainable crop production. Proceedings of a consultants meeting

    2000-06-01

    Forests of the tropics are invaluable ecosystems of global, regional and local importance, particularly in terms of protection and conservation of biodiversity and water resources. The indiscriminate conversion of tropical forests into agricultural land as a result of intense human activities - logging and modem shifting cultivation - continues to cause soil erosion and degradation. However, the acid savannahs of the world, such as the cerrado of Brazil, the Llanos in Venezuela and Colombia, the savannahs of Africa, and the largely anthropic savannahs of tropical Asia, encompass vast areas of potentially arable land. The acid soils of the savannahs are mostly considered marginal because of low inherent fertility and susceptibility to rapid degradation. These constraints for agricultural development are exacerbated by the poverty of new settlers who try to cultivate such areas after deforestation. Low- or minimum-input systems are not sustainable on these tropical acid soils but, with sufficient investment and adequate technologies, they can be highly productive. Thus, there is a need to develop management practices for sustainable agricultural production systems on such savannah acid soils. The Soil and Water Management and Crop Nutrition Sub-programme of the Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture strongly supports an integrated approach to soil, water and nutrient management within cropping systems. In this context, nuclear and related techniques can be used to better understand the processes and factors influencing the productivity of agricultural production systems, and improve them through the use of better soil, water and nutrient management practices. A panel of experts actively engaged in field projects on acid soils of savannah agro-ecosystems in the humid and sub-humid tropics convened in March 1999 in Vienna to review and discuss recent research progress, along the following main lines of investigation: (i) utilization of

  17. Nurse management of 'same day' consultation for patients with minor illnesses: results of an extended programme in primary care in Catalonia.

    Fabrellas, Núria; Vidal, Angel; Amat, Gemma; Lejardi, Yolanda; del Puig Deulofeu, Maria; Buendia, Carmen

    2011-08-01

    This paper is a report of a study to assess the feasibility and efficacy of a programme of nurse management for patients requesting same day consultation for minor illnesses in primary care. The efficacy of such programmes has been demonstrated in randomized studies but there is little information on these programmes in highly populated areas. Patients seeking same day consultation for one of 23 preselected minor illnesses (16 for adults, 7 for paediatric patients) from March 2009 to April 2010 were seen by trained nurses who followed predefined algorithms. If signs of alarm were detected, patients were referred to a general practitioner. A total of 629,568 consultations were performed, 575,189 in adults and 54,379 in paediatric patients. Case resolution was achieved in 61.8% of adult and 75.6% of paediatric patients. In adults, the highest resolution rates (>90%) were obtained for burns, skin injury and emergency contraception, and the lowest for lower urinary symptoms (46.7%), sore throat (45.7%), pink eye (45.5%) and upper respiratory symptoms (41.4%). In paediatric patients, the highest resolution rates (>90%) were obtained for stomach cramps and burns and the lowest for cough (36.2%). A return to consultation during a 7-day period for the same reason as the first consultation was low, 4% for adults and 2.4% for paediatric patients. An extended programme of nurse management for same day consultation of patients with minor illnesses showed an acceptably high rate of resolution and low rate of return to consultation. The application of such programmes in extensive areas is feasible and effective. © 2011 Blackwell Publishing Ltd.

  18. Management of nutrients and water in rainfed arid and semi-arid areas. Proceedings of a consultants meeting

    1998-07-01

    Sustainable food security is needed for the arid and semi-arid regions of the tropical, subtropical and warm-temperate climatic zones. In these regions the supply of locally grown food is unreliable because much of it is produced in conditions of highly variable rainfall. Even in favourable seasons, these regions re becoming increasingly dependent on imported food. The IAEA's involvement in field studies on soil-water use dates back several years. A five year Co-ordinated Research Project on ''The Use of Nuclear and Related Techniques in Assessment of Irrigation Schedules of Field Crops to Increase Effective Use of Water in Irrigation Projects''. That project, completed in 1995, laid a solid foundation for future research. Because of a scarcity of water in many developing countries and increasing needs for sustainable food security in the face of increasing populations and lack of funds for irrigation schemes of significant dimension, research must focus on improved management of (i) the modest quantities of fertilizers that are available to farmers, (ii) the natural resources that are available to farmers for increasing soil organic matter content, and (iii) rain water. The Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture held a Consultants Meeting on Management of Nutrients and Water in Rainfed Arid and Semi-Arid Areas for Increasing Crop Production, 26-29 May 1997

  19. Managing Environmentally-Assisted Fatigue in U. S. Plants

    Gilman, T. D.

    2014-01-01

    Nuclear plants in the United States were originally licensed by the Nuclear Regulatory Commission (NRC) for 40 years of operation, but most of these plans have or are planning on renewing their license to 60 years. Plants are required by federal law to manage the aging effects of systems, structures and components in the scope of license renewal. One of the aging effects is environmentally-assisted fatigue of the primary system vessels and piping. This article discusses the strategies that U. S. utilities have utilized in order to safety NRC concerns with respect to fatigue damage in nuclear plants. (Author)

  20. Robotic-assisted laparoscopic management of a caliceal diverticular calculus

    Torricelli, Fabio Cesar Miranda; Batista, Lucas T; Colombo, Jose Roberto; Coelho, Rafael Ferreira

    2014-01-01

    Purpose To report the first case of robotic-assisted laparoscopic management of a symptomatic caliceal diverticular calculus and review the literature on laparoscopic treatment for this condition. Case report A 33-year-old obese woman with a 2×1 cm calculus within an anterior caliceal diverticulum located in the middle pole of the left kidney was referred to our service. She had already undergone two flexible ureterorenoscopies without success. We considered that a percutaneous approach would be very challenging due to stone location, thus we elected to perform a robotic-assisted laparoscopic procedure for stone removal and diverticulum fulguration. The procedure was uneventfully performed with no intraoperative or postoperative complications. The patient was discharged from the hospital on the second postoperative day and after 1.5 years of follow-up she is asymptomatic with no recurrence. Conclusions The robotic-assisted laparoscopic approach to caliceal diverticular calculi is feasible and safe, providing one more option for treatment of stones in challenging locations. PMID:25188925

  1. Disease management apps and technical assistance systems for bipolar disorder: Investigating the patients´ point of view.

    Daus, Henning; Kislicyn, Natalia; Heuer, Stephan; Backenstrass, Matthias

    2018-03-15

    Smartphone-based disease management has become increasingly interesting for research in the field of bipolar disorders. This article investigates the attitudes of persons affected by this disorder towards the appropriation of mobile apps or assistance systems for the management of their disease. We conducted two separate studies. Study 1 was an online survey with 88 participants. In study 2 we consulted 15 participants during a semi-structured interview. All the participants had formerly been diagnosed with bipolar disorder. More than half of the participants of study 1 and most participants of study 2 agreed with the use of an app or assistance system for self-ratings, third party ratings and an objective symptom monitoring. Potential interventions that were popular in both groups included a regular feedback, the visualization of monitored data and advice in crises. With study 1 we were not able to ensure correct diagnoses or to interact in a flexible way. In Study 2 those issues were resolved, but the small number of participants raises the question of a possible generalisability of the results. Furthermore, for both studies a selection bias could not be excluded. Our results indicate positive attitudes of bipolar patients towards disease management apps and assistance systems. Even new and innovative features such as partner apps or the analysis of facial expressions in video data were appreciated and daily interactions were favoured. However, the variety of answers calls for flexible systems which allow activating or deactivating certain features. Copyright © 2018 Elsevier B.V. All rights reserved.

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

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

    2017-01-01

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

  3. Using MARS to assist in managing a severe accident

    Raines, J.C.; Hammersley, R.J.; Henry, R.E.

    2004-01-01

    During an accident, information about the current and possible future states of the plant provides guidance for accident managers in evaluating which actions should be taken. However, depending upon the nature of the accident and the stress levels imposed on the plant staff responding to the accident the current and future plant assessments may be very difficult or nearly impossible to perform without supplemental training and/or appropriate tools. The MAAP Accident Response System (MARS) has been developed as a calculational aid to assist the responsible accident management individuals. Specifically MARS provides additional insights on the current and possible future states of the plant during an accident including the influence of operator actions. In addition to serving as a calculational aid, the MARS software can be an effective means for providing supplemental training. The MARS software uses engineering calculations to perform an integral assessment of the plant status including a consistency assessment of the available instrumentation. In addition, it uses the Modular Accident Analysis Program (MAAP) to provide near term predictions of the plant response if corrective actions are taken. This paper will discuss the types of information that are beneficial to the accident manager and how MARS addresses each. The MARS calculational functions include: instrumentation, validation and simulation, projected operator response based on the EOPs, as well as estimated timing and magnitude of in-plant and off-site radiation dose releases. Each of these items is influential in the management of a severe accident. (author)

  4. Security and emergency management technical assistance for the top 50 transit agencies

    2007-04-01

    Between May 2002 and July 2006, the Federal Transit Administration (FTA) provided technical assistance to the top 50 transit agencies through the Security and Emergency Management Technical Assistance Program (SEMTAP). The scope and purpose of the pr...

  5. [Quality Manager 2.0 in hospitals: A practical guidance for executive managers, medical directors, senior consultants, nurse managers and practicing quality managers].

    Pilz, Stefan; Hülsmann, Sylvia; Michallik, Stefan; Rimbach-Schurig, Monika; Schollmeier, Margarita; Sommerhoff, Benedikt; Weßling, Adelheid

    2013-01-01

    Aiming at the development of perspectives and recommendations for modern quality management in health services the GQMG conducted a study on the role and self-conception of quality managers in hospitals. It seems obvious that the effectiveness of quality management clearly depends on the executive board's skilful installation of quality management, their support of quality managers and, particularly in larger-sized institutions on the coordination of staff units and cross-sectional functions.(As supplied by author). Copyright © 2013. Published by Elsevier GmbH.

  6. deNIS IIplus - computer-assisted crisis management system

    Corr, B.

    2007-01-01

    The management of catastrophes, as natural disasters or manmade disasters, will only be effective and successful if all relevant information is available in time for decision-makers. During previous large-scale disasters it became evident that information needed for the disaster management was only partially available and that there were fundamental deficits in regard to the flow of information between federal states (''Laender'') as well as communication problems between disaster response teams in the effected regions. On this account in summer 2001 the Federal Ministry of the Interior has decided to develop the ''German Emergency Preparedness Information System (deNIS)''. The aim of the enhanced version deNIS II plus is to built up a network for the civil and disaster response and to assist as an information and communication system for decision-makers of the Federal Government and the Laender Governments to better co-ordination relief and rescue teams in the event of a natural disaster or technical accident. Correspondingly the primary task of deNIS is to support the decision-making of disaster management authorities. (orig.)

  7. Manager - Grant Administration Division | IDRC - International ...

    Assist Grant Administration Officers in the review of project approval ... or approve exceptions in areas such as financial monitoring, risk management, ... structure for the EFPs in consultation with Program Managers and the Chief, EFM.

  8. Manager, Grant Administration | IDRC - International Development ...

    ... all activities related to the administration and financial management of grants and ... Assists Administration Officers in reviewing project approval documents for the ... set up in EPIK in consultation with Program Managers and the Chief, EFM.

  9. Implementing the NICE osteoarthritis guidelines: a mixed methods study and cluster randomised trial of a model osteoarthritis consultation in primary care--the Management of OsteoArthritis In Consultations (MOSAICS) study protocol.

    Dziedzic, Krysia S; Healey, Emma L; Porcheret, Mark; Ong, Bie Nio; Main, Chris J; Jordan, Kelvin P; Lewis, Martyn; Edwards, John J; Jinks, Clare; Morden, Andrew; McHugh, Gretl A; Ryan, Sarah; Finney, Andrew; Jowett, Sue; Oppong, Raymond; Afolabi, Ebenezer; Pushpa-Rajah, Angela; Handy, June; Clarkson, Kris; Mason, Elizabeth; Whitehurst, Tracy; Hughes, Rhian W; Croft, Peter R; Hay, Elaine M

    2014-08-27

    There is as yet no evidence on the feasibility of implementing recommendations from the National Institute of Health and Care Excellence (NICE) osteoarthritis (OA) guidelines in primary care, or of the effect these recommendations have on the condition. The primary aim of this study is to determine the clinical and cost effectiveness of a model OA consultation (MOAC), implementing the core recommendations from the NICE OA guidelines in primary care. Secondary aims are to investigate the impact, feasibility and acceptability of the MOAC intervention; to develop and evaluate a training package for management of OA by general practitioners (GPs) and practice nurses; test the feasibility of deriving 'quality markers' of OA management using a new consultation template and medical record review; and describe the uptake of core NICE OA recommendations in participants aged 45 years and over with joint pain. A mixed methods study with a nested cluster randomised controlled trial. This study was developed according to a defined theoretical framework (the Whole System Informing Self-management Engagement). An overarching model (the Normalisation Process Theory) will be employed to undertake a comprehensive 'whole-system' evaluation of the processes and outcomes of implementing the MOAC intervention. The primary outcome is general physical health (Short Form-12 Physical component score [PCS]) (Ware 1996). The impact, acceptability and feasibility of the MOAC intervention at practice level will be assessed by comparing intervention and control practices using a Quality Indicators template and medical record review. Impact and acceptability of the intervention for patients will be assessed via self-completed outcome measures and semi-structured interviews. The impact, acceptability and feasibility of the MOAC intervention and training for GPs and practice nurses will be evaluated using a variety of methods including questionnaires, semi-structured interviews, and observations

  10. 3-D diagnosis-assisted management of anomalous mandibular molar

    Neelam Mittal

    2012-01-01

    Full Text Available This case report describes the successful non-surgical endodontic management of carious exposed three-rooted mandibular molar with four root canals detected on the pre-operative radiograph taken with 20 degrees mesial angulation and confirmed with a 64-slice helical computed tomography scan-assisted 3-D-reconstructed images. Access cavity shape was modified to locate the extra canal with respect to the distolingual root in the left mandibular first molar. Copious irrigation was accomplished with 5.25% sodium hypochlorite and 17% EDTA. Biomechanical preparation was done using protapers. Calcium hydroxide dressing was done for 1 week. The tooth was obturated using gutta percha and AH 26 root canal sealer, and it was permanently restored with composite. Clinical examination on follow-up visits revealed no sensitivity to percussion and palpation in the left mandibular first molar. Thorough knowledge of root canal variations and use of advanced diagnostic modalities lead to successful non-surgical management of the complex cases.

  11. Development of radioactive waste management licensing review assistant

    Wei-Whua Loa; Suan Chen; Wei-Chu Yu

    1992-01-01

    Regulations on radioactive waste disposal are now in urgent need due to our increasing consumption of electric power from nuclear origin. It is set forth that actually applying the regulations to evaluate the license application of new repositories for interim storage and final disposal of High-Level Waste and Low-Level Waste before the year of 2000. In the mean time, it is expected to establish the basis for the decision on issuing the license. The license review procedure can be very complicated, because too many factors must be taken into consideration. For the time being, licensing review is as much an art as it is a science. The authority usually faces three major problems; (1) the availability of domain expert, (2) maintaining of high quality and consistent reviews, and (3) the documentation of the review process. However, to maintain a more efficient, accurate, and systematic review procedure, and at the same time to reduce costs, the Artificial Intelligence (AI) techniques may be used. An expert system is designed as a radioactive waste management licensing review aid for the staff those are in charge of the license application. Tasks such as completeness checking, functional areas of review distribution, participation confirmation, knowledge acquisition, review comment collection, weighting calculation, and degree of satisfaction are considered. In this paper we will discuss the development of the radioactive waste management licensing review assistant

  12. Development of radioactive waste management licensing review assistant

    Loa, W.W.; Chen, S.; Yu, W.C.; Peng, C.M.; Huang, C.L.; Lin, C.

    1992-01-01

    Regulations on radioactive waste disposal are now in urgent need due to our increasing consumption of electric power from nuclear origin. It is set forth that actually applying the regulations to evaluate the license application of new repositories for interim storage and final disposal fo High-Level Waste and Low-Level Waste before the year of 2000. In the mean time, it is expected to establish the basis for the decision on issuing the license. The license review procedure can be very complicated because too many factors must be taken into consideration. However, to maintain a more efficient, accurate, and systematic review procedure, and at the same time to reduce costs, the Artificial Intelligence (AI) techniques may be used. An expert system is designed as a radioactive waste management licensing review aid for the staff those are in charge of the license application. Tasks such as completeness checking, functional areas of review distribution, participation confirmation, knowledge acquisition, review comment collection, weighting calculation, and degree of satisfaction are considered. In this paper the authors will discuss the development of the radioactive waste management licensing review assistant

  13. A delicate balance? : a study of work-life conflicts, work-life enrichment, and worklife balance among management consultants in Norway

    Nabong, Tristán; Trønnes, Hannah

    2016-01-01

    The purpose of this study is to identify the relationship among work-life balance, work-life enrichment, and work-life conflict by looking into the status, condition, and experiences of management consultants in Norway. The need to develop methods to achieve an optimal balance between employees’ productivity, work habits and personal life has sparked numerous studies investigating work-life balance in recent years. Because very few previous studies have dealt with work-life balance in the man...

  14. Analysis Of Performance Factors Of Construction Management Consultant Affecting The Failure In Achieving Time And Quality Targets On Construction Project Of Samarinda Baru Airport

    Maryudi Utomo; Kustamar; Bambang Wedyantadji

    2017-01-01

    This research aims to determine the performance factors of construction management consultants affecting the failure in achieving time and quality targets on construction project of Samarinda Baru Airport. This research uses survey method by collecting respondents opinion experience and attitude by taking primary data from questionnaires and secondary data from related institutions. The results of the research are 1 Factors directly affecting the Time Target Y1 are the Understanding of Contra...

  15. Planning and execution of knowledge management assist missions for nuclear organizations

    2008-05-01

    problems. The IAEA is implementing a special subprogram on Nuclear Knowledge Management with a focus on the development of guidance for KM, on networking nuclear education and training and on the preservation of nuclear knowledge. Knowledge management consists of three fundamental components: people, processes and technology. Knowledge management focuses on people and organizational culture to stimulate and nurture the sharing and use of knowledge; on processes or methods to find, create, capture and share knowledge; and on technology to store and make knowledge accessible which will allow people to work together without being located together. People are the most important component. Managing knowledge depends upon people's willingness to share and reuse knowledge. In 2005, the IAEA introduced the concept of KM missions. The missions were established to: Facilitate the transfer of pragmatic KM methodologies and tools; Assist Member States considering implementation of nuclear power programmes to integrate KM in their management system from the very beginning; Provide specific consultancy services to address emergent problems and long term issues related to KM and associated issues; Assist organizations formulate detailed requirements and action plans related to KM; Help organizations identify, by self-assessment, their own KM maturity levels against a set of pre-defined criteria. This document is written to provide a common framework for KM missions and to provide general guidance for all mission participants. This document has been prepared to provide a basic structure and common reference for KM missions. As such, it is addressed, principally, to the team members of KM missions and also to the Counterpart requesting a mission. Although not mandatory, the guidelines provided in this document should be used as the basis for all future KM missions

  16. Radioactive Substances Act 1993. Explanatory document and draft authorisation prepared by the Environment Agency to Assist public consultation on application by Devonport Royal Dockyard Limited to dispose of radioactive wastes from Devonport Royal Dockyard Plymouth Devon

    2000-01-01

    The Environment Agency (the Agency) is the independent public body responsible for regulating the use of radioactive substances and accumulation and disposal of radioactive wastes in order to ensure protection of people and the environment. Anyone who is proposing activities involving the use of radioactive substances or disposal of radioactive waste must apply for permission from the Agency. In 1993, the Government decided to locate all nuclear submarine refit work at Devonport. This will lead to increased amounts of radioactive waste arisings at Devonport and a decreased amount of waste arisings at Rosyth, where refit work was also previously carried out. In May 2000 Devonport Royal Dockyard Limited (DML) applied to the Agency for a variation to its authorisations under the Radioactive Substances Act 1993 to dispose of gaseous, liquid, and solid radioactive wastes from its site at Devonport in Plymouth. Once the application was received, the Agency made the information publicly available and held a well attended public meeting in Plymouth to highlight the issues. Since then the Agency has required DML to provide additional information in support of its application. Six rounds of questions were asked and responded to, and these responses have also been made publicly available. The application and responses from the company have been made publicly available. The Agency is now consulting widely on this information to assist its decision making. This Explanatory Document and the accompanying draft authorisation has been prepared by the Agency to assist the consultation process. They are intended to help members of the public and other consultees to understand the application and the Agency's considerations so far. The consultation is being carried out to enable the public and other consultees to draw the Agency's attention to any matters they would wish it to consider when reaching its decisions on this application. The Agency has not made any decisions on the DML

  17. Consultation, communication, and conflict management by out-of-operating room anesthesiologists: strangers in a strange land.

    Caplan, Jason P; Querques, John; Epstein, Lucy A; Stern, Theodore A

    2009-03-01

    With anesthesiology increasingly practiced outside the operating room (OR) environment, it is important that anesthesiologists begin to identify and to teach the communication skills required for practice in non-OR general hospital settings. The "one back" position of the consultant, and the associated diminished sense of immediate control, can generate discomfort for many clinicians. This article discusses the literature regarding practice as a consultant and the navigation of conflict with an emphasis on how anesthesiologists might apply the findings to out-of-OR practice.

  18. Wartime Toxicology: Evaluation of a Military Medical Toxicology Telemedicine Consults Service to Assist Physicians Serving Overseas and in Combat (2005-2012)

    2014-04-22

    Afghanistan, poppies, and the global pain crisis . Med Sci Monit 16(3):RA49–RA57 7. Schmidt T, Lappan CM, Hospenthal DR, Murray CK (2011) Deployed provider...familiarity with opioid exposure. Sever- al consultations were regarding synthetic cannabinoids indi- cating some military personnel were attempting to use

  19. Neurogenic lower urinary tract dysfunction: Clinical management recommendations of the Neurologic Incontinence committee of the fifth International Consultation on Incontinence 2013.

    Drake, Marcus John; Apostolidis, Apostolos; Cocci, Andrea; Emmanuel, Anton; Gajewski, Jerzy B; Harrison, Simon C W; Heesakkers, John P F A; Lemack, Gary E; Madersbacher, Helmut; Panicker, Jalesh N; Radziszewski, Piotr; Sakakibara, Ryuji; Wyndaele, Jean Jacques

    2016-08-01

    Evidence-based guidelines for the management of neurological disease and lower urinary tract dysfunction have been produced by the International Consultations on Incontinence (ICI). These are comprehensive guidelines, and were developed to have world-wide relevance. To update clinical management of neurogenic bladder dysfunction from the recommendations of the fourth ICI, 2009. A series of evidence reviews and updates were performed by members of the working group. The resulting guidelines were presented at the 2012 meeting of the European Association of Urology for consultation, and consequently amended to deliver evidence-based conclusions and recommendations in 2013. The current review is a synthesis of the conclusions and recommendations, including the algorithms for initial and specialized management of neurogenic lower urinary tract dysfunction. The pathophysiology is categorized according to the nature of onset of neurological disease and the part(s) of the nervous system affected. Assessment requires clinical evaluation, general investigations, and specialized testing. Treatment primarily focuses on ensuring safety of the patient and optimizing quality of life. Symptom management covers conservative and interventional measures to aid urine storage and bladder emptying, along with containment of incontinence. A multidisciplinary approach to management is essential. The review offers a pragmatic review of management in the context of complex pathophysiology and varied evidence base. Neurourol. Urodynam. 35:657-665, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  20. Clinical Manifestations and Management of Left Ventricular Assist Device–Associated Infections

    Nienaber, Juhsien Jodi C.; Kusne, Shimon; Riaz, Talha; Walker, Randall C.; Baddour, Larry M.; Wright, Alan J.; Park, Soon J.; Vikram, Holenarasipur R.; Keating, Michael R.; Arabia, Francisco A.; Lahr, Brian D.; Sohail, M. Rizwan

    2013-01-01

    We report the clinical manifestations and management of continuous-flow left ventricular assist device (LVAD) infections from a large multicenter cohort. On the basis of these observations, a management algorithm is derived to assist clinical decision making for LVAD infection.

  1. 78 FR 5164 - Notice of Agricultural Management Assistance Organic Certification Cost-Share Program

    2013-01-24

    ...] Notice of Agricultural Management Assistance Organic Certification Cost-Share Program AGENCY... Departments of Agriculture for the Agricultural Management Assistance Organic Certification Cost-Share Program... organic certification cost-share funds. The AMS has allocated $1.425 million for this organic...

  2. 76 FR 55000 - Notice of Agricultural Management Assistance Organic Certification Cost-Share Program

    2011-09-06

    ...] Notice of Agricultural Management Assistance Organic Certification Cost-Share Program AGENCY... Departments of Agriculture for the Agricultural Management Assistance Organic Certification Cost-Share Program... organic certification cost-share funds. The AMS has allocated $1.5 million for this organic certification...

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

    Joseph Lampel; Ajay Bhalla; Kaivalya Vishnu

    2010-01-01

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

  4. Using Behavioral Interventions to Assist Children with Type 1 Diabetes Manage Blood Glucose Levels

    Lasecki, Kim; Olympia, Daniel; Clark, Elaine; Jenson, William; Heathfield, Lora Tuesday

    2008-01-01

    Treatment and management of chronic disease processes on children occurs across multiple settings, placing demands for consultation and expertise on school personnel, including school psychologists. One such chronic condition in children is type I diabetes. Children with type I insulin dependent diabetes mellitus exhibit high rates of…

  5. Postpartum women's perspectives of engaging with a dietitian and exercise physiologist via video consultations for weight managment: A qualitative evaluation

    Optimising weight status after childbirth is important. Video consultations are an unexplored opportunity to deliver real-time support to postpartum women to improve lifestyle behaviours. This study aims to provide insight into postpartum women's perspectives of engaging with a dietitian and exercis...

  6. The Efficacy of Consulting Practicum in Enhancing Students' Readiness for Professional Career in Management Information Systems: An Empirical Analysis

    Akpan, Ikpe Justice

    2016-01-01

    Consulting practicum (CP) is a form of experiential learning technique to prepare students for professional careers. While CP has become a popular way to help students acquire the essential practical skills and experience to enhance career readiness and ensure a smooth transition from college to employment, there is a lack of empirical studies…

  7. Postpartum womens perspectives of engaging with a dietitian and exercise physiologist via video consultations for weight management: A qualitative evaluation

    Optimising weight status after childbirth is important. Video consultations are an unexplored opportunity to deliver real-time support to postpartum women to improve lifestyle behaviours. This study aims to provide insight into postpartum women's perspectives of engaging with a dietitian and exercis...

  8. 15 CFR 923.57 - Continuing consultation.

    2010-01-01

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

  9. 13 CFR 124.701 - What is the purpose of the 7(j) management and technical assistance program?

    2010-01-01

    ...) Business Development Management and Technical Assistance Program § 124.701 What is the purpose of the 7(j... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false What is the purpose of the 7(j) management and technical assistance program? 124.701 Section 124.701 Business Credit and Assistance SMALL...

  10. A descriptive report of management strategies used by chiropractors, as reviewed by a single independent chiropractic consultant in the Australian workers compensation system

    de Luca Katie

    2009-11-01

    Full Text Available Abstract Background In New South Wales, Australia, an injured worker enters the workers compensation system with the case often managed by a pre-determined insurer. The goal of the treating practitioner is to facilitate the claimant to return to suitable duties and progress to their pre-injury status, job and quality of life. Currently, there is very little documentation on the management of injured workers by chiropractors in the Australian healthcare setting. This study aims to examine treatment protocols and recommendations given to chiropractic practitioners by one independent chiropractic reviewer in the state of New South Wales, and to discuss management strategies recommended for the injured worker. Methods A total of 146 consecutive Independent Chiropractic Consultant reports were collated into a database. Pain information and management recommendations made by the Independent Chiropractic Consultant were tabulated and analysed for trends. The data formulated from the reports is purely descriptive in nature. Results The Independent Chiropractic Consultant determined the current treatment plan to be "reasonable" (80.1% or "unreasonable" (23.6%. The consultant recommended to "phase out" treatment in 74.6% of cases, with an average of six remaining treatments. In eight cases treatment was unreasonable with no further treatment; in five cases treatment was reasonable with no further treatment. In 78.6% of cases, injured workers were to be discharged from treatment and 21.4% were to be reassessed for the need of a further treatment plan. Additional recommendations for treatment included an active care program (95.2%, general fitness program (77.4%, flexibility/range of movement exercises (54.1%, referral to a chronic pain specialist (50.7% and work hardening program (22.6%. Conclusion It is essential chiropractic practitioners perform 'reasonably necessary treatment' to reduce dependency on passive treatment, increase compliance to active

  11. Intégrer un interprète dans les consultations de médecine familiale : une analyse de discours assistée par ordinateur

    Yvan Leanza

    2014-12-01

    Full Text Available We set up a research to explore representations of working with interpreters among family physicians in Quebec City. Focus-groups (FGs with third year medical students (6, N= 22, residents (4, N= 29 and senior physicians (5, N= 47 were conducted. We made three video vignettes of interpreted medical consultations. Each FG was presented two of them which were separately discussed. Results show that vignettes and status did elicit different discourses. Students seem more preoccupied with the physician-patient relationship whereas seniors discuss more about information. Residents’ discourse point to identity formation issues. Results are discussed in light of Habermas’ communication theory.

  12. Development and Implementation of an Inpatient Otolaryngology Consultation Service at an Academic Medical Center.

    Huddle, Matthew G; London, Nyall R; Stewart, C Matthew

    2018-02-01

    To design and implement a formal otolaryngology inpatient consultation service that improves satisfaction of consulting services, increases educational opportunities, improves the quality of patient care, and ensures sustainability after implementation. This was a retrospective cohort study in a large academic medical center encompassing all inpatient otolaryngology service consultations from July 2005 to June 2014. Staged interventions included adding fellow coverage (July 2007 onward), intermittent hospitalist coverage (July 2010 onward), and a physician assistant (October 2011 onward). Billing data were collected for incidences of new patient and subsequent consultation charges. The 2-year preimplementation period (July 2005-June 2007) was compared with the postimplementation periods, divided into 2-year blocks (July 2007-June 2013). Outcome measures of patient encounters and work relative value units were compared between pre- and postimplementation blocks. Total encounters increased from 321 preimplementation to 1211, 1347, and 1073 in postimplementation groups ( P < 0.001). Total work relative value units increased from 515 preimplementation to 2090, 1934, and 1273 in postimplementation groups ( P < 0.001). A formal inpatient consultation service was designed with supervisory oversight by non-Accreditation Council for Graduate Medical Education fellows and then expanded to include intermittent hospitalist management, followed by the addition of a dedicated physician assistant. These additions have led to the formation of a sustainable consultation service that supports the mission of high-quality care and service to consulting teams.

