Under-triage in telephone consultation is related to non-normative symptom description and interpersonal communication: a mixed methods study.

Science.gov (United States)

Gamst-Jensen, Hejdi; Lippert, Freddy K; Egerod, Ingrid

2017-05-15

Telephone consultation and triage are used to limit the workload on emergency departments. Lack of visual cues and clinical tests put telephone consultations to a disadvantage compared to face-to-face consultations increasing the risk of under-triage. Under-triage occurs in telephone triage; however why under-triage happens is not explored yet. The aim of the study was to describe situations of under-triage in context, to assess the quality of under-triaged calls, and to identify communication patterns contributing to under-triage in a regional OOH service in the capital region of Denmark. Explanatory simultaneous mixed method with thematic analysis and descriptive statistics was chosen. The study was carried out in an Out-Of-Hours service (OOH) in the Capital Region of Denmark, Copenhagen. Under-triage was defined as Potentially Under-Triaged Calls (PUTC) by specific criteria to an OOH Hotline, and identification by integration of three databases: Medical Hotline database, Emergency number database, including the Ambulance database, and electronic patient records. Distribution of PUTC were carried out using ICD-10 codes to identify diagnosis and main themes identified by qualitative analysis of audio recorded under-triaged calls. Study period was October 15 th to November 30 th 2014. Three hundred twenty seven PUTC were identified, representing 0.04% of all calls (n = 937.056) to the OOH. Distribution of PUTC according to diagnoses was: digestive (24%), circulatory (19%), respiratory (15%) and all others (42%). Thematic analysis of the voice logs suggested that inadequate communication and non-normative symptom description contributed to under-triage. The incidence of potentially under-triage is low (0.04%). However, the over-representation of digestive, circulatory, and respiratory diagnoses might suggest that under-triage is related to inadequate symptom description. We recommend that caller and call-handler collaborate systematically on problem

Development of a Remote Consultation System Using Avatar Technology

Science.gov (United States)

Ohnishi, Tatsuya; Yajima, Hiroshi; Sawamoto, Jun

The chance to use the Internet as a communications tool has been increasing, and the consultation businesses for customers at remote places are diversifying in their communication media and forms. In the remote consultation, the lack of non-verbal information is reported as one of the reasons for inefficiency and customer's dissatisfaction compared with the face-to-face consultation. The technique for supplementing non-verbal information with a TV telephone is proposed, and helps to confirm understanding degree or the utterance timing by watching the movement of the face. But the displayed face of the partner causes strong feeling of strain between strangers and the participants also care about background scene displayed on the monitor producing risks in the consultation tasks. In this paper, we propose a remote consultation method that uses avatar technology in the virtual space in order to provide non-verbal information and also avoiding the problem of TV telephone at the same time. The effectiveness of the proposed remote consultation method is confirmed by experiments.

Nurse-led telephone follow-up after total knee arthroplasty

DEFF Research Database (Denmark)

Szöts, Kirsten; Konradsen, Hanne; Solgaard, Søren

2015-01-01

AIM AND OBJECTIVES: To generate information on how telephone follow-up consultations, structured by nursing status according to the VIPS-model, functioned after total knee arthroplasty. The objectives were to unfold the content of the telephone follow-ups according to the structure for nursing...... status and to explore the patients' views of the telephone follow-ups. BACKGROUND: The length of stay in hospital following total knee arthroplasty has fallen markedly, and patients now have to be responsible for their recovery from a very early stage. After discharge, patients may experience a variety...... Telephone follow-up was valued by total knee arthroplasties patients as representing a holistic approach and providing adequate information, counselling and support after discharge to home. Three categories were identified with regard to the patients' views: 'A means for reflection and provision of adequate...

Electronic consultation system demonstrates educational benefit for primary care providers.

Science.gov (United States)

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

2017-01-01

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

40 CFR 725.17 - Consultation with EPA.

Science.gov (United States)

2010-07-01

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

Development and Preliminary Application of Multi-channel Agricultural Science and Technology Consulting Service U Disk

Science.gov (United States)

Yu, W. S.; Luo, C. S.; Wei, Q. F.; Zheng, Y. M.; Cao, C. Z.

2017-12-01

To deal with the “last kilometer” problem during the agricultural science and technology information service, the USB flash disk “Zixuntong”, which integrated five major consulting channels, i.e., telephone consultation, mutual video, message consultation, online customer service and QQ group was developed on the bases of capital experts and date resources. Since the products have the computer and telephone USB interface and are combined with localized information resources, users can obtain useful information on any terminal without the restriction of network. Meanwhile, the cartoon appearance make it friendly and attractive to people. The USB flash disk was used to provide agricultural expert consulting services and obtained a good preliminary application achievement. Finally, we concluded the creative application of USB flash disk in agricultural consulting services and prospected the future development direction of agricultural mobile consultation.

Telephone counseling for the public after the Fukushima Daiichi Nuclear Power Plant accident

International Nuclear Information System (INIS)

Horiguchi, T.; Kojima, K.; Itoh, T.

2011-01-01

After the Fukushima Daiichi Nuclear Power Plant accident, Kinki University Atomic Energy Research Institute provided telephone counseling services in order to respond the public's growing concerns about radiation and nuclear energy. Three telephone lines were newly installed for the counseling and the number of consultation marked 705 between March 24 and April 2. In this report, by summarizing the contents of the counseling, we will show what the public concerned about shortly after the accident and report how we responded to the concerns. (author)

Consequences of insecurity in emergency telephone consultations: an experimental study in medical students.

Science.gov (United States)

Barth, J; Ahrens, R; Schaufelberger, M

2014-01-01

Handling emergency telephone consultations (ETCs) is a challenging and very important task for doctors. The aims of the study were to document insecurity in medical students during ETCs and to identify the reasons for that insecurity. We hypothesised that insecurity is associated with advising more urgent action (e.g. advice to call for an ambulance) in ETCs. We used ETCs with simulated patients (SPs), with each student randomly allocated two of four possible cases. After the training, 137 students reported on any insecurity that they had in the various ETC phases. We analysed the reasons for insecurity using descriptive statistics. The association between the students' advice that urgent action was needed and their insecurity was analysed with Spearman rank correlation. Overall, 95% of the students felt insecure in at least one phase of their ETC. History taking was the phase in which students felt most insecure (63.1%), followed by the phase of analysing the information given by the patient (44.9%). Perceived insecurity was associated with more urgent advice in one case scenario (abdominal pain; correlation r = 0.46; p ETC decision-making. ETC training in medical schools, with a focus on structured history taking and formulating discriminating questions, might help decrease insecurity in ETCs. Medical education should also teach management of insecurity.

Doctor-patient communication on the telephone.

Science.gov (United States)

Curtis, P; Evens, S

1989-01-01

Since its invention, the telephone has been an important tool in medical practice, particularly for primary care physicians. Approximately half the calls made to a physician's office during regular consulting hours are for clinical problems and most are handled effectively over the phone without an immediate office visit. Telephone encounters are generally very brief, and managing such calls requires a pragmatic approach that is often quite different from the approach taken in the office visit. The telephone encounter should be recognized and recorded as a specific medical interaction in the medical chart for both clinical and legal reasons. Effective telephone encounters depend on good communication skills; decision making regarding disposition is a major goal. The physician's perception of a medical problem may be different from the patient's; patients are frequently seeking advice and reassurance rather than diagnosis and treatment, and may call because of anxiety and psychological stress. For physicians and their families who are not prepared for after-hours telephone encounters, calls that interrupt more "legitimate" activities may result in anger or frustration for the physician and dissatisfaction for the patient.

Group consultations in antenatal care: Patients’ perspectives on what patient-patient communication provides

DEFF Research Database (Denmark)

Jensen, Matilde Nisbeth; Fage-Butler, Antoinette Mary

Background and objectives: The group consultation, where a medical professional engages simultaneously with a group of patients, is increasingly being used in healthcare encounters. Its introduction has been associated with two perceived advantages: 1) that it can provide a more economically...... in our understanding of the group consultation. Our specific focus is on interpersonal communication in group consultations, with specific focus on patient-patient communication. This paper presents findings from a research project on pregnant women’s experiences of group consultations with a midwife...... in the Danish setting. Methods: Using a sequential mixed methods design, we first performed a discourse analysis of the written materials provided to the women about the group consultations. In the second step, we interview the women about their experiences of the group consultations. Findings: The analysis...

Maintaining clinical governance when giving telephone advice.

Science.gov (United States)

Alazawi, William; Agarwal, Kosh; Suddle, Abid; Aluvihare, Varuna; Heneghan, Michael A

2013-10-01

Delivering excellent healthcare depends on accurate communication between professionals who may be in different locations. Frequently, the first point of contact with the liver unit at King's College Hospital (KCH) is through a telephone call to a specialist registrar or liver fellow, for whom no case notes are available in which to record information. The aim of this study was to improve the clinical governance of telephone referrals and to generate contemporaneous records that could be easily retrieved and audited. An electronic database for telephone referrals and advice was designed and made securely available to registrars in our unit. Service development in a tertiary liver centre that receives referrals from across the UK and Europe. Demographic and clinical data were recorded prospectively and analysed retrospectively. Data from 350 calls were entered during 5 months. The information included the nature and origin of the call (200 from 75 different institutions), disease burden and severity of disease among the patients discussed with KCH, and outcome of the call. The majority of cases were discussed with consultants or arrangements were made for formal review at KCH. A telephone referrals and advice database provides clinical governance, serves as a quality indicator and forms a contemporaneous record at the referral centre. Activity data and knowledge of disease burden help to tailor services to the needs of referrers and commissioners. We recommend implementation of similar models in other centres that give extramural verbal advice.

Shared consultant physician posts.

LENUS (Irish Health Repository)

Cooke, J

2012-01-31

Our aim was to assess the acceptability and cost-efficiency of shared consultancy posts. Two consultant physicians worked alternate fortnights for a period of twelve months. Questionnaires were distributed to general practitioners, nurses, consultants and junior doctors affected by the arrangement. Patients or their next of kin were contacted by telephone. 1\\/17 of consultants described the experience as negative. 14\\/19 junior doctors reported a positive experience. 11 felt that training had been improved while 2 felt that it had been adversely affected. 17\\/17 GPs were satisfied with the arrangement. 1\\/86 nurses surveyed reported a negative experience. 1\\/48 patients were unhappy with the arrangement. An extra 2.2 (p<0.001) patients were seen per clinic. Length of stay was shortened by 2.49 days (p<0.001). A saving of 69,212 was made due to decreased locum requirements. We present data suggesting structured shared consultancy posts can be broadly acceptable and cost efficient in Ireland.

Can audio recording of outpatient consultations improve patients recall and understanding?

DEFF Research Database (Denmark)

Wolderslund, Maiken

of the dialogue between the patient and the clinician via the telephone in the consultation room. By dialing a dedicated number, patients can get access to an audio recording of their consultation by entering their social security number along with a PIN. The primary objective of this study is to determine......Introduction Information provided in an outpatient consultation concerns medication, diagnostic tests, treatment and rehabilitation, all of which are crucial knowledge with regards to patient compliance, decision making and general patient satisfaction. Despite good communication skills among...... clinicians, the communication is challenged by the fact that patients tend to forget or misunderstand parts of the information given. Thus we have designed a study which gives the patients a possibility to hear their consultation again. An Interactive Voice Response platform enables an audio recording...

Understanding the use of email consultation in primary care using a retrospective observational study with data of Dutch electronic health records

Science.gov (United States)

Huygens, Martine W J; Swinkels, Ilse C S; Verheij, Robert A; Friele, Roland D; van Schayck, Onno C P; de Witte, Luc P

2018-01-01

Objectives It is unclear why the use of email consultation is not more widespread in Dutch general practice, particularly because, since 2006, its costs can be reimbursed. To encourage further implementation, it is needed to understand the current use of email consultations. This study aims to understand the use of email consultation by different patient groups, compared with other general practice (GP) consultations. Setting For this retrospective observational study, we used Dutch routine electronic health record data obtained from NIVEL Primary Care Database for the years 2010 and 2014. Participants 200 general practices were included in 2010 (734 122 registered patients) and 434 in 2014 (1 630 386 registered patients). Primary outcome measures The number and percentage of email consultations and patient characteristics (age, gender, neighbourhood socioeconomic status and diagnoses) of email consultation users were investigated and compared with those who had a telephone or face-to-face consultation. General practice characteristics were also taken into account. Results 32.0% of the Dutch general practices had at least one email consultation in 2010, rising to 52.8% in 2014. In 2014, only 0.7% of the GP consultations were by email (the others comprised home visits, telephone and face-to-face consultations). Its use highly varied among general practices. Most email consultations were done for psychological (14.7%); endocrine, metabolic and nutritional (10.9%); and circulatory (10.7%) problems. These diagnosis categories appeared less frequently in telephone and face-to-face consultations. Patients who had an email consultation were older than patients who had a telephone or face-to-face consultation. In contrast, patients with diabetes who had an email consultation were younger. Conclusion Even though email consultation was done in half the general practices in the Netherlands in 2014, the actual use of it is extremely low. Patients who had an email consultation

Consultations of health service providers amongst patients of pulmonary tuberculosis from an urban area

Directory of Open Access Journals (Sweden)

Geeta S. Pardeshi

2008-11-01

Full Text Available Aims: To describe the number, types and reasons of consultations amongst patients of pulmonary tuberculosis from an urban area. Settings and Design Cross sectional study was conducted amongst new patients of pulmonary tuberculosis initiated on DOTS at District Tuberculosis Centre (DTC, Yavatmal from January to June 2006. Material and Methods: The data regarding consultations were collected along a time line. The reasons for consultations were studied by in-depth interviews. Statistical analysis: Logistic regression analysis and transcripts of interviews. Results and Conclusions A total of 55 patients were studied in whom median duration between first consultation to treatment initiation was 15 days. A majority of cases (87.27% had first consulted a private practitioner. A total of 32 patients reported more than two consultations and 19 had consulted more than two private health service providers. Amongst the movements between consultations, a majority were from private to government. Only four patients had come to DTC without any prior consultation. Many patients came to government health service provider on their own when the symptomatic treatment prescribed by the private practitioners did not relieve their symptoms.

29 CFR 1908.4 - Offsite consultation.

Science.gov (United States)

2010-07-01

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

Telephoning in English

CERN Document Server

Naterop, B Jean

1994-01-01

Many people have to use English on the telephone in the course of their work, either at the level of taking a simple message or involving more complex tasks such as requesting information. Telephoning in English provides an up-to-date and relevant context in which students from lower-intermediate level upwards can develop practical telephone skills. The course principally develops spoken interactive skills, but also includes reading material on telephone systems and techniques. As the material is not restricted to particular job functions, it is suitable for students in a wide range of business and administration fields.

Role of telephone triage in obstetrics.

Science.gov (United States)

Manning, Nirvana Afsordeh; Magann, Everett F; Rhoads, Sarah J; Ivey, Tesa L; Williams, Donna J

2012-12-01

The telephone has become an indispensable method of communication in the practice of obstetrics. The telephone is one of the primary methods by which the patient makes her appointments and contacts her health care provider for advice, reassurance, and referrals. Current methods of telephone triage include personal at the physicians' office, telephone answering services, labor and delivery nurses, and a dedicated telephone triage system using algorithms. Limitations of telephone triage include the inability of the provider to see the patient and receive visual clues from the interaction and the challenges of obtaining a complete history over the telephone. In addition, there are potential safety and legal issues with telephone triage. To date, there is insufficient evidence to either validate or refute the use of a dedicated telephone triage system compared with a traditional system using an answering service or nurses on labor and delivery. Obstetricians and gynecologists, family physicians. After completing this CME activity, physicians should be better able to analyze the scope of variation in telephone triage across health care providers and categorize the components that go into a successful triage system, assess the current scope of research in telephone triage in obstetrics, evaluate potential safety and legal issues with telephone triage in obstetrics, and identify issues that should be addressed in any institution that is using or implementing a system of telephone triage in obstetrics.

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

International Nuclear Information System (INIS)

Harris, R.; Paterson, A.

2016-01-01

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

Service provider perceptions of transitioning from audio to video capability in a telehealth system: a qualitative evaluation

OpenAIRE

Clay-Williams, Robyn; Baysari, Melissa; Taylor, Natalie; Zalitis, Dianne; Georgiou, Andrew; Robinson, Maureen; Braithwaite, Jeffrey; Westbrook, Johanna

2017-01-01

Background Telephone consultation and triage services are increasingly being used to deliver health advice. Availability of high speed internet services in remote areas allows healthcare providers to move from telephone to video telehealth services. Current approaches for assessing video services have limitations. This study aimed to identify the challenges for service providers associated with transitioning from audio to video technology. Methods Using a mixed-method, qualitative approach, w...

Using Clinical Questions Asked by Primary Care Providers Through eConsults to Inform Continuing Professional Development.

Science.gov (United States)

Archibald, Douglas; Liddy, Clare; Lochnan, Heather A; Hendry, Paul J; Keely, Erin J

2018-01-01

Continuing professional development (CPD) offerings should address the educational needs of health care providers. Innovative programs, such as electronic consultations (eConsults), provide unique educational opportunities for practice-based needs assessment. The purpose of this study is to assess whether CPD offerings match the needs of physicians by coding and comparing session content to clinical questions asked through eConsults. This study analyzes questions asked by primary care providers between July 2011 and January 2015 using a service that allows specialists to provide consultation over a secure web-based server. The content of these questions was compared with the CPD courses offered in the area in which these primary care providers are practicing over a similar period (2012-2014). The clinical questions were categorized by the content area. The percentage of questions asked about each content area was calculated for each of the 12 specialties consulted. CPD course offerings were categorized using the same list of content areas. Percentage of minutes dedicated to each content area was calculated for each specialty. The percentage of questions asked and the percentage of CPD course minutes for each content area were compared. There were numerous congruencies and discrepancies between the proportion of questions asked about a given content area and the CPD minutes dedicated to it. Traditional needs assessment may underestimate the need to address topics that are frequently the subject of eConsults. Planners should recognize eConsult questions as a valuable source of practice-associated challenges that can identify professional development needs of physicians.

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

Science.gov (United States)

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

2009-07-01

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

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.

Science.gov (United States)

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.

Using Your VOICE(S: Adding Telephonic Communication to Pharmacy Education

Directory of Open Access Journals (Sweden)

Lorin B Grieve

2017-06-01

Full Text Available Pharmacists utilize a myriad of communication methods to deliver patient care. One of the most prevalent communication methods is the telephone. The University of Pittsburgh School of Pharmacy created a novel instructional and assessment technique to enhance student pharmacist training experiences in telephonic communication within the PharmD curriculum. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received, employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties   Type: Note

The transition from learner to provider/teacher: The learning needs of new orthopaedic consultants

Directory of Open Access Journals (Sweden)

Elliot Katy

2005-05-01

Full Text Available Abstract Background Given the relatively sudden change from learner to teacher-provider that new consultants experience and the likely clinical and managerial challenges this may pose, there is a relative dearth of research into the problems they may have in relation to their new roles, or how supported they feel by senior colleagues acting in a mentoring role. This research sought to determine new consultants views on the quality and relevance of their training, its relationship to their confidence in clinical and managerial skills and their views on mentorship by senior colleagues. Methods Detailed postal questionnaire to new consultants using open and closed questions. Open questionnaire to established consultants to validate new consultant responses. Results Respondents felt their clinical training was good and were generally confident in most clinical skills although some perceived deficiencies in more complex procedures and specialist areas. Most lacked confidence in many managerial skills. These perceptions were verified by established consultants. Although no relationship was found between total training time or quality of training with confidence, extra training in specific sub-specialities improved confidence in these areas. While most established consultants thought that mentorship would be useful for new consultants, only 52% of them shared this view. Conclusion Training and experience in management should be given greater emphasis. There may be a need for specific, targeted training in complex procedures for doctors who experience lack of confidence in these areas. Mentorship should be offered to new consultants and recognised in the job-plan of the new consultant contract.