  13. Lay Consultations in Heart Failure Symptom Evaluation.

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

    2017-01-01

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

  14. 13 CFR 124.704 - What additional management and technical assistance is reserved exclusively for concerns eligible...

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false What additional management and.../SMALL DISADVANTAGED BUSINESS STATUS DETERMINATIONS 8(a) Business Development Management and Technical Assistance Program § 124.704 What additional management and technical assistance is reserved exclusively for...

  15. Skills for Effective Consultation.

    Dustin, Dick; Ehly, Stewart

    1984-01-01

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

  16. Learning to consult with computers.

    Liaw, S T; Marty, J J

    2001-07-01

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

  17. 75 FR 50713 - Procedural Changes to the Fire Management Assistance Declaration Process

    2010-08-17

    ... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency 44 CFR Part 204 [Docket ID FEMA-2010-0036] RIN-1660-AA72 Procedural Changes to the Fire Management Assistance Declaration Process AGENCY: Federal Emergency Management Agency, DHS. ACTION: Final rule. SUMMARY: By this final rule, the...

  18. Energy saving consulting in Hamburg

    1982-10-01

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

  19. Interconsulta psicológica: demanda e assistência em hospital geral Interconsulta psicológica: demanda y asistencia en hospital general Consultation-liaison psychology: demand and assistance in general hospital

    Nátali Castro Antunes Santos

    2011-06-01

    Full Text Available A interconsulta psicológica no hospital geral representa uma modalidade de atendimento clínico e um instrumento metodológico utilizado pelo psicólogo na assistência ao paciente internado, mediante solicitação de outros profissionais da saúde. O estudo objetivou caracterizar a demanda da interconsulta psicológica em um hospital geral, a partir da análise dos registros de solicitação de atendimento. Cento e sete pacientes foram atendidos entre janeiro e junho de 2010, dos quais 53% eram do sexo masculino e 57% eram adultos acima de 45 anos. A maioria das solicitações foi realizada por médicos (44% e enfermeiros (38%, formalmente (59%, e mediante contato prévio entre interconsultor e solicitante (85%. Os principais motivos alegados para a solicitação da interconsulta foram sintomas psicológicos relacionados ao adoecimento (43% e identificação de comprometimento na adaptação do paciente à hospitalização (41%. O modelo de interconsulta psicológica adotado no contexto estudado foi adequado, havendo engajamento da equipe multiprofissional na efetivação da prática.La interconsulta psicológica en los hospitals generales representan una modalidad de clínica y una herramienta metodológica utilizada por los psicólogos en la atención hospitalaria del paciente, a petición de los profesionales de la salud. El objetivo del estudio fue caracterizar la demanda psicológica para referirlo a un hospital general, desde el análisis del servicio de solicitud de registros. Ciento siete pacientes fueron tratados entre enero y junio de 2010, siendo 53% hombres y 57% de los adultos mayores de 45 años. La mayoría de las solicitudes fueron realizadas por los médicos (44% y enfermeras (38%, de manera formal (59% y el contacto previo entre interconsultor y su interés (85%. Las razones principales de la solicitud de remisión fueron: síntomas psicológicos relacionados con la enfermedad (43% y la identificación de la deficiencia en la

  20. [Benefits of nursing care service in the assisted reproduction clinic to self-cycle-management and self-efficiency of infertility patients].

    Li, Xiao-Qin; Sun, Chao-Feng; Guo, Mei

    2017-06-01

    To investigate the benefits of nursing care service in the assisted reproduction clinic to self-cycle-management and self-efficiency of the outpatients with infertility. We randomly divided 600 females preliminarily diagnosed with infertility into a control and an experimental group, 288 in the former and 285 in the latter group excluding those whose husbands had azoospermia. For the women patients of the experimental group, we conducted nursing care intervention concerning related knowledge, skills, diet, excise, medication, and psychology, by one-to-one consultation, individualized or group communication, establishing files, telephone follow-up, and wechat guidance. After 3 months of intervention, we compared the compliance of medical visits, effectiveness of cycle management, sense of self-efficiency, satisfaction, and anxiety score between the two groups of patients. In comparison with the controls, the patients of the experimental group showed significantly better knowledge about assisted reproduction and higher effectiveness of self-cycle-management, self-efficiency, and satisfaction (P <0.05), but a markedly lower degree of anxiety (P <0.05). Nursing care service in the assisted reproduction clinic can improve the compliance of medical visits, effectiveness of self-cycle-management, self-efficiency, and satisfaction and reduce the anxiety of the patients.

  1. Report: EPA Needs an Agency-Wide Plan to Provide Tribal Solid Waste Management Capacity Assistance

    Report #11-P-0171, March 21, 2011. EPA cannot determine whether its efforts are assisting tribal governments in developing the capacity to manage solid waste or reduce the risks of open dumps in Indian country.

  2. The Organizational Communication Consulting Spectrum.

    Tubbs, Stewart L.

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

  3. Manager, Grant Administration | IDRC - International Development ...

    Assist Grant Administration Officers in the review of project approval ... Coordinate program staff training with respect to financial and administrative aspects of ... structure for the EFPs in consultation with Program Managers and the Chief, EFM.

  4. [Development and application of information management system for advanced schistosomiasis chemotherapy and assistance in Jiangxi Province].

    Mao, Yuan-Hua; Li, Dong; Ning, An; Qiu, Ling; Xiong, Ji-Jie

    2011-04-01

    To develop the information management system for advanced schistosomiasis chemotherapy and assistance in Jiangxi Province. Based on Access 2003, the system was programmed by Visual Basic 6.0 and packaged by Setup Factory 8.0. In the system, advanced schistosomiasis data were able to be input, printed, indexed, and statistically analyzed. The system could be operated and maintained easily and timely. The information management system for advanced schistosomiasis chemotherapy and assistance in Jiangxi Province is successfully developed.

  5. HomeNL: Homecare Assistance in Natural Language. An Intelligent Conversational Agent for Hypertensive Patients Management.

    Rojas Barahona , Lina Maria; Quaglini , Silvana; Stefanelli , Mario

    2009-01-01

    International audience; The prospective home-care management will probably of- fer intelligent conversational assistants for supporting patients at home through natural language interfaces. Homecare assistance in natural lan- guage, HomeNL, is a proof-of-concept dialogue system for the manage- ment of patients with hypertension. It follows up a conversation with a patient in which the patient is able to take the initiative. HomeNL pro- cesses natural language, makes an internal representation...

  6. La Matriz BCG (Boston Consulting Group para la Gestión de Publicaciones Periádicas The BCG (Boston Consulting Group matrix for management of periodic publications

    Mª del Pilar Serrano Gallardo

    2005-11-01

    Full Text Available El marketing documental se ha de encargar de satisfacer las necesidades informativas de los usuarios de forma rentable para ellos y para el centro; para ello se ha de partir de un conjunto de herramientas técnicas que se conocen como el Marketing - Mix, y que abarcan el Producto, el Precio, la Distribución y la Comunicación. Dentro de las herramientas destinadas al producto se encuentra la matriz BCG (Boston Consulting Group, que está orientada a gestión, sobre la base de la situación del producto en el mercado. El objetivo del presente artículo es proponer una matriz BCG para la gestión de una publicación periódica enfermera en nuestro mercado.La matriz BCG se construye con dos variables: el Crecimiento del Mercado y la Tasa Relativa del Mercado, las cuales se han operacionalizado como Media de Crecimiento Anual en el número de suscripciones de tres revistas enfermeras (Rol de Enfermería, Metas de Enfermería y Nursing durante el último quinquenio y Media de Tirada Actual de las tres publicaciones. Se han utilizado datos ofrecidos por la Oficina para el Control de la Difusión (OJD. La matriz BCG puede constituirse como herramienta básica en la gestión de publicaciones, dado que tras determinar la situación del producto, se pueden establecer estrategias que ayuden o favorezcan el mejor posicionamiento posible del producto en el mercado.Documentary marketing has to address the information needs of the users in a manner that is cost-effective not only for them but also for the institution. To do this, a set of technical tools, known as Marketing- Mix, need to be used. These tools include the Product, Price, Distribution and Communication. Within the set of tools used for the Product, we find the BCG matrix (Boston Consulting Group, a tool aimed at the management of the product on the basis of where it is positioned in the market. The objective of this paper is to propose a BCG matrix for the management of a nursing periodic

  7. EmmA, An Evolution Memory Management Assistant

    McCullough, Daryl

    2000-01-01

    .... EMMA differs from current project management tools in that it manages not only the system requirements that developers must satisfy, but also the context in which the developers develop the system...

  8. Final priority; Technical Assistance on State Data Collection--IDEA Data Management Center. Final priority.

    2014-08-05

    The Assistant Secretary for the Office of Special Education and Rehabilitative Services (OSERS) announces a priority under the Technical Assistance on State Data Collection program. The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2014 and later years. We take this action to fund a cooperative agreement to establish and operate an IDEA Data Management Center (Center) that will provide technical assistance (TA) to improve the capacity of States to meet the data collection requirements of the Individuals with Disabilities Education Act (IDEA).

  9. Differences in psychophysical well-being and signs of depression in couples undergoing their first consultation for assisted reproduction technology (ART): an Italian pilot study.

    Valoriani, Vania; Lotti, Francesco; Lari, Donatella; Miccinesi, Guido; Vaiani, Serena; Vanni, Claudia; Coccia, Maria Elisabetta; Maggi, Mario; Noci, Ivo

    2016-02-01

    The data we refer to belong to a longitudinal research project starting at the first contact of individual couples with the Infertility Unity; they were then followed-up till pregnancy or failure of treatments. The study aims at investigating in depth the emotional state of patients admitted for first consultation. Specifically, we investigated the emotional state of the two members of an infertile couple, considering also their biomedical and socio-demographic characteristics. This is a cross-sectional study evaluating a consecutive series of 309 couples, consulting for the first time our Infertility Unit for a multidisciplinary diagnostic evaluation in relation to their infertility. The multidisciplinary equip is composed of a gynaecologist, an andrologist and a clinical psychologist. Two standardized instruments were administered by the clinical psychologist to the two members of the couple: the Edinburgh Depression Scale (EDS) and the General Health Questionnaire-form 12 (GHQ-12), for screening of non-somatic signs of depression and psychophysical well-being, respectively. Couples were eligible for the study if they had not received any prior ART treatment in our Unit and were able to read and understand Italian. In addition, they had to agree to provide informed consent for the study. We obtained a response in 62% of all eligible couples. There were two major unexpected findings: Psychological and counselling services dedicated to ART should consider also socio-demographic data and always specifically consider gender differences, not only a couple's psychology and its dynamics. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. 42 CFR 493.1419 - Standard; Clinical consultant responsibilities.

    2010-10-01

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

  11. Anesthetic management of robot-assisted thoracoscopic thymectomy

    Anil Karlekar

    2016-01-01

    Full Text Available Myasthenia gravis (MG is a rare disorder involving neuromuscular junction. In conjunction with medical therapy, thymectomy is a known modality of treatment of MG and has shown to increase the probability of remission and overall symptomatic improvement. For minimally invasive thymectomy, video-.assisted thoracoscopic surgery has been the preferred surgical approach till recently. The robotic surgical procedure must necessarily bring new challenges to the anesthesiologists to effectively meet the specific requirements of the technique. At present, there is a paucity of literature regarding the anesthetic concerns of robotic assisted thymectomy, patient in question specifically posed a challenge since different maneuvers and techniques had to be tried to obtain optimum surgical conditions with stable ventilatory and hemodynamic parameters. Concerns of patient positioning and hemodynamic monitoring have also been discussed.

  12. 78 FR 52131 - Notice of Funds Availability: Agricultural Management Assistance Organic Certification Cost-Share...

    2013-08-22

    ...] Notice of Funds Availability: Agricultural Management Assistance Organic Certification Cost-Share Program... . SUPPLEMENTARY INFORMATION: This Organic Certification Cost-Share Program is part of the Agricultural Management... Wyoming. The AMS has allocated $1,352,850 for this organic certification cost- share program in Fiscal...

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

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

    2016-02-12

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

  14. Marker assisted selection and crop management for salt tolerance: A ...

    use

    2011-10-26

    Oct 26, 2011 ... Accepted 4 July, 2011. Salinity is one of the major abiotic constraints for crop management in irrigated as well as rainfed areas ... INTRODUCTION. Salt tolerance is ... arid and arid climates (Asch et al.,1997) in general, and.

  15. Using employee assistance programmes to achieve total quality management

    2012-01-01

    M.Comm. As global competition among organisations intensifies, it has become increasingly important for an organisation to identify and develop a competitive advantage over its rivals. Increasingly, as service quality and customer delight has caught the attention of managers, awareness is dawning on management that they depend on employees to communicate and deliver value to customers. Therefore, although organisations declare that customer is king, reality has dictated that often the cust...

  16. Developing a trust model for assisting management during change

    Nico Martins

    2000-06-01

    Full Text Available This study investigates the relation of the "Big Five" personality dimensions and managerial practices to the dimension of trust relationships between managers and employees. The "Big Five" dimensions are conscientiousness, agreeableness, emotional stability, resourcefulness and extraversion. Managerial practices are credibility, team management, information sharing and work support. Results indicate that managerial practices have an influence on the trust relationships between managers and employees. For the "Big Five" personality dimensions, a weaker relationship with the dimension of trust was obtained. Although there appears to be a weaker relationship between the "Big Five" and the dimension of trust relationships, the relatively good fit of the model indicates that an overall implication of the model is that both managerial practices and the "Big Five" personality aspects of the manager might influence his/her subordinates indirectly. These findings have numerous implications for the relationships between managers and employees, especially in the selection, recruitment and appointment of managers and the role of managers during transformation. Opsomming Die studie ondersoek die verhouding tussen die Groot Vyf ("Big Five" persoonlikheidsdimensies en bestuurspraktyke en die dimensie van vertroue tussen bestuur en werknemers. Die Groot Vyf dimensies is konsensieusheid, eenstemmigheid, emosionele stabiliteit, vernuftigheid en ekstroversie. Die bestuurspraktyke is kredietwaardigheid, spanbestuur, die deel van inligting en werksondersteuning. Die resultate dui aan dat die bestuurspraktyke 'n invloed het op die verhouding tussen bestuur en werknemers. Wat die Groot Vyf dimensies aanbetref, is n swakker verhouding met die dimensie van vertroue bevind. Alhoewel dit skyn as of daar n swakker verhouding tussen die Groot Vyf en die dimensie van vertroue is, toon die relatiewe goeie passing van die model dat beide die bestuurspraktyke en die Groot Vyf

  17. Managing brain metastases patients with and without radiotherapy: initial lessonsfrom a team-based consult service through a multidisciplinary integrated palliative oncology clinic.

    Jung, Hellen; Sinnarajah, Aynharan; Enns, Bert; Voroney, Jon-Paul; Murray, Alison; Pelletier, Guy; Wu, Jackson Sai-Yiu

    2013-12-01

    A new ambulatory consultative clinic with integrated assessments by palliative care, radiation oncology, and allied health professionals was introduced to (1) assess patients with brain metastases at a regional comprehensive cancer center and (2) inform and guide patients on management strategies, including palliative radiotherapy, symptom control, and end-of-life care issues. We conducted a quality assurance study to inform clinical program development. Between January 2011 and May 2012, 100 consecutive brain metastases patients referred and assessed through a multidisciplinary clinic were evaluated for baseline characteristics, radiotherapy use, and supportive care decisions. Overall survival was examined by known prognostic groups. Proportion of patients receiving end-of-life radiotherapy (death within 30 and 14 days of brain radiotherapy) was used as a quality metric. The median age was 65 years, with non-small cell lung cancer (n = 38) and breast cancer (n = 23) being the most common primary cancers. At least 57 patients were engaged in advance care planning discussions at first consult visit. In total, 75 patients eventually underwent brain radiotherapy, whereas 25 did not. The most common reasons for nonradiotherapy management were patient preference and rapid clinical deterioration. Overall survival for prognostic subgroups was consistent with literature reports. End-of-life brain radiotherapy was observed in 9 % (death within 30 days) and 1 % (within 14 days) of treated patients. By integrating palliative care expertise to address the complex needs of patients with newly diagnosed brain metastases, end-of-life radiotherapy use appears acceptable and improved over historical rates at our institution. An appreciable proportion of patients are not suitable for palliative brain radiotherapy or opt against this treatment option, but the team approach involving nurses, palliative care experts, allied health, and clinical oncologists facilitates

  18. Consultations for the management of radio physics and radiation processes; Consultas para la gestion de procesos de Radiofisica y Radioterapia

    Martinez, D.; Melchor, M.; Candela, F.; Camara, A.

    2011-07-01

    In the services of Radio Physics and Radiation Hospital has implemented an electronic patient data management, both of the treatment plan and the medical history of radiotherapy, so that we can exploit the advantages it brings to automate the analysis.

  19. Consultancy on Strategic Information Planning.

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

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

  20. Financial Management Regulation. Volume 15. Security Assistance Policy and Procedures

    1993-03-01

    as follows: (3). (5). (6). (7). (I). Qty, (4). SC/MOS/ Ofr Del Itm (2). Unit of Costs TA or Rel Trm Nbr Item Descriction issue (a) Unit (b) Total...the period rubber stamp or computer printing to: ended followed by an alphabetic management code assigned by SAAC. The management code 1. Notify the...EDIT DTC (1) 22 --- Validated it TBC is invalid. See TBC va’idation TYPE-ASST(1) 23 --- NO EDIT DOC- NBR -LST-8(8) 󈧜-27 --- NO EDIT DT-RQSN(4) DOC-SERIAL

  1. New developments in employee assistance programs.

    White, R K; McDuff, D R; Schwartz, R P; Tiegel, S A; Judge, C P

    1996-04-01

    Employee assistance programs have developed from alcoholism assessment and referral centers to specialized behavioral health programs. Comprehensive employee assistance programs are defined by six major components: identification of problems based on job performance, consultation with supervisors, constructive confrontation, evaluation and referral, liaison with treatment providers, and substance abuse expertise. Other services have been added as enhancements to the basic model and include managed behavioral health activities and professional assistance committees, which provide services for impaired professionals and executives. Recent developments in the field are illustrated through examples from the experience of the employee assistance program at the University of Maryland Medical System in Baltimore.

  2. Teaching Laboratory Management Principles and Practices Through Mentorship and Graduated Responsibility: The Assistant Medical Directorship.

    Hanley, Timothy; Sowder, Aleksandra M; Palmer, Cheryl Ann; Weiss, Ronald L

    2016-01-01

    With the changing landscape of medicine in general, and pathology in particular, a greater emphasis is being placed on laboratory management as a means of controlling spiraling medical costs and improving health-care efficiency. To meet this challenge, pathology residency programs have begun to incorporate formal laboratory management training into their curricula, using institutional curricula and/or online laboratory management courses offered by professional organizations. At the University of Utah, and its affiliated national reference laboratory, ARUP Laboratories, Inc, interested residents are able to supplement the departmental lecture-based and online laboratory management curriculum by participating in assistant medical directorship programs in one of several pathology subspecialty disciplines. The goals of many of the assistant medical directorship positions include the development of laboratory management skills and competencies. A survey of current and recent assistant medical directorship participants revealed that the assistant medical directorship program serves as an excellent means of improving laboratory management skills, as well as improving performance as a fellow and practicing pathologist.

  3. Capacity development for community health nurses in Pakistan: the assistant manager role.

    Gulzar, S A; Mistry, R; Upvall, M J

    2011-09-01

    Community health nurses (CHNs), as leaders in developing countries, can promote successful outcomes in meeting the targets of the Millennium Development Goals. A community-based organization in Pakistan is striving to achieve the goals of maternal and child health through the development of the assistant manager role for community health nursing. The purpose of this study was to assess the perception of the role of the CHN assistant manager, with the goal of strengthening that role. This interpretive, qualitative study included 13 participants already familiar with CHNs in Pakistan. Interviewing was utilized to explore perceptions of the assistant manager role and to uncover challenges currently existing within this new role. Content analysis revealed the following themes: 'role perceptions', 'expectations of the role' and 'collaboration with other community healthcare providers'. Changes to the role are necessary including increased education of the assistant manager CHNs and preparing administration to work with the assistant mangers for effective leadership. © 2011 The Authors. International Nursing Review © 2011 International Council of Nurses.

  4. Tribal Consultation Tracking System

    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...

  5. Ubiquitous consultation tool for decentral knowledge workers

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

    2003-01-01

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

  6. ARL/OMS Consultant Training Program.

    Euster, Joanne R.

    1982-01-01

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

  7. Bioethics Consultations and Resources

    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.

  8. 3 CFR - Tribal Consultation

    2010-01-01

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

  9. Increasing In-Service Teacher Implementation of Classroom Management Practices through Consultation, Implementation Planning, and Participant Modeling

    Hagermoser Sanetti, Lisa M.; Williamson, Kathleen M.; Long, Anna C. J.; Kratochwill, Thomas R.

    2018-01-01

    Numerous evidence-based classroom management strategies to prevent and respond to problem behavior have been identified, but research consistently indicates teachers rarely implement them with sufficient implementation fidelity. The purpose of this study was to evaluate the effectiveness of implementation planning, a strategy involving logistical…

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

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

    2015-05-01

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

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

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

    2015-01-01

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

  12. Fifteen minute consultation: A structured approach to the management of children and adolescents with medically unstable anorexia nervosa.

    Allison, Elizabeth; Dawson, Nicola; Phillips, Jane; Lynch, Catherine; Coleman, Jacinta

    2017-08-01

    Assessing and managing children who are underweight is an integral part of paediatric practice. Young people with anorexia nervosa (AN) are mainly cared for in the community by specialist eating disorder services. However, increasing numbers require admission to paediatric wards with medical instability due to the complications of starvation. Despite recommendations published in the junior MARSIPAN report in 2012, many paediatricians still feel poorly equipped to care for these high-risk patients. This article aims to provide a safe and structured approach to the assessment and management of children and adolescents with medically unstable AN. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  13. Use of film digitizers to assist radiology image management

    Honeyman-Buck, Janice C.; Frost, Meryll M.; Staab, Edward V.

    1996-05-01

    The purpose of this development effort was to evaluate the possibility of using digital technologies to solve image management problems in the Department of Radiology at the University of Florida. The three problem areas investigated were local interpretation of images produced in remote locations, distribution of images to areas outside of radiology, and film handling. In all cases the use of a laser film digitizer interfaced to an existing Picture Archiving and Communication System (PACS) was investigated as a solution to the problem. In each case the volume of studies involved were evaluated to estimate the impact of the solution on the network, archive, and workstations. Communications were stressed in the analysis of the needs for all image transmission. The operational aspects of the solution were examined to determine the needs for training, service, and maintenance. The remote sites requiring local interpretation included were a rural hospital needing coverage for after hours studies, the University of Florida student infirmary, and the emergency room. Distribution of images to the intensive care units was studied to improve image access and patient care. Handling of films originating from remote sites and those requiring urgent reporting were evaluated to improve management functions. The results of our analysis and the decisions that were made based on the analysis are described below. In the cases where systems were installed, a description of the system and its integration into the PACS system is included. For all three problem areas, although we could move images via a digitizer to the archive and a workstation, there was no way to inform the radiologist that a study needed attention. In the case of outside films, the patient did not always have a medical record number that matched one in our Radiology Information Systems (RIS). In order to incorporate all studies for a patient, we needed common locations for orders, reports, and images. RIS orders

  14. Left ventricular assist device management in patients chronically supported for advanced heart failure.

    Cowger, Jennifer; Romano, Matthew A; Stulak, John; Pagani, Francis D; Aaronson, Keith D

    2011-03-01

    This review summarizes management strategies to reduce morbidity and mortality in heart failure patients supported chronically with implantable left ventricular assist devices (LVADs). As the population of patients supported with long-term LVADs has grown, patient selection, operative technique, and patient management strategies have been refined, leading to improved outcomes. This review summarizes recent findings on LVAD candidate selection, and discusses outpatient strategies to optimize device performance and heart failure management. It also reviews important device complications that warrant close outpatient monitoring. Managing patients on chronic LVAD support requires regular patient follow-up, multidisciplinary care teams, and frequent laboratory and echocardiographic surveillance to ensure optimal outcomes.

  15. Photon management assisted by surface waves on photonic crystals

    Angelini, Angelo

    2017-01-01

    This book illustrates original pathways to manipulate light at the nanoscale by means of surface electromagnetic waves (here, Bloch surface waves, BSWs) on planar dielectric multilayers, also known as one-dimensional photonic crystals. This approach is particularly valuable as it represents an effective alternative to the widely exploited surface plasmon paradigm. After a brief overview on the fundamentals of BSWs, several significant applications of BSW-sustaining structures are described. Particular consideration is given to the propagation, guiding, and diffraction of BSW-coupled radiation. Further, the interaction of organic emitters with BSWs on planar and corrugated multilayers is investigated, including fluorescence beaming in free space. To provide greater insight into sensing applications, an illustrative example of fluorescent microarray-based detection is presented. The book is intended for scientists and researchers working on photon management opportunities in fields such as biosensing, optical c...

  16. The impact on the workload of the Ward Manager with the introduction of administrative assistants.

    Locke, Rachel; Leach, Camilla; Kitsell, Fleur; Griffith, Jacki

    2011-03-01

    To evaluate the impact on the workload of the Ward Manager (WM) with the introduction of administrative assistants into eight trusts in the South of England in a year-long pilot. Ward Managers are nurse leaders who are responsible for ward management and delivering expert clinical care to patients. They have traditionally been expected to achieve this role without administrative assistance. Meeting the workload demands of multiple roles and overload has meant the leadership and clinical role has suffered, presenting issues of low morale among existing WMs and issues of recruiting the next generation of WMs. Sixty qualitative interviews were carried out with 16 WMs, 12 Ward Manager Assistants (WMAs), and six senior nurse executives about the impact of the introduction of the WMA post. Quantitative data to measure change in WM workload and ward activity was supplied by 24 wards. Ward Managers reported spending reduced time on administrative tasks and having increased time available to spend on the ward with patients and leading staff. With the introduction of WMAs, there was also improvement in key performance measures (the maintenance of quality under service pressures) and increased staff motivation. There was overwhelming support for the introduction of administrative assistants from participating WMs. The WMAs enabled WMs to spend more time with patients and, more widely, to provide greater support to ward teams. The success of the pilot is reflected in wards working hard to be able to extend contracts of WMAs. The extent of the success is reflected in wards that were not participants in the pilot, observing the benefits of the post, having worked to secure funding to recruit their own WMAs. The widespread introduction of administrative assistance could increase ward productivity and provide support for clinical leaders. Continuing professional development for WMs needs to incorporate training about management responsibilities and how to best use administrative

  17. National water management in the Republic of South Africa — Towards a consultative partnership with diverse users in a semi-arid country

    Conley, Alan H.; Midgley, Desmond C.

    1988-07-01

    A resourceful holistic water management strategy has been developed for ensuring equitable provision of adequate quantities of water of satisfactory quality at acceptable risk and affordable cost to a wide international range of competing user groups subject to adverse physical and hydrological factors and under rapidly changing social conditions. Scarce resource allocation strategies, based on scientific studies and supported by modern data processing facilities, focus primarily on supply, demand and quality. Supply management implies creation of the best combination of affordable elements of infrastructure for bulk water supplies from available runoff, groundwater, re-use, imports and unconventional sources, sized to meet determinable requirements with appropriate degrees of assurance, coupled with continuous optimization of system operation. Demand management seeks optimum allocation of available supplies to towns, power generation, industry, mining, agriculture, forestry, recreation and ecology, according to priority criteria determined from scientific, economic and socioeconomic studies. Quality management strategies relate to the control of salination, eutrophication and pollution from both diffuse and point sources. As the combined demands of complex First and Third World societies and economies on the available resources rise, increasing attention has to be paid to finding practical compromises to facilitate handling of conflict between legitimate users having widely divergent interests, aspirations and levels of sophistication. For optimum joint utilization, the central regulating authority is striving to forge a consultative partnership within which to promote, among the widest possible spectrum of users, enlightened understanding of the opportunities and limitations in handling complex international, social, political, legal, economic and financial issues associated with water development. These cannot readily be resolved by the methods of traditional

  18. Medical Assistant-based care management for high risk patients in small primary care practices

    Freund, Tobias; Peters-Klimm, Frank; Boyd, Cynthia M.

    2016-01-01

    Background: Patients with multiple chronic conditions are at high risk of potentially avoidable hospital admissions, which may be reduced by care coordination and self-management support. Medical assistants are an increasingly available resource for patient care in primary care practices. Objective......: To determine whether protocol-based care management delivered by medical assistants improves patient care in patients at high risk of future hospitalization in primary care. Design: Two-year cluster randomized clinical trial. Setting: 115 primary care practices in Germany. Patients: 2,076 patients with type 2......, and monitoring delivered by medical assistants with usual care. Measurements: All-cause hospitalizations at 12 months (primary outcome) and quality of life scores (Short Form 12 Health Questionnaire [SF-12] and the Euroqol instrument [EQ-5D]). Results: Included patients had, on average, four co-occurring chronic...

  19. Traffic Steering Framework for Mobile-Assisted Resource Management in Heterogeneous Networks

    Dogadaev, Anton Konstantinovich; Checko, Aleksandra; Popovska Avramova, Andrijana

    2013-01-01

    With the expected growth of mobile data traffic it is essential to manage the network resources efficiently. In order to undertake this challenge, we propose a framework for network-centric, mobile-assisted resource management, which facilitates traffic offloading from mobile network to Wi-Fi...... to the network backbone. What is more, we give an overview of existing standardization activities on offloading the mobile traffic through Wi-Fi....

  20. The DISAM Journal of International Security Assistance Management. Volume 23, Number 1, Fall 2000

    2000-01-01

    Security Assistance Command Figure 1 The USASAC, including OPM-SANG, is staffed by 621 men and women , of whom 104 are military. These professionals are...by program managers. These program managers are like “front-line entreprenuers ” delivering products and services to their customers. They have been...NATO history was to be commanded by a Polish general in June 1988. The brigade of some 3000 men and women was composed of five national battalions

  1. Beating Obesity: Factors Associated with Interest in Workplace Weight Management Assistance in the Mining Industry

    Tamara D. Street

    2017-03-01

    Conclusion: Weight management programs should provide information, motivation. and trouble-shooting assistance to meet the needs of at-risk mining employees, including those who are attempting to change and maintain behaviors to achieve a healthy weight and be suitably fit for work.