‘Why does it happen like this?’ Consulting with users and providers prior to an evaluation of services for children with life limiting conditions and their families

Science.gov (United States)

Brown, Erica; Coad, Jane; Staniszewska, Sophie; Hacking, Suzanne; Chesworth, Brigit; Chambers, Lizzie

2015-01-01

Children with life limiting conditions and their families have complex needs. Evaluations must consider their views and perspectives to ensure care is relevant, appropriate and acceptable. We consulted with children, young people, their parents and local professionals to gain a more informed picture of issues affecting them prior to preparing a bid to evaluate services in the area. Multiple methods included focus groups, face-to-face and telephone interviews and participatory activities. Recordings and products from activities were analysed for content to identify areas of relevance and concern. An overarching theme from parents was ‘Why does it happen like this?’ Services did not seem designed to meet their needs. Whilst children and young people expressed ideas related to quality of environment, services and social life, professionals focused on ways of meeting the families’ needs. The theme that linked families’ concerns with those of professionals was ‘assessing individual needs’. Two questions to be addressed by the evaluation are (1) to what extent are services designed to meet the needs of children and families and (2) to what extent are children, young people and their families consulted about what they need? Consultations with families and service providers encouraged us to continue their involvement as partners in the evaluation. PMID:24270996

Patient compliance with a health care provider referral for an occupational therapy lymphedema consult.

Science.gov (United States)

Dominick, Sally A; Natarajan, Loki; Pierce, John P; Madanat, Hala; Madlensky, Lisa

2014-07-01

Limited information exists on breast cancer patients' compliance to attend outpatient appointments with an occupational therapy (OT) lymphedema specialist. The objectives of this study were (1) to examine patient compliance with a health care provider referral for an OT lymphedema consult and (2) to identify potential barriers to compliance. A retrospective chart review of female breast cancer patients at the UC San Diego Health System was conducted. Electronic medical records were queried for breast cancer patients, who received a health care provider referral for an OT lymphedema consult between June 1, 2010 and December 31, 2011. Descriptive statistics and Fisher's exact chi-square tests were used to examine how specific participant characteristics were associated with attending an OT appointment. A total of 210 female patients received an OT referral from a health care provider related to their breast cancer diagnosis. Forty-three (20.5%) patients did not attend an OT appointment. Non-attenders were more likely to have had fewer lymph nodes removed (Pcancer patients attended recommended OT lymphedema consults, a substantial number of women might benefit from further education about OT for lymphedema prevention following breast cancer treatment. Further research to understand barriers to attendance is recommended, particularly among women with only sentinel nodes removed.

Initial development of the recovery-oriented services assessment: A collaboration with peer-provider consultants.

Science.gov (United States)

Lodge, Amy C; Kuhn, Wendy; Earley, Juli; Stevens Manser, Stacey

2018-06-01

The Recovery Self-Assessment (RSA) is a reliable and valid tool used to measure recovery-oriented services. Recent studies, however, suggest that the length and reading level of the RSA makes its routine use in service settings difficult. Recognizing the importance of including people with lived experience of a mental health challenge in research processes and the need to enhance the utility of tools that measure recovery-oriented services, this paper describes an innovative researcher-peer provider consultant multistep process used to revise the provider version of the RSA to create a new instrument-the Recovery-Oriented Services Assessment (ROSA). The authors conducted an exploratory factor analysis (EFA) with principal axis factoring extraction and direct oblimin rotation to evaluate the underlying structure of the provider RSA using data from mental health employees (n = 323). To triangulate the findings of the EFA, quantitative and qualitative data were collected from peer provider consultants (n = 9) on the importance of and language of RSA items. EFA results indicated that a 1-factor solution provided the best fit and explained 48% of the total variance. Consultants triangulated EFA results and recommended the addition of 2 items and language revisions. These results were used to develop the ROSA-a 15-item instrument measuring recovery-oriented services with accessible language. Two versions of the ROSA were developed: a staff version and a people-in-services version. The ROSA may provide organizations with a more accessible way to measure the extent to which their services are recovery oriented. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

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

Science.gov (United States)

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

2016-01-29

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

Providing Cardiology Care in Rural Areas Through Visiting Consultant Clinics.

Science.gov (United States)

Gruca, Thomas S; Pyo, Tae-Hyung; Nelson, Gregory C

2016-06-30

Workforce experts predict a future shortage of cardiologists that is expected to impact rural areas more severely than urban areas. However, there is little research on how rural patients are currently served through clinical outreach. This study examines the impact of cardiology outreach in Iowa, a state with a large rural population, on participating cardiologists and on patient access. Outreach clinics are tracked annually in the Office of Statewide Clinical Education Programs Visiting Medical Consultant Database (University of Iowa Carver College of Medicine). Data from 2014 were analyzed. In 2014, an estimated 5460 visiting consultant clinic days were provided in 96 predominantly rural cities by 167 cardiologists from Iowa and adjoining states. Forty-five percent of Iowa cardiologists participated in rural outreach. Visiting cardiologists from Iowa and adjoining states drive an estimated 45 000 miles per month. Because of monthly outreach clinics, the average driving time to the nearest cardiologist falls from 42.2±20.0 to 14.7±11.0 minutes for rural Iowans. Cardiology outreach improves geographic access to office-based cardiology care for more than 1 million Iowans out of a total population of 3 million. Direct travel costs and opportunity costs associated with physician travel are estimated to be more than $2.1 million per year. Cardiologists in Iowa and adjoining states have expanded access to office-based cardiology care from 18 to 89 of the 99 counties in Iowa. In these 71 counties without a full-time cardiologist, visiting consultant clinics can accommodate more than 50% of office visits in the patients' home county. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

[Topics on Which Relatives of Persons with Dementia Seek Counseling Over Telephone or Email: Current Results of a Nationwide Counseling Service of the German Alzheimer Society].

Science.gov (United States)

Pendergrass, Anna; Weiß, Saskia; Gräßel, Elmar

2018-04-19

Since 15 years, the Alzheimer 's Telephone of the German Alzheimer Society (Deutsche Alzheimer Gesellschaft e.V.; DAlzG), a nationwide psychosocial counseling service, has been offering support for people with dementia (PwD) and their families. The aim of this study was to evaluate: a) why informal PwD caregivers seek telephone counseling, b) whether these telephone calls are one-time counseling or long-term support, and c) whether the telephone inquiries differ from the email-based inquiries with regard to the addressed issues. The data are based on the inquiries of 3,744 informal caregivers, which consulted the DAlzG in 2015. Sociodemographic data on the informal caregivers and the PwD, the characteristics of the telephone call, and the topics addressed in the email inquiries were collected. 70.3% of the callers were female. Most of them (59.9%) were the children (in-law) of and half of them (49.7%) lived with PwD. More than two-thirds of the callers (70%) were seeking help in dealing with the person with dementia (e. g. challenging behavior) and 36.5% of the relatives needed recommendations for further local help and assistance. In the third place, the calls were related to financial and legal topics (23.5%). 92.2% of the calls were one-time consultations. The addressed issues in the email inquiries did not significantly differ from the topics discussed over the telephone. On many topics there is a need for further "on site" consultation. Doctors and other health professionals should therefore be actively involved in counseling relatives of PwD. © Georg Thieme Verlag KG Stuttgart · New York.

Telephone calls by individuals with cancer.

Science.gov (United States)

Flannery, Marie; McAndrews, Leanne; Stein, Karen F

2013-09-01

To describe symptom type and reporting patterns found in spontaneously initiated telephone calls placed to an ambulatory cancer center practice. Retrospective, descriptive. Adult hematology oncology cancer center. 563 individuals with a wide range of oncology diagnoses who initiated 1,229 telephone calls to report symptoms. Raw data were extracted from telephone forms using a data collection sheet with 23 variables obtained for each phone call, using pre-established coding criteria. A literature-based, investigator-developed instrument was used for the coding criteria and selection of which variables to extract. Symptom reporting, telephone calls, pain, and symptoms. A total of 2,378 symptoms were reported by telephone during the four months. At least 10% of the sample reported pain (38%), fatigue (16%), nausea (16%), swelling (12%), diarrhea (12%), dyspnea (10%), and anorexia (10%). The modal response was to call only one time and to report only one symptom (55%). Pain emerged as the symptom that most often prompted an individual to pick up the telephone and call. Although variation was seen in symptom reporting, an interesting pattern emerged with an individual reporting on a solitary symptom in a single telephone call. The emergence of pain as the primary symptom reported by telephone prompted educational efforts for both in-person clinic visit management of pain and prioritizing nursing education and protocol management of pain reported by telephone. Report of symptoms by telephone can provide nurses unique insight into patient-centered needs. Although pain has been an important focus of education and research for decades, it remains a priority for individuals with cancer. A wide range in symptom reporting by telephone was evident.

Post-operative telephone review is cost-effective and acceptable to patients.

LENUS (Irish Health Repository)

Gray, R T

2012-02-01

INTRODUCTION: Patients undergoing selective minor emergency and elective procedures are followed up by a nurse-led structured telephone review six weeks post-operatively in our hospital. Our study objectives were to review patients\\' satisfaction, assess cost-effectiveness and compare our practice with other surgical units in Northern Ireland (NI). PATIENTS AND METHODS: Completed telephone follow-up forms were reviewed retrospectively for a three-year period and cost savings calculated. Fifty patients were contacted prospectively by telephone using a questionnaire to assess satisfaction of this follow-up. A postal questionnaire was sent to 68 general and vascular surgeons in NI, assessing individual preferences for patient follow-up. RESULTS: A total of 1378 patients received a telephone review from September 2005 to September 2008. One thousand one hundred and seventy-seven (85.4%) were successfully contacted, while 201 (14.6%) did not respond despite multiple attempts. One hundred and forty-seven respondents (10.7%) required further outpatient follow-up, thereby saving 1231 outpatient reviews, equivalent to pound41,509 per annum. Thirty-nine (78%) patients expected post-operative follow-up, with 29 (58%) expecting this in the outpatient department. However, all patients were satisfied with the nurse-led telephone review. Fifty-three (78%) consultants responded. Those who always, or occasionally, review patients post-operatively varies according to the operation performed, ranging from 2.2% appendicectomy patients to 40.0% for varicose vein surgery. CONCLUSION: Current practice in NI varies, but a significant proportion of patients are not routinely reviewed. This study confirmed that patients expect post-operative follow-up. A nurse-led telephone review service is acceptable to patients, cost-effective and reduces the number of unnecessary outpatient reviews.

Owners and Veterinary Surgeons in the United Kingdom Disagree about What Should Happen during a Small Animal Vaccination Consultation.

Science.gov (United States)

Belshaw, Zoe; Robinson, Natalie J; Dean, Rachel S; Brennan, Marnie L

2018-01-18

Dog and cat vaccination consultations are a common part of small animal practice in the United Kingdom. Few data are available describing what happens during those consultations or what participants think about their content. The aim of this novel study was to investigate the attitudes of dog and cat owners and veterinary surgeons towards the content of small animal vaccination consultations. Telephone interviews with veterinary surgeons and pet owners captured rich qualitative data. Thematic analysis was performed to identify key themes. This study reports the theme describing attitudes towards the content of the consultation. Diverse preferences exist for what should be prioritised during vaccination consultations, and mismatched expectations may lead to negative experiences. Vaccination consultations for puppies and kittens were described to have a relatively standardised structure with an educational and preventative healthcare focus. In contrast, adult pet vaccination consultations were described to focus on current physical health problems with only limited discussion of preventative healthcare topics. This first qualitative exploration of UK vaccination consultation expectations suggests that the content and consistency of adult pet vaccination consultations may not meet the needs or expectations of all participants. Redefining preventative healthcare to include all preventable conditions may benefit owners, pets and veterinary surgeons, and may help to provide a clearer structure for adult pet vaccination consultations. This study represents a significant advance our understanding of this consultation type.

Owners and Veterinary Surgeons in the United Kingdom Disagree about What Should Happen during a Small Animal Vaccination Consultation

Directory of Open Access Journals (Sweden)

Zoe Belshaw

2018-01-01

Full Text Available Dog and cat vaccination consultations are a common part of small animal practice in the United Kingdom. Few data are available describing what happens during those consultations or what participants think about their content. The aim of this novel study was to investigate the attitudes of dog and cat owners and veterinary surgeons towards the content of small animal vaccination consultations. Telephone interviews with veterinary surgeons and pet owners captured rich qualitative data. Thematic analysis was performed to identify key themes. This study reports the theme describing attitudes towards the content of the consultation. Diverse preferences exist for what should be prioritised during vaccination consultations, and mismatched expectations may lead to negative experiences. Vaccination consultations for puppies and kittens were described to have a relatively standardised structure with an educational and preventative healthcare focus. In contrast, adult pet vaccination consultations were described to focus on current physical health problems with only limited discussion of preventative healthcare topics. This first qualitative exploration of UK vaccination consultation expectations suggests that the content and consistency of adult pet vaccination consultations may not meet the needs or expectations of all participants. Redefining preventative healthcare to include all preventable conditions may benefit owners, pets and veterinary surgeons, and may help to provide a clearer structure for adult pet vaccination consultations. This study represents a significant advance our understanding of this consultation type.

Owners and Veterinary Surgeons in the United Kingdom Disagree about What Should Happen during a Small Animal Vaccination Consultation

Science.gov (United States)

Robinson, Natalie J.; Dean, Rachel S.

2018-01-01

Dog and cat vaccination consultations are a common part of small animal practice in the United Kingdom. Few data are available describing what happens during those consultations or what participants think about their content. The aim of this novel study was to investigate the attitudes of dog and cat owners and veterinary surgeons towards the content of small animal vaccination consultations. Telephone interviews with veterinary surgeons and pet owners captured rich qualitative data. Thematic analysis was performed to identify key themes. This study reports the theme describing attitudes towards the content of the consultation. Diverse preferences exist for what should be prioritised during vaccination consultations, and mismatched expectations may lead to negative experiences. Vaccination consultations for puppies and kittens were described to have a relatively standardised structure with an educational and preventative healthcare focus. In contrast, adult pet vaccination consultations were described to focus on current physical health problems with only limited discussion of preventative healthcare topics. This first qualitative exploration of UK vaccination consultation expectations suggests that the content and consistency of adult pet vaccination consultations may not meet the needs or expectations of all participants. Redefining preventative healthcare to include all preventable conditions may benefit owners, pets and veterinary surgeons, and may help to provide a clearer structure for adult pet vaccination consultations. This study represents a significant advance our understanding of this consultation type. PMID:29346332

An assessment of the impact of trauma systems consultation on the level of trauma system development.

Science.gov (United States)

Winchell, Robert J; Ball, Jane W; Cooper, Gail F; Sanddal, Nels D; Rotondo, Michael F

2008-11-01

Studies have shown that trauma systems decrease morbidity and mortality after injury. Despite these findings, overall progress in system development has been slow and inconsistent. The American College of Surgeons Committee on Trauma (COT) has developed a process to provide expert consultation to facilitate regional trauma system development. This study evaluated the progress that occurred after COT consultation visits in six regional systems. All six trauma systems undergoing COT consultation between January 1, 2004 and September 1, 2006 were included in the study. Using a set of 16 objective indicators, preconsultation status was retrospectively assessed by members of the original consultation team using data from the final consultation reports. Postconsultation status was assessed by directed telephone conference, conducted by members of the original consultation team with current key representatives from each system. Progress was assessed by comparing changes in both aggregate and individual indicator scores. This study showed a statistically significant increase in aggregate indicator scores after consultation. The largest gains were seen in systems with the longest time interval between the two assessments. Individual indicators related to system planning and quality assurance infrastructure showed the most improvement. Little or no change was seen in indicators related to system funding. The COT consultation process appears to be effective in facilitating regional trauma system development. In this short-term followup study, progress was seen primarily in areas related to planning and system design. Consultation was not effective in helping systems secure stable funding.

The Impact of Telemedicine on Pediatric Critical Care Triage.

Science.gov (United States)

Harvey, Jillian B; Yeager, Brooke E; Cramer, Christina; Wheeler, David; McSwain, S David

2017-11-01

To examine the relationship between pediatric critical care telemedicine consultation to rural emergency departments and triage decisions. We compare the triage location and provider rating of the accuracy of remote assessment for a cohort of patients who receive critical care telemedicine consultations and a similar group of patients receiving telephone consultations. Retrospective evaluation of consultations occurring between April 2012 and March 2016. Pediatric critical care telemedicine and telephone consultations in 52 rural healthcare settings in South Carolina. Pediatric patients receiving critical care telemedicine or telephone consultations. Telemedicine consultations. Data were collected from the consulting provider for 484 total consultations by telephone or telemedicine. We examined the providers' self-reported assessments about the consultation, decision-making, and triage outcomes. We estimate a logit model to predict triage location as a function of telemedicine consult age and sex. For telemedicine patients, the odds of triage to a non-ICU level of care are 2.55 times larger than the odds for patients receiving telephone consultations (p = 0.0005). Providers rated the accuracy of their assessments higher when consultations were provided via telemedicine. When patients were transferred to a non-ICU location following a telemedicine consultation, providers indicated that the use of telemedicine influenced the triage decision in 95.7% of cases (p telemedicine consultation to community hospitals is feasible and results in a reduction in PICU admissions. This study demonstrates an improvement in provider-reported accuracy of patient assessment via telemedicine compared with telephone, which may produce a higher comfort level with transporting patients to a lower level of care. Pediatric critical care telemedicine consultations represent a promising means of improving care and reducing costs for critically ill children in rural areas.

7 CFR 1744.63 - The telephone loan budget.

Science.gov (United States)

2010-01-01

... 7 Agriculture 11 2010-01-01 2010-01-01 false The telephone loan budget. 1744.63 Section 1744.63... Disbursement of Funds § 1744.63 The telephone loan budget. When the loan is made, RUS provides the borrower a Telephone Loan Budget, RUS Form 493. This budget divides the loan into budget accounts such as “Engineering...

Implementing telephone triage in general practice: a process evaluation of a cluster randomised controlled trial.

Science.gov (United States)

Murdoch, Jamie; Varley, Anna; Fletcher, Emily; Britten, Nicky; Price, Linnie; Calitri, Raff; Green, Colin; Lattimer, Valerie; Richards, Suzanne H; Richards, David A; Salisbury, Chris; Taylor, Rod S; Campbell, John L

2015-04-10

Telephone triage represents one strategy to manage demand for face-to-face GP appointments in primary care. However, limited evidence exists of the challenges GP practices face in implementing telephone triage. We conducted a qualitative process evaluation alongside a UK-based cluster randomised trial (ESTEEM) which compared the impact of GP-led and nurse-led telephone triage with usual care on primary care workload, cost, patient experience, and safety for patients requesting a same-day GP consultation. The aim of the process study was to provide insights into the observed effects of the ESTEEM trial from the perspectives of staff and patients, and to specify the circumstances under which triage is likely to be successfully implemented. Here we report perspectives of staff. The intervention comprised implementation of either GP-led or nurse-led telephone triage for a period of 2-3 months. A qualitative evaluation was conducted using staff interviews recruited from eight general practices (4 GP triage, 4 Nurse triage) in the UK, implementing triage as part of the ESTEEM trial. Qualitative interviews were undertaken with 44 staff members in GP triage and nurse triage practices (16 GPs, 8 nurses, 7 practice managers, 13 administrative staff). Staff reported diverse experiences and perceptions regarding the implementation of telephone triage, its effects on workload, and on the benefits of triage. Such diversity were explained by the different ways triage was organised, the staffing models used to support triage, how the introduction of triage was communicated across practice staff, and by how staff roles were reconfigured as a result of implementing triage. The findings from the process evaluation offer insight into the range of ways GP practices participating in ESTEEM implemented telephone triage, and the circumstances under which telephone triage can be successfully implemented beyond the context of a clinical trial. Staff experiences and perceptions of telephone

Psychiatric Consultation in Community Clinics: A Decade of Experience in the Community Clinics in Jerusalem.

Science.gov (United States)

Avny, Ohad; Teitelbaum, Tatiana; Simon, Moshe; Michnick, Tatiana; Siman-Tov, Maya

2016-01-01

A consultation model between primary care physicians and psychiatrists that has been in operation for 12 years in the Jerusalem district of the Clalit Health Services in Israel is evaluated. In this model psychiatrists provide consultations twice a month at the primary care clinic. All patients are referred by their family physicians. Communication between the psychiatric consultant and the referring physician is carried out by telephone, correspondence and staff meetings. Evaluation of the psychiatric care consultation model in which a psychiatrist consults at the primary care clinic. A questionnaire-based survey distributed to 17 primary care physicians in primary care clinics in Jerusalem in which a psychiatric consultant is present. Almost all of the doctors (93%) responded that the consultation model was superior to the existing model of referral to a secondary psychiatric clinic alone and reduced the workload in caring for the referred patients. The quality of psychiatric care was correlated with the depression prevalence among patients referred for consultation at their clinic (r=0.530, p=0.035). In addition, correlation was demonstrated between primary care physicians impression of alleviation of care of patients and their impression of extent of the patients' cooperation with the consulting psychiatrist (r=0.679, p = 0.015) Conclusions: Very limited conclusions may be drawn from this questionnaire distributed to primary care physicians who were asked to assess psychiatric consultation in their clinic. Our conclusion could be influenced by the design and the actual distribution of the questionnaires by the consulting psychiatrist. Nevertheless answers to the questionnaire might imply that the consultation model of care between a psychiatric consultant and the primary care physician, where the patient's primary care physician takes a leading role in his psychiatric care, is perceived by family physicians as a good alternative to referral to a psychiatric

Telephone Exchange Maintenance

CERN Multimedia

2005-01-01

Urgent maintenance work on CERN telephone exchanges will be performed on 24 March from 6 a.m. to 8 a.m. Telephone services may be disrupted or even interrupted during this time. For more details, please contact us by email at Standard.Telephone@cern.ch.

The telephone effect: Overcoming initiation deficits in two settings.

Science.gov (United States)

Vickers, Kayci L; Keesler, Michael E; Williams, Kelli S; Charles, Jeremy Y; Hamilton, Roy H

2018-04-19

Disorders of motivation substantially impair an individual's ability to communicate with their families, therapists, and doctors. One method of overcoming initiation deficits is by utilizing the telephone effect, which is the ability for individuals with severe motivation deficits to communicate more readily when speaking on a telephone. However, little is available in the extant literature on how this effect works or how best to integrate this into patient care. This article aims to provide the first report of a proposed mechanism underlying the telephone effect and the first published procedures for eliciting this effect. This is largely a review article that also contains descriptions of clinical procedures for eliciting the telephone effect with 2 patient populations: acute inpatients following brain injury and dementia residents. A case vignette is also provided. We propose that the telephone effect is the result of an interaction between the patient and environment, and occurs because of Gibson's (1979) law of affordances. The use of this theory provides an explanation of the behaviors often observed when attempting to elicit this effect (i.e., disruption of the effect when using a cellular phone). Moreover, we argue that this can, and does, apply to social interactions as well. The telephone effect is an understudied phenomenon that provides a means of improving care for individuals with disorders of motivation. Future directions include systematic research into the telephone effect and further investigation of the mechanism underlying this effect. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Total Telephone Tips.

Science.gov (United States)

Corder, Lloyd E.; And Others

This manual of telephone behavior tips for business and sales professionals offers ways to handle the disgruntled caller and makes suggestions on topics relevant to the telephone. The manual is divided into the following sections and subsections: (1) Common Courtesy (staff tips, answering the telephone, screening calls, transferring calls, taking…

Telephone Service

CERN Multimedia

2005-01-01

As part of the upgrade of telephone services, the CERN exchange switches will be updated on Thursday 2 June between 7.00 p.m. and midnight. Telephone services may be affected and possibly even disrupted during this operation. 

"I Always Feel Like I Have to Rush…" Pet Owner and Small Animal Veterinary Surgeons' Reflections on Time during Preventative Healthcare Consultations in the United Kingdom.

Science.gov (United States)

Belshaw, Zoe; Robinson, Natalie J; Dean, Rachel S; Brennan, Marnie L

2018-02-08

Canine and feline preventative healthcare consultations can be more complex than other consultation types, but they are typically not allocated additional time in the United Kingdom (UK). Impacts of the perceived length of UK preventative healthcare consultations have not previously been described. The aim of this novel study was to provide the first qualitative description of owner and veterinary surgeon reflections on time during preventative healthcare consultations. Semi-structured telephone interviews were conducted with 14 veterinary surgeons and 15 owners about all aspects of canine and feline preventative healthcare consultations. These qualitative data were thematically analysed, and four key themes identified. This paper describes the theme relating to time and consultation length. Patient, owner, veterinary surgeon and practice variables were recalled to impact the actual, versus allocated, length of a preventative healthcare consultation. Preventative healthcare consultations involving young, old and multi-morbid animals and new veterinary surgeon-owner partnerships appear particularly susceptible to time pressures. Owners and veterinary surgeons recalled rushing and minimizing discussions to keep consultations within their allocated time. The impact of the pace, content and duration of a preventative healthcare consultation may be influential factors in consultation satisfaction. These interviews provide an important insight into the complex nature of preventative healthcare consultations and the behaviour of participants under different perceived time pressures. These data may be of interest and relevance to all stakeholders in dog and cat preventative healthcare.

“I Always Feel Like I Have to Rush…” Pet Owner and Small Animal Veterinary Surgeons’ Reflections on Time during Preventative Healthcare Consultations in the United Kingdom

Science.gov (United States)

Robinson, Natalie J.; Dean, Rachel S.

2018-01-01

Canine and feline preventative healthcare consultations can be more complex than other consultation types, but they are typically not allocated additional time in the United Kingdom (UK). Impacts of the perceived length of UK preventative healthcare consultations have not previously been described. The aim of this novel study was to provide the first qualitative description of owner and veterinary surgeon reflections on time during preventative healthcare consultations. Semi-structured telephone interviews were conducted with 14 veterinary surgeons and 15 owners about all aspects of canine and feline preventative healthcare consultations. These qualitative data were thematically analysed, and four key themes identified. This paper describes the theme relating to time and consultation length. Patient, owner, veterinary surgeon and practice variables were recalled to impact the actual, versus allocated, length of a preventative healthcare consultation. Preventative healthcare consultations involving young, old and multi-morbid animals and new veterinary surgeon-owner partnerships appear particularly susceptible to time pressures. Owners and veterinary surgeons recalled rushing and minimizing discussions to keep consultations within their allocated time. The impact of the pace, content and duration of a preventative healthcare consultation may be influential factors in consultation satisfaction. These interviews provide an important insight into the complex nature of preventative healthcare consultations and the behaviour of participants under different perceived time pressures. These data may be of interest and relevance to all stakeholders in dog and cat preventative healthcare. PMID:29419766

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

Science.gov (United States)

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%).

Mobile phone consultation for community health care in rural north India.

Science.gov (United States)

Bali, Surya; Singh, Amar Jeet

2007-01-01

We conducted a study to ascertain the acceptability and feasibility of consultation by mobile phone in a rural area of northern India. The mobile phone number of a community physician was advertised to the general public and people were invited to telephone at any time for a medical consultation. Details of the calls received were recorded. During a seven-month study, 660 calls were received. The mean call duration was 2.7 min. Eighty percent of calls were made by men. Forty-eight percent of calls were made during office hours. A total of 417 (63%) calls were for seeking advice, 146 (22%) were for outpatient follow-up, 23 (4%) were for seeking appointments and the remaining 74 (11%) for other reasons. The most common problems were skin, respiratory, mental health and sexual problems. Of the 387 callers who were interviewed at follow-up, 302 (78%) stated that they had followed the advice provided. Of these, 91% found the advice very helpful in managing their health problems. About 96% of users wished to continue to use the service in future. The majority of calls made were of a primary care nature which could easily be dealt with by phone. The concept of using mobile phones for medical consultation seemed to be acceptable to people in rural Haryana.

Consultation Models Revisited

International Nuclear Information System (INIS)

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

2006-01-01

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

Skills for Effective Consultation.

Science.gov (United States)

Dustin, Dick; Ehly, Stewart

1984-01-01

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

26 CFR 49.4251-4 - Prepaid telephone cards.

Science.gov (United States)

2010-04-01

...; adding value. (i) After using the card described in Example 2, P arranges with A by telephone to have 30... EXCISE TAXES FACILITIES AND SERVICES EXCISE TAXES Communications § 49.4251-4 Prepaid telephone cards. (a... section provides rules for the application of the section 4251 tax to PTCs. (b) Definitions. The following...

Impact of the telephone assistive device (TAD) on stuttering severity while speaking on the telephone.

Science.gov (United States)

Chambers, Nola

2009-01-01

There is extensive experimental evidence that altered auditory feedback (AAF) can have a clinically significant effect on the severity of speech symptoms in people who stutter. However, there is less evidence regarding whether these experimental effects can be observed in naturalistic everyday settings particularly when using the telephone. This study aimed to investigate the effectiveness of the Telephone Assistive Device (TAD), which is designed to provide AAF on the telephone to people who stutter, on reducing stuttering severity. Nine adults participated in a quasi-experimental study. Stuttering severity was measured first without and then with the device in participants' naturalistic settings while making and receiving telephone calls (immediate benefit). Participants were then allowed a week of repeated use of the device following which all measurements were repeated (delayed benefit). Overall, results revealed significant immediate benefits from the TAD in all call conditions. Delayed benefits in received and total calls were also significant. There was substantial individual variability in response to the TAD but none of the demographic or speech-related factors measured in the study were found to significantly impact the benefit (immediate or delayed) derived from the TAD. Results have implications for clinical decision making for adults who stutter.

Quantification of diabetes consultations by the main primary health care nurse groups in Auckland, New Zealand.

Science.gov (United States)

Daly, Barbara; Arroll, Bruce; Sheridan, Nicolette; Kenealy, Timothy; Scragg, Robert

2016-09-01

Diabetes prevalence continues to increase, with most diabetes patients managed in primary care. This report quantifies the number of diabetes consultations undertaken by primary healthcare nurses in Auckland, New Zealand. Of 335 primary healthcare nurses randomly selected, 287 (86%) completed a telephone interview in 2006-2008. On a randomly sampled day (from the past seven) for each nurse, 42% of the nurses surveyed (n=120) consulted 308 diabetes patients. From the proportion of nurses sampled in the study, it is calculated that the number of diabetes patients consulted by primary healthcare nurses per week in Auckland between September 2006 and February 2008 was 4210, with 61% consulted by practice, 23% by specialist and 16% by district nurses. These findings show that practice nurses carry out the largest number of community diabetes consultations by nurses. Their major contribution needs to be incorporated into future planning of the community management of diabetes.

A Sandia telephone database system

Energy Technology Data Exchange (ETDEWEB)

Nelson, S.D.; Tolendino, L.F.

1991-08-01

Sandia National Laboratories, Albuquerque, may soon have more responsibility for the operation of its own telephone system. The processes that constitute providing telephone service can all be improved through the use of a central data information system. We studied these processes, determined the requirements for a database system, then designed the first stages of a system that meets our needs for work order handling, trouble reporting, and ISDN hardware assignments. The design was based on an extensive set of applications that have been used for five years to manage the Sandia secure data network. The system utilizes an Ingres database management system and is programmed using the Application-By-Forms tools.

Identifying the core competencies of mental health telephone triage.

Science.gov (United States)

Sands, Natisha; Elsom, Stephen; Gerdtz, Marie; Henderson, Kathryn; Keppich-Arnold, Sandra; Droste, Nicolas; Prematunga, Roshani K; Wereta, Zewdu W

2013-11-01

The primary aim of this study was to identify the core competencies of mental health telephone triage, including key role tasks, skills, knowledge and responsibilities, in which clinicians are required to be competent to perform safe and effective triage. Recent global trends indicate an increased reliance on telephone-based health services to facilitate access to health care across large populations. The trend towards telephone-based health services has also extended to mental health settings, evidenced by the growing number of mental health telephone triage services providing 24-hour access to specialist mental health assessment and treatment. Mental health telephone triage services are critical to the early identification of mental health problems and the provision of timely, appropriate interventions. In spite of the rapid growth in mental health telephone triage and the important role these services play in the assessment and management of mental illness and related risks, there has been very little research investigating this area of practice. An observational design was employed to address the research aims. Structured observations (using dual wireless headphones) were undertaken on 197 occasions of mental health telephone triage over a three-month period from January to March 2011. The research identified seven core areas of mental health telephone triage practice in which clinicians are required to be competent in to perform effective mental health telephone triage, including opening the call; performing mental status examination; risk assessment; planning and action; termination of call; referral and reporting; and documentation. The findings of this research contribute to the evidence base for mental health telephone triage by articulating the core competencies for practice. The mental health telephone triage competencies identified in this research may be used to define an evidence-based framework for mental health telephone triage practice that aims to

Post-donation telephonic interview of blood donors providing an insight into delayed adverse reactions: First attempt in India.

Science.gov (United States)

Tiwari, Aseem K; Aggarwal, Geet; Dara, Ravi C; Arora, Dinesh; Srivastava, Khushboo; Raina, Vimarsh

2017-04-01

Blood donor experiences both immediate adverse reactions (IAR) and delayed adverse reactions (DAR). With limited published data available on the incidence of DAR, a study was conducted to estimate incidence and profile of DAR through telephonic interview. Study was conducted over a 45-day period for consecutive volunteer whole blood donations at tertiary care hospital. Donors were divided into first-time, repeat and regular and were monitored for IAR. They were given written copy of post-donation advice. Donors were contacted telephonically three weeks post-donation and enquired about general wellbeing and specific DAR in accordance with a standard n international (International Society of Blood Transfusion) standard format. Donors participated in the study of which 1.6% donors experienced an IAR. Much larger number reported DAR (10.3% vs.1.6% pdonors (age donors (>50 years). First time (12.3%) and repeat donors (13.5%) had similar frequency of DAR but were lower among regular donors (6.7%). DARs are more common than IAR and are of different profile. Post-donation interview has provided an insight into donor experiences and can be used as a valuable tool in donor hemovigilance. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

Directory of Open Access Journals (Sweden)

Nuttall Jacqueline

2008-04-01

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

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

OpenAIRE

Kreutzer, Markus; Menz, Markus

2012-01-01

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

Advanced training of tax consultants

Directory of Open Access Journals (Sweden)

Adigamova Farida F.

2016-01-01

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

20 CFR 638.516 - Laundry, mail, and telephone service.

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Laundry, mail, and telephone service. 638.516... PROGRAM UNDER TITLE IV-B OF THE JOB TRAINING PARTNERSHIP ACT Center Operations § 638.516 Laundry, mail, and telephone service. (a) The center operator shall provide adequate laundry services and supplies at...

Willingness to pay for rural telephone services: Implications for rural ...

African Journals Online (AJOL)

WTP) for rural telephone services and the implications on poverty reduction in Southeast Nigeria. The key research problem was the inability of the telephone providers or regulatory agencies to estimate the amount the people were willing to pay ...

Harvard Catalyst | The Clinical Translational Science Center IND/IDE Consult Service: providing an IND/IDE consult service in a decentralized network of academic healthcare centers.

Science.gov (United States)

Kim, Min J; Winkler, Sabune J; Bierer, Barbara E; Wolf, Delia

2014-04-01

The Food and Drug Administration (FDA) regulations require sponsors of clinical investigations involving an investigational drug or device to submit an Investigational New Drug (IND) or Investigational Device Exemption (IDE) application. Strict adherence to applicable regulations is vital to the success of clinical research. Unlike most major pharmaceutical sponsors, investigator sponsors often do not fully appreciate their regulatory obligations nor have resources to ensure compliance. As a result they can place themselves and their institutions at risk. Nevertheless, investigator-initiated clinical trials are vital to the further development of innovative drugs, biologics, and medical devices. The IND/IDE Subcommittee under the Regulatory Knowledge and Support Program at Harvard Catalyst, The Harvard Clinical and Translational Science Center worked in collaboration with Harvard and Harvard affiliated institutions to create and launch an IND/IDE Consult Service in a decentralized network of collaborating Academic Healthcare Centers (AHC). The IND/IDE Consult Service offers expertise, resources, and shared experiences to assist sponsor-investigators and IRBs in meeting regulatory requirements for conducting and reviewing investigator-initiated IND/IDE studies. The scope of the services provided by the Harvard Catalyst IND/IDE Consult Service are described, including the specifics of the service, lessons learned, and challenges faced, in a scalable model that builds inter-institutional capacity. © 2014 Wiley Periodicals, Inc.