  2. VEHIL: a test facility for validation of fault management systems for advanced driver assistance systems

    Gietelink, O.J.; Ploeg, J.; Schutter, de B.; Verhaegen, M.H.

    2004-01-01

    We present a methodological approach for the validation of fault management systems for Advanced Driver Assistance Systems (ADAS). For the validation process the unique VEHIL facility, developed by TNO Automotive and currently situated in Helmond, The Netherlands, is applied. The VEHIL facility

  3. State forestry agency perspectives on carbon management and carbon market assistance to family forest owners

    Kristell A. Miller; Stephanie A. Snyder; Michael A. Kilgore

    2015-01-01

    Family forest owners within the United States could potentially make significant contributions to sequestration efforts. However, we expect that landowners will need assistance if they are to successfully implement carbon management techniques and/or navigate through complex carbon market requirements. State forestry agencies were surveyed to gather their perspectives...

  4. Retention Rates, Graduates, and LAM-Series Completers for the Legal Assistant Management Program.

    Hamilton, John

    In February 1996, Gainesville College, in Georgia, conducted a study of students in its Legal Assistant Management (LAM) Program to determine retention rates, numbers of graduates, and course pass rates. Retention and graduation rates were calculated for 175 students who enrolled in at least one LAM course from spring 1991 to fall 1995. In…

  5. Assisting community management of groundwater: Irrigator attitudes in two watersheds in Rajasthan and Gujarat, India

    Varua, M. E.; Ward, J.; Maheshwari, B.; Oza, S.; Purohit, R.; Hakimuddin; Chinnasamy, P.

    2016-06-01

    The absence of either state regulations or markets to coordinate the operation of individual wells has focussed attention on community level institutions as the primary loci for sustainable groundwater management in Rajasthan and Gujarat, India. The reported research relied on theoretical propositions that livelihood strategies, groundwater management and the propensity to cooperate are associated with the attitudinal orientations of well owners in the Meghraj and Dharta watersheds, located in Gujarat and Rajasthan respectively. The research tested the hypothesis that attitudes to groundwater management and farming practices, household income and trust levels of assisting agencies were not consistent across the watersheds, implying that a targeted approach, in contrast to default uniform programs, would assist communities craft rules to manage groundwater across multiple hydro-geological settings. Hierarchical cluster analysis of attitudes held by survey respondents revealed four statistically significant discrete clusters, supporting acceptance of the hypothesis. Further analyses revealed significant differences in farming practices, household wealth and willingness to adapt across the four groundwater management clusters. In conclusion, the need to account for attitudinal diversity is highlighted and a framework to guide the specific design of processes to assist communities craft coordinating instruments to sustainably manage local aquifers described.

  6. Management of the assisted instruction environment in economic higher education

    Adriana REVEIU

    2006-01-01

    Full Text Available The world has entered the Knowledge Age. Information Technology is gradually turning the world into an Information Highway Network. The development of technology has greatly accelerated the international flow of information, capital and commodities and speeded the growth of economic integration. At the same time, the cycle of technological development and commercialization is becoming shorter and shorter [Zhouying, 1999]. Information technology is bringing rapid and profound changes to higher education, as it has to virtually every process in our society. Productivity often suffers because is difficult and timeconsuming to conduct a team effort. A portal solution base on SharePoint Portal Server can greatly facilitate the process of bringing knowledge teachers together as a team to achieve educational goals by providing a single point to access: automated essential day-to-day email communication, management of contacts, calendars, and instant messages, shared facilities to allow small teams of teachers to contribute to team and project-focused Web site, track tasks and events, shortened web-publishing cycles by linking collaboration and publishing processes.

  7. How can laparoscopic management assist radiation treatment in cervix carcinoma?

    Gerbaulet, A.; Lartigau, E.; Haie-Meder, C.; Castaigne, D.; Morice, P.; Breton, C.; Pautier, P.; Duvillard, P.

    1999-01-01

    Purpose: To determine the role of laparoscopic lymphadenectomy (pelvis ± para-aortic nodes) and laparoscopic hysterectomy in cervical cancer compared to 'classic radical surgery' in patients undergoing surgery in comparison with modern imaging in patients treated with radiotherapy alone.Materials and methods: The limitations of modern imaging are presented as well as how complication rates can be increased when classic laparotomy is followed by radiation therapy.Laparoscopic procedures are described with particular emphasis on how to provide information on lymph node metastases with the risk of overlooking microscopic involvement. A number of clinical experiences are cited to illustrate this problem and show how treatment approaches can be adapted.Results: The role of laparoscopy is evaluated according to different clinical situations and treatment protocols emphasizing the possibilities offered by this method to the radiotherapist. Conclusion: When developing laparoscopic techniques for the management of cervical carcinoma, caution must be exercised to ensure that these techniques are not detrimental to the prognosis. (Copyright (c) 1999 Elsevier Science B.V., Amsterdam. All rights reserved.)

  8. Animal-assisted therapy at an outpatient pain management clinic.

    Marcus, Dawn A; Bernstein, Cheryl D; Constantin, Janet M; Kunkel, Frank A; Breuer, Paula; Hanlon, Raymond B

    2012-01-01

    The objective of this study was to evaluate the effects of brief therapy dog visits to an outpatient pain management facility compared with time spent in a waiting room. The design of this study is open-label. Setting.  This study was conducted in a university tertiary care adult chronic pain outpatient clinic. The subjects of this study include outpatients, adults accompanying outpatients to their appointments, and clinic staff. Intervention.  Participants were able to spend clinic waiting time with a certified therapy dog instead of waiting in the outpatient waiting area. When the therapy dog was not available, individuals remained in the waiting area. Self-reported pain, fatigue, and emotional distress were recorded using 11-point numeric rating scales before and after the therapy dog visit or waiting room time. Two hundred ninety-five therapy dog visits (235 with patients, 34 family/friends, and 26 staff) and 96 waiting room surveys (83 from patients, 6 family/friends, and 7 staff) were completed over a 2-month study period. Significant improvements were reported for pain, mood, and other measures of distress among patients after the therapy dog visit but not the waiting room control, with clinically meaningful pain relief (decrease ≥2 points) in 23% after the therapy dog visit and 4% in the waiting room control. Significant improvements were likewise seen after therapy dog visits for family/friends and staff. Therapy dog visits in an outpatient setting can provide significant reduction in pain and emotional distress for chronic pain patients. Therapy dog visits can also significantly improve emotional distress and feelings of well-being in family and friends accompanying patients to appointments and clinic staff. Wiley Periodicals, Inc.

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

    Sibarani, Roza Marsaulina

    2014-01-01

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

  10. "Sorry Can You Speak It in English with Me?" Managing Routines in Lingua Franca Doctor--Patient Consultations in a Diabetes Clinic

    Martin, Gillian S.

    2015-01-01

    Research on the routines of doctor-patient consultations has been conducted in language and culture concordant dyads and in dyads where either doctor or patient uses a foreign language; yet there is an absence of scholarly engagement with consultations where both participants are using a foreign language. In seeking to address this gap, this…

  11. Conservative management for female urinary incontinence and pelvic organ prolapse review 2013: Summary of the 5th International Consultation on Incontinence.

    Dumoulin, Chantale; Hunter, Kathleen F; Moore, Katherine; Bradley, Catherine S; Burgio, Kathryn L; Hagen, S; Imamura, M; Thakar, R; Williams, K; Chambers, T

    2016-01-01

    The objective of the 5th International Consultation on Incontinence (ICI) chapter on Adult Conservative Management was to review and summarize the new evidence on conservative management of urinary incontinence (UI) and pelvic organ prolapse (POP) in order to compile a current reference source for clinicians, health researchers, and service planners. In this paper, we present the review highlights and new evidence on female conservative management. Revision and updates of the 4th ICI Report using systematic review covering years 2008-2012. Each section begins with a brief definition and description of the intervention followed by a summary, where possible, of both the state and level of evidence for prevention and treatment, and ends with a "grade of recommendation." The paper concludes with areas identified as requiring further research. For UI, there are no prevention trials on lifestyle interventions. There are, however, few new intervention trials of lifestyle interventions involving weight loss and fluid intake with improved levels of evidence and grade of recommendation. Outside of pre- and post-natal pelvic floor muscle training (PFMT) trials for the prevention of female UI, there is a dearth of PFMT prevention trials for women with UI. PFMT remains the first-line treatment for female UI with high levels of evidence and grades of recommendation. Bladder training levels of evidence and grades of recommendation are maintained. For POP, new evidence supports the effectiveness of physiotherapy in the treatment of POP and there are now improved levels of evidence and grades of recommendation. Neurourol. Urodynam. 35:15-20, 2016. © 2014 Wiley Periodicals, Inc. © 2014 Wiley Periodicals, Inc.

  12. Fault-tolerance of Cluster Management in (MANETs) by assistant and mobile agents

    Hamad, H.

    2007-01-01

    Most researches today trend to clustering in ad hoc networks as a solution to the management problem in flat ad hoc networks. Clustering aims to choose suitable nodes to lead the network i.e., the cluster heads. When a cluster head fails, reclustering is needed. However, this will be costly due to the characteristics of the ad hoc networks such as mobility and exhaustion. In this research we developed a fault tolerance mechanism to avoid re-clustering and other drawbacks that result from loosing the Cluster Head (CH). A Mobile Agent (MA) will be responsible of carrying out the jobs of the CH i.e., the CH will host the MA which will be the real manager of the cluster. Furthermore, the closest node to the CH will be chosen as an assistant and the MA will update the assistant. Each of the CH and the assistant will have Remote Objects (RO) to communicate with each other. The main jobs of the assistant are to temporarily replace the CH when fails; then it will choose the next CH based on clustering algorithm. Simulation results show an enhancement of the performance of using an assistant, MA and RO. (author)

  13. 78 FR 63974 - Student Assistance General Provisions-Subpart K-Cash Management; Extension of Public Comment...

    2013-10-25

    ... DEPARTMENT OF EDUCATION Student Assistance General Provisions--Subpart K--Cash Management... an information collection entitled, ``Student Assistance General Provisions--Subpart K--Cash Management''. ED is extending the comment period to November 18, 2013 due to the public's inability to access...

  14. Total Isolation Status Monitoring and Management System by CAD Assisted Technology

    Nakamura, Masaaki

    1995-01-01

    Isolation tasks in a nuclear power station require high confidence and quick response particularly during the annual inspection when the equipment must be checked in a safe and planned manner. To realize these advanced isolation works, JAPC has developed TOtal Isolation Status Monitoring and Management System using CAD Assisted Technology. This system, TOMM-CAT, developed under the concept of 'User friendly advanced man-machine interface', allows planning and management to be performed on a CRT display. TOMM-CAT allows isolation tasks to be performed accurately and efficiently in conjunction with equipment information from the existing Job Order Management System, which runs on the station host computer. (author)

  15. The art of consultation

    Kulwant S Bhangoo

    2014-01-01

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

  16. The art of consultation.

    Bhangoo, Kulwant S

    2014-05-01

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

  17. Beating Obesity: Factors Associated with Interest in Workplace Weight Management Assistance in the Mining Industry.

    Street, Tamara D; Thomas, Drew L

    2017-03-01

    Rates of overweight and obese Australians are high and continue to rise, putting a large proportion of the population at risk of chronic illness. Examining characteristics associated with preference for a work-based weight-loss program will enable employers to better target programs to increase enrolment and benefit employees' health and fitness for work. A cross-sectional survey was undertaken at two Australian mining sites. The survey collected information on employee demographics, health characteristics, work characteristics, stages of behavior change, and preference for workplace assistance with reaching a healthy weight. A total of 897 employees participated; 73.7% were male, and 68% had a body mass index in the overweight or obese range. Employees at risk of developing obesity-related chronic illnesses (based on high body mass index) were more likely to report preference for weight management assistance than lower risk employees. This indicates that, even in the absence of workplace promotion for weight management, some at risk employees want workplace assistance. Employees who were not aware of a need to change their current nutrition or physical activity behaviors were less likely to seek assistance. This indicates that practitioners need to communicate the negative effects of excess weight and promote the benefits of a healthy lifestyle to increase the likelihood of weight management. Weight management programs should provide information, motivation. and trouble-shooting assistance to meet the needs of at-risk mining employees, including those who are attempting to change and maintain behaviors to achieve a healthy weight and be suitably fit for work.

  18. A guide to defining the competence required of a consultant in clinical chemistry and laboratory medicine.

    Beastall, Graham; Kenny, Desmond; Laitinen, Paivi; ten Kate, Joop

    2005-01-01

    A definition has been agreed for the most senior professional (consultant) in clinical chemistry and laboratory medicine. A model job description for a consultant has been determined, which is intended to act as a toolkit to assist employing authorities and professional bodies to define the role of individual consultant posts. A total of 86 competences for a consultant have been designated and expressed in the form of simple generic proficiency standards. These competences have been allocated to six broad areas: clinical [13]; scientific [15]; technical [12]; communication [12]; management and leadership [20]; professional autonomy and accountability [14]. The competences are intended to be illustrative rather than definitive and to enable the duties of any consultant post to be defined. Assessment of competence is likely to entail consideration of qualifications, registration status, continuing professional development and performance review. The project is intended as a guide to European societies of clinical chemistry and laboratory medicine. The guide should be capable of local interpretation to encourage a greater degree of commonality in the role of the consultant whilst protecting national identity. The guide should stimulate international understanding and collaboration and contribute to an overall improvement in the quality of practice.

  19. Analysis Of Performance Factors Of Construction Management Consultant Affecting The Failure In Achieving Time And Quality Targets On Construction Project Of Samarinda Baru Airport

    Maryudi Utomo

    2017-11-01

    Full Text Available This research aims to determine the performance factors of construction management consultants affecting the failure in achieving time and quality targets on construction project of Samarinda Baru Airport. This research uses survey method by collecting respondents opinion experience and attitude by taking primary data from questionnaires and secondary data from related institutions. The results of the research are 1 Factors directly affecting the Time Target Y1 are the Understanding of Contract Document X1 Material Requirements X3 Worker Requirements X4 and Equipment Completeness X5 while factors indirectly affecting the Time Target Y1 are the Understanding of Technical Specifications X2 and Local Government Regulations X7 2 Factors directly affecting the Quality Target Y2 are the Understanding of Contract Document X1 the Understanding of Technical Specifications X2 Material Requirements X3 Worker Requirements X4 Equipment Completeness X5 and Time Target Y1 while factor indirectly affecting the Quality Target Y1 is Local Government Regulations X7 3 The most dominant factor affecting the unsuccessful Time Target Y1 is the Worker Requirements X4 with the path coefficient value of 0.431. While the most dominant factor affecting the unsuccessful Quality Target Y2 is Worker Requirements X4 with path coefficient value of 0.579 4.

  20. Inpatient Consultative Dermatology.

    Biesbroeck, Lauren K; Shinohara, Michi M

    2015-11-01

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

  1. Uruguay; 2011 Article IV Consultation

    International Monetary Fund

    2011-01-01

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

  2. Consultancy and innovation the business service revolution in Europe

    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.

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

    Hayes, Marie; Stringer, Phil

    2016-01-01

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

  4. Laparoscopy-Assisted Cystectomy: Management of a Large Ovarian Cyst with Torsion

    Emin Üstunyurt

    2013-04-01

    Full Text Available Ovarian cysts are the most common cause of pelvic masses in women. Although laparoscopic surgery is considered the gold standard treatment for ovarian cysts, most of the large ovarian cysts continue to be treated by laparotomy due to technical difficulties. Laparoscopic-assisted cystectomy is an alternative operation type for managing such cases. A case of large ovarian cyst with adnexal torsion in a 21-year-old virgin patient is presented in this report. In this case laparoscopic-assisted cystectomy was performed without intraoperatif complication. Postoperative course was uneventful. Pathology revealed a benign serous cystadenoma. At 6 months follow up, she continued to be asymptomatic, and sonography showed no recurrence of her disease. Laparoscopic-assisted cystectomy is a safe and effective procedure for large adnexal cysts.

  5. Services of strategic consulting: special features and types

    Klenin Oleh Volodymyrovych

    2016-09-01

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

  6. Diamond knife-assisted deep anterior lamellar keratoplasty to manage keratoconus.

    Vajpayee, Rasik B; Maharana, Prafulla K; Sharma, Namrata; Agarwal, Tushar; Jhanji, Vishal

    2014-02-01

    To evaluate the outcomes of a new surgical technique, diamond knife-assisted deep anterior lamellar keratoplasty (DALK), and compare its visual and refractive results with big-bubble DALK in cases of keratoconus. Tertiary eyecare hospital. Comparative case series. The visual and surgical outcomes of diamond knife-assisted DALK were compared with those of successful big-bubble DALK. Diamond knife-assisted DALK was performed in 19 eyes and big-bubble DALK, in 11 eyes. All surgeries were completed successfully. No intraoperative or postoperative complications occurred with diamond knife-assisted DALK. Six months after diamond knife-assisted DALK, the mean corrected distance visual acuity (CDVA) improved significantly from 1.87 logMAR ± 0.22 (SD) to 0.23 ± 0.06 logMAR, the mean keratometry improved from 65.99 ± 8.86 diopters (D) to 45.13 ± 1.16 D, and the mean keratometric cylinder improved from 7.99 ± 3.81 D to 2.87 ± 0.59 D (all P=.005). Postoperatively, the mean refractive astigmatism was 2.55 ± 0.49 D and the mean spherical equivalent was -1.97 ± 0.56 D. The mean logMAR CDVA (P = .06), postoperative keratometry (P=.64), refractive cylinder (P=.63), and endothelial cell loss (P=.11) were comparable between diamond knife-assisted DALK and big-bubble DALK. Diamond knife-assisted DALK was effective and predictable as a surgical technique for management of keratoconus cases. This technique has the potential to offer visual and refractive outcomes comparable to those of big-bubble DALK. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  7. Making consultations run smoothly

    Jespersen, Astrid Pernille; Elgaard Jensen, Torben

    2012-01-01

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

  8. The Dream Consultant

    Muhr, Sara Louise; Kirkegaard, Line

    2013-01-01

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

  9. Classification and management of gynecomastia: defining the role of ultrasound-assisted liposuction.

    Rohrich, Rod J; Ha, Richard Y; Kenkel, Jeffrey M; Adams, William P

    2003-02-01

    Gynecomastia, or excessive male breast development, has an incidence of 32 to 65 percent in the male population. This condition has important physical and psychological impacts. Advances in elucidating the pathophysiology of gynecomastia have been made, though understanding remains limited. Recommendations for evaluation and workup have varied and are often arbitrary. A diagnostic algorithm is suggested, with emphasis on a comprehensive history, physical examination, and minimizing unnecessary diagnostic testing. Medical management has had limited success; surgical therapy, primarily through excisional techniques, has been the accepted standard. Although effective, excisional techniques subject patients to large, visible scars. Ultrasound-assisted liposuction has recently emerged as a safe and effective method for the treatment of gynecomastia. It is particularly efficient in the removal of the dense, fibrous male breast tissue while offering advantages in minimal external scarring. A new system of classification and graduated treatment is proposed, based on glandular versus fibrous hypertrophy and degree of breast ptosis (skin excess). The authors' series of 61 patients with gynecomastia from 1987 to 2000 at the University of Texas Southwestern Department of Plastic Surgery demonstrated an overall success rate of 86.9 percent using suction-assisted lipectomy (1987 to 1997) and ultrasound-assisted liposuction (1997 to 2000). The authors have found ultrasound-assisted liposuction to be effective in treating most grades of gynecomastia. Excisional techniques are reserved for severe gynecomastia with significant skin excess after attempted ultrasound-assisted liposuction.

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

    Eichman, Caroline

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

  11. GP registrar consultations addressing menopause-related symptoms: a cross-sectional analysis.

    De Giovanni, Jasmine M; Tapley, Amanda; Druce, Penny L; Davey, Andrew R; van Driel, Mieke L; Henderson, Kim M; Catzikiris, Nigel F; Mulquiney, Katie J; Morgan, Simon; Spike, Neil A; Kerr, Rohan H; Magin, Parker J

    2018-05-01

    To investigate the prevalence and associations of general practitioner registrars' (trainees') management of women with menopause-related symptoms. A cross-sectional analysis from the Registrar Clinical Encounters in Training (ReCEnT) cohort study. In ReCEnT registrars collected data of 60 consecutive consultations on three occasions during training. The outcome factor was menopause-related problems/diagnoses (compared with other problems/diagnoses). Associations of registrar, patient, practice, and consultation-independent variables were assessed by univariate and multivariable logistic regression. In all, 1,333 registrars conducted 189,774 consultations involving 295,017 problems/diagnoses. Of these, there were 1,291 problems/diagnoses (0.44% of all problems/diagnoses) relating to menopause. Significant multivariable independent associations of a problem being menopause-related were registrar female sex (odds ratio [OR] 2.74, 95% confidence interval [CI] 2.30-3.26) and registrars working part-time (OR 0.84, 95% CI 0.72-0.98 for full-time work). Consultation-related associations included an increased number of problems addressed in the consultation (OR 1.29, 95% CI 1.21-1.37), and menopause-related problems/diagnoses not being new (OR 0.75, 95% CI 0.66-0.86). Significant educational associations were increased odds of recourse to in-consultation sources of information or assistance (OR 2.09, 95% CI 1.80-2.44) and of generating learning goals (OR 3.15, 95% CI 2.66-3.72). Registrars seek more assistance and further knowledge about menopause compared with other problems. Thus, they may find the area particularly challenging and could benefit from further education regarding managing menopause. Our findings may help inform the design of measures aimed at improving the delivery of menopause training for general practice registrars.

  12. Fiberoptic endoscopic-assisted diverticulotomy: a novel technique for the management of Zenker's diverticulum.

    Altman, Jason I; Genden, Eric M; Moche, Jason

    2005-05-01

    Endoscopic diverticulotomy is rapidly becoming the procedure of choice for treatment of Zenker's diverticulum. The endoscopic approach has resulted in significant decreases in patient morbidity, time to resumption of oral intake, and overall cost as compared with open treatment. However, a small but significant patient population is unable to accommodate the rigid laryngoscope and therefore requires open treatment. We present a novel technique, flexible fiberoptic endoscopic-assisted diverticulotomy, for the management of patients who are unable to undergo rigid endoscopy.

  13. The DISAM Journal of International Security Assistance Management. Volume 23, Number 3, Spring 2001

    2001-01-01

    there are rights and freedoms to which every human is entitled, no matter where he or she lives. In this issue we offer the introduction to the report...Assistance Management INTRODUCTION The last DISAM Journal, Winter 2000/2001 Edition, provided an extensive description and analysis of the numerous...FY2001 Country/Program by ESF Budget ESF Geographical Region Funding Request Funding Partnerships to Eliminate Sweatshops 4.000 5.000 3.986 Environmental

  14. Diode laser and periodontal regeneration-assisted management of implant complications in anterior maxilla

    Sanjeev Kumar Salaria

    2018-01-01

    Full Text Available Dental implant is being considered successful if the patient is pleased with both of its functional and esthetic outcome. As implant complications (such as peri-implantitis, inappropriate implant position, wrong angulation, and implant location too close to anatomical structures have been frequently encountered in dental practice, therefore, thorough knowledge to manage such complications is the key prerequisite to prevent the failure of implant. The present case report discussed the etiology, diagnosis of early peri-implantitis, and periodontal abscess with their successful management through periodontal regeneration and diode laser-assisted therapy.

  15. Diode Laser and Periodontal Regeneration-Assisted Management of Implant Complications in Anterior Maxilla.

    Salaria, Sanjeev Kumar; Sharma, Isha; Brar, Navjot Kaur; Kaur, Satwant

    2018-01-01

    Dental implant is being considered successful if the patient is pleased with both of its functional and esthetic outcome. As implant complications (such as peri-implantitis, inappropriate implant position, wrong angulation, and implant location too close to anatomical structures) have been frequently encountered in dental practice, therefore, thorough knowledge to manage such complications is the key prerequisite to prevent the failure of implant. The present case report discussed the etiology, diagnosis of early peri-implantitis, and periodontal abscess with their successful management through periodontal regeneration and diode laser-assisted therapy.

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

    Trohanis, Pascal L.; And Others

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

  17. SOME INDICATORS OF CONSULTATIVE SERVICES DEVELOPMENT IN SERBIA

    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.

  18. Knowledge Sharing in IT Consultant and SME Interactions

    Adrian Bradshaw

    2015-10-01

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

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

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

    2004-01-01

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

  20. Efficiency principles of consulting entrepreneurship

    Moroz Yustina S.; Drozdov Igor N.

    2015-01-01

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

  1. Options for change in the NHS consultant contract.

    Clarke, R W; Gray, C

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

  2. Telephone consultations on exposure to nuclear disaster radiation

    Yashima, Sachiko; Chida, Koichi

    2014-01-01

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

  3. Services of strategic consulting: special features and types

    Klenin Oleh Volodymyrovych

    2016-01-01

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

  4. Applying Strategic Management in the Office of the Assistant Secretary of the Army for Financial Management and Comptroller (ASA(FM&C))

    Sturek, Frank

    2000-01-01

    The Assistant Secretary of the Army for Financial Management and Comptroller (ASA(FM&C)), the Honorable Mrs. Helen T. McCoy, started an organizational performance improvement initiative in September 1999...

  5. ADVANTAGES OBTAINED BY THE SMALL COMPANIES BY APPEALING TO MANAGERIAL AND FINANCIAL CONSULTANCY IN A COMPETITIVE ENVIRONMENT ON THE TOURISM SERVICES MARKET

    MONICA PĂTRUŢESCU

    2012-01-01

    Full Text Available The tourism is a field which offers multiple opportunities in deploying an activity, by the small companies. The problems arise as activities related to the creation, management and development of the business become more and more complex. Their solving is possible if the entrepreneur understands the need to benefit from assistance from outside the company, consultancy in management and financial-accounting consultancy capable to defend the interests of his customer and to ensure the support needed for a successful business.

  6. Consulting Basics for the Teacher-Turned-Technology Consultant.

    Stager, Sue; Green, Kathy

    1988-01-01

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

  7. CRITICAL INCIDENTS AND CRITICAL INCIDENT STRESS MANAGEMENT (CISM – AN EMPLOYEE ASSISTANCE PROGRAMME (EAP PERSPECTIVE

    Terblanche, Lourie

    2014-04-01

    Full Text Available Employees are increasingly becoming victims of critical incidents. From a systems theory point of view, it is necessary to acknowledge the impact of critical incidents not only on the personal life of the employee, but on the workplace itself. Employees respond differently to critical incidents, which makes it even more complicated when this reaches the point of requiring therapeutic intervention. The most common response to critical incidents may be the risk of developing post-traumatic stress disorder (PTSD and/or depression. This reality requires management – through the Employee Assistance Programme (EAP – to be able to effectively deal with such critical incidents.

  8. Vacuum-assisted wound closure for the management of a foot ulcer due to Buerger's disease.

    Canter, Halil Ibrahim; Isci, Evren; Erk, Yucel

    2009-02-01

    Thromboangiitis obliterans is a segmental inflammatory disease of the small- and medium-sized vessels mainly affecting the extremities. Although there are numerous reports concerning the treatment of these debilitating, chronic ulcers, such as skin grafting, local flaps, and free flaps, this report is the first published case of a patient with Buerger's disease, successfully managed with vacuum-assisted closure (VAC) application. This therapy decreases the period of hospital stay and increases patient comfort between dressings. Further clinical studies are needed to demonstrate the effectiveness and safety of VAC therapy in treatment of ulcers due to different kinds of vasculitis.

  9. Bladder Pain Syndrome International Consultation on Incontinence

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

    2010-01-01

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

  10. Developing a Knowledge Management Framework to Assist With Current USMC Information Management Practices

    2010-09-01

    OF CONTENTS I. INTRODUCTION ........................................................................................................1 II. LITERATURE...LEFT BLANK 1 I. INTRODUCTION Marine Corps Information Management is performed in accordance with Marine Corps Warfighting Publication (MCWP) 3...November 13). Air Force Center of Excellence for Knowledge Mangement Briefing. Washington, D.C. Alavi, M., & Leidner, D. E. (2001). Review: Knowledge

  11. Consultation and IBA negotiations in wind projects

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

    2011-07-01

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

  12. Shared consultant physician posts.

    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.

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

    Fiester, Autumn

    2015-01-01

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

  14. Core Competencies in Disaster Management and Humanitarian Assistance: A Systematic Review.

    Ripoll Gallardo, Alba; Djalali, Ahmadreza; Foletti, Marco; Ragazzoni, Luca; Della Corte, Francesco; Lupescu, Olivera; Arculeo, Chris; von Arnim, Gotz; Friedl, Tom; Ashkenazi, Michael; Fisher, Philipp; Hreckovski, Boris; Khorram-Manesh, Amir; Komadina, Radko; Lechner, Konstanze; Stal, Marc; Patru, Cristina; Burkle, Frederick M; Ingrassia, Pier Luigi

    2015-08-01

    Disaster response demands a large workforce covering diverse professional sectors. Throughout this article, we illustrate the results of a systematic review of peer-reviewed studies to identify existing competency sets for disaster management and humanitarian assistance that would serve as guidance for the development of a common disaster curriculum. A systematic review of English-language articles was performed on PubMed, Google Scholar, Scopus, ERIC, and Cochrane Library. Studies were included if reporting competency domains, abilities, knowledge, skills, or attitudes for professionals involved disaster relief or humanitarian assistance. Exclusion criteria included abstracts, citations, case studies, and studies not dealing with disasters or humanitarian assistance. Thirty-eight papers were analyzed. Target audience was defined in all articles. Five references (13%) reported cross-sectorial competencies. Most of the articles (81.6%) were specific to health care. Eighteen (47%) papers included competencies for at least 2 different disciplines and 18 (47%) for different professional groups. Nursing was the most widely represented cadre. Eighteen papers (47%) defined competency domains and 36 (94%) reported list of competencies. Nineteen articles (50%) adopted consensus-building to define competencies, and 12 (31%) included competencies adapted to different professional responsibility levels. This systematic review revealed that the largest number of papers were mainly focused on the health care sector and presented a lack of agreement on the terminology used for competency-based definition.