Harvard Catalyst | The Clinical Translational Science Center IND/IDE Consult Service: Providing an IND/IDE Consult Service in a Decentralized Network of Academic Healthcare Centers

Science.gov (United States)

Winkler, Sabune J.; Bierer, Barbara E.; Wolf, Delia

2014-01-01

Abstract The Food and Drug Administration (FDA) regulations require sponsors of clinical investigations involving an investigational drug or device to submit an Investigational New Drug (IND) or Investigational Device Exemption (IDE) application. Strict adherence to applicable regulations is vital to the success of clinical research. Unlike most major pharmaceutical sponsors, investigator sponsors often do not fully appreciate their regulatory obligations nor have resources to ensure compliance. As a result they can place themselves and their institutions at risk. Nevertheless, investigator‐initiated clinical trials are vital to the further development of innovative drugs, biologics, and medical devices. The IND/IDE Subcommittee under the Regulatory Knowledge and Support Program at Harvard Catalyst, The Harvard Clinical and Translational Science Center worked in collaboration with Harvard and Harvard affiliated institutions to create and launch an IND/IDE Consult Service in a decentralized network of collaborating Academic Healthcare Centers (AHC). The IND/IDE Consult Service offers expertise, resources, and shared experiences to assist sponsor‐investigators and IRBs in meeting regulatory requirements for conducting and reviewing investigator‐initiated IND/IDE studies. The scope of the services provided by the Harvard Catalyst IND/IDE Consult Service are described, including the specifics of the service, lessons learned, and challenges faced, in a scalable model that builds inter‐institutional capacity. PMID:24455986

Psychotherapeutic intervention by telephone

Directory of Open Access Journals (Sweden)

Erika Mozer

2008-06-01

Full Text Available Erika Mozer1,2, Bethany Franklin1,3, Jon Rose11Department of Veterans Affairs, Palo Alto Health Care System, Palo Alto, CA, USA; 2PGSP Stanford PsyD Consortium Palo Alto, CA, USA; 3Pacific Graduate School of Psychology Palo Alto, California, USAAbstract: Psychotherapy conducted over the telephone has received increasing amounts of empirical attention given practical advantages that side-step treatment barriers encountered in traditional office-based care. The utility and efficacy of telephone therapy appears generalizable across diverse clinical populations seeking care in community-based hospital settings. Treatment barriers common to older adults suggest that telephone therapy may be an efficient and effective mental health resource for this population. This paper describes empirical studies of telehealth interventions and case examples with psychotherapy conducted via telephone on the Spinal Cord Injury Unit of the Palo Alto Veterans’ Administration. Telephone therapy as appears to be a viable intervention with the aging population.Keywords: telehealth, rural mental health, psychotherapy, healthcare delivery, telecare

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

Directory of Open Access Journals (Sweden)

Jennifer B McCormick

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

Patient assessment: effective consultation and history taking.

Science.gov (United States)

Kaufman, Gerri

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

Strategies for Suicide Intervention by Telephone.

Science.gov (United States)

Hinson, Jennifer

1982-01-01

Describes techniques helpful for telephone counselors dealing with suicide intervention, including reinstating control, reducing anxiety through problem clarification, and providing hope by active listening and tolerance of dispositions. The use of time-outs and detective work is also discussed. (JAC)

Guidelines for Education and Training at the Doctoral and Postdoctoral Levels in Consulting Psychology/Organizational Consulting Psychology

Science.gov (United States)

American Psychologist, 2007

2007-01-01

The purpose of these "Guidelines for Education and Training at the Doctoral and Postdoctoral Levels in Consulting Psychology/Organizational Consulting Psychology" is to provide a common framework for use in the development, evaluation, and review of education and training in consulting psychology/organizational consulting psychology (CP/OCP). The…

Effectiveness of telephone-assisted parent-administered behavioural family intervention for preschool children with externalizing problem behaviour: a randomized controlled trial.

Science.gov (United States)

Kierfeld, Frauke; Ise, Elena; Hanisch, Charlotte; Görtz-Dorten, Anja; Döpfner, Manfred

2013-09-01

Externalizing problem behaviour is one of the most common childhood disorders. Parent training is an effective treatment for these children and there is growing interest in the effects of parent-administered interventions with minimal therapist contact. This randomized controlled study examined the efficacy of a telephone-assisted parent-administered behavioural intervention (bibliotherapy) in families with preschool children with externalizing problem behaviour. Families were randomly assigned to a treatment group (n = 26) and an untreated waitlist control group (n = 22). The intervention comprised the reading of an 11 chapter self-help book and 11 weekly telephone consultations. Compared to the control group, the treatment group demonstrated significant decreases in parent-reported externalizing and internalizing child problem behaviour and dysfunctional parenting practices. Moreover, treated parents reported less parenting-related strains and decreases in parental depression, anxiety, and stress. The results suggest that telephone-assisted self-administered parent training is an effective alternative to more intensive forms of behavioural family intervention for preschool children with externalizing problem behaviour.

What are the cost savings associated with providing access to specialist care through the Champlain BASE eConsult service? A costing evaluation

Science.gov (United States)

Liddy, Clare; Drosinis, Paul; Deri Armstrong, Catherine; McKellips, Fanny; Afkham, Amir; Keely, Erin

2016-01-01

Objective This study estimates the costs and potential savings associated with all eConsult cases completed between 1 April 2014 and 31 March 2015. Design Costing evaluation from the societal perspective estimating the costs and potential savings associated with all eConsults completed during the study period. Setting Champlain health region in Eastern Ontario, Canada. Population Primary care providers and specialists registered to use the eConsult service. Main outcome measures Costs included (1) delivery costs; (2) specialist remuneration; (3) costs associated with traditional (face-to-face) referrals initiated as a result of eConsult. Potential savings included (1) costs of traditional referrals avoided; (2) indirect patient savings through avoided travel and lost wages/productivity. Net potential societal cost savings were estimated by subtracting total costs from total potential savings. Results A total of 3487 eConsults were completed during the study period. In 40% of eConsults, a face-to-face specialist visit was originally contemplated but avoided as result of eConsult. In 3% of eConsults, a face-to-face specialist visit was not originally contemplated but was prompted as a result of the eConsult. From the societal perspective, total costs were estimated at $207 787 and total potential savings were $246 516. eConsult led to a net societal saving of $38 729 or $11 per eConsult. Conclusions Our findings demonstrate potential cost savings from the societal perspective, as patients avoided the travel costs and lost wages/productivity associated with face-to-face specialist visits. Greater savings are expected once we account for other costs such as avoided tests and visits and potential improved health outcomes associated with shorter wait times. Our findings are valuable for healthcare delivery decision-makers as they seek solutions to improve care in a patient-centred and efficient manner. PMID:27338880

Use of complementary alternative medicine for low back pain consulting in general practice: a cohort study

Science.gov (United States)

Chenot, Jean-François; Becker, Annette; Leonhardt, Corinna; Keller, Stefan; Donner-Banzhoff, Norbert; Baum, Erika; Pfingsten, Michael; Hildebrandt, Jan; Basler, Heinz-Dieter; Kochen, Michael M

2007-01-01

Background Although back pain is considered one of the most frequent reasons why patients seek complementary and alternative medical (CAM) therapies little is known on the extent patients are actually using CAM for back pain. Methods This is a post hoc analysis of a longitudinal prospective cohort study embedded in a RCT. General practitioners (GPs) recruited consecutively adult patients presenting with LBP. Data on physical function, on subjective mood, and on utilization of health services was collected at the first consultation and at follow-up telephone interviews for a period of twelve months Results A total of 691 (51%) respectively 928 (69%) out of 1,342 patients received one form of CAM depending on the definition. Local heat, massage, and spinal manipulation were the forms of CAM most commonly offered. Using CAM was associated with specialist care, chronic LBP and treatment in a rehabilitation facility. Receiving spinal manipulation, acupuncture or TENS was associated with consulting a GP providing these services. Apart from chronicity disease related factors like functional capacity or pain only showed weak or no association with receiving CAM. Conclusion The frequent use of CAM for LBP demonstrates that CAM is popular in patients and doctors alike. The observed association with a treatment in a rehabilitation facility or with specialist consultations rather reflects professional preferences of the physicians than a clear medical indication. The observed dependence on providers and provider related services, as well as a significant proportion receiving CAM that did not meet the so far established selection criteria suggests some arbitrary use of CAM. PMID:18088435

Use of complementary alternative medicine for low back pain consulting in general practice: a cohort study

Directory of Open Access Journals (Sweden)

Baum Erika

2007-12-01

Full Text Available Abstract Background Although back pain is considered one of the most frequent reasons why patients seek complementary and alternative medical (CAM therapies little is known on the extent patients are actually using CAM for back pain. Methods This is a post hoc analysis of a longitudinal prospective cohort study embedded in a RCT. General practitioners (GPs recruited consecutively adult patients presenting with LBP. Data on physical function, on subjective mood, and on utilization of health services was collected at the first consultation and at follow-up telephone interviews for a period of twelve months Results A total of 691 (51% respectively 928 (69% out of 1,342 patients received one form of CAM depending on the definition. Local heat, massage, and spinal manipulation were the forms of CAM most commonly offered. Using CAM was associated with specialist care, chronic LBP and treatment in a rehabilitation facility. Receiving spinal manipulation, acupuncture or TENS was associated with consulting a GP providing these services. Apart from chronicity disease related factors like functional capacity or pain only showed weak or no association with receiving CAM. Conclusion The frequent use of CAM for LBP demonstrates that CAM is popular in patients and doctors alike. The observed association with a treatment in a rehabilitation facility or with specialist consultations rather reflects professional preferences of the physicians than a clear medical indication. The observed dependence on providers and provider related services, as well as a significant proportion receiving CAM that did not meet the so far established selection criteria suggests some arbitrary use of CAM.

Use of complementary alternative medicine for low back pain consulting in general practice: a cohort study.

Science.gov (United States)

Chenot, Jean-François; Becker, Annette; Leonhardt, Corinna; Keller, Stefan; Donner-Banzhoff, Norbert; Baum, Erika; Pfingsten, Michael; Hildebrandt, Jan; Basler, Heinz-Dieter; Kochen, Michael M

2007-12-18

Although back pain is considered one of the most frequent reasons why patients seek complementary and alternative medical (CAM) therapies little is known on the extent patients are actually using CAM for back pain. This is a post hoc analysis of a longitudinal prospective cohort study embedded in a RCT. General practitioners (GPs) recruited consecutively adult patients presenting with LBP. Data on physical function, on subjective mood, and on utilization of health services was collected at the first consultation and at follow-up telephone interviews for a period of twelve months A total of 691 (51%) respectively 928 (69%) out of 1,342 patients received one form of CAM depending on the definition. Local heat, massage, and spinal manipulation were the forms of CAM most commonly offered. Using CAM was associated with specialist care, chronic LBP and treatment in a rehabilitation facility. Receiving spinal manipulation, acupuncture or TENS was associated with consulting a GP providing these services. Apart from chronicity disease related factors like functional capacity or pain only showed weak or no association with receiving CAM. The frequent use of CAM for LBP demonstrates that CAM is popular in patients and doctors alike. The observed association with a treatment in a rehabilitation facility or with specialist consultations rather reflects professional preferences of the physicians than a clear medical indication. The observed dependence on providers and provider related services, as well as a significant proportion receiving CAM that did not meet the so far established selection criteria suggests some arbitrary use of CAM.

The role of the consultant radiographer - Experience of appointees

International Nuclear Information System (INIS)

Ford, Peter

2010-01-01

Aim: To explore the experience of the first consultant practitioners appointed; including the appointment process, nature of the role, their perceptions of success and challenges. Method: This was a whole population study of the known consultant radiographers appointed up to March 2005. It consisted of 3 phases. The first compared appointees job descriptions with the Department of Health guidance, the second collected contextual information using a questionnaire, and the third explored postholders experiences using telephone interviews. Results: Ten of the possible twelve appointees participated. All posts were established according to the guidelines, with largely similar job descriptions allowing for the different clinical specialist areas. All were very positive in their perceptions of their role, and faced similar challenges. They were strongest in their expert clinical practice working but had strong training and leadership roles. The number working at strategic level was low with limited research and few published papers, although there were notable exceptions. Conclusions: The first appointees demonstrated notable successes, strongest in the expert clinical practice element of roles, with evidence of team leadership, and involvement in training and education. Strategic engagement was disappointing, with little research being undertaken. Their experience was that the nature of consultancy was poorly understood by peers and medical colleagues.

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

Directory of Open Access Journals (Sweden)

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.

Mental health consultations in the perinatal period: a cost-analysis of Medicare services provided to women during a period of intense mental health reform in Australia.

Science.gov (United States)

Chambers, Georgina M; Randall, Sean; Mihalopoulos, Cathrine; Reilly, Nicole; Sullivan, Elizabeth A; Highet, Nicole; Morgan, Vera A; Croft, Maxine L; Chatterton, Mary Lou; Austin, Marie-Paule

2017-12-05

Objective To quantify total provider fees, benefits paid by the Australian Government and out-of-pocket patients' costs of mental health Medicare Benefits Schedule (MBS) consultations provided to women in the perinatal period (pregnancy to end of the first postnatal year). Method A retrospective study of MBS utilisation and costs (in 2011-12 A$) for women giving birth between 2006 and 2010 by state, provider-type, and geographic remoteness was undertaken. Results The cost of mental health consultations during the perinatal period was A$17.5million for women giving birth in 2007, rising to A$29million in 2010. Almost 9% of women giving birth in 2007 had a mental health consultation compared with more than 14% in 2010. An increase in women accessing consultations, along with an increase in the average number of consultations received, were the main drivers of the increased cost, with costs per service remaining stable. There was a shift to non-specialist care and bulk billing rates increased from 44% to 52% over the study period. In 2010, the average total cost (provider fees) per woman accessing mental health consultations during the perinatal period was A$689, and the average cost per service was A$133. Compared with women residing in regional and remote areas, women residing in major cities where more likely to access consultations, and these were more likely to be with a psychiatrist rather than an allied health professional or general practitioner. Conclusion Increased access to mental health consultations has coincided with the introduction of recent mental health initiatives, however disparities exist based on geographic location. This detailed cost analysis identifies inequities of access to perinatal mental health services in regional and remote areas and provides important data for economic and policy analysis of future mental health initiatives. What is known about the topic? The mental healthcare landscape in Australia has changed significantly over the

[Role of the physician qualified to provide a notice in compliance of the viewpoint on non-criminal interruption of pregnancy. Experience in the Cantonal Commission of Consultation and Petitions of the canton of Vaud].

Science.gov (United States)

Barbier, Y

1991-02-01

A physician on the consultative committee for noncriminal abortions in the canton of Vaud, Switzerland, offers personal reflections on her view of her role. Physicians at the commission evaluate appeals after an initial refusal, cases of foreigners not residing in the canton for 3 months, and particularly difficult cases referred by colleagues. Members of the commission judge whether the case meets the legal criteria for noncriminal abortions. The procedures followed are basically the same as for any other medical consultation: establishing trust with the patient, gathering and evaluating data on the patient's condition, making a decision and communicating it to the patient, and using the rapport established to further therapeutic and preventive goals. The consultation is of extreme importance to the patient, because it will affect her entire future life. Establishing trust begins before the consultation and is aided by a warm and respectful reception of the woman. During the 1st minute of the consultation, the physician should make introductions, define the function of the interview, and attempt to create an authentic physician-patient relationship. The information gathering stage does not involve a physical examination as the pregnancy has already been confirmed. Linguistic problems may arise with foreign women, but use of an interpreter should be avoided if possible. The physician should seek information on whether both partners are in agreement on the abortion, and about cultural problems likely to affect the patient if the pregnancy is continued or alternatively in case of an abortion. The physician can seek further information if necessary by telephoning the patient's family doctor, social worker, or other sources. The decision should be communicated to the patient by the interviewing physician, and may be made immediately or after a period of reflection. When authorization of an abortion is granted, the patient immediately faces the prospect of the procedure

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

OpenAIRE

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

2017-01-01

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

Telephone consultations on palliative sedation therapy and euthanasia in general practice in The Netherlands in 2003 : a report from inside

NARCIS (Netherlands)

van Heest, F. B.; Finlay, I. G.; Kramer, J. J. E.; Otter, R.; Meyboom-de Jong, B.

2009-01-01

Objective. Data from 2003 were analysed independently to reveal how often and in what way palliative sedation and euthanasia were discussed. Methods. The telephone documentation forms and corresponding evaluation forms of two GP advisors were systematically analysed for problems relating to the role

Update of telephone exchange

CERN Multimedia

2006-01-01

As part of the upgrade of telephone services, the CERN switching centre will be updated on Wednesday 14 June between 8.00 p.m. and midnight. Telephone services may be disrupted and possibly even interrupted during this operation. We apologise in advance for any inconvenience this may cause. CERN TELECOM Service

What are the cost savings associated with providing access to specialist care through the Champlain BASE eConsult service? A costing evaluation.

Science.gov (United States)

Liddy, Clare; Drosinis, Paul; Deri Armstrong, Catherine; McKellips, Fanny; Afkham, Amir; Keely, Erin

2016-06-23

This study estimates the costs and potential savings associated with all eConsult cases completed between 1 April 2014 and 31 March 2015. Costing evaluation from the societal perspective estimating the costs and potential savings associated with all eConsults completed during the study period. Champlain health region in Eastern Ontario, Canada. Primary care providers and specialists registered to use the eConsult service. Costs included (1) delivery costs; (2) specialist remuneration; (3) costs associated with traditional (face-to-face) referrals initiated as a result of eConsult. Potential savings included (1) costs of traditional referrals avoided; (2) indirect patient savings through avoided travel and lost wages/productivity. Net potential societal cost savings were estimated by subtracting total costs from total potential savings. A total of 3487 eConsults were completed during the study period. In 40% of eConsults, a face-to-face specialist visit was originally contemplated but avoided as result of eConsult. In 3% of eConsults, a face-to-face specialist visit was not originally contemplated but was prompted as a result of the eConsult. From the societal perspective, total costs were estimated at $207 787 and total potential savings were $246 516. eConsult led to a net societal saving of $38 729 or $11 per eConsult. Our findings demonstrate potential cost savings from the societal perspective, as patients avoided the travel costs and lost wages/productivity associated with face-to-face specialist visits. Greater savings are expected once we account for other costs such as avoided tests and visits and potential improved health outcomes associated with shorter wait times. Our findings are valuable for healthcare delivery decision-makers as they seek solutions to improve care in a patient-centred and efficient manner. 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/

From Solution Shop to Boutique Consulting? Capturing Recent Developments on the German Consulting Marke

Directory of Open Access Journals (Sweden)

Jörg Jasper DÖTSCH

2016-12-01

Full Text Available Digitalization, globalization, new technologies and shorter product life cycles are only a few keywords underlining the fact that companies are under increasing pressure for faster adaptation, innovation and hence applying a higher knowledge intensity. We assume that these conditions require an increasingly important role of consulting companies, because they seem to be the intermediaries needed to bridge the faster growing gaps between existing business models, organizational structures and accelerating market change. Market pressure is growing on the market for consultant companies as well. New technologies and digitalization should influence both the structure of the consultancy market and the business models of consultancies. Christensen suggested a trend from Dzsolution shop” to Dzboutique consulting.” To track current developments, we concentrate on the German consulting market as one of the most important consultant markets worldwide and explore changes of the last two years based on various studies. Processes of change seem to be both substantially driven by digitalization and to reflect change on the non-consultancy markets. A high willingness to switch among providers documents a high pressure on performance. The impact of digitalisation seem• to be observable in structural and qualitative change. With regard to the German consulting market and the latest available data we cannot validate a tendency from a dominance of “solution shop” consultancies to “boutique” consultancy services.