  15. Assistive technologies for self-managed pressure ulcer prevention in spinal cord injury: a scoping review.

    Tung, James Y; Stead, Brent; Mann, William; Ba'Pham; Popovic, Milos R

    2015-01-01

    Pressure ulcers (PUs) in individuals with spinal cord injury (SCI) present a persistent and costly problem. Continuing effort in developing new technologies that support self-managed care is an important prevention strategy. Specifically, the aims of this scoping review are to review the key concepts and factors related to self-managed prevention of PUs in individuals with SCI and appraise the technologies available to assist patients in self-management of PU prevention practices. There is broad consensus that sustaining long-term adherence to prevention regimens is a major concern. Recent literature highlights the interactions between behavioral and physiological risk factors. We identify four technology categories that support self-management: computer-based educational technologies demonstrated improved short-term gains in knowledge (2 studies), interface pressure mapping technologies demonstrated improved adherence to pressure-relief schedules up to 3 mo (5 studies), electrical stimulation confirmed improvements in tissue tolerance after 8 wk of training (3 studies), and telemedicine programs demonstrated improvements in independence and reduced hospital visits over 6 mo (2 studies). Overall, self-management technologies demonstrated low-to-moderate effectiveness in addressing a subset of risk factors. However, the effectiveness of technologies in preventing PUs is limited due to a lack of incidence reporting. In light of the key findings, we recommend developing integrated technologies that address multiple risk factors.

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

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

    2009-01-01

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

  17. Understanding the consultation processes

    Laing, A.C.

    1998-01-01

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

  18. Vacuum-assisted closure (VAC) therapy in the management of wound infection following renal transplantation.

    Shrestha, B M; Nathan, V C; Delbridge, M C; Parker, K; Throssell, D; McKane, W S; Karim, M S; Raftery, A T

    2007-01-01

    Wound infection in the setting of immunosuppressed state such as renal transplantation (RT) causes significant morbidity from sepsis, prolongs hospital stay and is expensive. Vacuum-assisted closure (VAC) therapy is a new technique of management of wound based on the principle of application of controlled negative pressure. The aim of this study was to assess the efficacy of VAC therapy in the management of wound infection following RT. This is a prospective study of a cohort of 180 consecutive RTs performed over a period of 4 years, where the data were retrieved from a prospectively maintained computerised database and case-notes. 9 of 180 (5%) patients developed wound infection following RT which led to cavitations and dehiscence with copious discharge, and refused to heal with conventional treatment. All 9 cases were treated with VAC therapy. The VAC system was removed after a median of 9 (range 3-30) days when discharge from the wound ceased. Four patients were discharged home with portable VAC device and managed on an outpatient basis, where the system was removed after a median 5.5 (range 3-7) days. The median hospital stay after initiation of VAC therapy was significantly shorter (5, range 2-12 days) than on conventional treatment prior to VAC therapy (11, range, 5-20 days) (p=0.003). Complete healing was achieved in all cases. The use of VAC therapy is an effective and safe adjunct to conventional and established treatment modalities for the management of wound infection and dehiscence following RT. Key words: Renal transplantation, wound infection, vacuum-assisted closure therapy.

  19. The experience of organization of consulting and diagnostical work in central polyclinic

    Bredikhin, V.V.; Knysh, V.I.; Novikov, V.S.; Taranukha, V.K.; Rogovchenko, G.A.

    1995-01-01

    Advisability of creating regional large-scale consulting-diagnostical centers is indicated. The consulting-diagnostical assistance is provides for relative to 24 medical professions. Above 64000 patients were consulted and more than 30.5 thousand X-ray and ultrasonic examinations were performed during the period of 1989-1993. 2 tabs

  20. Perioperative management of calves undergoing implantation of a left ventricular assist device.

    Wilson, D V; Kantrowitz, A; Pacholewicz, J; Salat, O; Paules, B R; Zhou, Y; Dawe, E J

    2000-01-01

    To describe perioperative management of calves that underwent left lateral thoracotomy, aortic cross-clamping, partial left heart bypass and implantation of a left ventricular assist device. A total of 43 healthy castrated male calves, weighing 121 +/- 24 kg. Diazepam (mean +/- SD, 0.26 +/- 0.07 mg/kg), ketamine (5.9 +/- 2.17 mg/kg) and isoflurane were used in the anesthetic management of calves undergoing implantation of a left ventricular assist device in the descending thoracic aorta. Other adjunctive agents administered were fentanyl (11 +/- 5.4 microg/kg), lidocaine (4.9 +/- 3.19 mg/kg), bupivacaine (0.75%) and butorphanol (0.49 +/- 0.13 mg/kg). None of the calves regurgitated at induction or during intubation. A tube was used to drain the rumen and prevent bloat during the procedure. Partial left heart bypass was used to perfuse the caudal half of the body during the period of aortic cross clamp and device implantation. Initial mean systemic blood pressure was 96 +/- 25 mm Hg, and pressures measured in the auricular artery increased during aortic cross-clamping and bypass. Vasoconstrictor therapy was required to treat caudal arterial hypotension during the procedure in 9 calves. Mean systemic arterial pressures returned to baseline values by the end of the anesthetic period. Initial mean pulmonary arterial pressures (PAP) were 22 +/- 3 mm Hg. A significant but transient increase in pulmonary arterial pressure occurred after both heparin and protamine administration. The described anesthetic protocol was effective for thoracotomy and implantation of an intra-aortic left ventricular assist device in normal calves. Partial left ventricular bypass was a useful adjunct during the period of aortic cross clamp. The doses of heparin and protamine administered were effective. Responsibility to monitor oxygenation of the cranial half of the animal continues during the bypass period as hypoxemia due to pulmonary dysfunction will not be detected by the perfusionist.

  1. Tales of IT Consultants: Understanding Psychological Contract Maintenance and Employment Termination

    Karlheinz Kautz

    2015-09-01

    Full Text Available This research investigates the question why dedicated Information Technology (IT consultants quit their jobs and voluntarily terminate their employment contracts. A research approach inspired by grounded theory is used and as a theoretical contribution a novel, cyclic process model for the maintenance or neglect of the psychological contract between employees and employers is derived from the empirical data. The model is subsequently substantiated through the integration of various concepts and theories identified in the literature, combining the concept of psychological contract with social influence theory and a theory of the relation between intrinsic motivation and management practices. The research is based on a revelatory case study which provides tales from four IT consultants in an IT consulting firm. The model helps to explain IT consultants’ behaviour of voluntarily terminating their employment contracts. Additionally, it should assist managers in IT consulting firms to avoid practices which might lead to their employees’ loss of intrinsic motivation and result in the loss of valuable employees for the organization.

  2. Video-assisted thoracoscopic surgery in the management of penetrating and blunt thoracic trauma

    Milanchi S

    2009-01-01

    Full Text Available Background: The role of video-assisted Thoracoscopic Surgery (VATS is still being defined in the management of thoracic trauma. We report our trauma cases managed by VATS and review the role of VATS in the management of thoracic trauma. Materials and Methods: All the trauma patients who underwent VATS from 2000 to 2007 at Cedars-Sinai Medical Center were retrospectively studied. Results: Twenty-three trauma patients underwent 25 cases of VATS. The most common indication for VATS was retained haemothorax. Thoracotomy was avoided in 21 patients. VATS failed in two cases. On an average VATS was performed on trauma day seven (range 1-26 and the length of hospital stay was 20 days (range 3-58. There was no mortality. VATS was performed in an emergency (day 1-2, or in the early (day 2-7 or late (after day 7 phases of trauma. Conclusion: VATS can be performed safely for the management of thoracic traumas. VATS can be performed before or after thoracotomy and at any stage of trauma. The use of VATS in trauma has a trimodal distribution (emergent, early, late, each with different indications.

  3. Video-assisted thoracoscopic surgery in the management of penetrating and blunt thoracic trauma.

    Milanchi, S; Makey, I; McKenna, R; Margulies, D R

    2009-01-01

    The role of video-assisted Thoracoscopic Surgery (VATS) is still being defined in the management of thoracic trauma. We report our trauma cases managed by VATS and review the role of VATS in the management of thoracic trauma. All the trauma patients who underwent VATS from 2000 to 2007 at Cedars-Sinai Medical Center were retrospectively studied. Twenty-three trauma patients underwent 25 cases of VATS. The most common indication for VATS was retained haemothorax. Thoracotomy was avoided in 21 patients. VATS failed in two cases. On an average VATS was performed on trauma day seven (range 1-26) and the length of hospital stay was 20 days (range 3-58). There was no mortality. VATS was performed in an emergency (day 1-2), or in the early (day 2-7) or late (after day 7) phases of trauma. VATS can be performed safely for the management of thoracic traumas. VATS can be performed before or after thoracotomy and at any stage of trauma. The use of VATS in trauma has a trimodal distribution (emergent, early, late), each with different indications.

  4. Exploring nursing assistants' roles in the process of pain management for cognitively impaired nursing home residents: a qualitative study.

    Liu, Justina Y W

    2014-05-01

    To explore nursing assistants' roles during the actual process of pain management (assessment, reporting, implementation of pain-relieving interventions and re-assessment) for cognitively impaired home residents with pain. Nursing assistants provide most of the direct care to residents and represent the major taskforce in nursing homes. They may develop specialized knowledge of residents' pain experience that enables them to play both a pivotal role in pain assessment and possibly a supporting role in pain treatment. Currently, there is a lack of research into nursing assistants' functions in pain management. This is a descriptive, exploratory qualitative study. Forty-nine nursing assistants were recruited from 12 nursing homes, 12 of them participating in semi-structured individual interviews and 37 in 8 semi-structured focus groups. All interviews were carried out from May to September 2010. Data collected via both data collection methods were transcribed verbatim and analysed by content analysis. Nursing assistants were found to play four roles in the pain management process: (1) pain assessor; (2) reporter; (3) subordinate implementing prescribed medications; and (4) instigator implementing non-pharmacological interventions. This study highlights the importance of nursing assistants in successful pain assessment and identifies their possible supporting roles in other aspects of pain management. However, nursing assistants' scope of practice resulted in their functions in pain management being continually undervalued by other healthcare professionals. Continuous in-service training, the use of a standardized pain management protocol and strategies for building coherent work teams in nursing homes are suggested to improve this situation. © 2013 John Wiley & Sons Ltd.

  5. Atmospheric Radiation Measurement's Data Management Facility captures metadata and uses visualization tools to assist in routine data management.

    Keck, N. N.; Macduff, M.; Martin, T.

    2017-12-01

    The Atmospheric Radiation Measurement's (ARM) Data Management Facility (DMF) plays a critical support role in processing and curating data generated by the Department of Energy's ARM Program. Data are collected near real time from hundreds of observational instruments spread out all over the globe. Data are then ingested hourly to provide time series data in NetCDF (network Common Data Format) and includes standardized metadata. Based on automated processes and a variety of user reviews the data may need to be reprocessed. Final data sets are then stored and accessed by users through the ARM Archive. Over the course of 20 years, a suite of data visualization tools have been developed to facilitate the operational processes to manage and maintain the more than 18,000 real time events, that move 1.3 TB of data each day through the various stages of the DMF's data system. This poster will present the resources and methodology used to capture metadata and the tools that assist in routine data management and discoverability.

  6. Employee assistance programs: history and program description.

    Gilbert, B

    1994-10-01

    1. The history and development of Employee Assistance Programs (EAPs) can be traced back to the 1800s. There are currently over 10,000 EAPs in the United States. 2. Standards for program accreditation and counselor certification have been established for EAPs. The "core technology of Employee Assistance Programs" includes identification of behavioural problems based on job performance issues, expert consultation with supervisors, appropriate use of constructive confrontation, microlinkages with treatment providers and resources, macrolinkages between providers, resources, and work organizations, focus on substance abuse, and evaluation of employee success based on job performance. 3. Some EAPs take a broad brush approach, and incorporate health promotion and managed care functions.

  7. Patient presentation and physician management of upper respiratory tract infections: a retrospective review of over 5 million primary clinic consultations in Hong Kong.

    Kung, Kenny; Wong, Carmen Ka Man; Wong, Samuel Yeung Shan; Lam, Augustine; Chan, Christy Ka Yan; Griffiths, Sian; Butler, Chris

    2014-05-13

    Upper respiratory tract infection (URTI) has a significant healthcare burden worldwide. Considerable resources are consumed through health care consultations and prescribed treatment, despite evidence for little or no effect on recovery. Patterns of consultations and care including use of symptomatic medications and antibiotics for upper respiratory tract infections are poorly described. We performed a retrospective review of computerized clinical data on patients presenting to all public primary care clinics in Hong Kong with symptoms of respiratory tract infections. International Classification of Primary care (ICPC)codes used to identify patients included otitis media (H71), streptococcal pharyngitis (R72), acute URTI (R74), acute sinusitis (R75), acute tonsillitis (R76), acute laryngitis (R77), and influenza (R80). Sociodemographic variables such as gender, age, chronic illness status, attendance date, type and duration of drug prescribed were also collected. Of the 5,529,755 primary care consultations for respiratory symptoms from 2005 to 2010, 98% resulted in a prescription. Prescription patterns of symptomatic medication were largely similar across the 5 years. In 2010 the mean number of drugs prescribed per consultation was 3.2, of which the commonly prescribed medication were sedating antihistamines (79.9%), analgesia (58.9%), throat lozenges (40.4%) and expectorant cough syrup (33.8%). During the study period, there was an overall decline in antibiotic prescription (8.1% to 5.1%). However, in consultations where the given diagnosis was otitis media (H71), streptococcal pharyngitis (R72), acute sinusitis (R75) or acute laryngitis (R76), over 90% resulted in antibiotic prescription. There was a decline in overall antibiotic prescription over the study period. However, the use of antibiotics was high in some conditions e.g. otitis media and acute laryngitis a. Multiple symptomatic medications were given for upper respiratory tract infections. Further

  8. Responses to language barriers in consultations with refugees and asylum seekers: a telephone survey of Irish general practitioners.

    MacFarlane, Anne

    2008-01-01

    BACKGROUND: Refugees and asylum seekers experience language barriers in general practice. Qualitative studies have found that responses to language barriers in general practice are ad hoc with use of both professional interpreters and informal interpreters (patients\\' relatives or friends). However, the scale of the issues involved is unknown. This study quantifies the need for language assistance in general practice consultations and examines the experience of, and satisfaction with, methods of language assistance utilized. METHODS: Data were collected by telephone survey with general practitioners in a regional health authority in Ireland between July-August 2004. Each respondent was asked a series of questions about consulting with refugees and asylum seekers, the need for language assistance and the kind of language assistance used. RESULTS: There was a 70% (n = 56\\/80) response rate to the telephone survey. The majority of respondents (77%) said that they had experienced consultations with refugees and asylum seekers in which language assistance was required. Despite this, general practitioners in the majority of cases managed without an interpreter or used informal methods of interpretation. In fact, when given a choice general practitioners would more often choose informal over professional methods of interpretation despite the fact that confidentiality was a significant concern. CONCLUSION: The need for language assistance in consultations with refugees and asylum seekers in Irish general practice is high. General practitioners rely on informal responses. It is necessary to improve knowledge about the organisational contexts that shape general practitioners responses. We also recommend dialogue between general practitioners, patients and interpreters about the relative merits of informal and professional methods of interpretation so that general practitioners\\' choices are responsive to the needs of patients with limited English.

  9. Analysis on incidence and management of complications after femtosecond laser-assisted small incision lenticule extraction

    Cai-Hong Li

    2018-04-01

    Full Text Available AIM: To evaluate the safety and postoperative complications of femtosecond laser-assisted small incision lenticule extraction(SMILE. METHODS: Retrospective case series. A total of 1127 patients(2 236 eyeswho were treated with SMILE for myopia or myopia astigmatism between June 2016 and May 2017 were enrolled in this study. Eyes that developed postoperative complications were noted and identified. The incidence, risk factors, management and prognosis were analyzed. The follow-up was 6mo.RESULTS: The rate of postoperative complications was 8.05%, included diffuse lamellar keratitis(3.31%, delayed visual acuity(2.59%, minor interface residue(0.63%, and ghost images(1.52%. These complications had an impact on best corrected visual acuity(BCVAat 3mo in only 1 eye with decentered ablation and was re-treated with topography-guided laser-assisted subepithelial keratomileusis(LASEK. Good visual outcomes were achieved in all eyes finally. CONCLUSION: Although few eyes suffered postoperative complications, SMILE is an acceptable safe surgery. Careful surgical skill, appropriate surgical parameter, and rational postoperative medication can decrease the risk of complication.

  10. The FachRef-Assistant: Personalised, subject specific, and transparent stock management

    Eike T. Spielberg

    2017-07-01

    Full Text Available We present in this paper a personalized web application for the weeding of printed resources: the FachRef-Assistant. It offers an extensive range of tools for evidence based stock management, based on the thorough analysis of usage statistics. Special attention is paid to the criteria individualization, transparency of the parameters used, and generic functions. Currently, it is designed to work with the Aleph-System from ExLibris, but efforts were spent to keep the application as generic as possible. For example, all procedures specific to the local library system have been collected in one Java package. The inclusion of library specific properties such as collections and systematics has been designed to be highly generic as well by mapping the individual entries onto an in-memory database. Hence simple adaption of the package and the mappings would render the FachRef-Assistant compatible to other library systems. The personalization of the application allows for the inclusion of subject specific usage properties as well as of variations between different collections within one subject area. The parameter sets used to analyse the stock and to prepare weeding and purchase proposal lists are included in the output XML-files to facilitate a high degree of transparency, objectivity and reproducibility.

  11. Building automation: Photovoltaic assisted thermal comfort management system for energy saving

    Reyasudin Basir Khan, M.; Jidin, Razali; Pasupuleti, Jagadeesh; Azwa Shaaya, Sharifah

    2013-06-01

    Building automation plays an important key role in the means to reduce building energy consumption and to provide comfort for building occupants. It is often that air conditioning system operating features ignored in building automation which can result in thermal discomfort among building occupants. Most automation system for building is expensive and incurs high maintenance cost. Such system also does not support electricity demand side management system such as load shifting. This paper discusses on centralized monitoring system for room temperature and photovoltaic (PV) output for feasibility study of PV assisted air conditioning system in small office buildings. The architecture of the system consists of PV modules and sensor nodes located at each room. Wireless sensor network technology (WSN) been used for data transmission. The data from temperature sensors and PV modules transmitted to the host personal computer (PC) wirelessly using Zigbee modules. Microcontroller based USB data acquisition device used to receive data from sensor nodes and displays the data on PC.

  12. A prototype case-based reasoning human assistant for space crew assessment and mission management

    Owen, Robert B.; Holland, Albert W.; Wood, Joanna

    1993-01-01

    We present a prototype human assistant system for space crew assessment and mission management. Our system is based on case episodes from American and Russian space missions and analog environments such as polar stations and undersea habitats. The general domain of small groups in isolated and confined environments represents a near ideal application area for case-based reasoning (CBR) - there are few reliable rules to follow, and most domain knowledge is in the form of cases. We define the problem domain and outline a unique knowledge representation system driven by conflict and communication triggers. The prototype system is able to represent, index, and retrieve case studies of human performance. We index by social, behavioral, and environmental factors. We present the problem domain, our current implementation, our research approach for an operational system, and prototype performance and results.

  13. Building automation: Photovoltaic assisted thermal comfort management system for energy saving

    Khan, M Reyasudin Basir; Jidin, Razali; Shaaya, Sharifah Azwa; Pasupuleti, Jagadeesh

    2013-01-01

    Building automation plays an important key role in the means to reduce building energy consumption and to provide comfort for building occupants. It is often that air conditioning system operating features ignored in building automation which can result in thermal discomfort among building occupants. Most automation system for building is expensive and incurs high maintenance cost. Such system also does not support electricity demand side management system such as load shifting. This paper discusses on centralized monitoring system for room temperature and photovoltaic (PV) output for feasibility study of PV assisted air conditioning system in small office buildings. The architecture of the system consists of PV modules and sensor nodes located at each room. Wireless sensor network technology (WSN) been used for data transmission. The data from temperature sensors and PV modules transmitted to the host personal computer (PC) wirelessly using Zigbee modules. Microcontroller based USB data acquisition device used to receive data from sensor nodes and displays the data on PC.

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

    I. Hollaender

    2007-01-01

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

  15. 75 FR 54064 - Consultation Agreements: Proposed Changes to Consultation Procedures

    2010-09-03

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

  16. Clinical manifestations and management of left ventricular assist device-associated infections.

    Nienaber, Juhsien Jodi C; Kusne, Shimon; Riaz, Talha; Walker, Randall C; Baddour, Larry M; Wright, Alan J; Park, Soon J; Vikram, Holenarasipur R; Keating, Michael R; Arabia, Francisco A; Lahr, Brian D; Sohail, M Rizwan

    2013-11-01

    Infection is a serious complication of left ventricular assist device (LVAD) therapy. Published data regarding LVAD-associated infections (LVADIs) are limited by single-center experiences and use of nonstandardized definitions. We retrospectively reviewed 247 patients who underwent continuous-flow LVAD implantation from January 2005 to December 2011 at Mayo Clinic campuses in Minnesota, Arizona, and Florida. LVADIs were defined using the International Society for Heart and Lung Transplantation criteria. We identified 101 episodes of LVADI in 78 patients (32%) from this cohort. Mean age (± standard deviation [SD]) was 57±15 years. The majority (94%) underwent Heartmate II implantation, with 62% LVADs placed as destination therapy. The most common type of LVADIs were driveline infections (47%), followed by bloodstream infections (24% VAD related, and 22% non-VAD related). The most common causative pathogens included gram-positive cocci (45%), predominantly staphylococci, and nosocomial gram-negative bacilli (27%). Almost half (42%) of the patients were managed by chronic suppressive antimicrobial therapy. While 14% of the patients had intraoperative debridement, only 3 underwent complete LVAD removal. The average duration (±SD) of LVAD support was 1.5±1.0 years. At year 2 of follow-up, the cumulative incidence of all-cause mortality was estimated to be 43%. Clinical manifestations of LVADI vary on the basis of the type of infection and the causative pathogen. Mortality remained high despite combined medical and surgical intervention and chronic suppressive antimicrobial therapy. Based on clinical experiences, a management algorithm for LVADI is proposed to assist in the decision-making process.

  17. The added value of a mobile application of Community Case Management on referral, re-consultation and hospitalization rates of children aged under 5 years in two districts in Northern Malawi: study protocol for a pragmatic, stepped-wedge cluster-randomized controlled trial.

    Hardy, Victoria; O'Connor, Yvonne; Heavin, Ciara; Mastellos, Nikolaos; Tran, Tammy; O'Donoghue, John; Fitzpatrick, Annette L; Ide, Nicole; Wu, Tsung-Shu Joseph; Chirambo, Griphin Baxter; Muula, Adamson S; Nyirenda, Moffat; Carlsson, Sven; Andersson, Bo; Thompson, Matthew

    2017-10-11

    There is evidence to suggest that frontline community health workers in Malawi are under-referring children to higher-level facilities. Integrating a digitized version of paper-based methods of Community Case Management (CCM) could strengthen delivery, increasing urgent referral rates and preventing unnecessary re-consultations and hospital admissions. This trial aims to evaluate the added value of the Supporting LIFE electronic Community Case Management Application (SL eCCM App) compared to paper-based CCM on urgent referral, re-consultation and hospitalization rates, in two districts in Northern Malawi. This is a pragmatic, stepped-wedge cluster-randomized trial assessing the added value of the SL eCCM App on urgent referral, re-consultation and hospitalization rates of children aged 2 months and older to up to 5 years, within 7 days of the index visit. One hundred and two health surveillance assistants (HSAs) were stratified into six clusters based on geographical location, and clusters randomized to the timing of crossover to the intervention using simple, computer-generated randomization. Training workshops were conducted prior to the control (paper-CCM) and intervention (paper-CCM + SL eCCM App) in assigned clusters. Neither participants nor study personnel were blinded to allocation. Outcome measures were determined by abstraction of clinical data from patient records 2 weeks after recruitment. A nested qualitative study explored perceptions of adherence to urgent referral recommendations and a cost evaluation determined the financial and time-related costs to caregivers of subsequent health care utilization. The trial was conducted between July 2016 and February 2017. This is the first large-scale trial evaluating the value of adding a mobile application of CCM to the assessment of children aged under 5 years. The trial will generate evidence on the potential use of mobile health for CCM in Malawi, and more widely in other low- and middle

  18. The intersection of software and strengths: Using internet technology and case management software to assist Strength-Based Practice.

    Clark, Michael D; Brien, Dale W

    2016-01-01

    The focus of this investigation is the helping professionals working within American Indian and Alaska Native (AI/AN) communities. This article looks at how innovative technology-in the form of automated case management software and Internet connectivity-can assist effective implementation of Strength-based Practice and agency services within tribal courts and the many other helping agencies that serve AI/AN populations. We seek to expand practice knowledge by reviewing the benefits that this software and Internet connectivity can offer to agency operations and exploring how they can assist case management services.

  19. Management issues during HeartWare left ventricular assist device implantation and the role of transesophageal echocardiography

    Sanjay Orathi Patangi

    2013-01-01

    Full Text Available Left ventricular assist devices (LVAD are increasingly used for mechanical circulatory support of patients with severe heart failure, primarily as a bridge to heart transplantation. Transesophageal echocardiography (TEE plays a major role in the clinical decision making during insertion of the devices and in the post-operative management of these patients. The detection of structural and device-related mechanical abnormalities is critical for optimal functioning of assist device. In this review article, we describe the usefulness of TEE for optimal perioperative management of patients presenting for HeartWare LVAD insertion.

  20. Preparation + consultation = better regulation

    Bines, W.

    2001-01-01

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

  1. Tutoring Mentoring Peer Consulting

    Szczyrba, Birgit; Wildt, Johannes

    2006-01-01

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

  2. "Systematizing" ethics consultation services.

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

    2015-03-01

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

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

    Wiertelak, Eric P.

    2012-01-01

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

  4. Addressing Cultural Responsiveness in Consultation: An Empirical Demonstration

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

    2017-01-01

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

  5. 76 FR 28446 - Policy on Consultation With Indian Tribes

    2011-05-17

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

  6. Users enlist consultants to calculate costs, savings

    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)

  7. Preferred supplier programs for consulting services: An exploratory study of German client companies

    Sieweke, J.; Birkner, Stephanie; Mohe, Michael

    2012-01-01

    Research has recently provided evidence that at least some companies have involved purchasing departments in buying professional services such as management consulting services. Some departments have established preferred supplier programs (PSPs) for consulting services, i.e., programs for

  8. Miniscrew-assisted rapid palatal expansion for managing arch perimeter in an adult patient

    Amanda Carneiro da Cunha

    Full Text Available ABSTRACT Introduction: Etiology of dental crowding may be related to arch constriction in diverse dimensions, and an appropriate manipulation of arch perimeter by intervening in basal bone discrepancies cases, may be a key for crowding relief, especially when incisors movement is limited due to underlying pathology, periodontal issues or restrictions related to soft tissue profile. Objectives: This case report illustrates a 24-year old woman, with maxillary transverse deficiency, upper and lower arches crowding, Class II, division 1, subdivision right relationship, previous upper incisors traumatic episode and straight profile. A non-surgical and non-extraction treatment approach was feasible due to the miniscrew-assisted rapid palatal expansion technique (MARPE. Methods: The MARPE appliance consisted of a conventional Hyrax expander supported by four orthodontic miniscrews. A slow expansion protocol was adopted, with an overall of 40 days of activation and a 3-month retention period. Intrusive traction miniscrew-anchored mechanics were used for correcting the Class II subdivision relationship, managing lower arch perimeter and midline deviation before including the upper central incisors. Results: Post-treatment records show an intermolar width increase of 5 mm, bilateral Class I molar and canine relationships, upper and lower crowding resolution, coincident dental midlines and proper intercuspation. Conclusions: The MARPE is an effective treatment approach for managing arch-perimeter deficiencies related to maxillary transverse discrepancies in adult patients.

  9. New Jersey's EMS response to Superstorm Sandy: a case study of the emergency management assistance compact.

    Clancy, Terry; Christensen, Kenneth; Cortacans, Henry P

    2014-06-01

    In the United States, understanding the Emergency Management Assistance Compact (EMAC) is critical to responding to a natural disaster or manmade event. Recently, the State of New Jersey responded to Superstorm Sandy and implemented the EMAC system by requesting ambulances to aid in the Emergency Medical Services response. New Jersey's response to Superstorm Sandy was unprecedented in that this storm affected the entire state and EMS community. New Jersey's EMS community and infrastructure were impacted greatly, despite years of planning and preparation for such an event. Once received, out-of-state EMS resources were integrated into New Jersey's emergency management and EMS systems. In this report, each phase of the EMAC in New Jersey is explored, from how the response was coordinated to how it ultimately was executed. The state coordinated its response on multiple levels and, as such, tested the practical applicability of the EMAC process and employed best practices and solutions to issues that arose. These best practices and solutions may prove invaluable for any state or territory that may activate the EMAC system for emergency medical service resources.

  10. Telemedicine and international disaster response. Medical consultation to Armenia and Russia via a Telemedicine Spacebridge.

    Houtchens, B A; Clemmer, T P; Holloway, H C; Kiselev, A A; Logan, J S; Merrell, R C; Nicogossian, A E; Nikogossian, H A; Rayman, R B; Sarkisian, A E

    1993-01-01

    The Telemedicine Spacebridge, a satellite-mediated, audio-video-fax link between four United States and two Armenian and Russian medical centers, permitted remote American consultants to assist Armenian and Russian physicians in the management of medical problems following the December 1988 earthquake in Armenia and the June 1989 gas explosion near Ufa. During 12 weeks of operations, 247 Armenian and Russian and 175 American medical professionals participated in 34 half-day clinical conferences. A total of 209 patients were discussed, requiring expertise in 20 specialty areas. Telemedicine consultations resulted in altered diagnoses for 54, new diagnostic studies for 70, altered diagnostic processes for 47, and modified treatment plans for 47 of 185 Armenian patients presented. Simultaneous participation of several US medical centers was judged beneficial; quality of data transmission was judged excellent. These results suggest that interactive consultation by remote specialists can provide valuable assistance to on-site physicians and favorably influence clinical decisions in the aftermath of major disasters.

  11. Telemedicine and international disaster response: medical consultation to Armenia and Russia via a Telemedicine Spacebridge.