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

Energy Technology Data Exchange (ETDEWEB)

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

2017-01-15

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

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

Science.gov (United States)

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

2017-01-01

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

Update of telephone exchange

CERN Multimedia

2006-01-01

As part of the upgrade of telephone services, the CERN switching centre will be updated on Monday 3 July between 8.00 p.m. and 3.00 a.m. Telephone services may be disrupted and possibly even interrupted during this operation.We apologise in advance for any inconvenience this may cause. CERN TELECOM Service

Update of telephone exchange

CERN Multimedia

2006-01-01

As part of the upgrade of telephone services, the CERN switching centre will be updated on Monday 3 July between 8.00 p.m. and 3.00 a.m. Telephone services may be disrupted and possibly even interrupted during this operation. We apologise in advance for any inconvenience this may cause. CERN TELECOM Service

One-Year Weight Loss with a Telephone-Based Lifestyle Program

Directory of Open Access Journals (Sweden)

Christina Holzapfel

2016-07-01

Full Text Available Objective: Telephone-based weight loss programs are offered as an alternative to face-to-face obesity treatments, but data on the effectiveness regarding weight loss are limited. Therefore, we evaluated a telephone-based lifestyle program in a real-world setting. Methods: The telephone-based intervention consists of regular phone calls providing individualized lifestyle recommendations, and delivery of printed materials. Anthropometric and metabolic data are collected by general practitioners or are self-reported. Results: Baseline data were available from 398 participants (61% men; weight 103.12 ± 14.21 kg; BMI 33.38 ± 2.83 kg/m2 and 1-year data from 258 (65% participants. In the completers, mean weight change was -4.25 ± 5.18 kg (p Conclusions: The telephone-based lifestyle program results in a moderate weight loss after 12 months, which may be comparable to face-to-face interventions. Telephone-based weight loss support is independent of time and location and represents a tool which is also accepted by men.

Maintenance of the CERN telephone exchanges

CERN Multimedia

2007-01-01

Maintenance work will be carried out on the CERN telephone exchanges between 8 p.m. and midnight on 20 November. Fixed-line telephone and audioconference services may be disrupted while the work is being carried out. However, the CCC and the fire brigade will be contactable at any time. Mobile telephony services (GSM) will not be affected by the maintenance work. For further details about the maintenance work, please contact the telephone switchboard on 76111 or by email to standard.telephone@cern.ch. Telecom Section IT/CS

Update of telephone exchange

CERN Multimedia

2006-01-01

As part of the upgrade of telephone services, the CERN switching centre will be updated on between Monday 23 October 8.00 p.m. and Tuesday 24 October 2.00 a.m. Telephone services may be disrupted and possibly even interrupted during this operation. We apologise in advance for any inconvenience this may cause. CERN TELECOM Service

Upgrade of telephone exchange

CERN Multimedia

2006-01-01

As part of the upgrade of telephone services, work will be carried out on the CERN switching centre between Monday 23 October 8.00 p.m. and Tuesday 24 October 2.00 a.m. Telephone services may be disrupted and possibly even interrupted during this operation. We apologise in advance for any inconvenience this may cause. CERN TELECOM Service

A 3-Arm randomised controlled trial of Communicating Healthy Beginnings Advice by Telephone (CHAT to mothers with infants to prevent childhood obesity

Directory of Open Access Journals (Sweden)

Li Ming Wen

2017-01-01

Full Text Available Abstract Background With an increasing prevalence of obesity in young children globally, there is an urgent need for the development of effective early interventions. A previous Healthy Beginnings Trial using a nurse-led home visiting program has demonstrated that providing mothers with evidence-based advice can improve maternal practice regarding obesity prevention, and can reduce Body Mass Index (BMI in the first few years of life. However, the costs for scale-up of home visiting limit its population reach. This trial aims to determine the efficacy of Communicating Healthy Beginnings Advice by Telephone (CHAT to mothers with infants in improving infant feeding practices and preventing the early onset of childhood overweight and obesity. Methods/Design We propose a 3-arm randomised controlled trial (RCT with a consecutive sample of 1056 mothers with their newborn children in New South Wales (NSW Australia. Pregnant women who are between weeks 28 and 34 of their pregnancy will be invited to participate in the CHAT trial. Informed consent will be obtained, and after baseline data collection, participants will be randomly allocated to the telephone intervention, text messaging intervention, or the control group. The intervention comprises telephone consultations or text messages, together with 6 intervention packages being mailed at specific times from the third trimester of pregnancy until 12 months post birth. The main trial outcome measures include a duration of breastfeeding, b timing of introduction of solids, c nutrition behaviours, physical activity and television viewing, and d weight and BMI z-score at 12 and 24 months, e cost-effectiveness, as well as f feasibility and acceptability of the interventions. Discussion The results will ascertain whether early intervention using telephone consultation or text messaging together with staged mailed intervention resources can be feasible and effective in improving infant feeding practices

Exploring emerging learning needs: a UK-wide consultation on environmental sustainability learning objectives for medical education.

Science.gov (United States)

Walpole, Sarah C; Mortimer, Frances; Inman, Alice; Braithwaite, Isobel; Thompson, Trevor

2015-12-24

This study aimed to engage wide-ranging stakeholders and develop consensus learning objectives for undergraduate and postgraduate medical education. A UK-wide consultation garnered opinions of healthcare students, healthcare educators and other key stakeholders about environmental sustainability in medical education. The policy Delphi approach informed this study. Draft learning objectives were revised iteratively during three rounds of consultation: online questionnaire or telephone interview, face-to-face seminar and email consultation. Twelve draft learning objectives were developed based on review of relevant literature. In round one, 64 participants' median ratings of the learning objectives were 3.5 for relevance and 3.0 for feasibility on a Likert scale of one to four. Revisions were proposed, e.g. to highlight relevance to public health and professionalism. Thirty three participants attended round two. Conflicting opinions were explored. Added content areas included health benefits of sustainable behaviours. To enhance usability, restructuring provided three overarching learning objectives, each with subsidiary points. All participants from rounds one and two were contacted in round three, and no further edits were required. This is the first attempt to define consensus learning objectives for medical students about environmental sustainability. Allowing a wide range of stakeholders to comment on multiple iterations of the document stimulated their engagement with the issues raised and ownership of the resulting learning objectives.

Bundling the value of discharge telephone calls and leader rounding.

Science.gov (United States)

Setia, Nina; Meade, Christine

2009-03-01

Discharge telephone calls made by hospital staff provide invaluable opportunities to prevent adverse events, improve quality of care, and increase patient satisfaction. Similarly, the effect of rounding on patients can improve clinical quality and improve both patient and staff satisfaction. The author discusses how the combination of implementing both nurse leader rounding and discharge telephone calls simultaneously produced powerful positive outcomes in satisfaction and patient quality of care.

Telephone based weight loss intervention: Relevance for developing countries.

Science.gov (United States)

Ayisi Addo, Sandra; Steiner-Asiedu, Matilda

2018-02-08

Obesity is a major public health challenge not only for developed but developing countries as well. The World Health Organization recommends the immediate use of effective, efficient and widely accessible weight loss interventions. Telephone based weight loss intervention could provide a cheaper and wider reach of obese participants. Previous systematic reviews on telephone based weight loss interventions either excluded studies that had obese participants with co-morbidities or were silent on their inclusion. Obese/overweight individuals with co-morbidities constitute an important population in any weight loss intervention study due to the strong association of obesity with major chronic health conditions. This paper, reviews the efficacy of telephone based weight loss intervention solely in overweight/obese individuals with obesity related diseases and discusses its relevance for developing countries.

Systems configured to distribute a telephone call, communication systems, communication methods and methods of routing a telephone call to a service representative

Science.gov (United States)

Harris, Scott H.; Johnson, Joel A.; Neiswanger, Jeffery R.; Twitchell, Kevin E.

2004-03-09

The present invention includes systems configured to distribute a telephone call, communication systems, communication methods and methods of routing a telephone call to a customer service representative. In one embodiment of the invention, a system configured to distribute a telephone call within a network includes a distributor adapted to connect with a telephone system, the distributor being configured to connect a telephone call using the telephone system and output the telephone call and associated data of the telephone call; and a plurality of customer service representative terminals connected with the distributor and a selected customer service representative terminal being configured to receive the telephone call and the associated data, the distributor and the selected customer service representative terminal being configured to synchronize, application of the telephone call and associated data from the distributor to the selected customer service representative terminal.

Maintenance of the CERN telephone exchanges

CERN Multimedia

TS Department

2008-01-01

Maintenance work will be carried out on the CERN telephone exchanges between 8 p.m. and midnight on 3 December. During this time, the fixed-line telephone and audio-conference services may be disrupted. However, the CCC and the Fire Brigade will be reachable at all times. Mobile telephone services (GSM) will not be affected by this work. For further details please contact mailto:Netops@cern.ch.

Maintenance of the CERN telephone exchanges

CERN Multimedia

TS Department

2008-01-01

Maintenance work will be carried out on the CERN telephone exchanges between 8 p.m. and midnight on 3 December. During this time, the fixed-line telephone and audio-conference services may be disrupted. However, the CCC and the Fire Brigade will be reachable at all times. Mobile telephone services (GSM) will not be affected by this work. For further details please contact Netops@cern.ch.

EMS providers and exception from informed consent research: benefits, ethics, and community consultation.

Science.gov (United States)

Ripley, Elizabeth; Ramsey, Cornelia; Prorock-Ernest, Amy; Foco, Rebecca; Luckett, Solomon; Ornato, Joseph P

2012-01-01

As attention to, and motivation for, emergency medical services (EMS)-related research continues to grow, particularly exception from informed consent (EFIC) research, it is important to understand the thoughts, beliefs, and experiences of EMS providers who are actively engaged in the research. We explored the attitudes, beliefs, and experiences of EMS providers regarding their involvement in prehospital emergency research, particularly EFIC research. Using a qualitative design, 24 participants were interviewed including nationally registered paramedics and Virginia-certified emergency medical technicians employed at Richmond Ambulance Authority, the participating EMS agency. At the time of our interviews, the EMS agency was involved in an EFIC trial. Transcribed interview data were coded and analyzed for themes. Findings were presented back to the EMS agency for validation. Overall, there appeared to be support for prehospital emergency research. Participants viewed research as necessary for the advancement of the field of EMS. Improvement in patient care was identified as one of the most important benefits. A number of ethical considerations were identified: individual risk versus public good and consent. The EMS providers in our study were open to working with EMS researchers throughout the community consultation and public disclosure process. The EMS providers in our study valued research and were willing to participate in studies. Support for research was balanced with concerns and challenges regarding the role of providers in the research process.

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

Directory of Open Access Journals (Sweden)

Eduard-Gabriel Ceptureanu

2017-02-01

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

Managing outpatient consultations: from referral to discharge.

Science.gov (United States)

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

2017-08-01

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

Information giving and receiving in hematological malignancy consultations.

Science.gov (United States)

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

2012-03-01

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

ARL/OMS Consultant Training Program.

Science.gov (United States)

Euster, Joanne R.

1982-01-01

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

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

Science.gov (United States)

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

2017-08-04

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

Consulting Basics for the Teacher-Turned-Technology Consultant.

Science.gov (United States)

Stager, Sue; Green, Kathy

1988-01-01

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

Maintenance of the CERN telephone exchanges

CERN Multimedia

2007-01-01

Maintenance work on the CERN telephone exchanges will be performed on 10 July from 8 p.m. to midnight. During this intervention, the fixed telephone services, audioconference services and GSM calls made via the 333 prefix may be disrupted. However, the CCC and the fire brigade will be reachable at all times. For more details about this maintenance work, please call the telephone switchboard on 76111 or send an e-mail. Telecom SectionIT/CS

Maintenance of the CERN telephone exchanges

CERN Multimedia

2007-01-01

A maintenance of the CERN telephone exchanges will be performed on the 10th of July from 8 p.m. to midnight. During this intervention, the fixed telephone services, audioconference services, and GSM calls made via the 333 prefix may be disrupted. However, the CCC and the fire brigade will be reachable at any time. For more details about this maintenance, please contact the telephone switchboard at 76111 or by email. Telecom Section IT/CS

Effect of a printed reminder in the waiting room to turn off mobile phones during consultation: a before and after study

Directory of Open Access Journals (Sweden)

de Aguiar Sylvia

2009-03-01

Full Text Available Abstract Background Telephone interruptions during consultations are one cause of work-related stress amongst general practitioners. Many health care centers recommend that patients turn off any mobile phones to avoid interruptions to the discussion with the physicians. Methods The purpose of this before and after study was to determine whether a printed reminder for turning off the mobile phone in the waiting room is helpful in decreasing the number of interruptions during consultation. A visual phone off sign utilizing the International "No" symbol of a diagonal line through a circle, along with a "please turn off your phone during consultation" reminder was used in the waiting room in the "after" period. Results A significant difference was found in the proportion of patients receiving or making a call during the consultation (8.8% vs. 13.5%, RR = 0.66; 95%CI 0.46–0.94; p = 0.021 and in the total number of calls (10.4% vs. 17.3%, RR = 0.60; 95%CI 0.44–0.83, p = 0.003 between the exposed and the non-exposed groups. However, no significant differences were found in the total time or the median time spent talking during consultation. The duration of the calls had median times of 20.5 seconds and 22.3 seconds in the exposed and the non-exposed groups respectively. Women from both groups who received a call during consultation answered significantly more when compared to men (70% vs. 52%; p = 0.05; Conclusion Our findings suggest that a printed reminder in the waiting room is helpful in decreasing the number of interruptions by mobile phone during consultation in our settings. The study provides the basis for further quantitative and qualitative research on this topic

Alternatives to the face-to-face consultation in general practice: focused ethnographic case study.

Science.gov (United States)

Atherton, Helen; Brant, Heather; Ziebland, Sue; Bikker, Annemieke; Campbell, John; Gibson, Andy; McKinstry, Brian; Porqueddu, Tania; Salisbury, Chris

2018-04-01

NHS policy encourages general practices to introduce alternatives to the face-to-face consultation, such as telephone, email, e-consultation systems, or internet video. Most have been slow to adopt these, citing concerns about workload. This project builds on previous research by focusing on the experiences of patients and practitioners who have used one or more of these alternatives. To understand how, under what conditions, for which patients, and in what ways, alternatives to face-to-face consultations present benefits and challenges to patients and practitioners in general practice. Focused ethnographic case studies took place in eight UK general practices between June 2015 and March 2016. Non-participant observation, informal conversations with staff, and semi-structured interviews with staff and patients were conducted. Practice documents and protocols were reviewed. Data were analysed through charting and the 'one sheet of paper' mind-map method to identify the line of argument in each thematic report. Case study practices had different rationales for offering alternatives to the face-to-face consultation. Beliefs varied about which patients and health issues were suitable. Co-workers were often unaware of each other's practice; for example, practice policies for use of e-consultations systems with patients were not known about or followed. Patients reported benefits including convenience and access. Staff and some patients regarded the face-to-face consultation as the ideal. Experience of implementing alternatives to the face-to-face consultation suggests that changes in patient access and staff workload may be both modest and gradual. Practices planning to implement them should consider carefully their reasons for doing so and involve the whole practice team. © British Journal of General Practice 2018.

Epidemiological Safety Surveillance of Cellular Telephones in the US (invited paper)

International Nuclear Information System (INIS)

Dreyer, N.A.; Loughlin, J.E.; Rothman, K.J.

1999-01-01

In 1994 a surveillance programme was initiated to monitor the effects of exposure to the human head from radiofrequency waves, such as those emitted from handheld cellular telephones. Cellular carriers contributed information about 1.5 million telephone account holders, their phones and two months of data on minutes used and number of calls. Cellular telephone manufacturers provided data that allowed classification of phones as analogue or digital and a handheld or mobile (car or bag) for 67% of the phones. Thus far 1,021,767 individuals have been identified who had at least one active cellular telephone account in 1994 and/or 1995 and who used either a handheld (41%) or a mobile (59%) phone during the study period, but not both. Seventy-four per cent of the cohort had used their cellular phone for ≥2 years, and 30% for ≥3 years. (author)

Maintenance of the telephone exchange in building 40

CERN Multimedia

2006-01-01

In order to secure the power supply of the telephone exchange in Building 40, maintenance work will be done on 18th December from 7.30 am to 8 am. During this intervention, the fixed telephone services in Building 39 and 40 will be interrupted. The fixed telephone services in other CERN buildings will not be affected by this maintenance. The mobile telephone services (GSM) will not be affected. For more details, please send your questions to Standard.Telephone@cern.ch Telecom Services IT/CS

Multimedia consultation session recording and playback using Java-based browser in global PACS

Science.gov (United States)

Martinez, Ralph; Shah, Pinkesh J.; Yu, Yuan-Pin

1998-07-01

The current version of the Global PACS software system uses a Java-based implementation of the Remote Consultation and Diagnosis (RCD) system. The Java RCD includes a multimedia consultation session between physicians that includes text, static image, image annotation, and audio data. The JAVA RCD allows 2-4 physicians to collaborate on a patient case. It allows physicians to join the session via WWW Java-enabled browsers or stand alone RCD application. The RCD system includes a distributed database archive system for archiving and retrieving patient and session data. The RCD system can be used for store and forward scenarios, case reviews, and interactive RCD multimedia sessions. The RCD system operates over the Internet, telephone lines, or in a private Intranet. A multimedia consultation session can be recorded, and then played back at a later time for review, comments, and education. A session can be played back using Java-enabled WWW browsers on any operating system platform. The JAVA RCD system shows that a case diagnosis can be captured digitally and played back with the original real-time temporal relationships between data streams. In this paper, we describe design and implementation of the RCD session playback.

Emotion Analysis of Telephone Complaints from Customer Based on Affective Computing

OpenAIRE

Gong, Shuangping; Dai, Yonghui; Ji, Jun; Wang, Jinzhao; Sun, Hai

2015-01-01

Customer complaint has been the important feedback for modern enterprises to improve their product and service quality as well as the customer's loyalty. As one of the commonly used manners in customer complaint, telephone communication carries rich emotional information of speeches, which provides valuable resources for perceiving the customer's satisfaction and studying the complaint handling skills. This paper studies the characteristics of telephone complaint speeches and proposes an anal...

7 CFR 1737.60 - Telephone loan budget.

Science.gov (United States)

2010-01-01

... 7 Agriculture 11 2010-01-01 2010-01-01 false Telephone loan budget. 1737.60 Section 1737.60... Cost Estimation Procedures § 1737.60 Telephone loan budget. (a) RUS shall prepare a “Telephone Loan Budget” (RUS Form 493) showing all costs for the proposed project and the amount of loan and nonloan...

Maintenance of the CERN telephone exchanges

CERN Multimedia

2007-01-01

Maintenance work will be carried out on the CERN telephone exchanges between 8 p.m. and midnight on 20 November. Fixed-line telephone and audioconference services may be disrupted while the work is being carried out. However, the CCC and the fire brigade will be reachable at any time. Mobile telephony services (GSM) will not be affected by the maintenance work. For further details about the maintenance work, please contact the telephone switchboard on 76111 or by email. Telecom Section - IT/CS

Longer-term impact of cardiology e-consults.

Science.gov (United States)

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

2016-03-01

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

Lay Consultations in Heart Failure Symptom Evaluation.

Science.gov (United States)

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

2017-01-01

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

24 CFR 3285.704 - Telephone and cable TV.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 5 2010-04-01 2010-04-01 false Telephone and cable TV. 3285.704....704 Telephone and cable TV. Refer to § 3285.906 for considerations pertinent to installation of telephone and cable TV. ...

Using information and communication technologies to consult with patients in Victorian primary care: the views of general practitioners.

Science.gov (United States)

Hanna, Lisa; Fairhurst, Karen

2013-01-01

Information and communication technologies such as email, text messaging and video messaging are commonly used by the general population. However, international research has shown that they are not used routinely by GPs to communicate or consult with patients. Investigating Victorian GPs' perceptions of doing so is timely given Australia's new National Broadband Network, which may facilitate web-based modes of doctor-patient interaction. This study therefore aimed to explore Victorian GPs' experiences of, and attitudes toward, using information and communication technologies to consult with patients. Qualitative telephone interviews were carried out with a maximum variation sample of 36GPs from across Victoria. GPs reported a range of perspectives on using new consultation technologies within their practice. Common concerns included medico-legal and remuneration issues and perceived patient information technology literacy. Policy makers should incorporate GPs' perspectives into primary care service delivery planning to promote the effective use of information and communication technologies in improving accessibility and quality of general practice care.

Cellular telephone use and cancer risk

DEFF Research Database (Denmark)

Schüz, Joachim; Jacobsen, Rune; Olsen, Jørgen H.

2006-01-01

BACKGROUND: The widespread use of cellular telephones has heightened concerns about possible adverse health effects. The objective of this study was to investigate cancer risk among Danish cellular telephone users who were followed for up to 21 years. METHODS: This study is an extended follow......-up of a large nationwide cohort of 420,095 persons whose first cellular telephone subscription was between 1982 and 1995 and who were followed through 2002 for cancer incidence. Standardized incidence ratios (SIRs) were calculated by dividing the number of observed cancer cases in the cohort by the number...... expected in the Danish population. RESULTS: A total of 14,249 cancers were observed (SIR = 0.95; 95% confidence interval [CI] = 0.93 to 0.97) for men and women combined. Cellular telephone use was not associated with increased risk for brain tumors (SIR = 0.97), acoustic neuromas (SIR = 0.73), salivary...

Network of mobile telephone communication: necessarily of 3. Millennium

International Nuclear Information System (INIS)

Dejana, V.; Dragan, M.; Nebojsa, V.; Simo, S.

2002-01-01

Mobile telephones have transformed the telecommunications industry. These devices can be used to make telephone calls from almost anywhere. There are two types, one has the antenna mounted on the handset and the other has the antenna mounted on a separate transmitter or, if the telephone is installed in a vehicle, mounted on the roof or rear window. Communication between a mobile telephone and the nearest base station is achieved by the microwave emissions from the antenna. Concerns have been raised about the type of mobile telephone that has the antenna in the handset. In this case, the antenna is very close to the user's head during normal use of the telephone and there is concern about the level of microwave emissions to which the brain is being exposed. Those telephones that have the antenna mounted elsewhere are of no concern, since exposure levels decrease rapidly with increasing distance from the antenna. Cordless telephones, which need to be operated within about 20 metres of a base unit that is connected directly to the telephone system, do not have any health concerns associated with their use because exposure levels are very low

Consultant breast radiographers: Where are we now?

International Nuclear Information System (INIS)

Rees, Zebby

2014-01-01

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

78 FR 53684 - Misuse of Internet Protocol (IP) Captioned Telephone Service; Telecommunications Relay Services...

Science.gov (United States)

2013-08-30

..., and during regular business hours at the FCC Reference Information Center, Portals II, 445 12th Street... and persons using end user telephone equipment, such as a standard phone, smartphone, or computer. 2... displayed on a captioned telephone device, a computer, or a smartphone. The service also provides captions...

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

Science.gov (United States)

Afifi, Ladan; Shinkai, Kanade

2017-03-01

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

The Contemporary Consultant

DEFF Research Database (Denmark)

Olson, Thomas; Poulfelt, Flemming; Greiner, Larry

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

Consultation for Parents of Young Gifted Children.

Science.gov (United States)

Wolf, Joan S.

1989-01-01

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

Telephone Care Management of Fall Risk:: A Feasibility Study.

Science.gov (United States)

Phelan, Elizabeth A; Pence, Maureen; Williams, Barbara; MacCornack, Frederick A

2017-03-01

Care management has been found to be more effective than usual care for some chronic conditions, but few studies have tested care management for prevention of elder falls. This study aimed to assess the feasibility and preliminary efficacy of telephone care management of older adults presenting for medical attention due to a fall. The setting was an independent practice association in western Washington serving 1,300 Medicare Advantage-insured patients. Patients aged ≥65 years treated for a fall in an emergency department or their primary care provider's office were contacted via telephone by a care manager within 48 hours of their fall-related visit and invited to participate in a telephone-administered interview to identify modifiable fall risk factors and receive recommendations and follow-up to address identified risk factors. Data from care manager records, patient medical records, and healthcare claims for the first 6 months (November 2009-April 2010) of program implementation were analyzed in 2011. The feasibility of screening and management of fall risk factors over the telephone and the effect on medically attended falls were assessed. Twenty-two patients eligible for fall care management were reached and administered the protocol. Administration took 15-20 minutes and integrated easily with the care manager's other responsibilities. Follow-through on recommendations varied, from 45% for those for whom exercise participation was recommended to 100% for other recommendations. No medically attended falls occurred over 6 months of follow-up. Telephone care management of fall risk appears feasible and may reduce falls requiring medical attention. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Modeling Auditory-Haptic Interface Cues from an Analog Multi-line Telephone

Science.gov (United States)

Begault, Durand R.; Anderson, Mark R.; Bittner, Rachael M.

2012-01-01

The Western Electric Company produced a multi-line telephone during the 1940s-1970s using a six-button interface design that provided robust tactile, haptic and auditory cues regarding the "state" of the communication system. This multi-line telephone was used as a model for a trade study comparison of two interfaces: a touchscreen interface (iPad)) versus a pressure-sensitive strain gauge button interface (Phidget USB interface controllers). The experiment and its results are detailed in the authors' AES 133rd convention paper " Multimodal Information Management: Evaluation of Auditory and Haptic Cues for NextGen Communication Dispays". This Engineering Brief describes how the interface logic, visual indications, and auditory cues of the original telephone were synthesized using MAX/MSP, including the logic for line selection, line hold, and priority line activation.

Group Work in Schools: A Process Consultation Approach

Science.gov (United States)

Farouk, Shaalan

2004-01-01

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

Effect of providing cancer patients with the audiotaped initial consultation on satisfaction, recall, and quality of life: a randomized, double-blind study

NARCIS (Netherlands)

Ong, L. M.; Visser, M. R.; Lammes, F. B.; van der Velden, J.; Kuenen, B. C.; de Haes, J. C.

2000-01-01

PURPOSE: By means of a randomized double-blind study, the effect of providing taped initial consultations on cancer patients' satisfaction, recall, and quality of life was investigated. PATIENTS AND METHODS: Consecutive cancer patients referred to either the gynecology or medical oncology outpatient

Supporting Family Carers Through Telephone-Mediated Group Programs: Opportunities For Gerontological Social Workers.

Science.gov (United States)

Shanley, Chris

2008-01-01

Telephone-mediated group programs are an important but under-utilized medium for reaching frail or disabled older persons' family carers who are in need of support. The primary purpose and style of group programs can range across a broad spectrum–encompassing educational, supportive and therapeutic types. Gerontological social workers are the members of the multidisciplinary care team whose training, experience and supervision makes them most suitable for facilitating this broad range of group types. Drawing on the experience of training a number of group facilitators, this article provides suggestions for social workers contemplating the use of telephone-mediated groups and highlights groupwork skills peculiar to conducting group programs via the telephone.

Upgrade of the CERN telephone exchange

CERN Multimedia

2006-01-01

As part of the upgrade of telephone services, maintenance work will be carried out on the CERN switching centre between 8.00 p.m. and 10.00 p.m. on Monday 9 October. Telephone services may be disrupted and possibly even interrupted during this time. We apologise in advance for any inconvenience this may cause. CERN TELECOM Service

Qualification of contractor/consultant instructors

International Nuclear Information System (INIS)

Hanson, H.D.

1985-01-01

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

Services of strategic consulting: special features and types

Directory of Open Access Journals (Sweden)

Klenin Oleh Volodymyrovych

2016-09-01

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

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

Science.gov (United States)

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

2016-10-01

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

Providing cell phone numbers and email addresses to Patients: the physician's perspective

Science.gov (United States)

2011-01-01

Background The provision of cell phone numbers and email addresses enhances the accessibility of medical consultations, but can add to the burden of physicians' routine clinical practice and affect their free time. The objective was to assess the attitudes of physicians to providing their telephone number or email address to patients. Methods Primary care physicians in the southern region of Israel completed a structured questionnaire that related to the study objective. Results The study population included 120 primary care physicians with a mean age of 41.2 ± 8.5, 88 of them women (73.3%). Physicians preferred to provide their cell phone number rather than their email address (P = 0.0007). They preferred to answer their cell phones only during the daytime and at predetermined times, but would answer email most hours of the day, including weekends and holidays (P = 0.001). More physicians (79.7%) would have preferred allotted time for email communication than allotted time for cell phone communication (50%). However, they felt that email communication was more likely to lead to miscommunication than telephone calls (P = 0.0001). There were no differences between male and female physicians on the provision of cell phone numbers or email addresses to patients. Older physicians were more prepared to provide cell phone numbers that younger ones (P = 0.039). Conclusions The attitude of participating physicians was to provide their cell phone number or email address to some of their patients, but most of them preferred to give out their cell phone number. PMID:21426591

Providing cell phone numbers and email addresses to Patients: the physician's perspective

Directory of Open Access Journals (Sweden)

Freud Tamar

2011-03-01

Full Text Available Abstract Background The provision of cell phone numbers and email addresses enhances the accessibility of medical consultations, but can add to the burden of physicians' routine clinical practice and affect their free time. The objective was to assess the attitudes of physicians to providing their telephone number or email address to patients. Methods Primary care physicians in the southern region of Israel completed a structured questionnaire that related to the study objective. Results The study population included 120 primary care physicians with a mean age of 41.2 ± 8.5, 88 of them women (73.3%. Physicians preferred to provide their cell phone number rather than their email address (P = 0.0007. They preferred to answer their cell phones only during the daytime and at predetermined times, but would answer email most hours of the day, including weekends and holidays (P = 0.001. More physicians (79.7% would have preferred allotted time for email communication than allotted time for cell phone communication (50%. However, they felt that email communication was more likely to lead to miscommunication than telephone calls (P = 0.0001. There were no differences between male and female physicians on the provision of cell phone numbers or email addresses to patients. Older physicians were more prepared to provide cell phone numbers that younger ones (P = 0.039. Conclusions The attitude of participating physicians was to provide their cell phone number or email address to some of their patients, but most of them preferred to give out their cell phone number.

Does professional-centred training improve consultation outcomes?

DEFF Research Database (Denmark)

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

2006-01-01

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

Evaluating the privacy properties of telephone metadata

Science.gov (United States)

Mayer, Jonathan; Mutchler, Patrick; Mitchell, John C.

2016-01-01

Since 2013, a stream of disclosures has prompted reconsideration of surveillance law and policy. One of the most controversial principles, both in the United States and abroad, is that communications metadata receives substantially less protection than communications content. Several nations currently collect telephone metadata in bulk, including on their own citizens. In this paper, we attempt to shed light on the privacy properties of telephone metadata. Using a crowdsourcing methodology, we demonstrate that telephone metadata is densely interconnected, can trivially be reidentified, and can be used to draw sensitive inferences. PMID:27185922

47 CFR 64.1505 - Restrictions on collect telephone calls.

Science.gov (United States)

2010-10-01

... SERVICES (CONTINUED) MISCELLANEOUS RULES RELATING TO COMMON CARRIERS Interstate Pay-Per-Call and Other Information Services § 64.1505 Restrictions on collect telephone calls. (a) No common carrier shall provide interstate transmission or billing and collection services to an entity offering any service within the scope...

Applicability of structured telephone monitoring to follow up heart ...

African Journals Online (AJOL)

Over 90% of the contacted patients gave valuable information regarding their clinical status. Conclusion: Majority of HF patients can be contacted and provide valuable clinical information through mobile phones within a month post discharge from the national hospital in Tanzania. Structured telephone monitoring could be ...

Medical microbiology training needs and trainee experience.

Science.gov (United States)

Seale, Josephine; Elamin, Wael; Millar, Michael

2014-02-01

Training in microbiology is continuing to evolve. Standardisation of this process has, in part, been achieved through the development of a training curriculum by the Royal College of Pathologists (RCPath). A substantial proportion of microbiology training occurs through telephone consultations. To ascertain the content of these interactions and the extent to which the necessary skills outlined by the curriculum are attainable via these consultations. Records of telephone consultations made by microbiology registrars (SpR) on the Laboratory Information Management System (LIMS) over a 6 month period were analysed with regard to who initiated contact and the type of advice provided. An average of 426 SpR entries per month were made on the LIMS following telephone consultations. These consultations were predominantly initiated by fellow clinicians as opposed to the SpR. The majority (79%) of advice entailed guidance as to the use of antimicrobials which resulted in an alteration of the current regimen in 54% of cases. This study represents the first attempt to quantify the telephone consultations of microbiology trainees. It is concluded that although such interactions provide a means of attaining some of the competencies outlined by the RCPath curriculum, the bias towards antimicrobial advice reflects a discrepancy between the needs of the service users and the broad skill set advocated by the current microbiology training programme. Future modifications will need to take this into account to ensure both the training of SpRs and the microbiology service is fit for purpose.

Maintenance of the CERN telephone exchanges

CERN Multimedia

IT/CS

2014-01-01

Maintenance work will be carried out on the CERN telephone exchanges between 8 p.m. and 2 a.m. on 26 August.   Fixed-line telephone and audio-conference services may be disrupted during this intervention. Nevertheless, the CCC and the Fire Brigade will be reachable at any time. Mobile telephony services (GSM) will not be affected by the maintenance work.

Maintenance of the CERN telephone exchanges

CERN Multimedia

IT Department

2011-01-01

Maintenance work will be carried out on the CERN telephone exchanges between 20h00 and 2h00 on the 16 November. Fixed-line telephone and audio-conference services may be disrupted during this intervention. Nevertheless, the CCC and the fire brigade will be reachable at any time. Mobile telephony services (GSM) will not be affected by the maintenance work. IT/CS

Telephone-Based Coaching.

Science.gov (United States)

Boccio, Mindy; Sanna, Rashel S; Adams, Sara R; Goler, Nancy C; Brown, Susan D; Neugebauer, Romain S; Ferrara, Assiamira; Wiley, Deanne M; Bellamy, David J; Schmittdiel, Julie A

2017-03-01

Many Americans continue to smoke, increasing their risk of disease and premature death. Both telephone-based counseling and in-person tobacco cessation classes may improve access for smokers seeking convenient support to quit. Little research has assessed whether such programs are effective in real-world clinical populations. Retrospective cohort study comparing wellness coaching participants with two groups of controls. Kaiser Permanente Northern California, a large integrated health care delivery system. Two hundred forty-one patients who participated in telephonic tobacco cessation coaching from January 1, 2011, to March 31, 2012, and two control groups: propensity-score-matched controls, and controls who participated in a tobacco cessation class during the same period. Wellness coaching participants received an average of two motivational interviewing-based coaching sessions that engaged the patient, evoked their reason to consider quitting, and helped them establish a quit plan. Self-reported quitting of tobacco and fills of tobacco cessation medications within 12 months of follow-up. Logistic regressions adjusting for age, gender, race/ethnicity, and primary language. After adjusting for confounders, tobacco quit rates were higher among coaching participants vs. matched controls (31% vs. 23%, p Coaching participants and class attendees filled tobacco-cessation prescriptions at a higher rate (47% for both) than matched controls (6%, p coaching was as effective as in-person classes and was associated with higher rates of quitting compared to no treatment. The telephonic modality may increase convenience and scalability for health care systems looking to reduce tobacco use and improve health.

IAS telecommunication infrastructure and value added network services provided by IASNET

Science.gov (United States)

Smirnov, Oleg L.; Marchenko, Sergei

The topology of a packet switching network for the Soviet National Centre for Automated Data Exchange with Foreign Computer Networks and Databanks (NCADE) based on a design by the Institute for Automated Systems (IAS) is discussed. NCADE has partners all over the world: it is linked to East European countries via telephone lines while satellites are used for communication with remote partners, such as Cuba, Mongolia, and Vietnam. Moreover, there is a connection to the Austrian, British, Canadian, Finnish, French, U.S. and other western networks through which users can have access to databases on each network. At the same time, NCADE provides western customers with access to more than 70 Soviet databases. Software and hardware of IASNET use data exchange recommendations agreed with the International Standard Organization (ISO) and International Telegraph and Telephone Consultative Committee (CCITT). Technical parameters of IASNET are compatible with the majority of foreign networks such as DATAPAK, TRANSPAC, TELENET, and others. By means of IASNET, the NCADE provides connection of Soviet and foreign users to information and computer centers around the world on the basis of the CCITT X.25 and X.75 recommendations. Any information resources of IASNET and value added network services, such as computer teleconferences, E-mail, information retrieval system, intelligent support of access to databanks and databases, and others are discussed. The topology of the ACADEMNET connected to IASNET over an X.25 gateway is also discussed.

The Bandung neurosurgery patient outcomes project, Indonesia (Part II): Patient pathways and feasibility and acceptability of telephone follow-up.

Science.gov (United States)

Sutiono, Agung Budi; Faried, Ahmad; McAllister, Susan; Ganefianty, Amelia; Sarjono, Kalih; Arifin, Muhammad Zafrullah; Derrett, Sarah

2018-01-01

Support of neurosurgery patients following discharge from hospital is important. Currently, little is known about patients' in low- and middle-income countries before and after their hospital treatment. This companion paper reports patients' pathways before and after hospital admission and the feasibility of following up this ill-patient population by telephone. Eligible patients were aged ≥18 years admitted to the Neurosurgery Department in Dr. Hasan Sadikin Hospital-a regional referral hospital in Bandung City, Indonesia. Clinical data were collected on admission by clinicians. In-person interviews were undertaken with a clinical research nurse 1 to 2 days pre-discharge, and telephone follow-up interviews at 1, 2, and 3 months post-discharge. Information was also collected on pathways prior to admission and following discharge. The number of contact attempts for each patient interview was documented, as was the overall acceptability of undertaking a telephone interview. Of 178 patients discharged from hospital, 12 later died. Of the remaining 166 patients, 95% were able to be followed up to 3 months. Two-thirds of patients had been referred from another hospital. Patients came from, and were discharged to, locations throughout the West Java region. At the 1-month interview, 84% participants reported that they had had a follow-up consultation with a health professional-mostly with a neurosurgeon. This study has shown that, with a neurosurgery nurse delegated to the role, it is feasible to conduct follow-up telephone interviews with patients after discharge from a neurosurgery ward and that in fact such follow-up was appreciated by patients. Copyright © 2017 John Wiley & Sons, Ltd.

Telephone versus usual care in management of acute whiplash ...

African Journals Online (AJOL)

Whiplash associated disorder (WAD) is a common and costly condition, and recommended management includes advice to “act as usual” and exercise. Providing this treatment through a telephonic intervention may help to improve access to care, and reduce costs. This pilot study assessed: (1) the effectiveness of a ...

Participants' views of telephone interviews within a grounded theory study.