    Houtchens, B A; Clemmer, T P; Holloway, H C; Kiselev, A A; Logan, J S; Merrell, R C; Nicogossian, A E; Nikogossian, H A; Rayman, R B; Sarkisian, A E; Siegel, J H

    1993-01-01

    The Telemedicine Spacebridge, a satellite-mediated, audio-video-fax link between four United States and two Armenian and Russian medical centers, permitted remote American consultants to assist Armenian and Russian physicians in the management of medical problems following the December 1988 earthquake in Armenia and the June 1989 gas explosion near Ufa. During 12 weeks of operations, 247 Armenian and Russian and 175 American medical professionals participated in 34 half-day clinical conferences. A total of 209 patients were discussed, requiring expertise in 20 specialty areas. Telemedicine consultations resulted in altered diagnoses for 54, new diagnostic studies for 70, altered diagnostic processes for 47, and modified treatment plans for 47 of 185 Armenian patients presented. Simultaneous participation of several US medical centers was judged beneficial; quality of data transmission was judged excellent. These results suggest that interactive consultation by remote specialists can provide valuable assistance to on-site physicians and favorably influence clinical decisions in the aftermath of major disasters.

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

    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.

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

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

    2017-08-04

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

  14. Public consultation: regulatory requirement or business principle?

    Seeley, R.

    1999-01-01

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

  15. Identifying challenges in project consultants engagement practices

    Shariffuddin, Nadia Alina Amir; Abidin, Nazirah Zainul

    2017-10-01

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

  16. Public consultation: regulatory requirement or business principle?

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

    1999-07-01

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

  17. Enhancing Saarc Disaster Management: A Comparative Study With Asean Coordinating Centre For Humanitarian Assistance On Disaster Management

    2016-03-01

    North Atlantic Treaty Organization NDMA National Disaster Management Authority NDMO National Disaster Management Organization NIDM National...disaster management authorities. National Disaster Management Authority ( NDMA ) has envisaged the role of the army in relief, recovery, management of

  18. Management of Benign Tracheal Stenosis by Small-diameter Tube-assisted Bronchoscopic Balloon Dilatation

    Yi-Lin Liang

    2015-01-01

    Full Text Available Background: A limitation of bronchoscopic balloon dilatation (BBD is that airflow must be completely blocked for as long as possible during the operation. However, the patient often cannot hold his or her breath for a long period affecting the efficacy of the procedure. In this study, we used an extra-small-diameter tube to provide assisted ventilation to patients undergoing BBD and assessed the efficacy and safety of this technique. Methods: Bronchoscopic balloon dilatation was performed in 26 patients with benign tracheal stenosis using an extra-small-diameter tube. The tracheal diameter, dyspnea index, blood gas analysis results, and complications were evaluated before and after BBD. Statistical analyses were performed by SPSS version 16.0 for Windows (SPSS, Inc., Chicago, IL, USA. Results: Sixty-three BBD procedures were performed in 26 patients. Dyspnea immediately improved in all patients after BBD. The tracheal diameter significantly increased from 5.5 ± 1.5 mm to 13.0 ± 1.3 mm (P < 0.001, and the dyspnea index significantly decreased from 3.4 ± 0.8 to 0.5 ± 0.6 (P < 0.001. There was no significant change in the partial pressure of oxygen during the operation (before, 102.5 ± 27.5 mmHg; during, 96.9 ± 30.4 mmHg; and after, 97.2 ± 21.5 mmHg; P = 0.364, but there was slight temporary retention of carbon dioxide during the operation (before, 43.5 ± 4.2 mmHg; during, 49.4 ± 6.8 mmHg; and after, 40.1 ± 3.9 mmHg; P < 0.001. Conclusion: Small-diameter tube-assisted BBD is an effective and safe method for the management of benign tracheal stenosis.

  19. Vacuum-assisted closure device: a useful tool in the management of severe intrathoracic infections.

    Saadi, Alend; Perentes, Jean Yannis; Gonzalez, Michel; Tempia, Adrien Caliera; Wang, Yabo; Demartines, Nicolas; Ris, Hans-Beat; Krueger, Thorsten

    2011-05-01

    This study is an evaluation of the vacuum-assisted closure (VAC) therapy for the treatment of severe intrathoracic infections complicating lung resection, esophageal surgery, viscera perforation, or necrotizing pleuropulmonary infections. We reviewed the medical records of all patients treated by intrathoracic VAC therapy between January 2005 and December 2008. All patients underwent surgical debridement-decortication and control of the underlying cause of infection such as treatment of bronchus stump insufficiency, resection of necrotic lung, or closure of esophageal or intestinal leaks. Surgery was followed by intrathoracic VAC therapy until the infection was controlled. The VAC dressings were changed under general anesthesia and the chest wall was temporarily closed after each dressing change. All patients received systemic antibiotic therapy. Twenty-seven patients (15 male, median age 64 years) underwent intrathoracic VAC dressings for the management of postresectional empyema (n=8) with and without bronchopleural fistula, necrotizing infections (n=7), and intrathoracic gastrointestinal leaks (n=12). The median length of VAC therapy was 22 days (range 5 to 66) and the median number of VAC changes per patient was 6 (range 2 to 16). In-hospital mortality was 19% (n=5) and was not related to VAC therapy or intrathoracic infection. Control of intrathoracic infection and closure of the chest cavity was achieved in all surviving patients. Vacuum-assisted closure therapy is an efficient and safe adjunct to treat severe intrathoracic infections and may be a good alternative to the open window thoracostomy in selected patients. Long time intervals in between VAC changes and short course of therapy result in good patient acceptance. Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  20. Persuasive robotic assistant for health self-management of older adults: Design and evaluation of social behaviors

    Looije, R.; Neerincx, M.A.; Cnossen, F.

    2010-01-01

    Daily health self-management, such as the harmonization of food, exercise and medication, is a major problem for a large group of older adults with obesity or diabetics. Computer-based personal assistance can help to behave healthy by persuading and guiding older adults. For effective persuasion,

  1. Persuasive robotic assistant for health self-management of older adults : Design and evaluation of social behaviors

    Looije, Rosemarijn; Neerincx, Mark A.; Cnossen, Fokie

    Daily health self-management, such as the harmonization of food, exercise and medication, is a major problem for a large group of older adults with obesity or diabetics Computer-based personal assistance can help to behave healthy by persuading and guiding older adults For effective persuasion, the

  2. Consulting in Electronic Commerce

    Florentina Loredana Tache

    2010-10-01

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

  3. Development and design of a computer-assisted information management system for radiation safety management at the University of Washington

    Riches, C.G.; Riordan, F.J.; Robb, D.; Grieb, C.; Pence, G.; O'Brien, M.J.

    1984-01-01

    The Radiation Safety Office (RSO) at the University of Washington (UW) found that it needed a computerized information system to help manage the campus radiation safety program and to help provide the records necessary to show compliance with regulations and license requirements. The John L. Locke Computer Center at the UW had just developed the GLAMOR system to aid information entry and query for their computer when the RSO turned to them for assistance. The module that was developed provided a mechanism for controlling and monitoring radioactive materials on campus. This became one part of a multi-faceted system that registers users, employees, sealed sources and radiation-producing machines. The system is designed to be interactive, for immediate information recall, and powerful enough to provide routine and special reports on compliance status. The RSO information system is designed to be flexible and can easily incorporate additional features. Some future features include an interactive SNM control program, an interface to the information system currently being developed for the occupational safety and health program and an interface to the database provided by the commercial film badge service used by the University. Development of this program lead the RSO to appreciate the usefulness of having health physics professionals on the staff who were also knowledgeable about computers and who could develop programs and reports necessary to their activities

  4. 1,000 consecutive cases of laser-assisted liposuction and suction-assisted lipectomy managed with local anesthesia.

    Chia, Christopher T; Theodorou, Spero J

    2012-08-01

    Advances in suction-assisted lipectomy (SAL) include improved instrumentation, better understanding of fluid dynamics, and an improved concept of appropriate indications. The tumescent technique uses subcutaneous injection of isotonic fluid containing vasoconstrictive and analgesic agents and is proved to be safe, with low morbidity and mortality rates. Laser-assisted liposuction (LAL) using local infiltration of an anesthetic and no general anesthesia or sedation has been developed, with claims of fat destruction and skin tightening. This study aimed to review 1,000 consecutive cases of LAL and SAL performed with the patient under local anesthesia and to determine whether this represents a safe technique with few complications. During a period of 22 months, 581 consecutive patients (486 females and 95 males) underwent 1,000 LAL/SAL operations, 545 of whom had multiple procedures performed. None of the patients had a body mass index (BMI) higher than 30 kg/m2. The patients ranged in age from 18 to 62 years. The fat aspirate ranged from 50 to 1,400 ml. Patients were given an oral sedative, an antibiotic, and an analgesic. Ringer's lactate solution containing lidocaine and epinephrine was injected into the subcutaneous space. The 1,064-nm and/or 1,320-nm neodymium:yttrium-aluminum-garnet (Nd:YAG) laser was used for laser lipolysis followed by SAL using standard and/or power-assisted liposuction (PAL) cannulas. The treated areas included the neck, triceps, male breast, midback, flanks, axilla, abdomen, mons pubis, thighs, presacrum, and knees. No patient was administered intravenous sedation or general anesthesia. The average number of areas treated was 1.8, and no major complications or mortalities were observed. There were three burns, two infections, one hematoma, and one seroma. A total of 73 secondary procedures were performed (7.3%). No tertiary procedures were required. For appropriately selected patients, comparable results can be obtained with an excellent

  5. A novel prescription pedometer-assisted walking intervention and weight management for Chinese occupational population.

    Yingxiang Yu

    Full Text Available Information technology has been previously used for the research and practice of health promotion. Appropriate and effective health promotion methods used by professional groups remain to be investigated. This study aimed to assess the feasibility and effectiveness of a weight management program among the Chinese occupational population using and a novel information technology exercise prescription.A 3-month open, self-monitored intervention trial, involving individualized pedometer-assisted exercise prescription and a one-time targeted dietary guidance prior to exercise was conducted on the Chinese occupational population aged 18-65 years in China from 2015 to 2016. Data were collected from March 2015 to May 2016 and analyzed from June 2016 to August 2016. Participants were also asked to synchronize exercise data of the pedometer to the Internet-based Health System Center daily (at least weekly, by connecting to the personal computer (PC using a USB cable or via Bluetooth.Eligible participants included 802 Chinese occupational persons, and 718 of them followed exercise interventions with 89.5% (718/802 adherence to the exercise programs. Of them, 688 participants completed the program with 85.8% (688/802 adherence to the exercise program and their data were analyzed. Weight decreased by 2.2% among all overweight/obese participants, with 1.8% reduction in waist circumference and 3.3% reduction in body fat percentage (p< 0.001. Weight and body fat percentage in normal-weight individuals decreased by 0.7% and 2.5%, respectively (p < 0.01. A weight gain of 1.0% was observed in all underweight participants (p< 0.05, and 68.2% (208/305 of overweight/obese participants experienced weight loss, with an average reduction of 3.5%, with 20.2% (42/208 of them achieving weight loss ≥5%. Blood pressure and fasting serum glucose decreased significantly in both the overweight/obese and the normal-weight individuals (p < 0.05. The incidence of hypertension

  6. 41 CFR 101-1.107 - Agency consultation regarding FPMR.

    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...

  7. Role of Laryngological Consultation in the Intervention of Dysphonia

    Stone, Ed.; And Others

    1978-01-01

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

  8. Managing nursing assistants with a web-based system: an empirical investigation of the mixed-staff strategy.

    Lin, I-Chun; Hou, Ying-Hui; Huang, Hui-Ling; Chu, Tsui-Ping; Chang, Ray-E

    2010-06-01

    Under the global shortage of Registered Nurses (RNs), some hospitals have integrated nursing assistants (NAs) into their teams to help to provide maximum quality care for acute patients, while keeping the hospital's staff-related costs down. However, the RNs may have to shoulder an increased burden of assigning and overseeing NAs. A web-based Nursing Assistants Management System (NAMS) was developed and evaluated for a case hospital in Taiwan to compare the processes of assigning and managing NAs before and after the NAMS intervention. The results showed that NAMS saved 80% of the time needed for manual operation and there were no more complains about NAs being slow in dealing with patients after the system intervention. The satisfaction levels of all NA managers and RNs were acceptable. Based on the research findings, the implication and limitations of this study were discussed.

  9. Role of robot-assisted radical prostatectomy in the management of high-risk prostate cancer

    Akshay Sood

    2014-01-01

    Full Text Available We aimed to evaluate the role of robot-assisted radical prostatectomy (RARP in the management of high-risk prostate cancer (PCa, with a focus on oncological, functional and perioperative outcomes. Further, we also aimed to briefly describe our novel modification to conventional RARP that allows immediate organ retrieval and examination for intra-operative surgical margin assessment. A literature search of PubMed was performed for articles on the management of high-risk PCa. Papers written in English and concerning clinical outcomes following RARP for locally advanced and high-risk PCa were selected. Outcomes data from our own center were also included. A total of 10 contemporary series were evaluated. Biopsy Gleason score ≥ 8 was the most common cause for classification of patients into the high-risk PCa group. Biochemical failure rate, in the few series that looked at long-term follow-up, varied from 9% to 26% at 1 year. The positive surgical margin rate varied from 12% to 53.3%. Urinary continence rates varied from 78% to 92% at 1 year. The overall complication rates varied from 2.4% to 30%, with anastomotic leak and lymphocele being the most common complications. Long-term data on oncological control following RARP in high-risk patients is lacking. Short-term oncological outcomes and functional outcomes are equivalent to open radical prostatectomy (RP. Safety outcomes are better in patients undergoing RARP when compared with open RP. Improved tools for predicting the presence of organ-confined disease (OCD are available. High-risk patients with OCD would be ideal candidates for RARP and would benefit most from surgery alone.

  10. Interdisciplinary semantic model for managing the design of a steam-assisted gravity drainage tooling system

    Michael Leitch

    2018-01-01

    Full Text Available Complex engineering systems often require extensive coordination between different expert areas in order to avoid costly design iterations and rework. Cyber-physics system (CPS engineering methods could provide valuable insights to help model these interactions and optimize the design of such systems. In this work, steam assisted gravity drainage (SAGD, a complex oil extraction process that requires deep understanding of several physical-chemical phenomena, is examined whereby the complexities and interdependencies of the system are explored. Based on an established unified feature modeling scheme, a software modeling framework is proposed to manage the design process of the production tools used for SAGD oil extraction. Applying CPS methods to unify complex phenomenon and engineering models, the proposed CPS model combines effective simulation with embedded knowledge of completion tooling design in order to optimize reservoir performance. The system design is expressed using graphical diagrams of the unified modelling language (UML convention. To demonstrate the capability of this system, a distributed research group is described, and their activities coordinated using the described CPS model.

  11. Integrated employee assistance program/managed behavioral health plan utilization by persons with substance use disorders.

    Merrick, Elizabeth S Levy; Hodgkin, Dominic; Hiatt, Deirdre; Horgan, Constance M; Greenfield, Shelly F; McCann, Bernard

    2011-04-01

    New federal parity and health reform legislation, promising increased behavioral health care access and a focus on prevention, has heightened interest in employee assistance programs (EAPs). This study investigated service utilization by persons with a primary substance use disorder (SUD) diagnosis in a managed behavioral health care (MBHC) organization's integrated EAP/MBHC product (N = 1,158). In 2004, 25.0% of clients used the EAP first for new treatment episodes. After initial EAP utilization, 44.4% received no additional formal services through the plan, and 40.4% received regular outpatient services. Overall, outpatient care, intensive outpatient/day treatment, and inpatient/residential detoxification were most common. About half of the clients had co-occurring psychiatric diagnoses. Mental health service utilization was extensive. Findings suggest that for service users with primary SUD diagnoses in an integrated EAP/MBHC product, the EAP benefit plays a key role at the front end of treatment and is often only one component of treatment episodes. Copyright © 2011 Elsevier Inc. All rights reserved.

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

    Hicks, Jeff

    2010-01-01

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

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

    Hau, M L

    1997-01-01

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

  14. Experience of a year of adult hospital dermatology consultations.

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

    2015-10-01

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

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

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

    2009-08-01

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

  16. 7 CFR 610.4 - Technical assistance furnished.

    2010-01-01

    ... consultants who provide services such as engineering, planning, environmental assessment, tax assessment, and... of program assistance, planning assistance, application of conservation practices, and assistance in...) County and other local government units such as park authorities, departments of public works, planning...

  17. International telemedicine consultations for neurodevelopmental disabilities.

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

    2014-06-01

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

  18. 78 FR 48342 - Consultation Agreements: Proposed Changes to Consultation Procedures

    2013-08-08

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

  19. Consultant tells how to reduce nuclear risk

    Smock, R.

    1983-01-01

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

  20. A New Resource for STD Clinical Providers: The Sexually Transmitted Diseases Clinical Consultation Network.

    Caragol, Laura A; Wendel, Karen A; Anderson, Teri S; Burnside, Helen C; Finkenbinder, Allison; Fitch, John D; Kelley, Destiny H; Stewart, Terry W; Thrun, Mark; Rietmeijer, Cornelis A

    2017-08-01

    An online consultation tool, the Sexually Transmitted Diseases Clinical Consultation Network is a new resource for sexually transmitted disease clinicians and clinic managers. An initial evaluation shows that most requests (29%) were from medical doctors, followed by nurse practitioners (22%). Syphilis queries comprised 39% of consults followed by gonorrhea (12%) and chlamydia (11%).

  1. Quality Computer Assisted Mobile Learning (CAML and Distance Education Leadership in Managing Technology Enhanced Learning Management System (TELMS in the Malaysian Public Tertiary Education

    Lee Tan Luck

    2009-07-01

    Full Text Available Abstract - The success in the implementation of a quality computer assisted mobile learning and distance education in a Technology Enhanced Learning Management System is highly rely on the academic leadership in managing and application of Information and Communication Technology (ICT in the tertiary level. The effectiveness of its leadership, knowledge, application and management of ICT and learning management system is of utmost important. Successful application and management includes quality and cost effectiveness of universities administration, CAML and distance education leadership development, organizational culture, academic staffs and students’ attitude and their commitment towards teaching and learning process, support towards the usage of state of the art techno-educational facilities, availability of ICT resources, maintenance and funding of a Learning Management System. This paper will discuss the above factors, which present a comprehensive framework for the implementation of a quality CAML and distance education environment in ICT application and management in the Malaysian public universities. Selected Fifty-two respondents from two Malaysian public universities which offer e Learning and distance education with Learning Management System were acquired. A survey questionnaire is used to determine the effectiveness of ICT and mobile learning application management. Data from the questionnaires were analyzed by using non-parametric and parametric statistics testing. Results of this study show there is significant different in the CAML and distance education leadership in TELMS and the application of ICT and its management in the Malaysian public universities. The study will also address the implementation elements necessary for transforming the public universities and its CAML and distance education teaching and learning process into an effective and result oriented computer assisted mobile learning management model in public

  2. An integrated model to measure service management and physical constraints' effect on food consumption in assisted-living facilities.

    Huang, Hui-Chun; Shanklin, Carol W

    2008-05-01

    The United States is experiencing remarkable growth in the elderly population, which provides both opportunities and challenges for assisted-living facilities. The objective of this study was to explore how service management influences residents' actual food consumption in assisted-living facilities. Physical factors influencing residents' service evaluation and food consumption also were investigated. A total of 394 questionnaires were distributed to assisted-living residents in seven randomly selected facilities. The questionnaire was developed based on an in-depth literature review and pilot study. Residents' perceived quality evaluations, satisfaction, and physical constraints were measured. Residents' actual food consumption was measured using a plate waste technique. A total of 118 residents in five facilities completed both questionnaires and food consumption assessments. Descriptive, multivariate analyses and structural equation modeling techniques were employed. Service management, including food and service quality and customer satisfaction, was found to significantly influence residents' food consumption. Physical constraints associated with aging, including a decline in health status, chewing problems, sensory loss, and functional disability, also significantly influenced residents' food consumption. A significant relationship was found between physical constraints and customer satisfaction. Foodservice that provides good food and service quality increases customer satisfaction and affects residents' actual food consumption. Physical constraints also influence residents' food consumption directly, or indirectly through satisfaction. The findings suggest that food and nutrition professionals in assisted-living should consider the physical profiles of their residents to enhance residents' satisfaction and nutrient intake. Recommendations for exploring residents' perspectives are discussed.

  3. Service Learning In Physics: The Consultant Model

    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. Store-Assistance Management for a Supply Chain with Consumer Return under Consignment Contract

    Zhihui Wu

    2017-01-01

    Full Text Available In this paper, the strategy problems of pricing and store-assistance service investment are investigated for a supply chain with consumer return, where the considered supply chain under consignment contract consists of a single manufacturer and a single retailer. Firstly, we use differential equation to model the evolution of store-assistance service level and depict the effect of store-assistance service level on the return rate. By applying two-stage game, both optimal pricing and store-assistance service strategies are obtained based on the presented optimal control model. Subsequently, the committed dynamic consignment price contract is designed to coordinate and improve the performance of supply chain. Finally, a numerical example is provided to illustrate the impacts of the effectiveness of store-assistance service level and decay rate on the feasible region of corresponding contract.

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

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

    2013-10-01

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

  6. Delayed flap reconstruction with vacuum-assisted closure management of the open IIIB tibial fracture.

    Hou, Zhiyong; Irgit, Kaan; Strohecker, Kent A; Matzko, Michelle E; Wingert, Nathaniel C; DeSantis, Joseph G; Smith, Wade R

    2011-12-01

    Vacuum-assisted closure (VAC) therapy has been shown to be effective at reducing bacterial counts in wounds until definitive bony coverage. However, there is continued debate over timing and type of definitive wound coverage even with VAC therapy application. From 2004 to 2009, 32 patients with Gustilo type IIIB open tibia fractures were initially treated with VAC therapy were included. The number of debridements, length of treatment with VAC dressing, definitive wound coverage management, and length of hospital stay, flap-related complications, and time to radiographic fracture healing were recorded. The mean Injury Severity Score was 17.3 ± 2.0. All wounds closed after being treated with the primary VAC closure. The mean interval between the initial injury and definitive intervention was 10.9 days ± 0.3 days. Twenty of 27 patients (74%) underwent rotational muscle flaps; four received free muscle flaps and three only with split-thickness skin grafts for definitive wound coverage. Nine of 32 patients (28%) underwent below knee amputation, five without flap coverage after several VAC sessions and four after definitive flap coverage. The average time to union was 10.0 months ± 2.0 months. Eight patients developed nonunion and 11 patients developed infections. The average follow-up time is 2.4 years ± 0.2 years. Patients were divided into two groups for analysis according to the interval time. The rate of infection was significantly increased in patients who had an interval of more than 7 days from the time of injury to flap coverage. The VAC therapy may help to reduce the flap size and need for a flap transfer for type IIIB open tibial fractures. However, prolonged periods of VAC usage, greater than 7 days, should be avoided to reduce higher infection and amputation risks.

  7. Minimally invasive vacuum-assisted closure therapy in the management of complex pleural empyema.

    Sziklavari, Zsolt; Grosser, Christian; Neu, Reiner; Schemm, Rudolf; Szöke, Tamas; Ried, Michael; Hofmann, Hans-Stefan

    2013-07-01

    The pool of potential candidates for pleural empyema is expanding. In a previous technical report, we tested the feasibility of the minimally invasive insertion of a vacuum-assisted closure (Mini-VAC) system without the insertion of an open-window thoracostomy (OWT). In this study, we describe a consecutive case series of complex pleural empyemas that were managed by this Mini-VAC therapy. In this retrospective study, we investigated 6 patients with multimorbidity (Karnofsky index ≤ 50%) who were consecutively treated with Mini-VAC for a primary, postoperative or recurrent pleural empyema between January 2011 and February 2012. Local control of the infection and control of sepsis were satisfactory in all 6 of the patients treated by Mini-VAC therapy. The suction used did not create any air leaks or bleeding from the lung or mediastinal structures. Mini-VAC therapy allowed a reduction of the empyema cavity and improved the re-expansion of the residual lung. Mini-VAC therapy resulted in a rapid eradication of the empyema. The chest wall was closed in all patients during the first hospital stay. All patients left the hospital in good health (Karnofsky index >70%) and with a non-infected pleural cavity at a mean of 22 ± 11 days after Mini-VAC installation. Pleural empyema was not detected in any of the 6 patients at the 3-month follow-up appointment. The Mini-VAC procedure with the abdication of an OWT offers a rapid treatment for complex pleural empyema with minimal surgical effort and the opportunity for a primary closure of the empyema cavity.

  8. How career counseling, management coaching, and mentoring can assist in reducing today’s lack of ethics in business

    Ronald Jean Degen

    2013-01-01

    This paper discusses how career counseling, management coaching, and mentoring can assist in reducing today’s lack of ethics in business by orienting future corporate leaders not only to identifying their skills, making better career choices, and becoming more productive and satisfied in their work, but also by explaining how to behave and decide properly when confronted with the myriad ethical dilemmas of the corporate world. Thus it is essential that they understand today’s lack of business...

  9. The transition to hospital consultant

    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....

  10. Compensation Consultants and CEO Pay

    Kabir, Mohammed Rezaul; Minhat, Marizah

    2014-01-01

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

  11. Advanced training of tax consultants

    Adigamova Farida F.

    2016-01-01

    Full Text Available The purpose of the research is to review and analyze the data on the necessity to provide an educational environment for training and advanced training of tax consultants in Russia. The article considers the types of tax consulting, the historical background of training financiers in Russia, as well as identifies conditions determining the significance of tax consulting. The research establishes the connection between the negative attitude to tax payment and tax evasion. The advanced training of tax consultants should be a continuous process as they need to take into account both external and internal taxpayers risks associated with the development of law and law-enforcement practice. Obviously, the training of tax consultants should take into account the experience of developed foreign countries, such as Germany, Austria, Czech Republic, Slovakia and other European countries as well. In Russia, it is necessary to open educational institutions, which will not only be involved in the certification of tax consultants, but also provide training courses. These courses should contribute to constant increase of tax consultants knowledge, consider the tax treatment of economic activities, as well changes in the legislation, economics, finance, accounting, manufacturing processes, which will improve the quality of services provided by tax consultants.

  12. 22 CFR 61.6 - Consultation with subject matter specialists.

    2010-04-01

    ... FREE FLOW OF AUDIO-VISUAL MATERIALS § 61.6 Consultation with subject matter specialists. (a) The... assisting the Department in its determination of whether materials for which export certification or import authentication is sought contain widespread and gross misstatements of fact. (b) As necessary, the Department may...

  13. Comunidades de prática de consultores: uma estratégia para a gestão do conhecimento Communities of consulting practice: a strategy for knowledge management

    Naldeir dos Santos Vieira

    2007-01-01

    Full Text Available Como a prática de consultoria organizacional tem no gerenciamento de conhecimento o requisito básico para o atendimento da eficácia de suas atividades, o consultor precisa estar constantemente adquirindo novos conhecimentos e informações. Esses conhecimentos podem ser adquiridos por meio de discussões, interações e reflexão em grupos e comunidades de práticas. Apesar de proporcionarem muitos benefícios aos seus membros, essas comunidades enfrentam dificuldades que impactam na sua sustentabilidade. Diante disso, o objetivo deste trabalho é identificar e analisar as aspirações, as dificuldades enfrentadas e os benefícios obtidos pela Comunidade de Formação de Consultores Organizacionais, organizada em Recife-PE. Trata-se de um estudo de caso qualitativo, realizado por meio da aplicação de entrevistas semi-estruturadas com consultores que participaram da comunidade. Várias dificuldades foram identificadas, destacando-se a pouca disponibilidade de tempo dos consultores para se envolver e se comprometer com a comunidade e o fato de serem pouco abertos a expor suas experiências. Não obstante isso, vários benefícios foram identificados, com destaque para a mudança de postura dos consultores envolvidos, que se tornaram mais eficazes em suas práticas.The basic requirement for effective action in organizational consulting is knowledge management. As such, to acquire new knowledge and information consultants must constantly learn through discussion, interaction and reflection in groups and more recently in communities of practice. Although these communities provide many benefits for members, difficulties are faced that can affect sustainability. Therefore this work identified and analyzed the aims, difficulties and benefits that the "Comunidade de Formação de Consultores Organizacionais" in Recife, Brazil, had experienced since inception. A qualitative method was used in this case study to interview participating consultants

  14. About the Principal Deputy Assistant Administrator of EPA’s Office of Administration and Resources Management

    Donna Vizian manages essential support functions, including human resources management, diversity and inclusion, acquisition (contracts), grants management, and the protection of EPA’s facilities and other critical assets nationwide.

  15. Endangered Species Act Consultation

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

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

    Walsh, Cian; Ryan, Patrick; Flynn, Daniel

    2018-01-01

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

  17. Pediatric Trainees Managing a Difficult Airway: Comparison of Laryngeal Mask Airway, Direct, and Video-Assisted Laryngoscopy

    Art Ambrosio MD

    2017-05-01

    Full Text Available Objective Difficult airway management is a key skill required by all pediatric physicians, yet training on multiple modalities is lacking. The objective of this study was to compare the rate of, and time to, successful advanced infant airway placement with direct laryngoscopy, video-assisted laryngoscopy, and laryngeal mask airway (LMA in a difficult airway simulator. This study is the first to compare the success with 3 methods for difficult airway management among pediatric trainees. Study Design Randomized crossover pilot study. Setting Tertiary academic medical center. Methods Twenty-two pediatric residents, interns, and medical students were tested. Participants were provided 1 training session by faculty using a normal infant manikin. Subjects then performed all 3 of the aforementioned advanced airway modalities in a randomized order on a difficult airway model of a Robin sequence. Success was defined as confirmed endotracheal intubation or correct LMA placement by the testing instructor in ≤120 seconds. Results Direct laryngoscopy demonstrated a significantly higher placement success rate (77.3% than video-assisted laryngoscopy (36.4%, P = .0117 and LMA (31.8%, P = .0039. Video-assisted laryngoscopy required a significantly longer amount of time during successful intubations (84.8 seconds; 95% CI, 59.4-110.1 versus direct laryngoscopy (44.9 seconds; 95% CI, 33.8-55.9 and LMA placement (36.6 seconds; 95% CI, 24.7-48.4. Conclusions Pediatric trainees demonstrated significantly higher success using direct laryngoscopy in a difficult airway simulator model. However, given the potential lifesaving implications of advanced airway adjuncts, including video-assisted laryngoscopy and LMA placement, more extensive training on adjunctive airway management techniques may be useful for trainees.