Science.gov (United States)

Ward, Kim; Gott, Merryn; Hoare, Karen

2015-12-01

To offer a unique contribution to the evolving debate around the use of the telephone during semistructured interview by drawing on interviewees' reflections on telephone interview during a grounded theory study. The accepted norm for qualitative interviews is to conduct them face-to-face. It is typical to consider collecting qualitative data via telephone only when face-to-face interview is not possible. During a grounded theory study, exploring users' experiences with overnight mask ventilation for sleep apnoea, the authors selected the telephone to conduct interviews. This article reports participants' views on semistructured interview by telephone. An inductive thematic analysis was conducted on data pertaining to the use of the telephone interview in a grounded theory study. The data were collected during 4 months of 2011 and 6 months in 2014. The article presents an inductive thematic analysis of sixteen participants' opinions about telephone interviewing and discusses these in relation to existing literature reporting the use of telephone interviews in grounded theory studies. Overall, participants reported a positive experience of telephone interviewing. From each participants reports we identified four themes from the data: being 'phone savvy; concentrating on voice instead of your face; easy rapport; and not being judged or feeling inhibited. By drawing on these data, we argue that the telephone as a data collection tool in grounded theory research and other qualitative methodologies need not be relegated to second best status. Rather, researchers can consider telephone interview a valuable first choice option. © 2015 John Wiley & Sons Ltd.

Service Learning In Physics: The Consultant Model

Science.gov (United States)

Guerra, David

2005-04-01

Each year thousands of students across the country and across the academic disciplines participate in service learning. Unfortunately, with no clear model for integrating community service into the physics curriculum, there are very few physics students engaged in service learning. To overcome this shortfall, a consultant based service-learning program has been developed and successfully implemented at Saint Anselm College (SAC). As consultants, students in upper level physics courses apply their problem solving skills in the service of others. Most recently, SAC students provided technical and managerial support to a group from Girl's Inc., a national empowerment program for girls in high-risk, underserved areas, who were participating in the national FIRST Lego League Robotics competition. In their role as consultants the SAC students provided technical information through brainstorming sessions and helped the girls stay on task with project management techniques, like milestone charting. This consultant model of service-learning, provides technical support to groups that may not have a great deal of resources and gives physics students a way to improve their interpersonal skills, test their technical expertise, and better define the marketable skill set they are developing through the physics curriculum.

Telephone: The Old Technology that is Never Old

Directory of Open Access Journals (Sweden)

Olubunmi Philip Aborisade

2012-09-01

Full Text Available Telephone technology is a technology that stands the test of time. Since it was invented in 1876 by Alexander Graham Belle, it remains the technology of all time. This article reports the major finding of a recent research, how technology transforms citizen journalism business in Nigeria. According to the research, Telephone technology has over the years emerged the major tool with which ordinary citizens in Nigeria without journalism and media background or affiliation participate in the process of news gathering, reporting and distribution. Guided by the recent use of telephone around the world by ordinary citizens to report themselves during protests through different social media outlets-Facebook, Tweeter, Youtube, the article illuminates the evergreen nature of the telephone. The article therefore concluded that the telephone technology invented in 1876 has survived the test of time. Instead of being obsolete, it blends with emerging communications technology to improve on its performance.

[Potential selection bias in telephone surveys: landline and mobile phones].

Science.gov (United States)

Garcia-Continente, Xavier; Pérez-Giménez, Anna; López, María José; Nebot, Manel

2014-01-01

The increasing use of mobile phones in the last decade has decreased landline telephone coverage in Spanish households. This study aimed to analyze sociodemographic characteristics and health indicators by type of telephone service (mobile phone vs. landline or landline and mobile phone). Two telephone surveys were conducted in Spanish samples (February 2010 and February 2011). Multivariate logistic regression analyses were performed to analyze differences in the main sociodemographic characteristics and health indicators according to the type of telephone service available in Spanish households. We obtained 2027 valid responses (1627 landline telephones and 400 mobile phones). Persons contacted through a mobile phone were more likely to be a foreigner, to belong to the manual social class, to have a lower educational level, and to be a smoker than those contacted through a landline telephone. The profile of the population that has only a mobile phone differs from that with a landline telephone. Therefore, telephone surveys that exclude mobile phones could show a selection bias. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

Maintenance of the CERN telephone exchanges

CERN Multimedia

IT Department

2009-01-01

Maintenance work will be carried out on the CERN telephone exchanges between 8h30 and 17h30 on Saturday 9 May. Fixed-line telephone and audio-conference services may be disrupted during this intervention. Nevertheless, the CCC and the fire brigade will be reachable at any time. Mobile telephony services (GSM) will not be affected by the maintenance work. IT/CS/CS

Consultation: Creating School-Based Interventions. Second Edition.

Science.gov (United States)

Dinkmeyer, Don, Jr.; Carlson, Jon

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

Improvement of Metroliner Telephone Channel Capacity and Modeling of Telephone Channel Demands

Science.gov (United States)

1972-03-01

The channel capacity of the present Metroliner telephone system is analyzed and methods are proposed to increase that capacity without increasing the overall bandwidth. To determine the number of channels required, calculations have been carried out ...

Large Pelagics Telephone Survey

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Large Pelagics Telephone Survey (LPTS) collects fishing effort information directly from captains holding Highly Migratory Species (HMS) permits (required by...

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

NARCIS (Netherlands)

I. Hollaender

2007-01-01

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

Efficacy and experiences of telephone counselling for informal carers of people with dementia.

Science.gov (United States)

Lins, Sabine; Hayder-Beichel, Daniela; Rücker, Gerta; Motschall, Edith; Antes, Gerd; Meyer, Gabriele; Langer, Gero

2014-09-01

integrated quantitative RCT data with the qualitative data. Nine RCTs and two qualitative studies were included. Six studies investigated telephone counselling without additional intervention, one study combined telephone counselling with video sessions, and two studies combined it with video sessions and a workbook. All quantitative studies had a high risk of bias in terms of blinding of participants and outcome assessment. Most studies provided no information about random sequence generation and allocation concealment. The quality of the qualitative studies ('thin descriptions') was assessed as moderate. Meta-analyses indicated a reduction of depressive symptoms for telephone counselling without additional intervention (three trials, 163 participants: standardised mean different (SMD) 0.32, 95% confidence interval (CI) 0.01 to 0.63, P value 0.04; moderate quality evidence). The estimated effects on other outcomes (burden, distress, anxiety, quality of life, self-efficacy, satisfaction and social support) were uncertain and differences could not be excluded (burden: four trials, 165 participants: SMD 0.45, 95% CI -0.01 to 0.90, P value 0.05; moderate quality evidence; support: two trials, 67 participants: SMD 0.25, 95% CI -0.24 to 0.73, P value 0.32; low quality evidence). None of the quantitative studies included reported adverse effects or harm due to telephone counselling. Three analytical themes (barriers and facilitators for successful implementation of telephone counselling, counsellor's emotional attitude and content of telephone counselling) and 16 descriptive themes that present the carers' needs for telephone counselling were identified in the thematic synthesis. Integration of quantitative and qualitative data shows potential for improvement. For example, no RCT reported that the counsellor provided 24-hour availability or that there was debriefing of the counsellor. Also, the qualitative studies covered a limited range of ways of performing telephone counselling

"Systematizing" ethics consultation services.

Science.gov (United States)

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

2015-03-01

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

Internet-based CBT for depression with and without telephone tracking in a national helpline: randomised controlled trial.

Directory of Open Access Journals (Sweden)

Louise Farrer

Full Text Available BACKGROUND: Telephone helplines are frequently and repeatedly used by individuals with chronic mental health problems and web interventions may be an effective tool for reducing depression in this population. AIM: To evaluate the effectiveness of a 6 week, web-based cognitive behaviour therapy (CBT intervention with and without proactive weekly telephone tracking in the reduction of depression in callers to a helpline service. METHOD: 155 callers to a national helpline service with moderate to high psychological distress were recruited and randomised to receive either Internet CBT plus weekly telephone follow-up; Internet CBT only; weekly telephone follow-up only; or treatment as usual. RESULTS: Depression was lower in participants in the web intervention conditions both with and without telephone tracking compared to the treatment as usual condition both at post intervention and at 6 month follow-up. Telephone tracking provided by a lay telephone counsellor did not confer any additional advantage in terms of symptom reduction or adherence. CONCLUSIONS: A web-based CBT program is effective both with and without telephone tracking for reducing depression in callers to a national helpline. TRIAL REGISTRATION: Controlled-Trials.comISRCTN93903959.

Maintenance of the CERN telephone exchanges

CERN Multimedia

IT Department

2011-01-01

Maintenance work will be carried out on the CERN telephone exchanges between 20h00 and midnight on the 21st of February in order to apply the latest software patches. Fixed-line telephone and audio-conference services may be disrupted during this intervention. Nevertheless, the CCC and the fire brigade will be reachable at any time. Mobile telephony services (GSM) will not be affected by the maintenance work. CS Group

ENERGY STAR Certified Telephones

Data.gov (United States)

U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 3.0 ENERGY STAR Program Requirements for Telephony (cordless telephones and VoIP...

Services of strategic consulting: special features and types

OpenAIRE

Klenin Oleh Volodymyrovych

2016-01-01

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

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

Science.gov (United States)

2010-09-03

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

Energy saving consulting in Hamburg

Energy Technology Data Exchange (ETDEWEB)

1982-10-01

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

Feasibility, acceptability and effectiveness of an online alternative to face-to-face consultation in general practice: a mixed-methods study of webGP in six Devon practices.

Science.gov (United States)

Carter, Mary; Fletcher, Emily; Sansom, Anna; Warren, Fiona C; Campbell, John L

2018-02-15

To evaluate the feasibility, acceptability and effectiveness of webGP as piloted by six general practices. Mixed-methods evaluation, including data extraction from practice databases, general practitioner (GP) completion of case reports, patient questionnaires and staff interviews. General practices in NHS Northern, Eastern and Western Devon Clinical Commissioning Group's area approximately 6 months after implementing webGP (February-July 2016). Six practices provided consultations data; 20 GPs completed case reports (regarding 61 e-consults); 81 patients completed questionnaires; 5 GPs and 5 administrators were interviewed. Attitudes and experiences of practice staff and patients regarding webGP. WebGP uptake during the evaluation was small, showing no discernible impact on practice workload. The completeness of cross-sectional data on consultation workload varied between practices.GPs judged 41/61 (72%) of webGP requests to require a face-to-face or telephone consultation. Introducing webGP appeared to be associated with shifts in responsibility and workload between practice staff and between practices and patients.81/231 patients completed a postal survey (35.1% response rate). E-Consulters were somewhat younger and more likely to be employed than face-to-face respondents. WebGP appeared broadly acceptable to patients regarding timeliness and quality/experience of care provided. Similar problems were presented by all respondents. Both groups appeared equally familiar with other practice online services; e-consulters were somewhat more likely to have used them.From semistructured staff interviews, it appeared that, while largely acceptable within practice, introducing e-consults had potential for adverse interactions with pre-existing practice systems. There is potential to assess the impact of new systems on consultation patterns by extracting routine data from practice databases. Staff and patients noticed subtle changes to responsibilities associated with

Addressing Cultural Responsiveness in Consultation: An Empirical Demonstration

Science.gov (United States)

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

2017-01-01

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

Perceived Educational Needs of the Integrated Care Psychiatric Consultant.

Science.gov (United States)

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

2015-08-01

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

Maintenance of the CERN telephone exchanges

CERN Multimedia

IT Department

2009-01-01

Maintenance work will be carried out on the CERN telephone exchanges between 20h00 and midnight on the 29th of July in order to apply the latest software patches. Fixed-line telephone and audio-conference services may be disrupted during this intervention. Nevertheless, the CCC and the fire brigade will be reachable at any time. Mobile telephony services (GSM) will not be affected by the maintenance work. IT/CS/CS

The telephone in family practice | Furman | South African Medical ...

African Journals Online (AJOL)

In a time-and-motion study in family practice it was found that 35,8% of all patient contact was per telephone. The study further revealed that 12,3% of total practice time was spent on the telephone, stressing its importance as a useful tool. in family practice. The study supports others which suggest that 'telephone medicine' ...

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

Science.gov (United States)

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

2007-01-01

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

Symptom appraisal, help seeking, and lay consultancy for symptoms of head and neck cancer.

Science.gov (United States)

Queenan, J A; Gottlieb, B H; Feldman-Stewart, D; Hall, S F; Irish, J; Groome, P A

2018-01-01

Early diagnosis is important in head and neck cancer (HNC) patients to maximize the effectiveness of the treatments and minimize the debilitation associated with both the cancer and the invasive treatments of advanced disease. Many patients present with advanced disease, and there is little understanding as to why. This study investigated patients' symptom appraisal, help seeking, and lay consultancy up to the time they first went to see a health care professional (HCP). We interviewed 83 patients diagnosed with HNC. The study design was cross sectional and consisted of structured telephone interviews and a medical chart review. We gathered information on the participant's personal reactions to their symptoms, characteristics of their social network, and the feedback they received. We found that 18% of the participants thought that their symptoms were urgent enough to warrant further investigation. Participants rarely (6%) attributed their symptoms to cancer. Eighty-nine percent reported that they were unaware of the early warning signs and symptoms of HNC. Fifty-seven percent of the participants disclosed their symptoms to at least one lay consultant before seeking help from an HCP. The lay consultants were usually their spouse (77%), and the most common advice they offered was to see a doctor (76%). Lastly, 81% of the participants report that their spouse influenced their decision to see an HCP. The results of this study suggest that patients frequently believe that their symptoms were nonurgent and that their lay consultants influence their decision to seek help from an HCP. Copyright © 2017 John Wiley & Sons, Ltd.

Malpractice and the Communication Consultant: A Proactive Approach.

Science.gov (United States)

Montgomery, Daniel J.; And Others

1995-01-01

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

Effects of enterostomal nurse telephone follow-up on postoperative adjustment of discharged colostomy patients.

Science.gov (United States)

Zhang, Jun-e; Wong, Frances Kam Yuet; You, Li-ming; Zheng, Mei-chun; Li, Qiong; Zhang, Bing-yan; Huang, Man-rong; Ye, Xin-Mei; Liang, Ming-juan; Liu, Jin-ling

2013-01-01

People with a new colostomy encounter many difficulties as they struggle to adjust to their ostomies. Nurse telephone follow-up is a convenient way to ensure continuity of care. There is a paucity of studies testing if nurse telephone follow-up can enhance adjustment of postdischarged colostomy patients. The purpose of this study was to evaluate the effect of enterostomal nurse telephone follow-up on the adjustment levels of discharged colostomy patients. This was a randomized controlled trial. Participants (n = 103) who had undergone colostomy operations in China were recruited and randomly assigned to the study or control group. Both the study and control groups received routine discharge care, whereas the study group received 2-3 nurse telephone calls in the follow-up period. The outcome measures included Ostomy Adjustment Scale, Stoma Self-efficacy Scale, satisfaction with care, and stoma complications. Results of this study indicated that participants in the study group had significantly better ostomy adjustment, higher stoma self-efficacy, higher satisfaction with care, and less stoma complications compared with those in the control group. This study provided evidence to support that enterostomal nurse telephone follow-up can improve patient ostomy adjustment level and other related outcomes. Nurse telephone follow-up is an effective intervention to support the adjustment of stoma patients after hospital discharge.

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

Science.gov (United States)

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

2017-10-01

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

Sport psychology group consultation using social networking web sites.

Science.gov (United States)

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

2012-08-01

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

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

Science.gov (United States)

Currie, Jane

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

Consultation and IBA negotiations in wind projects

Energy Technology Data Exchange (ETDEWEB)

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

2011-07-01

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

EQClinic: a platform for learning communication skills in clinical consultations.

Science.gov (United States)

Liu, Chunfeng; Scott, Karen M; Lim, Renee L; Taylor, Silas; Calvo, Rafael A

2016-01-01

Doctors' verbal and non-verbal communication skills have an impact on patients' health outcomes, so it is important for medical students to develop these skills. Traditional, non-verbal communication skills training can involve a tutor manually annotating a student's non-verbal behaviour during patient-doctor consultations, but this is very time-consuming. Tele-conference systems have been used in verbal communication skills training. We describe EQClinic, a system that enables verbal and non-verbal communication skills training during tele-consultations with simulated patients (SPs), with evaluation exercises promoting reflection. Students and SPs can have tele-consultations through the tele-consultation component. In this component, SPs can provide feedback to students through a thumbs-up/ thumbs-down tool and a comments box. EQClinic automatically analyses communication features in the recorded consultations, such as facial expressions, and provides graphical representations. Our 2015 pilot study investigated whether EQClinic helped students be aware of their non-verbal behaviour and improve their communication skills, and evaluated the usability of the platform. Students received automated feedback, and SP and tutor evaluations, and then completed self-assessment and reflection questionnaires. Eight medical students and three SPs conducted 13 tele-consultations using EQClinic. More students paid attention to their non-verbal communication and students who were engaged in two consultations felt more confident in their second consultation. Students rated the system positively, felt comfortable using it (5.9/7), and reported that the structure (5.4/7) and information (5.8/7) were clear. This pilot provides evidence that EQClinic helps, and positively influences, medical students practise their communication skills with SPs using a tele-conference platform. It is not easy to improve non-verbal communication skills in a short time period. Further evaluation of

EQClinic: a platform for learning communication skills in clinical consultations

Directory of Open Access Journals (Sweden)

Chunfeng Liu

2016-07-01

Full Text Available Background: Doctors’ verbal and non-verbal communication skills have an impact on patients’ health outcomes, so it is important for medical students to develop these skills. Traditional, non-verbal communication skills training can involve a tutor manually annotating a student's non-verbal behaviour during patient–doctor consultations, but this is very time-consuming. Tele-conference systems have been used in verbal communication skills training. Methods: We describe EQClinic, a system that enables verbal and non-verbal communication skills training during tele-consultations with simulated patients (SPs, with evaluation exercises promoting reflection. Students and SPs can have tele-consultations through the tele-consultation component. In this component, SPs can provide feedback to students through a thumbs-up/ thumbs-down tool and a comments box. EQClinic automatically analyses communication features in the recorded consultations, such as facial expressions, and provides graphical representations. Our 2015 pilot study investigated whether EQClinic helped students be aware of their non-verbal behaviour and improve their communication skills, and evaluated the usability of the platform. Students received automated feedback, and SP and tutor evaluations, and then completed self-assessment and reflection questionnaires. Results: Eight medical students and three SPs conducted 13 tele-consultations using EQClinic. More students paid attention to their non-verbal communication and students who were engaged in two consultations felt more confident in their second consultation. Students rated the system positively, felt comfortable using it (5.9/7, and reported that the structure (5.4/7 and information (5.8/7 were clear. This pilot provides evidence that EQClinic helps, and positively influences, medical students practise their communication skills with SPs using a tele-conference platform. Discussion: It is not easy to improve non

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

International Nuclear Information System (INIS)

Henwood, S.; Booth, L.

2016-01-01

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

Telephone versus face-to-face interviewing for household drug use surveys.

Science.gov (United States)

Aquilino, W S

1992-01-01

This research investigated the use of telephone versus face-to-face interviewing to gather data on the use of tobacco, alcohol, and illicit drugs. Telephone and personal drug use surveys of the 18-34 year-old household population were conducted in the state of New Jersey in 1986-1987. Survey modes were compared in terms of unit and item nonresponse rates, sample coverage, and levels of self-reported drug use. Results showed that the telephone survey achieved response rates lower than the personal survey, but comparable to telephone surveys of less threatening topics. Item nonresponse to sensitive drug questions was lower by phone than with the self-administered answer sheets in the personal mode. The exclusion of households without telephones in the telephone survey is a potential source of bias, and may lead to underestimation of alcohol and drug use for minority populations. After controlling for telephone status, the telephone survey furnished significantly lower drug use estimates on several indicators than the personal survey, with the largest mode differences found for Blacks.