  18. Employee Assistance Program Issues

    Gettleman, Alan G.; McGuire, William

    1999-01-01

    Employee Assistance Program (EAP) officers, as well as personnel in other disciplines from eight NASA Centers, attended this breakout session. Ms. Brenda Blair, MA, CEAP, a guest speaker at the conference, also attended as a consultant. Representatives from the NASA Centers introduced themselves and spoke briefly about their programs. In a discussion related to the conference theme on benchmarking, quality control issues within the EAP community and adequate documentation of cases were addressed. Disposition and provision for quality assurance checks for EAP providers in single person offices were also discussed. Ms. Blair presented methods for consulting with other NASA personnel in single person EAP offices as a quality control measure. EAP intervention in critical incidents was discussed. The question of whether EAP assistance is an asset or a potential liability in those situations was addressed. Suggestions were made of topics for future EAP video-teleconference topics. A program on EAP ethics was planned for a September video teleconference. Each person was asked to provide intake forms they use to Mr. Gettleman or Ms. Blair. Ms. Blair said she would review the forms to ensure that adequate notification is provided to the client for confidentiality. She would also review them to ensure they have adequate limits of confidentiality--a topic for future video teleconferencing. Mr. Gettleman described the NASA initiative to reduce stresses in the workplace, and the activities of an ad-hoc EAP group that will make recommendations to NASA senior management. Alternative training methods were discussed for reaching target audiences such as employees at risk, supervisors, and others. Pfc. David A. Pendleton, Victim Assistance Coordinator, U.S. Capitol Police. U.S. House of Representatives made a special presentation. Pfc. Pendleton was on duty during the tragic shooting of two Federal guards at the U.S. Capitol. He related the events immediately after the incident. He

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

    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.

  20. Starting a nursing consultation practice.

    Schulmeister, L

    1999-03-01

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

  1. Employing the nominal group technique to explore the views of pharmacists, pharmacy assistants and women on community pharmacy weight management services and educational resources.

    Fakih, Souhiela; Marriott, Jennifer L; Hussainy, Safeera Y

    2016-04-01

    The objectives of this study were to investigate how pharmacists, pharmacy assistants and women feel about community pharmacy involvement in weight management, and to identify what pharmacists, pharmacy assistants and women want in weight management educational resources. Three homogenous and one heterogeneous nominal group (NG) sessions of up to 120-min duration were conducted with nine women, ten pharmacists and eight pharmacy assistants. The NG technique was used to conduct each session to determine the most important issues that should be considered surrounding community pharmacy weight management services and development of any educational resources. The heterogeneous NG session was used to finalise what women, pharmacists and pharmacy assistants want in educational resources. Overall, pharmacists, pharmacy assistants and women believe that pharmacy staff have an important role in the management of overweight and obesity because of their accessibility, trust and the availability of products in pharmacy. Regarding the most suitable healthcare professional(s) to treat overweight and obesity, the majority of participants believed that no one member of the healthcare team was most suitable and that overweight and obesity needs to be treated by a multidisciplinary team. The importance of having weight management educational resources for pharmacy staff and women that come from trustworthy resources without financial gain or commercialisation was also emphasised. Pharmacists, pharmacy assistants and women feel that community pharmacies have a definite role to play in weight management. Pharmacy-specific weight management educational resources that are readily available to pharmacy staff and women are highly desirable. © 2015 Royal Pharmaceutical Society.

  2. Nuclear consultant: a new profession

    Hardung von Hardung, H

    1976-02-01

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

  3. Nuclear consultant - a new profession

    Hardung von Hardung, H.

    1976-01-01

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

  4. ANALYSIS OF TREATMENT OF WOUNDS IN PATIENTS WITH GRADE IIIB COMPOUND FRACTURE WITH VACUUM-ASSISTED WOUND MANAGEMENT

    Ashish R. Agarwal

    2017-08-01

    Full Text Available BACKGROUND Delayed wound healing is a significant health problem, particularly in patients with compound fractures. It still remains a challenging task in orthopaedic surgery, which in addition to the pain and suffering, failure of the wound to heal, also imposes social and financial burdens. The aim of the study is to evaluate the results of vacuum-assisted wound therapy in patients with open musculoskeletal injuries. MATERIALS AND METHODS 30 patients of open musculoskeletal injuries underwent randomised trial of vacuum-assisted closure therapy versus standard wound therapy around the upper limb and lower limb. Mean patient age was 39 ± 18 years necrotic tissues were debrided before applying VAC therapy. Dressings were changed every 3 or 4 days. For standard wound therapy, debridement followed by daily dressings was done. Data Management and Statistical Analysis- The results obtained were subjected to statistical analysis. RESULTS Granulation tissue status and skin healing is better in patients undergoing VAC therapy. Hospital stay of patients undergoing VAC therapy was also less. CONCLUSION Vacuum-assisted wound therapy was better method of wound management.

  5. Barriers and Facilitators for Information Exchange during Over-The-Counter Consultations in Community Pharmacy: A Focus Group Study

    Seubert, Liza J; Boeni, Fabienne; Hattingh, Laetitia; Clifford, Rhonda M

    2017-01-01

    Consumers are confident managing minor ailments through self-care, often self-medicating from a range of over-the-counter (OTC) medicines available from community pharmacies. To minimise risks, pharmacy personnel endeavour to engage in a consultation when consumers present with OTC enquiries however they find consumers resistant. The aim was to determine stakeholder perspectives regarding barriers and facilitators for information exchange during OTC consultations in community pharmacies and to understand the elicited themes in behavioural terms. Focus groups were undertaken with community pharmacist, pharmacy assistant and consumer participants. Independent duplicate analysis of transcription data was conducted using inductive and framework methods. Eight focus groups involving 60 participants were conducted. Themes that emerged indicated consumers did not understand pharmacists’ professional role, they were less likely to exchange information if asking for a specific product than if asking about symptom treatment, and they wanted privacy. Consumers were confident to self-diagnose and did not understand OTC medicine risks. Pharmacy personnel felt a duty of care to ensure consumer safety, and that with experience communication skills developed to better engage consumers in consultations. They also identified the need for privacy. Consumers need education about community pharmacists’ role and responsibilities to motivate them to engage in OTC consultations. They also require privacy when doing so. PMID:29211054

  6. Barriers and Facilitators for Information Exchange during Over-The-Counter Consultations in Community Pharmacy: A Focus Group Study

    Liza J Seubert

    2017-12-01

    Full Text Available Consumers are confident managing minor ailments through self-care, often self-medicating from a range of over-the-counter (OTC medicines available from community pharmacies. To minimise risks, pharmacy personnel endeavour to engage in a consultation when consumers present with OTC enquiries however they find consumers resistant. The aim was to determine stakeholder perspectives regarding barriers and facilitators for information exchange during OTC consultations in community pharmacies and to understand the elicited themes in behavioural terms. Focus groups were undertaken with community pharmacist, pharmacy assistant and consumer participants. Independent duplicate analysis of transcription data was conducted using inductive and framework methods. Eight focus groups involving 60 participants were conducted. Themes that emerged indicated consumers did not understand pharmacists’ professional role, they were less likely to exchange information if asking for a specific product than if asking about symptom treatment, and they wanted privacy. Consumers were confident to self-diagnose and did not understand OTC medicine risks. Pharmacy personnel felt a duty of care to ensure consumer safety, and that with experience communication skills developed to better engage consumers in consultations. They also identified the need for privacy. Consumers need education about community pharmacists’ role and responsibilities to motivate them to engage in OTC consultations. They also require privacy when doing so.

  7. Using computer-assisted learning to engage diverse learning styles in understanding business management principles.

    Frost, Mary E; Derby, Dustin C; Haan, Andrea G

    2013-01-01

    Objective : Changes in small business and insurance present challenges for newly graduated chiropractors. Technology that reaches identified, diverse learning styles may assist the chiropractic student in business classes to meet course outcomes better. Thus, the purpose of our study is to determine if the use of technology-based instructional aids enhance students' mastery of course learning outcomes. Methods : Using convenience sampling, 86 students completed a survey assessing course learning outcomes, learning style, and the helpfulness of lecture and computer-assisted learning related to content mastery. Quantitative analyses occurred. Results : Although respondents reported not finding the computer-assisted learning as helpful as the lecture, significant relationships were found between pre- and post-assisted learning measures of the learning outcomes 1 and 2 for the visual and kinesthetic groups. Surprisingly, however, all learning style groups exhibited significant pre- and post-assisted learning appraisal relationships with learning outcomes 3 and 4. Conclusion : While evidence exists within the current study of a relationship between students' learning of the course content corollary to the use of technologic instructional aids, the exact nature of the relationship remains unclear.

  8. Use of Nuclear Techniques in Biological Control: Managing Pests, Facilitating Trade and Protecting the Environment. Report of a Consultants Group Meeting. Working Material

    1999-01-01

    High-priority opportunities are proposed for use of nuclear techniques to effect improved production and shipping of augmentative biological control agents. Proposed subprojects include use of ionizing radiation to improve the production of insect natural enemies on natural hosts/prey or on artificial diets. Other subprojects pertain to improving the ability to move beneficial organisms in international trade, and in using them in the field. Additional high priority activities were identified proposing use of nuclear techniques to produce sterile and/or substerile F-1 weed biological control agents to help evaluate potential impact on non-target species in the pre-release phase, integration of augmentative releases and F-1 sterility in IPM and area-wide pest management programmes, and utilization of by-products from SIT mass-rearing facilities in augmentative biological control programmes. (author)

  9. Acceptability of an e-learning program to help nursing assistants manage relationship conflict in nursing homes.

    Marziali, Elsa; Mackenzie, Corey Scott; Tchernikov, Illia

    2015-02-01

    Management of nursing assistants' (NAs) emotional stress from relationship conflicts with residents, families, and coworkers is rarely the focus of educational programs. Our objective was to gather feedback from NAs and their nursing supervisors (NSs) about the utility of our e-learning program for managing relationship stress. A total of 147 NAs and their NSs from 17 long-term care homes viewed the educational modules (DVD slides with voice-over), either individually or in small groups, and provided feedback using conference call focus groups. Qualitative analysis of NA feedback showed that workplace relationship conflict stress was associated with workload and the absence of a forum for discussing relationship conflicts that was not acknowledged by NSs. This accessible e-learning program provides NAs with strategies for managing stressful emotions arising from workplace relationship conflict situations and underscores the importance of supervisory support and team collaboration in coping with emotionally evoked workplace stress. © The Author(s) 2014.

  10. Assessment on nursing serviceat hospital external consulting rooms

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

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

    2012-04-01

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

  12. Improving Risk Management and Resiliency: A Plan for a Proactive National Policy on Insurance Practices in FEMA’s Public Assistance Program

    2013-12-01

    and reduce insurance costs. 178 Department of Finance and Deregulation , “Managing the Cost of Damage to Road Infrastructure Caused by Natural...MANAGEMENT AND RESILIENCY: A PLAN FOR A PROACTIVE NATIONAL POLICY ON INSURANCE PRACTICES IN FEMA’S PUBLIC ASSISTANCE PROGRAM by Gregory W. Eaton...AND RESILIENCY: A PLAN FOR A PROACTIVE NATIONAL POLICY ON INSURANCE PRACTICES IN FEMA’S PUBLIC ASSISTANCE PROGRAM 5. FUNDING NUMBERS 6. AUTHOR(S

  13. Consultation document Energy Market Concentrations

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

    2006-06-01

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

  14. The Enhancement of Regional Disaster Management Agencies (BPBD of Sumbawa Regency’s Capability in Flash Flood Management Through Aid Assistance of Japan International Cooperation Agency (JICA

    Nudia Vebina Ayumahani

    2018-03-01

    Full Text Available The need for enhancing capability has a very important significance in effective disaster management activities. Regional Disaster Management Agencies (BPBD of Sumbawa Regency established cooperation with the Japan International Cooperation Agency (JICA in enhancing the capability of flash flood management. The purpose of this research was to review and evaluate the JICA’s aid assistance programs toward BPBD of Sumbawa Regency, hereafter analyze the impact of the programs. Evaluation and analysis of this research were measured by three indicators of capability which is resources, leadership and policy implementation. This research used a qualitative descriptive method and proceed through the source and method triangulation. The researcher used purposive sampling technique in choosing seven informants from BPBD of Sumbawa Regency’s staff. The results showed that JICA’s aid assistance programs towards BPBD of Sumbawa Regency had been achieved by the targets and goals that have been determined. This program has impacted on enhancing the capability of resources that leads to the ability in Mapping, Technical Guidelines (JUKNIS and Disaster Management Plan (RPB. Increasing the capability of Human Resources (HR gives the effect of increasing capability in other fields such as financial resource capability, technical resource capability, leadership capability and policy implementation capability. The main factors in the success of the capability enhancement are the discipline factor of BPBD staff, high willingness to improve capability by BPBD staff, capability- enhancing programs, and clear direction from JICA.

  15. Robot-Assisted Laparoscopic Management of Caliceal Diverticular Calculi

    Anneleen Verbrugghe

    2017-07-01

    Full Text Available Standard treatment modalities of caliceal diverticular calculi range from extracorporal shockwave lithotripsy (SWL over retrograde intrarenal surgery (RIRS, percutaneous nephrolithotomy (PNL and laparoscopic stone removal. A 55-year-old woman presented with a history of pyelonephritis based on a caliceal diverticular calculus. Due to the narrow infundibulum and anterior location, a robot-assisted laparoscopic calicotomy with extraction of the calculi and fulguration of the diverticulum was performed, with no specific perioperative problems and good stone-free results. This article shows technical feasibility with minimal morbidity of robot-assisted laparoscopic stone removal and obliteration of a caliceal diverticulum.

  16. The EPA-Wide Plan to Provide Solid Waste Management Capacity Assistance to Tribes

    This Plan is a strategy for building tribal capacity to manage solid waste. The Plan promotes the development and implementation of integrated waste management plans and describes how EPA will prioritize its resources to maximize environmental benefits.

  17. Employee Assistance Programs.

    Levine, Hermine Zagat

    1985-01-01

    The author reports company responses to a questionnaire concerning employee assistance programs (EAP). Answers concern EAP structure, staff training, use of outside consultant, services provided by EAPs, program administration, employee confidence in EAPs, advertising the program, program philosophy, problems encountered by EAP users, coverage and…

  18. The DISAM Journal of International Security Assistance Management. Volume 25, Number 3, Spring 2003

    2003-01-01

    OES Initiatives 4.000 2.000 1.500 Partnerships to Eliminate Sweatshops 4.000 4.000 2.000 Policy Initiatives 0.000 20.250 0.000 Subtotal – Global... disadvantaged youth. Limitation on Assistance to Security Forces (Section 556) • None of the funding made available by this Act may be provided to any

  19. Provision of assistive technology services method (ATSM) according to evidence-based information and knowledge management.

    Elsaesser, Linda-Jeanne; Bauer, Stephen M

    2011-01-01

    PURPOSE. This article develops a standardised method for assistive technology service (ATS) provision and a logical basis for research to improve health care quality. The method is 'interoperable' across disabilities, disciplines, assistive technology devices and ATSs. BACKGROUND. Absence of a standardised and interoperable method for ATS provision results in ineffective communication between providers, manufacturers, researchers, policy-makers and individuals with disabilities (IWD), a fragmented service delivery system, inefficient resource allocation and sub-optimal outcomes. OBJECTIVES. Synthesise a standardised, interoperable AT service method (ATSM) fully consistent with key guidelines, systems, models and Federal legislation. Express the ATSM using common and unambiguous language. RESULTS. Guidelines, systems, models and Federal legislation relevant to ATS provision are reviewed. These include the RESNA Guidelines for Knowledge and Skills for Provision of Assistive Technology Products and Services (RESNA Guidelines), IMPACT2 model, international classification of functioning, disability and health (ICF) and AT device classification (ATDC). Federal legislation includes the Assistive Technology Act of 2004, Americans with Disabilities Act of 2008 and Social Security Act. Based on these findings, the ATSM is synthesised and translated into common and accessible language. CONCLUSION. ATSM usage will improve communication between stakeholders, service delivery coherence, resource allocation and intervention outcomes.

  20. Development of a Knowledge Base for Enduser Consultation of AAL-Systems.

    Röll, Natalie; Stork, Wilhelm; Rosales, Bruno; Stephan, René; Knaup, Petra

    2016-01-01

    Manufacturer information, user experiences and product availability of assistive living technologies are usually not known to citizens or consultation centers. The different knowledge levels concerning the availability of technology shows the need for building up a knowledge base. The aim of this contribution is the definition of requirements in the development of knowledge bases for AAL consultations. The major requirements, such as a maintainable and easy to use structure were implemented into a web based knowledge base, which went productive in ~3700 consulting interviews of municipal technology information centers. Within this field phase the implementation of the requirements for a knowledge base in the field of AAL consulting was evaluated and further developed.

  1. Research Data Management Self-Education for Librarians: A Webliography

    Goben, Abigail; Raszewski, Rebecca

    2015-01-01

    As data as a scholarly object continues to grow in importance in the research community, librarians are undertaking increasing responsibilities regarding data management and curation. New library initiatives include assisting researchers in finding data sets for reuse; locating and hosting repositories for required archiving; consultations on…

  2. The influence pattern of key factors affecting the purpose of organizational excellence consulting on the efficiency of businesses consulting services (A case study of small and medium-size food enterprises in Tehran province

    Mansour Ezati Jivan

    2012-04-01

    Full Text Available Consulting helps managers or other people find appropriate solutions for challenges they face in their businesses. Most of the losses incurred by the people and the society could be prevented using appropriate consultation. Consultation, also, refers to people's participation in decision making. Despite dramatic development in management consulting industry in the world during the last three decades, consulting industry in Iran has faced numerous challenges. This study aims to examine the factors affecting the efficiency of management consulting services in small and medium-sized businesses and it focuses on food industries in Tehran as a real-world case study. The necessary suggestions regarding the hiring of a consultant and increasing the efficiency of management consulting services in business have been offered in this study. Some recommendations deal with the way that management consultants should respond to the managers' needs, act as a reliable and efficient adviser in public or private businesses and find their position in the Iranian market. The conceptual model of this study shows the influence of key factors affecting the purpose of consulting on the efficiency of management consulting services. To do the research, 90 people are selected as the sample size in a descriptive study with random sampling of the managers of aforementioned companies using a questionnaire. Cronbach’s alpha method was used to assess the reliability of the questionnaire. For assessing the validity of the questionnaire, we use standard questionnaire, which has already been used.

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

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

    2016-10-01

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

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

    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...

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

    Broberg, Ole

    2004-01-01

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

  6. The DISAM Journal of International Security Assistance Management. Volume 23, Number 2, Winter 2001

    2001-01-01

    The DISAM Journal, Winter 2001 90 Protection Project to continue its study of international trafficking, prostitution, slavery , debt bondage and other...amounting to debt bondage , involuntary servitude, or slavery . This includes about 50,000 women and children trafficked annually into the U.S. [Section 102...Vietnamese to receive modern demining equipment and other mine- related assistance through the U.S. humanitarian demining program. The Vietnamese will

  7. The DISAM Journal of International Security Assistance Management. Volume 30, Number 4, December 2008

    2008-12-01

    elections. Due to the electoral cycle, Japan may face a few years of legislative uncertainty, which will certainly affect the speed of government...Albania must accelerate judicial reforms and stay on track with its electoral reforms. The fight against corruption must be total in order to show that no...Recreacion Derecho de la Poblacion during the humanitarian/ civic assistance mission Continuing Promise (CP) 2008. Kearsarge is the primary platform

  8. Social work role in developing and managing employee assistance programs in health care settings.

    Foster, Z; Hirsch, S; Zaske, K

    1991-01-01

    The hospital setting presents special needs for an Employee Assistance Program and special complications for sponsorship, development, and maintenance. What has been learned, how certain problems can be solved or avoided, how responsibility and accountability can be negotiated are presented by a team that has successfully established such a program at a large metropolitan medical center. In addition to successes, some unsolved problems are identified for further study.

  9. Client/consultant model services agreement

    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

  10. Vacuum-assisted closure therapy in the management of lung abscess.

    Sziklavari, Zsolt; Ried, Michael; Hofmann, Hans-Stefan

    2014-09-06

    Despite significant advances in the treatment of thoracic infections, complex lung abscess remains a problem in modern thoracic surgery. We describe the novel application of vacuum-assisted closure for the treatment of a lung abscess. The technical details and preliminary results are reported. After the initial failed conservative treatment of an abscess, minimally invasive surgical intervention was performed with vacuum-assisted closure. The vacuum sponges were inserted in the abscess cavity at the most proximal point to the pleural surface. The intercostal space of the chest wall above the entering place was secured by a soft tissue retractor. The level of suction was initially set to 100 mm Hg, with a maximum suction of 125 mm Hg. The sponge was changed once on the 3rd postoperative day. The abscess cavity was rapidly cleaned and decreased in size. The mini-thoracotomy could be closed on the 9th postoperative day. Closure of the cavity was simple, without any short- or long-term treatment failure. This technique reduced the trauma associated with the procedure. The patient was discharged on the 11th postoperative day. Vacuum-assisted closure systems should be considered for widespread use as an alternative option for the treatment of complicated pulmonary abscess in elderly, debilitated, immunocompromised patients after failed conservative treatment.

  11. Demonstration of generic handbooks for assisting in the management of contaminated food production systems and inhabited areas in Europe

    Nisbet, A.F.; Andersson, Kasper Grann; Duranova, T.

    2010-01-01

    Two handbooks have been developed in conjunction with a wide range of stakeholders that provide assistance in the management of contaminated food production systems and inhabited areas following a radiological incident. Emergency centres in Member States not involved in the development...... of these handbooks were invited to take part in demonstration activities to establish whether the handbooks would be useful for the purposes of contingency planning and accident management. Some eight centres took part. Emergency exercises or similar events based on scenarios involving contamination of the foodchain...... and inhabited areas were used. Feedback from all of the demonstrations was positive with constructive criticism given on how to improve the navigation, structure and format of the handbooks. All of the key improvements highlighted during the demonstrations were taken into account and included in version 2...

  12. An Evaluation of the Federal Energy Management Program Technical Assistance Workshops: Results of a 1998 Customer Survey

    G. B. Gordon; N. Hall

    1999-04-01

    This report presents the results of a customer telephone survey of the participants of six workshops provided by the U. S. Department of Energy Federal Energy Management Program (FEMP) during calendar years 1995 and 1996. The primary purpose for the survey was to provide the Team Leader for FEMP Technical Assistance and members of the team with detailed customer feedback pertaining to how well selected FEMP workshops are doing and to identify areas for improvement. The information presented enables managers to see both the strengths of their workshops, as well as workshop components that can be improved. In addition, the report identifies the questions included in the survey that were the most productive for obtaining customers experiences, opinions and recommendations. The experiences gained during this survey provide a platform from which to launch an annual FEMP customer survey.

  13. Creative Counseling Techniques Applied to the Business World: The Use of Theory and Creativity in Consultation

    Stone, Victoria; Jacobs, E.

    2008-01-01

    This article presents an overview of the use of impact therapy, a multisensory, creative approach to counseling, in a consultation project the authors conducted with the managers of a local car dealership. The purpose of the consultation was to help the managers with the stress and anxiety associated with working in the car sales industry.…

  14. Key Value Considerations for Consultant Pharmacists.

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

    2016-07-01

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

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

    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.

  16. An online lifestyle diary with a persuasive computer assistant providing feedback on self-management

    Blanson Henkemans, O.A.; Boog, P.J.M. van der; Lindenberg, J.; Mast, C.A.P.G. van der; Neerincx, M.A.; Zwetsloot-Schonk, B.J.H.M.

    2009-01-01

    In accordance with the global trend, in The Netherlands approximately 45% of the population is overweight. Existing studies show that patient self-management can reduce these figures, but medical non-adherence is a persistent problem. eHealth can potentially increase adherence to self-management.

  17. Planning and Execution of Knowledge Management Assist Missions for Nuclear Organizations (Russian Edition)

    2012-06-01

    As a result of the widening knowledge gap in the nuclear industry and related organizations, the IAEA is developing a series of guidance documents on knowledge management. This publication represents one such activity and provides general guidance as to the nature of the knowledge management mission and the means by which its goals are to be achieved and executed.

  18. Experimental investigation on the thermal performance of heat pipe-assisted phase change material based battery thermal management system

    Wu, Weixiong; Yang, Xiaoqing; Zhang, Guoqing; Chen, Kai; Wang, Shuangfeng

    2017-01-01

    Highlights: • A heat pipe assisted phase change material based battery thermal management system is proposed. • The proposed system is compact and efficient from a view of practical application. • Cycling conditions are experimentally simulated for practical working environment. • The proposed system presents better thermal performance in comparison to other systems. • Combining forced air convection with heat pipe further enhances the cooling effect. - Abstract: In this paper, a heat pipe-assisted phase change material (PCM) based battery thermal management (BTM) system is designed to fulfill the comprehensive energy utilization for electric vehicles and hybrid electric vehicles. Combining the large heat storage capacity of the PCM with the excellent cooling effect of heat pipe, the as-constructed heat pipe-assisted PCM based BTM is feasible and effective with a relatively longer operation time and more suitable temperature. The experimental results show that the temperature maldistribution of battery module can be influenced by heat pipes when they are activated under high discharge rates of the batteries. Moreover, with forced air convection, the highest temperature could be controlled below 50 °C even under the highest discharge rate of 5C and a more stable and lower temperature fluctuation is obtained under cycling conditions. Meanwhile, the effectiveness of further increasing air velocity (i.e., more fan power consumption) is limited when the highest temperature continues to reduce at a lower rate due to the phase transition process of PCM. These results are expected to provide insights into the design and optimization of BTM systems.

  19. Patient assessment: effective consultation and history taking.

    Kaufman, Gerri

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

  20. Technology-assisted self-testing and management of oral anticoagulation therapy: a qualitative patient-focused study.

    Kuljis, Jasna; Money, Arthur G; Perry, Mark; Barnett, Julie; Young, Terry

    2017-09-01

    Oral anticoagulation therapy requires regular blood testing to ensure therapeutic levels are maintained and excessive bleeding/clotting is avoided. Technology-assisted self-testing and management is seen as one of the key areas in which quality of care can be improved whilst reducing costs. Nevertheless, levels of patient engagement in self-testing and management remain low. To date, little research emphasis has been placed on understanding the patients' perspectives for low engagement. The typical approach adopted by healthcare providers is to provide patient education programmes, with the expectation that individual patients will change their behaviour and adopt new self-care strategies. However, if levels of patient engagement are to be increased, healthcare providers must also develop a better understanding of how their clinical service provision is perceived by patients and make adaptations. To explore patient views, needs and expectations of an anticoagulation service and the self-testing and management services provided. Interviews were conducted with 17 patients who currently engage in international normalised ratio (INR) self-testing and management. Thematic coding and analysis were carried out on the interview transcripts. Four high-level themes emerged from interviews: (i) role of clinic, (ii) motivations for self-testing, (iii) managing INR and (iv) trust. The clinic was seen as adding value in terms of specifying testing frequency, dosage profiles and calibrating equipment. Prompt communication from clinic to patient was also valued, although more personalised/real-time communication would help avoid feelings of isolation. Patients felt more in control as self-tester/managers and often took decisions about treatment adjustments themselves. However, some also manipulated their own test results to avoid 'unnecessary' interventions. More personalised/real-time communication, pragmatic and collaborative patient-clinician partnerships and recognition of

  1. Assisted living: a place to manage uncertainty. The ambiguity of assisted living is unavoidable because residents' needs are always changing. The Wheat Valley example is used to examine this concept.

    Ekerdt, David J

    2005-01-01

    The assisted living environment lacks the satisfying clarity of the consumer model (a stay at the Holiday Inn) or the medical model (the hospital or nursing home). Yet the ambiguity of assisted living is unavoidable because it shelters individuals whose needs are changing, the model of care requires extensive negotiation with residents, and staff members must continually compromise as they implement the principles. Assisted living is a place where uncertainty is managed, not resolved. This indicates a need for the further pursuit of qualitative research, such as reported by these articles and others (e.g., Carder, 2002), to explore how participants construct, make sense of, and interpret their daily experience in assisted living.

  2. BNFL Sellafield further public consultation

    1994-01-01

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

  3. Case consultation: ablatio penis.

    Money, J

    1998-01-01

    In male infants, traumatic ablation of the penis, with or without loss of the testicles may occur as a sequel to mutilatory violence, accidental injury, or circumcision error. Post-traumatically, one program of case management is surgical sex reassignment to live as a girl, with female hormonal therapy at the age of puberty. The other program is genital reconstructive surgery to live as a boy, with male hormonal therapy at puberty if the testicles are missing. In both programs, the long term outcome is less than perfect and is contingent on intervening variables that include societal ideology; surgical technology; juvenile and adolescent timing and frequency of hospital admissions construed by the child as nosocomial abuse; development of body image; health and sex education; fertility versus sterility; coitus and orgasm; possible lesbian orientation if living as a girl; and long-term cost accounting, including the psychic cost of being a pawn in possible malpractice litigation on whose disability a very large fortune in compensation may devolve. There is, as yet, no unanimously endorsed set of guidelines for the treatment of genital trauma and mutilation in infancy, and no provision for a statistical depository for outcome data.

  4. Measuring Children's Perceptions of Parental Involvement in Conjoint Behavioral Consultation: Factor Structure and Reliability of the "Parental Support for Learning Scale"

    Rogers, Maria; Markel, Clarisa; Midgett, Jonathan D.; Ryan, Bruce A.; Tannock, Rosemary

    2014-01-01

    Practitioners of Conjoint Behavioral Consultation rely on several sources of information to assist in planning and evaluation of consultation efforts. Parental involvement in the home is an important aspect in Conjoint Behavioral Consultation, yet there are few questionnaires available to practitioners to assess this important construct,…

  5. Native American Technical Assistance and Training for Renewable Energy Resource Development and Electrical Generation Facilities Management

    A. David Lester

    2008-10-17

    The Council of Energy Resource Tribes (CERT) will facilitate technical expertise and training of Native Americans in renewable energy resource development for electrical generation facilities, and distributed generation options contributing to feasibility studies, strategic planning and visioning. CERT will also provide information to Tribes on energy efficiency and energy management techniques.This project will provide facilitation and coordination of expertise from government agencies and private industries to interact with Native Americans in ways that will result in renewable energy resource development, energy efficiency program development, and electrical generation facilities management by Tribal entities. The intent of this cooperative agreement is to help build capacity within the Tribes to manage these important resources.

  6. Development of software for management of radioactive waste in biological research and clinical assistance

    Maciel, Bianca; Mattos, Maria Fernanda S.S.; Medeiros, Regina B.; Franca Junior, Jose Antonio de

    2011-01-01

    This paper describes the development of software which facilitates the automation of this process by mean of the Safety Analysis Report generating a data base allowing the statistic analysis and elaboration of radioactive wastes inventory. The software was developed in PHP language and the information is stored in a data base generated in Oracle and organized in different tables which allows to calculate the storage time of waste and to register the specificities of radioisotopes, cadastral data of the professionals which handle that radioisotope and also the characteristics of handling laboratories. That tool collaborates for a effective control on the use of radioisotopes in research laboratories and assistance areas as well

  7. Management Consulting Practice on Intellectual Capital

    Dr. Daan Andriessen

    2005-01-01

    Today, Intellectual Capital plays a principal role in the delivery of corporate performance. This importance is reflected in the fact that companies, without the force of any regulations, start to produce intellectual capital statements to communicate their performance; accounting guidelines are

  8. Global Grid Telemedicine System: Expert Consult Manager

    2000-10-01

    0.00 3.07 0.00 BUCCAL 11.54 1.09 3.23 2.60 3.07 12.28 CHANGES 11.54 0.00 0.00 0.00 0.61 0.00 CYST 11.54 1.09 2.15...ieb’htult (tluffiber Ml Wm APICAL45.61403 |K STATUS 50.877193 :Eä’ PERIAPICAL 52.63158 |S>-’ ON 42 105263 iffl NOTES 38.596493 Spir RFNDFRFD 47

  9. GIS tailored questionnaires for assisting health care management in distributing resources

    Herselman, M

    2010-09-01

    Full Text Available A tailored questionnaire focuses on dynamic generation of items and questions according to the location where the questionnaire is used. The approach is connected to the management of resources and the support of decision making processes which...

  10. A methodological model to assist in the optimization and risk management of mining investment decisions

    Botin, Jose A; Guzman, Ronald R; Smith, Martin L

    2011-01-01

    Identifying, quantifying, and minimizing technical risks associated with investment decisions is a key challenge for mineral industry decision makers and investors. However, risk analysis in most bankable mine feasibility studies are based on the stochastic modeling of project N et Present Value (NPV)which, in most cases, fails to provide decision makers with a truly comprehensive analysis of risks associated with technical and management uncertainty and, as a result, are of little use for risk management and project optimization. This paper presents a value-chain risk management approach where project risk is evaluated for each step of the project life cycle, from exploration to mine closure, and risk management is performed as a part of a stepwise value-added optimization process.

  11. M2IRAGE: Management of measurements during radiological interventions geographically assisted in the environment

    Gerphagnon, O.; Roche, H.; Lelache, H.; Guelin, M.; Fauquant, J.M.; Kacenelen, Y.; Armand, Y.

    2010-01-01

    This report presents the M 2 IRAGE software, a data processing tool designed to share radioactivity measurements and to give a schematised view of a radiological situation and of its evolution, while respecting different legal frameworks, notably the obligation to produce a radiological measurement programme. After a simplified recall of the crisis management organisation, the authors describe the M 2 IRAGE software and hardware architecture, the functions of its main modules (presentation of radioprotection information during field intervention, field mission management, data browsing, and data transmission to field teams). While giving some display examples, the authors describe how an event is managed and processed by this tool: event creation, measurement acquisition, aid to decision, team management. They report and discuss the results of a national exercise which took place in September 2009 in Saclay with a prototype version of M 2 IRAGE

  12. Relationship outcomes as measurement criteria to assist communication strategists to manage organisational relationships

    E. Botha

    2011-06-01

    Full Text Available Nonfinancial assets like relationships are increasingly important to managers. Communication managers in particular are focusing on measuring and managing organisational relationships as a means to quantify the return on investment (ROI of public relations and communication strategies. Measuring relationships offers communication managers a way to evaluate its contribution to the organisation. A commonly agreed upon definition of these relationships, however, does not exist. If we consider communication management is a managerial function, it must first refine its instruments of measurement. This study looks at the three-stage model of organisational relationships (relationship antecedents, maintenance strategies and relationship outcomes proposed by Grunig & Huang (2000 to firstly review the development of the model. Secondly, the study takes an in-depth look at each relationship outcomes of trust, commitment, satisfaction and control mutuality. Lastly, we assess the reliability and validity of the use of current relationship outcome measures through a survey of 154 organisational relationships. Previous studies that have utilized these outcomes in the measurement of organisational relationships do not discuss the possible interaction (or relationship among these outcomes. This study contributes to current literature by both providing an improved framework for the measurement of relationship outcomes and hypothesizing about how these outcomes interact with one another. It also discusses the managerial implications of managing relationships through the constant measurement of trust, commitment, satisfaction and control mutuality

  13. An expert system for fault management assistance on a space sleep experiment

    Atamer, A.; Delaney, M.; Young, L. R.

    2002-01-01

    The expert system, Principal Investigator-in-a-box, or [PI], was designed to assist astronauts or other operators in performing experiments outside their expertise. Currently, the software helps astronauts calibrate instruments for a Sleep and Respiration Experiment without contact with the investigator on the ground. It flew on the Space Shuttle missions STS-90 and STS-95. [PI] displays electrophysiological signals in real time, alerts astronauts via the indicator lights when a poor signal quality is detected, and advises astronauts how to restore good signal quality. Thirty subjects received training on the sleep instrumentation and the [PI] interface. A beneficial effects of [PI] and training reduced troubleshooting time. [PI] benefited subjects on the most difficult scenarios, even though its lights were not 100% accurate. Further, questionnaires showed that most subjects preferred monitoring waveforms with [PI] assistance rather than monitoring waveforms alone. This study addresses problems of complex troubleshooting and the extended time between training and execution that is common to many human operator situations on earth such as in power plant operation, and marine exploration.

  14. [Change management: An analysis of actors; perceptions about technical assistance in the Democratic Republic of Congo].

    Ribesse, Nathalie; Iyeti, Alain; Macq, Jean

    2015-01-01

    Technical assistance (TA) is a common component of health system strengthening interventions. This type of intervention is too often designed and evaluated according to a logic that fails to take into account social complexity. Actors' perceptions are one element of this complexity. This article presents a study conducted in the Democratic Republic of Congo designed to identify perceptions concerning two types of technical support providers for health system strengthening: long-term technical assistants (agents of development agencies) and provincial technical advisors (agents of the Ministry of Health). Interviews were conducted with an innovative tool inspired by the principles of systems thinking. Interviewees were actors involved in a TA intervention in the province of Bandundu. Their expectations regarding TA providers were identified in terms of personal characteristics (knowledge, know-how and interpersonal skills), roles, and styles of interaction for capacity building ("interventionist/ prescriptive axes"). Interviewees emphasized the importance of mutual learning and the quality of interactions, which depends on TA provider's interpersonal skills and mutual willingness. Perceptions of TA provider's characteristics tend to be similar, but several differences were observed concerning the expectations about the roles of TAs, and the style that should be adopted for capacity building. Ignoring these differences in expectations may be a threat to the effectiveness of TA.

  15. "Learning to Assess" and "Assessing to Learn": The Construction of Knowledge about Assistive Technology

    Folkes, Clare; Carmichael, Patrick

    2006-01-01

    A key role in the development and deployment of Assistive Technology solutions is that of the "assessor-consultant". Assessor-consultants for the UK-based charity Abilitynet work with clients to develop customized computer-based assistive technology systems and draw on a range of shared knowledge from the assessor-consultant community.…

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

    Pecina, Jennifer L; North, Frederick

    2017-06-01

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

  17. The association between question type and the outcomes of a Dermatology eConsult service.

    O'Toole, Ashley; Joo, Jiyeh; DesGroseilliers, Jean-Pierre; Liddy, Clare; Glassman, Steven; Afkham, Amir; Keely, Erin

    2017-08-01

    eConsult is a web based service that facilitates communication between primary care providers (PCPs) and specialists, which can reduce the need for face-to-face consultations with specialists. One example is the Champlain BASE (Building Access to Specialist through eConsultation) service with dermatology being the largest specialty consulted. Dermatology eConsults submitted from July 2011 to January 2015 were reviewed. Post eConsult surveys for PCPs were analyzed to determine the number of traditional consults avoided and perceived value of eConsults. The time it took the PCP to receive a reply and the amount of time reported by the specialist to answer eConsult were proactively recorded and analyzed. A subset of 154 most recent eConsults was categorized for dermatology content and question type (e.g. diagnosis or management) using a validated taxonomy. A total of 965 eConsults were directed to dermatology from 217 unique PCPs. The majority of eConsults (64%) took the specialist between 10 and 15 minutes to answer. The overall value of this service to the provider was rated as very good or excellent in 95% of cases. In 49%, traditional in-person assessments were avoided. In the subset of the most recent cases, diagnosis was the most common question type asked (65.2%) followed by management (29%) and drug treatment (10.6%). The top five subject areas (40%) were: Dermatitis, Infections, Neoplasm, Nevi, and Pruritus. eConsults was feasible and well received by PCPs, which improves access to dermatology care with a potential to reduce wait times for traditional consultation. © 2017 The International Society of Dermatology.

  18. Narrative and Structure in Consultation

    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…

  19. Consultative Instructor Supervision and Evaluation

    Lee, William W.

    2010-01-01

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

  20. Improving Indonesian Construction Consulting Services

    Rizal Z. Tamin

    2015-05-01

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

  1. Gamification in a Consulting Company

    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

  2. Integrated employee assistance program/managed behavioral health care benefits: relationship with access and client characteristics.

    Levy Merrick, Elizabeth S; Hodgkin, Dominic; Horgan, Constance M; Hiatt, Deirdre; McCann, Bernard; Azzone, Vanessa; Zolotusky, Galina; Ritter, Grant; Reif, Sharon; McGuire, Thomas G

    2009-11-01

    This study examined service user characteristics and determinants of access for enrollees in integrated EAP/behavioral health versus standard managed behavioral health care plans. A national managed behavioral health care organization's claims data from 2004 were used. Integrated plan service users were more likely to be employees rather than dependents, and to be diagnosed with adjustment disorder. Logistic regression analyses found greater likelihood in integrated plans of accessing behavioral health services (OR 1.20, CI 1.17-1.24), and substance abuse services specifically (OR 1.23, CI 1.06-1.43). Results are consistent with the concept that EAP benefits may increase access and address problems earlier.

  3. Technical Evaluation Report 30: Vendor-Assisted Evaluation of a Learning Management System

    Adrienne De Schutter

    2004-04-01

    Full Text Available A product evaluation was conducted of Desire2Learn, an online learning management system gaining popularity in educational institutions. Since an online trial version of the software was not available for evaluation, an inspection meeting with the vendor was arranged. This provided the evaluation team with an opportunity to examine the precautions necessary for ensuring the objectivity of a product evaluation based on vendor-supplied information. The report outlines the team’s use of evaluator-driven enquiry and a triangulated approach to information checking. The Desire2Learn product is assessed as a flexible and useful addition to the range of learning management system options.

  4. Wound management with vacuum assisted closure in surgical site infection after ankle surgery.

    Zhou, Zhen-Yu; Liu, Ya-Ke; Chen, Hong-Lin; Liu, Fan

    2015-05-01

    The aim of this study was to compare the efficacy of vacuum assisted closure (VAC) with standard moist wound care (SMWC) in surgical site infection after ankle surgery. A prospective cohort was performed among patients with surgical site infection after ankle surgery between 2012 and 2013. The follow-up period was three month, and the efficacy end point was complete wound closure rate. Ninety-four patients were analyzed, with 61 patients in the VAC group and 33 in the SMWC group. The complete wound closure rate in the VAC group was higher than that in the SMWC group at 3 month follow up (90.2% Vs. 72.7%, p = 0.028). The median time to complete wound closure was 31 days (95% CI 20.2-41.8) for VAC, and 63 days (95% CI 46.9-79.1) for SMWC (χ(2) = 4.023, p = 0.045). In the superficial infection subgroup, the median times to complete wound closure were 20 days (95% CI 14.2-35.1) in the VAC group and 42 days (95% CI 35.4-69.4) in SMWC group (χ(2) = 4.331, p = 0.041). In the deep subgroup, the median times to complete wound closure were 46 days (95% CI 28.2-65.9) in the VAC group and 75 days (95% CI 43.2-79.6) in SMWC group (χ(2) = 6.475, p = 0.026). Our result showed that vacuum assisted closure was more effective than standard moist wound care in surgical site infection after ankle surgery. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  5. Collective prenatal consultation: a new proposal for comprehensive health care Consulta pre-natal colectiva: una nueva propuesta para la atención integral Consulta coletiva de pré-natal: uma nova proposta para uma assistência integral

    Lucia Helena Garcia Penna

    2008-02-01

    Full Text Available This article describes the Collective Prenatal Consultation as a new healthcare methodology, which is performed according to government standards, but collectively. Relaxation and sensitization techniques are used, as well as group dynamics, including a collective exam of the pregnant women. The Collective Consultation is carried out in a welcoming environment, which provides clarification and socialization of experiences and information, centered on those women. The healthcare professional records every obstetric parameter and behavior in the patient's prenatal card and history file. Priority is given to the principle of integrality and citizenship, with the aim to break the biomedical care paradigm, thus favoring humanized and comprehensive care to the women.Consiste en la descripción de la Consulta Pre-Natal Colectiva como una nueva metodología asistencial, la cual es realizada siguiendo los estándares gubernamentales, no obstante de forma colectiva. Se utilizan técnicas de relajación, sensibilización y dinámicas de grupo, incluyendo el examen colectivo de las gestantes en un lugar acogedor, informativo y socializador de experiencias e informaciones, en el cual la gestante es protagonista. En la Consulta Colectiva el profesional registra todos los parámetros y conductas obstétricas en el carnet e historia peri-natal, priorizando los principios de atención integral y ciudadanía, buscando romper con el paradigma asistencial-biomédico y favoreciendo para una atención humanizada e integral de la mujer.Este estudo consiste na descrição da Consulta Coletiva de Pré-Natal como nova metodologia assistencial, a qual é realizada seguindo os padrões governamentais, porém, coletivamente. Utilizou-se técnicas de relaxamento e de sensibilização e dinâmicas de grupo, incluindo o exame coletivo das gestantes em um espaço acolhedor, esclarecedor e socializador de experiências e informações, em que a gestante é protagonista. Na

  6. Provision of assistive technology devices among people with ALS in Germany: a platform-case management approach.

    Funke, Andreas; Spittel, Susanne; Grehl, Torsten; Grosskreutz, Julian; Kettemann, Dagmar; Petri, Susanne; Weyen, Ute; Weydt, Patrick; Dorst, Johannes; Ludolph, Albert C; Baum, Petra; Oberstadt, Moritz; Jordan, Berit; Hermann, Andreas; Wolf, Joachim; Boentert, Matthias; Walter, Bertram; Gajewski, Nadine; Maier, André; Münch, Christoph; Meyer, Thomas

    2018-01-30

    The procurement of assistive technology devices (ATD) is an essential component of managed care in ALS. The objective was to analyze the standards of care for ATD and to identify challenges in the provision process. A cohort study design was used. We investigated the provision of 11,364 ATD in 1494 patients with ALS at 12 ALS centers in Germany over four years. Participants were patients that entered a case management program for ATD including systematic assessment of ATD on a digital management platform. Wheelchairs (requested in 65% of patients), orthoses (52%), bathroom adaptations (49%), and communication devices (46%) were the most needed ATD. There was a wide range in the number of indicated ATD per patient: 1 to 4 ATD per patient in 45% of patients, 5 to 20 ATD in 48%, and >20 ATD in 7% of patients. Seventy percent of all requested ATD were effectively delivered. However, an alarming failure rate during procurement was found in ATD that are crucial for ALS patients such as powered wheelchairs (52%), communication devices (39%), or orthoses (21%). Leading causes for not providing ATD were the refusal by health insurances, the decision by patients, and the death of the patient before delivery of the device. The need for ATD was highly prevalent among ALS patients. Failed or protracted provision posed substantial barriers to ATD procurement. Targeted national strategies and the incorporation of ATD indication criteria in international ALS treatment guidelines are urgently needed to overcome these barriers.

  7. Public Financial Accountability: A pre-requisite to the management of Development Assistance in Mozambique beyond 2015

    Clive Makina

    2016-12-01

    Full Text Available In Sub-Saharan Africa, Mozambique remains as one of the poorest countries in the region receiving large volumes of Development Assistance (DA from the international donor community yet the majority of its population still continue to suffer from poverty. This article places much emphasis on efficient and effective Public Financial Management (PFM as a key ingredient for the achievement of both the national and international development goals in Mozambique. Through a literature based study, the article acknowledges progress that has been recorded in the Millennium Development Goals. However, the paper considers the strengthening of PFM systems through enhanced accountability and transparency as essential elements in face of the recent global development commitment to the Sustainable Development Goals. A reviewof challenges experienced in the era of MDGs in the country points to a need for greater transparency and accountability in the management of DA if the country is to achieve the SDGs. Thus, arguing on the basis of the Agency theory, the article proposes the adoption of a stringent governance mechanism for Public Financial Management measures to shape government and donor financial accountability frameworks with the view of creating an enabling environment aimed at ensuring the achievement of Agenda 2025 and the 2030 Sustainable Development Goal (SDG targets.

  8. The productivity of physician assistants and nurse practitioners and health work force policy in the era of managed health care.

    Scheffler, R M; Waitzman, N J; Hillman, J M

    1996-01-01

    Managed care is spreading rapidly in the United States and creating incentives for physician practices to find the most efficient combination of health professionals to deliver care to an enrolled population. Given these trends, it is appropriate to reexamine the roles of physician assistants (PAs) and nurse practitioners (NPs) in the health care workforce. This paper briefly reviews the literature on PA and NP productivity, managed care plans' use of PAs and NPs, and the potential impact of PAs and NPs on the size and composition of the future physician workforce. In general, the literature supports the idea that PAs and NPs could have a major impact on the future health care workforce. Studies show significant opportunities for increased physician substitution and even conservative assumptions about physician task delegation imply a large increase in the number of PAs and NPs that can be effectively deployed. However, the current literature has certain limitations that make it difficult to quantify the future impact of PAs and NPs. Among these limitations is the fact that virtually all formal productivity studies were conducted in fee-for-service settings during the 1970s, rather than managed care settings. In addition, the vast majority of PA and NP productivity studies have viewed PAs and NPs as physician substitutes rather than as members of interdisciplinary health care teams, which may become the dominant health care delivery model over the next 10-20 years.

  9. Observations of sexually transmitted disease consultations in India.

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

    1998-03-01

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

  10. Feasibility Study on UAV-assisted Construction Surplus Soil Tracking Control and Management Technique

    Jieh Haur, Chen; Kuo, Lin Sheng; Fu, Chen Ping; Li Hsu, Yeh; Da Heng, Chen

    2018-01-01

    Construction surplus soil tracking management has been the key management issue in Taiwan since 1991. This is mainly due to the construction surplus soils were often regarded as disposable waste and were disposed openly without any supervision, leading to environmental pollution. Even though the surplus soils were gradually being viewed as reusable resources, some unscrupulous enterprises still dump them freely for their own convenience. In order to dispose these surplus soils, site offices are required to confirm with the soil treatment plant regarding the approximate soil volume for hauling vehicle dispatch. However, the excavated soil volume will transform from bank volume to loose volume upon excavation, which may differ by a certain speculative coefficient (1.3), depending on the excavation site and geological condition. For managing and tracking the construction surplus soils, local government authorities frequently performed on-site spot check, but the lack of rapid assessment tools for soil volume estimation increased the evaluation difficulty for on-site inspectors. This study adopted unmanned aerial vehicle (UAV) in construction surplus soil tracking and rapidly acquired site photography and point cloud data, the excavated soil volume can be determined promptly after post-processing and interpretation, providing references to future surplus soil tracking management.

  11. Bladder neck contracture-incidence and management following contemporary robot assisted radical prostatectomy technique

    Jaspreet Singh Parihar

    2014-03-01

    Conclusions: BNC was identified in 1.6% of patients in our series following RARP. Intraoperative blood loss was a significant risk factor for BNC. In 20% of BNC patients a migrated foreign body was noted at vesicourethral anastomosis. Primary management of patients with BNC following RARP should be bladder neck incision and self CIC regimen.

  12. Farm level optimal water management : assistant for irrigation under deficit (FLOW-AID)

    Balendonck, J.; Stanghellini, C.; Hemming, J.; Kempkes, F.L.K.; Tuijl, van B.A.J.

    2008-01-01

    FLOW-AID is an on-going 6th Framework European project (2006-2009) with the objective to contribute to sustainable irrigated agriculture by developing an irrigation management system that can be used for crop production in cases with limited water supply and marginal water quality. The project

  13. Farm level optimal water management: Assistant for irrigation under Defecit (FLOW-AID)

    Balendonck, J.; Stanghellini, C.; Hemming, J.; Kempkes, F.L.K.; Tuijl, van B.A.J.

    2009-01-01

    Flow-aid is an on-going 6th Framework European project (2006-2009) with the objective to contribute to sustainable irrigated agriculture by developing an irrigation management system that can be used for crop production in cases with limited water supply and marginal water quality. The project

  14. Optimal waste-to-energy strategy assisted by GIS For sustainable solid waste management

    Tan, S T; Hashim, H; Lee, C T; Lim, J S; Kanniah, K D

    2014-01-01

    Municipal solid waste (MSW) management has become more complex and costly with the rapid socio-economic development and increased volume of waste. Planning a sustainable regional waste management strategy is a critical step for the decision maker. There is a great potential for MSW to be used for the generation of renewable energy through waste incineration or landfilling with gas capture system. However, due to high processing cost and cost of resource transportation and distribution throughout the waste collection station and power plant, MSW is mostly disposed in the landfill. This paper presents an optimization model incorporated with GIS data inputs for MSW management. The model can design the multi-period waste-to-energy (WTE) strategy to illustrate the economic potential and tradeoffs for MSW management under different scenarios. The model is capable of predicting the optimal generation, capacity, type of WTE conversion technology and location for the operation and construction of new WTE power plants to satisfy the increased energy demand by 2025 in the most profitable way. Iskandar Malaysia region was chosen as the model city for this study

  15. Epidemiological models to assist the management of highly pathogenic avian influenza

    Stegeman, J.A.; Bouma, A.; Jong, de M.C.M.

    2011-01-01

    In recent decades, epidemiological models have been used more and more frequently as a tool for the design of programmes for the management of infectious diseases such as highly pathogenic avian influenza. Predictive models are used to simulate the effects of various control measures on the spread

  16. Power Management Based Current Control Technique for Photovoltaic-Battery Assisted Wind-Hydro Hybrid System

    Ram Prabhakar, J.; Ragavan, K.

    2013-07-01

    This article proposes new power management based current control strategy for integrated wind-solar-hydro system equipped with battery storage mechanism. In this control technique, an indirect estimation of load current is done, through energy balance model, DC-link voltage control and droop control. This system features simpler energy management strategy and necessitates few power electronic converters, thereby minimizing the cost of the system. The generation-demand (G-D) management diagram is formulated based on the stochastic weather conditions and demand, which would likely moderate the gap between both. The features of management strategy deploying energy balance model include (1) regulating DC-link voltage within specified tolerances, (2) isolated operation without relying on external electric power transmission network, (3) indirect current control of hydro turbine driven induction generator and (4) seamless transition between grid-connected and off-grid operation modes. Furthermore, structuring of the hybrid system with appropriate selection of control variables enables power sharing among each energy conversion systems and battery storage mechanism. By addressing these intricacies, it is viable to regulate the frequency and voltage of the remote network at load end. The performance of the proposed composite scheme is demonstrated through time-domain simulation in MATLAB/Simulink environment.

  17. Optimal waste-to-energy strategy assisted by GIS For sustainable solid waste management

    Tan, S. T.; Hashim, H.

    2014-02-01

    Municipal solid waste (MSW) management has become more complex and costly with the rapid socio-economic development and increased volume of waste. Planning a sustainable regional waste management strategy is a critical step for the decision maker. There is a great potential for MSW to be used for the generation of renewable energy through waste incineration or landfilling with gas capture system. However, due to high processing cost and cost of resource transportation and distribution throughout the waste collection station and power plant, MSW is mostly disposed in the landfill. This paper presents an optimization model incorporated with GIS data inputs for MSW management. The model can design the multi-period waste-to-energy (WTE) strategy to illustrate the economic potential and tradeoffs for MSW management under different scenarios. The model is capable of predicting the optimal generation, capacity, type of WTE conversion technology and location for the operation and construction of new WTE power plants to satisfy the increased energy demand by 2025 in the most profitable way. Iskandar Malaysia region was chosen as the model city for this study.

  18. 44 CFR Appendix A to Part 62 - Federal Emergency Management Agency, Federal Insurance Administration, Financial Assistance...

    2010-10-01

    ... provided in Article V, Section C.2. E. In the event that the Company is unable or otherwise fails to carry... another WYO Company as provided by Article V, Section C.2. F. In the event the Act is amended, or repealed... domiciliary State. Article VII—Cash Management and Accounting A. FEMA shall make available to the Company...

  19. Assisting School Management Teams to Construct Their School Improvement Plans: An Action Learning Approach

    Van Der Voort, Geoffrey; Wood, Lesley

    2014-01-01

    This article reports on a first cycle of a larger action research study conducted to determine how Circuit Teams could support School Management Teams of underperforming high schools towards whole-school development. Although it is a mandated requirement by the Department of Education, none of the four schools involved in the study had developed a…

  20. Postinfarct VSD management using 3D computer printing assisted percutaneous closure

    Mohamad Lazkani

    2015-11-01

    Full Text Available Postinfarct VSD (PIVSD carries a grim prognosis. The mainstay of management has been surgical repair. The advent of septal occluder devices has offered an attractive alternative to surgical repair. Most PIVSD have serpiginous tracts with necrotic tissue, which makes assessing the defect challenging. 3D computer printing has become useful in preprocedure planning of complex surgical procedures in multiple subspecialties.

  1. Harnessing Resistance: Using the Theory of Constraints To Assist Change Management.

    Mabin, Victoria J.; Forgeson, Steve; Green, Lawrence

    2001-01-01

    Applies the Theory of Constraints, which views resistance to change as a necessary, positive force, to a case study of a bank merger. For each resistance factor, the theory provides tools for using it and managing change successfully. (Contains 46 references.) (SK)

  2. Robotic health assistant (Feverkit) for the rational management of fevers among nomads in Nigeria.

    Akogun, Oladele

    2011-06-01

    The innovation described in this paper was motivated by concern that in Africa, parasite resistance to antimalarial drugs is associated with irrational drug use where health facilities are inaccessible. However, advancement in digital technology, simple diagnostic devices and smart drug packaging inspire innovative strategies. The combination of communication technology, rapid diagnostic tools, and antibiotic and antimalarial medicines can increase access to evidence-based malaria management, reduce mortality and slow the development of resistance to drugs. The author initiated development of a solar-powered device (Feverkit) programmed with user-interactive capabilities and equipped with a detachable laboratory and dispensary for community management of fevers. The operational performance of 10 units of the device was evaluated among 20 nomadic Fulani communities in northeastern Nigeria. A brief introduction to its parts and functions was sufficient for community-selected nomadic caregivers to use it competently for managing 207 fever cases in eight weeks, with a 97% (p=.000) recovery rate. The Feverkit guided the nomads to distinguish between malaria and non-malaria-induced fevers, and thus selectively treat them. Camp communities accepted the device and were willing to pay between US$33 and $334 (mean, $113; mode, $67) to keep it. Public-private sector collaboration is essential for sustaining and scaling up production of the Feverkit as a commercial health device for the management of fevers among nomads.

  3. An information assistant system for the prevention of tunnel vision in crisis management

    Cao, Y.

    2008-01-01

    In the crisis management environment, tunnel vision is a set of bias in decision makers’ cognitive process which often leads to incorrect understanding of the real crisis situation, biased perception of information, and improper decisions. The tunnel vision phenomenon is a consequence of both the

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

    Franks, Helen; Howarth, Michelle

    2012-10-01

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

  5. Femtosecond-assisted keratopigmentation double tunnel technique in the management of a case of Urrets-Zavalia syndrome.

    Alio, Jorge L; Rodriguez, Alejandra E; Toffaha, Bader T; El Aswad, A

    2012-09-01

    To describe the successful use of a double intrastromal tunnel femtosecond-assisted keratopigmentation technique to manage a case of unilateral Urrets-Zavalia syndrome. A 33-year-old man was referred with a history of trauma in his right eye due to a labor-related accident. Because of myopic anisometropia, he had been previously implanted with an angle-supported phakic intraocular lens. The patient presented iris atrophy and a fixed dilated pupil. He complained of severe and incapacitating photophobia, glare, and decreased vision. To obtain a complete iris replica, the surgery involved creation of double keratopigmented intrastromal tunnels using femtosecond laser and micronized mineral pigments. The deepest layer was stained black first and then the superficial layer was stained with a contoured greenish blue-gray color, which matched the contralateral eye. In the immediate postoperative period, the patient reported a complete elimination of photophobia associated with the corrected distance visual acuity improvement. A very adequate cosmetic outcome was also achieved. Stability was observed during the 12-month follow-up. A femtosecond-assisted keratopigmentation technique using 2 pigmented intrastromal tunnels to achieve an intracorneal pigmented replica of the iris was effective in improving the patient's severe visual function disability and cosmetic appearance. To the best of our knowledge, this is the first report of severe visual function disability caused by atrophic iris and a fixed dilated pupil treated with double intrastromal layers of keratopigmentation by means of femtosecond-created tunnels.

  6. Assisting the U.S. Forest Service in monitoring and managing the Pacific pine marten

    Force, A.; Hadley, N.; Howell, B. L.; Holsinger, K.

    2017-12-01

    Innovative partnerships that bridge institutional sectors may be key in seizing many opportunities for highly effective projects. Adventure Scientists is a nonprofit organization that works in partnership with governments, universities, businesses and other nonprofits to support their need for actionable, research-grade data. In every partnership, it is critical that responsible decision-makers are involved and in place to use the data collected, such as to inform new resource management strategies or regulatory policies. In this presentation, we will highlight our experience working on one such partnership. In 2013, the U.S. Forest Service and Adventure Scientists collaborated on a two-year project to better understand Pacific pine marten (Martes caurina), a small native carnivore, in the Olympic National Forest. In response to the species' recent disappearance, Forest managers needed to gather more accurate data on martens' presence and abundance to support species management. Adventure Scientists was in a unique position to provide the agency this needed data-collection capacity. Volunteers collected data about the marten populations by positioning and monitoring camera traps throughout the area. Utilizing our volunteer-collected data, the U.S. Forest Service was able to inform the management and protection of these threatened species in U.S Forest Service Region 6. This project was also successful in establishing the foundation for an expanded, long-term relationship with the agency, where both parties continue to explore partnership opportunities for Adventure Scientists to collect data system-wide in support of U.S. Forest Service improved land management and policy decisions.

  7. Establishing specialized health services for professional consultation in euthanasia: experiences in the Netherlands and Belgium

    Bilsen Johan

    2009-12-01

    Full Text Available Abstract Background The Netherlands, Belgium, and Luxembourg have adopted laws decriminalizing euthanasia under strict conditions of prudent practice. These laws stipulate, among other things, that the attending physician should consult an independent colleague to judge whether the substantive criteria of due care have been met. In this context initiatives were taken in the Netherlands and Belgium to establish specialized services providing such consultants: Support and Consultation for Euthanasia in the Netherlands (SCEN and Life End Information Forum (LEIF in Belgium. The aim of this study is to describe and compare these initiatives. Methods We studied and compared relevant documents concerning the Dutch and Belgian consultation service (e.g. articles of bye-laws, inventories of activities, training books, consultation protocols. Results In both countries, the consultation services are delivered by trained physicians who can be consulted in cases of a request for euthanasia and who offer support and information to attending physicians. The context in which the two organisations were founded, as well as the way they are organised and regulated, is different in each country. By providing information on all end-of-life care matters, the Belgian LEIF seems to have a broader consultation role than the Dutch SCEN. SCEN on the other hand has a longer history, is more regulated and organised on a larger scale and receives more government funding than LEIF. The number of training hours for physicians is equal. However, SCEN-training puts more emphasis on the consultation report, whereas LEIF-training primarily emphasizes the ethical framework of end-of-life decisions. Conclusion In case of a request for euthanasia, in the Netherlands as well as in Belgium similar consultation services by independent qualified physicians have been developed. In countries where legalising physician-assisted death is being contemplated, the development of such a

  8. Integration of a framework with a learning management system for detection, assessment and assistance of university students with reading difficulties

    Carolina Mejía Corredor

    2015-12-01

    Full Text Available Rev.esc.adm.neg Dyslexia is a common learning disability in Spanish-speaking university students, and requires special attention from higher educational institutions in order to support affected individuals during their learning process. In previous studies, a framework to detect, assess and assist university students with reading difficulties related to dyslexia was developed. In this paper, the integration of this framework with a Learning Management System (LMS is presented. Two case studies were performed to test the functionality and the usability of this integration. The first case study was carried out with 20 students, while the second one with four teachers. The results show that both students and teachers were satisfied with the integration performed in Moodle.ce, among others.

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

    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…

  10. Prevalência de exposições ocupacionais de cirurgiões-dentistas e auxiliares de consultório dentário a material biológico Prevalence of occupational exposures to potentially infectious materials among dentists and dental assistants

    Leila Posenato Garcia

    2006-01-01

    Full Text Available Os cirurgiões-dentistas e auxiliares de consultório dentário trabalham em condições que favorecem a ocorrência de exposições ocupacionais a material biológico. Os objetivos do presente estudo são: determinar a prevalência de exposições ocupacionais ao longo da vida profissional e no ano anterior a este estudo, identificar as circunstâncias das exposições e verificar se existe relação entre sua ocorrência e o uso de equipamentos de proteção individual. Participaram do estudo 289 dentistas e 104 auxiliares do município de Florianópolis, Santa Catarina, Brasil. Os dados foram coletados por meio de questionário auto-aplicável. A prevalência de exposições ocupacionais na vida profissional foi maior entre os dentistas (94,5% do que entre os auxiliares (80,8%, ao passo que, no ano anterior, foi similar entre dentistas (39,1% e auxiliares (39,4%. Todavia, considerando as exposições ocorridas no ano anterior, as lesões percutâneas foram mais freqüentes nos auxiliares (95,2% do que nos dentistas (60,7%. O uso constante de óculos de proteção foi estatisticamente associado com menor ocorrência de respingos nos olhos de dentistas (p = 0,004. São recomendadas medidas educativas visando a reduzir a freqüência de exposições ocupacionais na população estudada.Dentists and dental assistants work in conditions that favor the occurrence of occupational exposures to potentially infectious materials. The aims of this study are: to determine the prevalence of occupational exposures throughout professional life and in the previous year, to identify the circumstances of exposures, and to verify if there exists a relationship between their occurrence and the use of personal protective equipment. 289 dentists and 104 dental assistants from the city of Florianópolis, Brazil, participated in this study. Data were collected through self-report questionnaires. The prevalence of occupational exposures throughout professional life

  11. Simulated consultations: a sociolinguistic perspective.

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

    2016-01-15

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

  12. State policies and requirements for management of uranium mining and milling in New Mexico. Volume V. State policy needs for community impact assistance

    Vandevender, S.G.

    1980-04-01

    The report contained in this volume describes a program for management of the community impacts resulting from the growth of uranium mining and milling in New Mexico. The report, submitted to Sandia Laboratories by the New Mexico Department of Energy and Minerals, is reproduced without modification. The state recommends that federal funding and assistance be provided to implement a growth management program comprised of these seven components: (1) an early warning system, (2) a community planning and technical assistance capability, (3) flexible financing, (4) a growth monitoring system, (5) manpower training, (6) economic diversification planning, and (7) new technology testing

  13. Assisting Sustainable Forest Management and Forest Policy Planning with the Sim4Tree Decision Support System

    Floris Dalemans

    2015-03-01

    Full Text Available As European forest policy increasingly focuses on multiple ecosystem services and participatory decision making, forest managers and policy planners have a need for integrated, user-friendly, broad spectrum decision support systems (DSS that address risks and uncertainties, such as climate change, in a robust way and that provide credible advice in a transparent manner, enabling effective stakeholder involvement. The Sim4Tree DSS has been accordingly developed as a user-oriented, modular and multipurpose toolbox. Sim4Tree supports strategic and tactical forestry planning by providing simulations of forest development, ecosystem services potential and economic performance through time, from a regional to a stand scale, under various management and climate regimes. Sim4Tree allows comparing the performance of different scenarios with regard to diverse criteria so as to optimize management choices. This paper explains the concept, characteristics, functionalities, components and use of the current Sim4Tree DSS v2.5, which was parameterized for the region of Flanders, Belgium, but can be flexibly adapted to allow a broader use. When considering the current challenges for forestry DSS, an effort has been made towards the participatory component and towards integration, while the lack of robustness remains Sim4Tree’s weakest point. However, its structural flexibility allows many possibilities for future improvement and extension.

  14. Non-intubated video-assisted thoracic surgery management of secondary spontaneous pneumothorax.

    Galvez, Carlos; Bolufer, Sergio; Navarro-Martinez, Jose; Lirio, Francisco; Corcoles, Juan Manuel; Rodriguez-Paniagua, Jose Manuel

    2015-05-01

    Secondary spontaneous pneumothorax (SSP) is serious entity, usually due to underlying disease, mainly chronic obstructive pulmonary disease (COPD). Its morbidity and mortality is high due to the pulmonary compromised status of these patients, and the recurrence rate is almost 50%, increasing mortality with each episode. For persistent or recurrent SSP, surgery under general anesthesia (GA) and mechanical ventilation (MV) with lung isolation is the gold standard, but ventilator-induced damages and dependency, and postoperative pulmonary complications are frequent. In the last two decades, several groups have reported successful results with non-intubated video-assisted thoracic surgery (NI-VATS) with thoracic epidural anesthesia (TEA) and/or local anesthesia under spontaneous breathing. Main benefits reported are operative time, operation room time and hospital stay reduction, and postoperative respiratory complications decrease when comparing to GA, thus encouraging for further research in these moderate to high risk patients many times rejected for the standard regimen. There are also reports of special situations with satisfactory results, as in contralateral pneumonectomy and lung transplantation. The aim of this review is to collect, analyze and discuss all the available evidence, and seek for future lines of investigation.

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

    Hicks, Jeff

    2010-01-01

    Management consulting is a $300 billion industry, about 70% of which is accounted for by organizational change work. These numbers aren’t especially remarkable, unless you consider that a similar percentage of change initiatives—about 70%, according to numerous studies—fail to meet their stated

  16. Application of assisted reproduction for population management in felids: the potential and reality for conservation of small cats.

    Swanson, William F

    2006-07-01

    Assisted reproductive technology (ART), using the primary applied tools of AI, ET, and sperm and embryo cryopreservation, has been promoted over the past decades for its potential to conserve endangered wildlife, including felids. However, if the goal is efficient, consistent production of viable offspring for population management, then the 'potential' of ART has yet to become 'reality' for any non-domestic cat species. For the five small-sized felids (i.e., Brazilian ocelot, fishing cat, Pallas' cat, Arabian sand cat, black-footed cat) managed by Species Survival Plans (SSPs) in North American zoos, achieving this potential may be an absolute necessity if genetically viable captive populations are to be maintained into the next century. Modeling programs suggest that current SSP populations are not sustainable without periodic introduction of new founders and improved demographic parameters, including longer generation intervals and larger population sizes. ART provides the means to address each of these management challenges. In each small cat SSP species, fecal hormone metabolite assays and seminal analysis have proven useful for characterizing basal reproductive parameters, a necessary prerequisite to developing ART. Of the five SSP species, ART has been used to produce living offspring only in the ocelot, including after AI with frozen-thawed spermatozoa and following transfer of frozen-thawed IVF embryos. The true efficacy of these techniques, however, is still unknown. To improve the applicability of ART for population management, priorities for immediate research include further investigation of ovarian stimulation protocols, sperm and embryo cryopreservation methods, embryo culture systems, and fetal and neonatal viability following ART.

  17. Austria; 2013 Article IV Consultation

    International Monetary Fund

    2013-01-01

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

  18. Interactive statistical packages to assist in radiotherapy management of prostate cancer. 148

    Altschuler, M.D.; Whittington, R.

    1987-01-01

    Selecting the treatment most likely to produce a satisfactory outcome is one of the major challenges in managing disease. Treatment decisions are influenced by institutional policy, personal experience, and patient characteristics. Expert systems based on a priori if-then rules are not suitable for the management of prostate cancer because of (1) a lack of general agreement among experts, (2) the large number of patient parameter possibilities that must be covered by rules, and (3) the difficulty for a clinician to state (even fuzzy) rules for each patient variable or variable combination. In this paper we describe an interactive statistical package that (1) learns an expert's decisions on cases generated by a random case simulator, (2) analyzes and explains new cases in the manner of the teaching expert, (3) can be individualized for each physician, (4) can be setup, modified, or verified quickly, and (5) can be networked with the individualized systems of other experts. An expert can use the system as a memory aid or to compare his decisions with those of his colleagues. A non-expert physician can inform his patient of the expert's likely approach. An institution can determine the domains of patient parameter space about which experts disagree and focus research resources there. Based on sampling statistics, the system weighs the relative preference for each decision path in a tree of questions specified by the expert and then integrates this information. Only statistically significant patient parametes are used for each question. The final result is a probability of each treatment option being selected by the expert. The use of the ISP will be shown for the management of prostate carcinoma. 5 refs.; 1 figure

  19. Crisis model to assist the patient to establish self-management in accepting stoma

    村田, 節子

    1995-01-01

    Patients with stoma are susceptible to psychological damage due to changes in both body image and bowel habituation Therefore, it is important to help those patients to be able to manage stoma care by themselves as well as to take care of postoperative recovery process. In gynecologic oncology field, almost all stoma ta are made for the patients who had metastatic tumor in the pelvis, or massive bleeding from rectum or fistula after radiation therapy. For the reason, there is a great risk of ...

  20. Intraoperative utilization of dexamethasone/bupivacaine/gentamicin solution in laparoscopic assisted vaginal hysterectomy and pain management.

    Fulcher, Paul H; Granese, Marsha; Chun, Yoon; Welch, Christine A; Seybold, Dara J; Randall, Gary; DePond, R Todd

    2014-01-01

    Adequately controlling pain is a key component of postoperative care after a hysterectomy. The purpose of this study was to evaluate the effects of two intraperitoneal (IP) administered solutions during Laparoscopic Assisted Vaginal Hysterectomy (LAVH), on the amount of postoperative self-administered morphine. In this prospective, randomized, double blinded study, twenty women undergoing LAVH randomly distributed to two treatment groups: (1) 100 ml dexamethasone/ bupivacaine/ gentamicin (DMG) solution: 60 cc injected vaginally at cuff and 40 cc placed topically via laparoscopy over intra-peritoneal postoperative surfaces (IP) and 5 ml bupivacaine or 5 ml saline injected at the laparoscopic incision sites, (2) 100 ml saline solution: 60 cc injected vaginally at cuff and 40 cc placed topically via laparoscopy over intra-peritoneal postoperative surfaces (IP) and 5 ml bupivacaine or 5 ml saline injected at the laparoscopic incision sites. The amount of morphine utilized by the patients was documented from their patient controlled anesthesia (PCA) pump. Patient parameters recorded included perceived pain score, height, weight, age, race, reason for surgery, pre-surgery medications, American Society of Anesthesiologist (ASA) classification, length of the surgery and estimated blood loss (EBL). Age, EBL, length of surgery, and ASA classification were not significantly different between the groups. The postoperative amount of morphine utilized was higher at 4 (p=.02) and 16 hours (p = .04) and tended to be higher at 8, 12 hours (p=.06), and 24 hours (p=.09) in the saline IP group. Overall the saline IP group (n=10) used (median; range) 21.5; 8-82 mg of morphine while the DMG IP group (n=10) used 10.5; 1-23 mg. No participants reported a postoperative infection. This study demonstrates that intraoperative utilization of DMG solution during LAVH enables patients clinically to have less perceived pain and subsequently tend to utilize about half the amount of morphine

  1. Vacuum-assisted closure device for the management of infected postpneumonectomy chest cavities.

    Perentes, Jean Yannis; Abdelnour-Berchtold, Etienne; Blatter, Jeannine; Lovis, Alban; Ris, Hans-Beat; Krueger, Thorsten; Gonzalez, Michel

    2015-03-01

    Infected postpneumonectomy chest cavities may be related to chronic postpneumonectomy empyema or arise in rare situations of necrotizing pneumonia with complete lung destruction where pneumonectomy and pleural debridement are required. We evaluated the safety and efficacy of an intrathoracic vacuum-assisted closure device (VAC) for the treatment of infected postpneumonectomy chest cavities. A retrospective single institution review of all patients with infected postpneumonectomy chest cavities treated by VAC between 2005 and 2013. Patients underwent surgical debridement of the thoracic cavity, muscle flap closure of the bronchial stump when a fistula was present, and repeated intrathoracic VAC dressings until granulation tissue covered the entire chest cavity. After this, the cavity was obliterated by a Clagett procedure and closed. Twenty-one patients (14 men and 7 women) underwent VAC treatment of their infected postpneumonectomy chest cavity. Twelve patients presented with a chronic postpneumonectomy empyema (10 of them with a bronchopleural fistula) and 9 patients with an empyema occurring in the context of necrotizing pneumonia treated by pneumonectomy. In-hospital mortality was 23%. The median duration of VAC therapy was 23 days (range, 4-61 days) and the median number of VAC changes per patient was 6 (range, 2-14 days). Infection control and successful chest cavity closure was achieved in all surviving patients. One adverse VAC treatment-related event was identified (5%). The intrathoracic VAC application is a safe and efficient treatment of infected postpneumonectomy chest cavities and allows the preservation of chest wall integrity. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  2. The impact of dermatology consultation on diagnostic accuracy and antibiotic use among patients with suspected cellulitis seen at outpatient internal medicine offices: a randomized clinical trial.

    Arakaki, Ryan Y; Strazzula, Lauren; Woo, Elaine; Kroshinsky, Daniela

    2014-10-01

    Cellulitis is a common and costly problem, often diagnosed in the outpatient setting. Many cutaneous conditions may clinically mimic cellulitis, but little research has been done to assess the magnitude of the problem. To determine if obtaining dermatology consultations in the outpatient primary care setting could assist in the diagnosis of pseudocellulitic conditions and reduce the rate of unnecessary antibiotic use. Nonblinded randomized clinical trial of competent adults who were diagnosed as having cellulitis by their primary care physicians (PCPs), conducted at outpatient internal medical primary care offices affiliated with a large academic medical center. Outpatient dermatology consultation. Primary outcomes were final diagnosis, antibiotic use, and need for hospitalization. A total of 29 patients (12 male and 17 female) were enrolled for participation in this trial. Nine patients were randomized to continue with PCP management (control group), and 20 patients were randomized to receive a dermatology consultation (treatment group). Of the 20 patients in the dermatology consultation group, 2 (10%) were diagnosed as having cellulitis. In the control group, all 9 patients were diagnosed as having cellulitis by PCPs, but dermatologist evaluation determined that 6 (67%) of these patients had a psuedocellulitis rather than true infection. All 9 patients (100%) in the control group were treated for cellulitis with antibiotics vs 2 patients (10%) in the treatment group (P Dermatology consultation in the primary care setting improves the diagnostic accuracy of suspected cellulitis and decreases unnecessary antibiotic use in patients with pseudocellulitic conditions. Obtaining an outpatient dermatology consultation may be a cost-effective strategy that improves quality of care. clinicaltrials.gov Identifier:NCT01795092.

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

    Mandefrot Belay

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

  4. Consultation for Parents of Young Gifted Children.

    Wolf, Joan S.

    1989-01-01

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

  5. Lbs Augmented Reality Assistive System for Utilities Infrastructure Management Through Galileo and Egnos

    Stylianidis, E.; Valaria, E.; Smagas, K.; Pagani, A.; Henriques, J.; Garca, A.; Jimeno, E.; Carrillo, I.; Patias, P.; Georgiadis, C.; Kounoudes, A.; Michail, K.

    2016-06-01

    There is a continuous and increasing demand for solutions, both software and hardware-based, that are able to productively handle underground utilities geospatial data. Innovative approaches that are based on the use of the European GNSS, Galileo and EGNOS, sensor technologies and LBS, are able to monitor, document and manage utility infrastructures' data with an intuitive 3D augmented visualisation and navigation/positioning technology. A software and hardware-based system called LARA, currently under develop- ment through a H2020 co-funded project, aims at meeting that demand. The concept of LARA is to integrate the different innovative components of existing technologies in order to design and develop an integrated navigation/positioning and information system which coordinates GNSS, AR, 3D GIS and geodatabases on a mobile platform for monitoring, documenting and managing utility infrastruc- tures on-site. The LARA system will guide utility field workers to locate the working area by helping them see beneath the ground, rendering the complexity of the 3D models of the underground grid such as water, gas and electricity. The capacity and benefits of LARA are scheduled to be tested in two case studies located in Greece and the United Kingdom with various underground utilities. The paper aspires to present the first results from this initiative. The project leading to this application has received funding from the European GNSS Agency under the European Union's Horizon 2020 research and innovation programme under grant agreement No 641460.

  6. LBS AUGMENTED REALITY ASSISTIVE SYSTEM FOR UTILITIES INFRASTRUCTURE MANAGEMENT THROUGH GALILEO AND EGNOS

    E. Stylianidis

    2016-06-01

    Full Text Available There is a continuous and increasing demand for solutions, both software and hardware-based, that are able to productively handle underground utilities geospatial data. Innovative approaches that are based on the use of the European GNSS, Galileo and EGNOS, sensor technologies and LBS, are able to monitor, document and manage utility infrastructures’ data with an intuitive 3D augmented visualisation and navigation/positioning technology. A software and hardware-based system called LARA, currently under develop- ment through a H2020 co-funded project, aims at meeting that demand. The concept of LARA is to integrate the different innovative components of existing technologies in order to design and develop an integrated navigation/positioning and information system which coordinates GNSS, AR, 3D GIS and geodatabases on a mobile platform for monitoring, documenting and managing utility infrastruc- tures on-site. The LARA system will guide utility field workers to locate the working area by helping them see beneath the ground, rendering the complexity of the 3D models of the underground grid such as water, gas and electricity. The capacity and benefits of LARA are scheduled to be tested in two case studies located in Greece and the United Kingdom with various underground utilities. The paper aspires to present the first results from this initiative. The project leading to this application has received funding from the European GNSS Agency under the European Union’s Horizon 2020 research and innovation programme under grant agreement No 641460.

  7. Incongruous consultation behaviour: results from a UK-wide population survey

    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

  8. A strategy to assist management in workforce engagement and employee retention in the high tech engineering environment.

    Kennedy, Elizabeth; Daim, Tugrul U

    2010-11-01

    Many companies use survey methods in an attempt to gauge employees' attitudes and opinions toward the company. These attitudes and opinions are directly related to an employee's engagement within the company. In many instances, employees wait in vain for the survey response and the subsequent employer actions, but the truth is sometimes management does not know what to do with the results. For this reason, we theorize that this type of survey, typically utilizing the Likert-scale, is not adequately assisting management in addressing employee engagement and retention issues. For instance, in many occasions, once the survey results are tabulated, companies are doing little or nothing to address the issues. In fact, far too many companies make the mistake of conducting employee engagement surveys, and then ignore the answers. Thus, we propose that a company should take advantage of the survey results, and utilize them to provide data to bridge employees' needs and goals with stakeholders' responsibilities and goals by refining and incorporating them into a hierarchical decision model (HDM). Thus, this would essentially be utilizing the quantitative data to determine what to measure qualitatively. We use a case from the high tech industry, specifically focusing on the engineering environment. Engineering environments are known to be more creative and such approaches would be more beneficial. Copyright (c) 2009 Elsevier Ltd. All rights reserved.

  9. Development and Application of a Stakeholder Assisted Dynamic Model to Facilitate Socio Hydrological Groundwater Management on Watershed Scale

    Baig, A. I.; Adamowski, J. F.; Malard, J. J.; Peng, G.

    2017-12-01

    Groundwater resource, especially in canal downstream areas are under direct threat due to over extraction by farming community. The resource is easily exploitable and no regulatory policies are enforced effectively in the region. Therefore, there is an urgent need to manage the resource judiciously through policy implementation and stakeholder engagement. In developing countries such as Pakistan, effective management solutions need consideration of some addition factors such as small land holdings, the poor economic status of farmers, and limited modeling and mathematical skills. This presentation will discuss development and application of a comprehensive but simple stakeholder assisted dynamic model to address such challenges. Two major components of the dynamic model were: (i) a system dynamics model that describes socio-economic factors such as market values; and ii) a physically based model that simulates the salt balance in the root zone with conjunctive use of canal and tube well irrigation water. Stakeholder proposed policy scenarios such as canal lining, government-sponsored tubewell installation schemes were tested and optimized through economic and environmental tradeoff criteria. After 20 years of simulation, government subsidies on tubewells appear as a short term policy that resulted 37% increase in water availability with 12% increase in farmer income. However, it showed detrimental effects on groundwater sustainability in long terms, with 10% drop in groundwater levels.

  10. Vacuum-Assisted Closure Combined with a Myocutaneous Flap in the Management of Osteomyelitis in a Dog

    Jeremy L. Shomper

    2013-01-01

    Full Text Available Case Description. A 2.5-year-old female spayed mixed breed dog presented to the Teaching Hospital for draining tracts on the left medial aspect of the tibia. Two years prior to presentation, the patient sustained a left tibial fracture, which was repaired with an intramedullary (IM pin and two cerclage wires. Multiple antimicrobials were utilized during this time. Clinical Findings. Radiographs were consistent with left tibial osteomyelitis. The implant was removed and the wound was debrided. Treatment and Outcome. A bone window on the medial aspect of the tibia was created in order to facilitate implant removal. The wound and associated bone window were treated with vacuum assisted closure (VAC in preparation for reconstructive surgery. Adjunctive VAC therapy was utilized following the caudal sartorius myocutaneous flap. Complications following this surgery included distal flap necrosis and donor site dehiscence. Clinical Relevance. This presents a difficult case of canine osteomyelitis with subsequent wound care in which VAC and a myocutaneous flap were useful adjunctive treatments for osteomyelitis. This is the first report of VAC in the management of canine osteomyelitis and management with a myocutaneous flap.

  11. Trends in the Management of Patients With Left Ventricular Assist Devices Presenting for Noncardiac Surgery: A 10-Year Institutional Experience.

    Stone, Marc; Hinchey, Joseph; Sattler, Christopher; Evans, Adam

    2016-09-01

    In our institution, the vast majority of patients presenting for noncardiac surgery (NCS) while supported by a left ventricular assist device (LVAD) are now cared for by noncardiac-trained anesthesiologists as the result of a decade of educational intervention to effect this transition. This represents a significant departure from the published experiences of other institutions. With institutional review board approval, we queried the database of our anesthesia record keeping system (CompuRecord) to determine various aspects of the perioperative management of these patients from July 1, 2003, through June 30, 2013, during which time 271 NCS procedures were performed on adult patients supported by LVADs. Over the entire study period (2003-2013), anesthetic care was provided by a cardiac anesthesiologist 47% of the time and by a noncardiac anesthesiologist 53% of the time. However, by the time period 2012-2013, 88% of the NCS procedures were staffed by a noncardiac anesthesiologist. Despite the prevalence of continuous flow devices in this series, the use of invasive blood pressure monitoring decreased dramatically by the later years of the study. Vasoactive and inotropic medications were rarely required intraoperatively. No intraoperative cardiac arrests, thromboembolic complications, or device malfunctions occurred. Our conclusion is that NCS procedures on LVAD-supported patients can be safely managed by educated noncardiac anesthesiologists. © The Author(s) 2015.

  12. Students' Research Experiences during Consulting Projects: Three Themes Emerging from Case Studies

    Phillips, Carissa M. Holler

    2010-01-01

    Student consulting projects, an advanced form of problem-based learning, allow students to apply the skills developed in their classes on behalf of client organizations. A review of selected case studies in business education and other management education literature shows that research is an integral part of this consulting process. More than…

  13. 34 CFR 75.191 - Consultation costs.

    2010-07-01

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

  14. Core Competencies for Training Effective School Consultants

    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. Edgar Schein's Process versus Content Consultation Models.

    Rockwood, Gary F.

    1993-01-01

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

  16. Infrared Red Intubation System (IRRIS) guided flexile videoscope assisted difficult airway management

    Kristensen, M S; Fried, E; Biro, P

    2018-01-01

    BACKGROUND: Tracheal intubation with a flexible scope is a cornerstone technique in patients with severely difficult airways, but may fail. We report on a technique, Infrared Red Intubation System (IRRIS), that seems to facilitate the identification of the glottis. METHODS: The IRRIS is placed over...... the patient's cricothyroid membrane and emits blinking infrared light through the patient's skin into the subglottic space. When a flexible videoscope (one that does not filter infrared light) is introduced into the airway, it will display this as a blinking white light emerging from the glottis, retrograde...... transillumination, showing the pathway to the trachea. We have introduced this as an adjunct when managing our patients with difficult airways. We describe the technique and retrospectively report on the first ten patients where it was used. RESULTS: All ten patients had significant pathology in the airway...

  17. Technologies for Distributed Energy Resources. Federal Energy Management Program (FEMP) Technical Assistance Fact Sheet

    Pitchford, P.; Brown, T.

    2001-01-01

    This four-page fact sheet describes distributed energy resources for Federal facilities, which are being supported by the U.S. Department of Energy's (DOE's) Federal Energy Management Program (FEMP). Distributed energy resources include both existing and emerging energy technologies: advanced industrial turbines and microturbines; combined heat and power (CHP) systems; fuel cells; geothermal systems; natural gas reciprocating engines; photovoltaics and other solar systems; wind turbines; small, modular biopower; energy storage systems; and hybrid systems. DOE FEMP is investigating ways to use these alternative energy systems in government facilities to meet greater demand, to increase the reliability of the power-generation system, and to reduce the greenhouse gases associated with burning fossil fuels

  18. Role of ultrasonography in infertility management : ovulation monitoring and assisted conception

    Haq, I.U.; Manzur, S.; Rehman, A.U.; Farooq, A.

    2010-01-01

    Infertility causes great stress to many couples. Most of those presenting with childlessness have reduced fertility, rather than absolute sterility, and many are likely to conceive spontaneously. In this 'ultrasonographic monitoring of growing follicles, in ovaries to determine the day of ovulation and its coordination with time of intercourse' has a well established role in the management of 'unexplained infertility'. This study was conducted to find out its efficacy in our setup. 86 female.s patients of unexplained infertility, with different post-marital time period, underwent ultrasonographic ovulation monitoring each with follow up for minimum of four menstrual cycles. Average follicular growth rate was 2 mm a day, which increased to 3 mm a day, two days prior to ovulation. Follicular diameter at the time of ovulation ranged from 22 mm to 27 mm with a mean of 24 mm. We observed ovulation in 79.2% of our patients. In 8.1% patient.s dominant follicle ceased to grow beyond 18 mm size and gradually become atretic. Leutinized un ruptured follicle was documented in 12.7% of our patients in whom follicular size reached to periovulatory range but did not rupture. Uterine endometrial thickness at the time of ovulation varied from 7 mm to 13 mm and multilayered appearance (triple line sign) was observed in 57.3% of patients. Overall conception rate was 16.3% whereas it was much more encouraging to see in 23.5% of patients who were in less than 5 years of their marriage. Keeping in view of easy to workup as out patient basis in large numbers of patient, less time consuming, promising results, cost effectiveness and non invasive nature of technique; ultrasonographic monitoring of ovulation is recommended as a part of management in all patients of unexplained infertility. (author)

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

    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. Systematic review: frequency and reasons for consultation for gastro-oesophageal reflux disease and dyspepsia.

    Hungin, A P S; Hill, C; Raghunath, A

    2009-08-15

    Upper gastrointestinal symptoms impose a substantial illness burden and management costs. Understanding perceptions and reasons for seeking healthcare is a prerequisite for meeting patients' needs effectively. To review systematically findings on consultation frequencies for gastro-oesophageal reflux disease (GERD) and dyspepsia and patients' reasons for consultation. Systematic literature searches. Reported consultation rates ranged from 5.4% to 56% for GERD and from 26% to 70% for dyspepsia. Consultation for GERD was associated with increased symptom severity and frequency, interference with social activities, sleep disturbance, lack of timetabled work, higher levels of comorbidity, depression, anxiety, phobia, somatization and obsessionality. Some consulted because of fears that their symptoms represented serious disease; others avoided consultation because of this. Inconsistent associations were seen with medication use. Patients were less likely to consult if they felt that their doctor would trivialize their symptoms. Few factors were consistently associated with dyspepsia consultation. However, lower socio-economic status and Helicobacter pylori infection were associated with increased consultation. Patients' perceptions of their condition, comorbid factors and external reasons such as work and social factors are related to consultation rates for GERD. Awareness of these factors can guide the clinician towards a more effective strategy than one based on drug therapy alone.