Telecommunications Policy Research Conference. Subsidies in Telephone Pricing Section. Papers.

Science.gov (United States)

Telecommunications Policy Research Conference, Inc., Washington, DC.

Three papers consider the provision of telephone service to rural and/or low income customers. The first paper, "An Analysis of Telephone Penetration" (Alexander Belinfante), analyzes the relationship between telephone penetration (the proportion of households with phone service) and prices, household income, and other factors. This…

Choosing a New Telephone System for Your Medical Practice.

Science.gov (United States)

Metherell, Brian

2016-01-01

E-mail may rule the world in other types of businesses, but for medical practices, the telephone remains the primary mode of communication with patients, specialists, and pharmacies. From making appointments to calling in prescriptions, telephones are essential to patient care. With technology changing very quickly and new capabilities coming into the medical practice, such as telemedicine and Skype, you need to know your options when choosing a new telephone system. The possibilities include on-site, cloud, and hybrid networked solutions. A wide variety of features and capabilities are available, from dozens of vendors. Of course, no matter what telephone solution you choose, you must meet regulatory compliance, particularly HIPAA, and Payment Card Industry Data Security Standard if you take credit cards. And it has to be affordable, reliable, and long lasting. This article explores what medical practices need to know when choosing a new business telephone system in order to find the right solutions for their businesses.

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

Science.gov (United States)

Ohl, Ricky

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

Fuel cells for telephone networks

International Nuclear Information System (INIS)

Wells, J.D.; Scott, D.S.

1993-01-01

Critical telephone network systems are currently protected from electric utility power failures by a backup system consisting of lead-acid batteries and an engine-alternator. It is considered here an alternate power system where less expensive off-peak commercial electricity electrolyses water, while fuel cells draw continuously on the stored gas products to provide direct current for the protected equipment. The lead acid batteries are eliminated. The benefits and costs of the existing and alternate systems in scenarios with various system efficiencies, capital costs, and electric utility rates and incentives, are compared. In today's conditions, the alternate system is not economical; however, cost and performance feasibility domains are identified. 2 figs., 4 tabs., 12 refs

Cellular telephone use among primary school children in Germany

International Nuclear Information System (INIS)

Boehler, Eva; Schuez, Joachim

2004-01-01

Background: There is some concern about potential health risks of cellular telephone use to children. We assessed data on how many children own a cellular telephone and on how often they use it in a population-based sample. Methods: We carried out a cross-sectional study among children in their fourth elementary school year, with a median-age of 10 years. The study was carried out in Mainz (Germany), a city with about 200,000 inhabitants. The study base comprised all 37 primary schools in Mainz and near surroundings. Altogether, 1933 children from 34 primary schools took part in the survey (participation rate of 87.8%). Results: Roughly a third of all children (n = 671, 34.7%) reported to own a cellular telephone. Overall, 119 (6.2%) children used a cellular telephone for making calls at least once a day, 123 (6.4%) used it several times a week and 876 (45.3%) children used it only once in a while. The remaining 805 (41.6%) children had never used a cellular telephone. The probability of owning a cellular telephone among children was associated with older age, being male, having no siblings, giving full particulars to height and weight, more time spent watching TV and playing computer games, being picked up by their parents from school by car (instead of walking or cycling) and going to bed late. The proportion of cellular telephone owners was somewhat higher in classes with more children from socially disadvantaged families. Conclusions: Our study shows that both ownership of a cellular telephone as well as the regular use of it are already quite frequent among children in the fourth grade of primary school. With regard to potential long-term effects, we recommend follow-up studies with children

Intervention among Suicidal Men: Future Directions for Telephone Crisis Support Research.

Science.gov (United States)

Hunt, Tara; Wilson, Coralie J; Woodward, Alan; Caputi, Peter; Wilson, Ian

2018-01-01

Telephone crisis support is a confidential, accessible, and immediate service that is uniquely set up to reduce male suicide deaths through crisis intervention. However, research focusing on telephone crisis support with suicidal men is currently limited. To highlight the need to address service delivery for men experiencing suicidal crisis, this perspective article identifies key challenges facing current telephone crisis support research and proposes that understanding of the role of telephone crisis helplines in supporting suicidal men may be strengthened by careful examination of the context of telephone crisis support, together with the impact this has on help-provision for male suicidal callers. In particular, the impact of the time- and information-poor context of telephone crisis support on crisis-line staff's identification of, and response to, male callers with thoughts of suicide is examined. Future directions for research in the provision of telephone crisis support for suicidal men are discussed.

24 CFR 3285.906 - Telephone and cable TV.

Science.gov (United States)

2010-04-01

... URBAN DEVELOPMENT MODEL MANUFACTURED HOME INSTALLATION STANDARDS Optional Information for Manufacturer's Installation Instructions § 3285.906 Telephone and cable TV. It is recommended that the installation instructions explain that telephone and cable TV wiring should be installed in accordance with requirements of...

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

Science.gov (United States)

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

1980-12-01

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

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

Science.gov (United States)

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.

The Effect of the Strictness of Consultation Requirements on Fraud Consultation

NARCIS (Netherlands)

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

2012-01-01

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

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

Science.gov (United States)

Wilk, Adam S; Chen, Lena M

2017-12-01

Hospital administrators are seeking to improve efficiency in medical consultation services, yet whether consultants make decisions to provide more or less care is unknown. We examined how medical consultants account for prior consultants' care when determining whether to provide intensive consulting care or sign off in the treatment of complex surgical inpatients. We applied three distinct theoretical frameworks in the interpretation of our results. We performed a retrospective cohort study of consultants' care intensity, measured alternately using a dummy variable for providing two or more days consulting (versus one) and a continuous measure of total days consulting, with 100% Medicare claims data from 2007-2010. Our analytic samples included consults for beneficiaries undergoing coronary artery bypass grafting (n = 61,785) or colectomy (n = 33,460) in general acute care hospitals. We compared the care intensity of consultants who observed different patterns of consulting care before their initial consults using ordinary least squares regression models at the patient-physician dyad level, controlling for patient comorbidity and many other patient- and physician-level factors as well as hospital region and year fixed effects. Consultants were less likely to provide intensive consulting care with each additional prior consultant on the case (1.2-1.7 percent) or if a prior consultant rendered intensive consulting care (20.6-21.5 percent) but more likely when prior consults were more concentrated across consultants (2.9-3.1 percent). Effects on consultants' total days consulting were similar. On average, consultants appeared to calibrate their care intensity for individual patients to maximize their value to all patients. Interventions for improving consulting care efficiency should seek to facilitate (not constrain) consultants' decision-making processes.

Prognosis of patients with whiplash-associated disorders consulting physiotherapy: development of a predictive model for recovery

Directory of Open Access Journals (Sweden)

Bohman Tony

2012-12-01

Full Text Available Abstract Background Patients with whiplash-associated disorders (WAD have a generally favourable prognosis, yet some develop longstanding pain and disability. Predicting who will recover from WAD shortly after a traffic collision is very challenging for health care providers such as physical therapists. Therefore, we aimed to develop a prediction model for the recovery of WAD in a cohort of patients who consulted physical therapists within six weeks after the injury. Methods Our cohort included 680 adult patients with WAD who were injured in Saskatchewan, Canada, between 1997 and 1999. All patients had consulted a physical therapist as a result of the injury. Baseline prognostic factors were collected from an injury questionnaire administered by Saskatchewan Government Insurance. The outcome, global self-perceived recovery, was assessed by telephone interviews six weeks, three and six months later. Twenty-five possible baseline prognostic factors were considered in the analyses. A prediction model was built using Cox regression. The predictive ability of the model was estimated with concordance statistics (c-index. Internal validity was checked using bootstrapping. Results Our final prediction model included: age, number of days to reporting the collision, neck pain intensity, low back pain intensity, pain other than neck and back pain, headache before collision and recovery expectations. The model had an acceptable level of predictive ability with a c-index of 0.68 (95% CI: 0.65, 0.71. Internal validation showed that our model was robust and had a good fit. Conclusions We developed a model predicting recovery from WAD, in a cohort of patients who consulted physical therapists. Our model has adequate predictive ability. However, to be fully incorporated in clinical practice the model needs to be validated in other populations and tested in clinical settings.

Prognosis of patients with whiplash-associated disorders consulting physiotherapy: development of a predictive model for recovery

Science.gov (United States)

2012-01-01

Background Patients with whiplash-associated disorders (WAD) have a generally favourable prognosis, yet some develop longstanding pain and disability. Predicting who will recover from WAD shortly after a traffic collision is very challenging for health care providers such as physical therapists. Therefore, we aimed to develop a prediction model for the recovery of WAD in a cohort of patients who consulted physical therapists within six weeks after the injury. Methods Our cohort included 680 adult patients with WAD who were injured in Saskatchewan, Canada, between 1997 and 1999. All patients had consulted a physical therapist as a result of the injury. Baseline prognostic factors were collected from an injury questionnaire administered by Saskatchewan Government Insurance. The outcome, global self-perceived recovery, was assessed by telephone interviews six weeks, three and six months later. Twenty-five possible baseline prognostic factors were considered in the analyses. A prediction model was built using Cox regression. The predictive ability of the model was estimated with concordance statistics (c-index). Internal validity was checked using bootstrapping. Results Our final prediction model included: age, number of days to reporting the collision, neck pain intensity, low back pain intensity, pain other than neck and back pain, headache before collision and recovery expectations. The model had an acceptable level of predictive ability with a c-index of 0.68 (95% CI: 0.65, 0.71). Internal validation showed that our model was robust and had a good fit. Conclusions We developed a model predicting recovery from WAD, in a cohort of patients who consulted physical therapists. Our model has adequate predictive ability. However, to be fully incorporated in clinical practice the model needs to be validated in other populations and tested in clinical settings. PMID:23273330

Inpatient Consultative Dermatology.

Science.gov (United States)

Biesbroeck, Lauren K; Shinohara, Michi M

2015-11-01

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

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

Science.gov (United States)

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

2015-03-01

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

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

Science.gov (United States)

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

2016-02-12

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

AIDS and condoms in Brasilia: a telephone survey.

Science.gov (United States)

Chequer, P; VanOss Marín, B; Paiva, L; Hudes, E S; Piazza, T; Rodrigues, L; Hearst, N

1997-10-01

A telephone survey was conducted to measure AIDS knowledge, media usage and condom attitudes and behaviors among 500 adults aged 18 to 49 in Brasilia, as well as to evaluate the feasibility of the telephone survey method in a developing country. The response rate was 91.6%. Respondents had good knowledge about correct modes of HIV transmission and prevention but also believed HIV was transmitted through blood donation, public toilets, swimming pools, and mosquito bites. TV and newspapers were the most important sources of information on health matters and AIDS, though health workers were considered the most credible sources of such information. Only 19% of sexual encounters in the 4 weeks prior to the survey included condoms. Single and younger respondents and those with more positive attitudes used condoms more frequently. More work is needed to identify appropriate messages to motivate people to use condoms. Telephone surveys regarding AIDS and sexual attitudes and behaviors are feasible in Brasilia, a planned community with universal telephone coverage.

THE IMPORTANCE OF CONSULTING IN CONTEMPORARY BUSINESS MANAGEMENT

Directory of Open Access Journals (Sweden)

Svetlana Vukotić

2017-07-01

Full Text Available Modern business is characterized by risk and uncertainty, and such an environment is reflected in the decisions taken by managers. On the other hand, management consulting is one of the most important management techniques developed over the last fifty years. The secondary effect of this invention is the rapid development of new frameworks, tools, and techniques improving the operations in a number of companies. Exposure of consulting organizations to varying combinations of business circumstances and experiences of different companies have allowed for the accumulation of valuable knowledge and business experience. From this coupling, or interaction of knowledge and experience of consulting companies, on the one hand and the needs of management companies to recognize their role and hire consultants, on the other hand, developed the importance of financial consulting and auditing. Rational management processes cannot be imagined without reliable information provided by the audit, especially as the strategic management includes the control phase. The importance and relationship between consulting and management in companies that do business according to modern principles is a central topic of consideration in this paper.

Determinants of Management Innovation in the Ghanaian Construction Consulting Sector

Directory of Open Access Journals (Sweden)

De-Graft Owusu-Manu

2015-03-01

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

THE EFFECTS OF MOBILE TELEPHONING ON DRIVING PERFORMANCE

NARCIS (Netherlands)

BROOKHUIS, KA; DEVRIES, G; DEWAARD, D

The effects of telephoning while driving were studied in three different traffic conditions, i.e. in light traffic on a quiet motorway, in heavy traffic on a four-lane ring-road, and in city traffic. Twelve subjects, unfamiliar with mobile telephones, drove an instrumented vehicle for one hour each

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

Science.gov (United States)

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

2016-02-01

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

Mental Health Consultation Among Ontario's Immigrant Populations.

Science.gov (United States)

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

2017-11-16

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

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

International Nuclear Information System (INIS)

Harris, R.; Paterson, A.

2016-01-01

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

Telemedicine as a tool to provide family conferences and palliative care consultations in critically ill patients at rural health care institutions: a pilot study.

Science.gov (United States)

Menon, Prema R; Stapleton, Renee D; McVeigh, Ursula; Rabinowitz, Terry

2015-06-01

Many critically ill patients who transfer from rural hospitals to tertiary care centers (TCCs) have poor prognoses, and family members are unable to discuss patient prognosis and goals of care with TCC providers until after transfer. Our TCC conducted teleconferences prior to transfer to facilitate early family discussions. We conducted a retrospective review of these telemedicine family conferences among critically ill patients requested for transfer which occurred from December 2008 to December 2009 at our TCC. Outcomes for each patient and detailed descriptions of the conference content were obtained. We also assessed limitations and attitudes and satisfaction with this intervention among clinicians. During the 12-month period, 12 telemedicine consultations were performed. Of these patients, 10 (83%) died in the 30 days following the request for transfer. After the telemedicine consultation, 8 (67%) patients were transferred to our TCC from their respective hospitals, while 4 (33%) patients continued care at their regional hospital and did not transfer. Of the patients who transferred to TCC, 7 (88% of those transferred) returned to their community after a stay at the TCC. This study demonstrates that palliative care consultations can be provided via telemedicine for critically ill patients and that adequate preparation and technical expertise are essential. Although this study is limited by the nature of the retrospective review, it is evident that more research is needed to further assess its applicability, utility, and acceptability. © The Author(s) 2014.

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

Science.gov (United States)

Barnes, M L; Hussain, S S M

2011-12-01

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

Accompanied consultations in occupational health.

Science.gov (United States)

Hobson, J; Hobson, H; Sharp, R

2016-04-01

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

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

Science.gov (United States)

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

2010-03-01

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

Can smartphones enhance telephone-based cognitive assessment (TBCA)?

Science.gov (United States)

Kwan, Rick Yiu-Cho; Lai, Claudia Kam-Yuk

2013-12-12

TBCA has emerged to solve the limitations of administering cognitive assessments face-to-face. The recent development of telephones and knowledge advances in the area of cognitive impairment may affect the development of TBCA. The purpose of this paper is to discuss how smartphones can be used to enhance the applicability of TBCA, which has previously been administered by conventional telephone. This paper will first review, describe and critique the existing TBCA instruments. It will then discuss the recent developments in tele-technology, the popularity of tele-technology among the elderly, potential benefits and challenges in using smartphones for cognitive assessment, and possible future developments in this technology. In the systematic review, eighteen TBCA instruments were identified. They were found to be valid in differentiating between people with and without dementia. TBCA was previously found to be launched on a conventional telephone platform. The advances in understanding of cognitive impairment may demand that telephones be equipped with more advanced features. Recently, the development and penetration of smartphones among the elderly has been rapid. This may allow the smartphone to enhance its TBCA applicability by overcoming the limitations of the conventional telephone, rendering the TBCA more efficient in addressing the increasing demand and complexity of cognitive assessments in the future. However, more research and technology developments are needed before smartphones can become a valid platform for TBCA.

Can Smartphones Enhance Telephone-Based Cognitive Assessment (TBCA?

Directory of Open Access Journals (Sweden)

Rick Yiu-Cho Kwan

2013-12-01

Full Text Available TBCA has emerged to solve the limitations of administering cognitive assessments face-to-face. The recent development of telephones and knowledge advances in the area of cognitive impairment may affect the development of TBCA. The purpose of this paper is to discuss how smartphones can be used to enhance the applicability of TBCA, which has previously been administered by conventional telephone. This paper will first review, describe and critique the existing TBCA instruments. It will then discuss the recent developments in tele-technology, the popularity of tele-technology among the elderly, potential benefits and challenges in using smartphones for cognitive assessment, and possible future developments in this technology. In the systematic review, eighteen TBCA instruments were identified. They were found to be valid in differentiating between people with and without dementia. TBCA was previously found to be launched on a conventional telephone platform. The advances in understanding of cognitive impairment may demand that telephones be equipped with more advanced features. Recently, the development and penetration of smartphones among the elderly has been rapid. This may allow the smartphone to enhance its TBCA applicability by overcoming the limitations of the conventional telephone, rendering the TBCA more efficient in addressing the increasing demand and complexity of cognitive assessments in the future. However, more research and technology developments are needed before smartphones can become a valid platform for TBCA.

Telephone Crisis Support Workers' Psychological Distress and Impairment.

Science.gov (United States)

Kitchingman, Taneile A; Wilson, Coralie J; Caputi, Peter; Wilson, Ian; Woodward, Alan

2018-01-01

In order to respond to crises with appropriate intervention, crisis workers are required to manage their own needs as well as the needs of those they respond to. A systematic review of the literature was conducted to examine whether telephone crisis support workers experience elevated symptoms of psychological distress and are impaired by elevated symptoms. Studies were identified in April 2015 by searching three databases, conducting a gray literature search, and forward and backward citation chaining. Of 113 identified studies, seven were included in the review. Results suggest that that telephone crisis support workers experience symptoms of vicarious traumatization, stress, burnout, and psychiatric disorders, and that they may not respond optimally to callers when experiencing elevated symptoms of distress. However, definitive conclusions cannot be drawn due to the paucity and methodological limitations of available data. While the most comprehensive search strategy possible was adopted, resource constraints meant that conference abstracts were not searched and authors were not contacted for additional unpublished information. There is an urgent need to identify the impact of telephone crisis support workers' role on their well-being, the determinants of worker well-being in the telephone crisis support context, and the extent to which well-being impacts their performance and caller outcomes. This will help inform strategies to optimize telephone crisis support workers' well-being and their delivery of support to callers.

Consultant management estimating tool.

Science.gov (United States)

2012-04-01

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

Intellectual Humility and Morality as Consultee-Centered Consultation Epistemologies

Science.gov (United States)

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

2017-01-01

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

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

Science.gov (United States)

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

2017-01-01

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

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

Science.gov (United States)

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

2017-09-15

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

Why and When do Patients Use e-Consultation Services? The Trust and Resource Supplementary Perspectives.

Science.gov (United States)

Li, Jia; Liu, Minghui; Liu, Xuan; Ma, Ling

2018-01-01

e-Consultation provides a new way to deliver healthcare services online. With the help of e-Consultation services, patients can gain access to nationwide medical expertise that otherwise would not be available to them. As an online delivery approach, e-Consultation also provides a choice for patients to receive medical advice from online doctors immediately, no matter how far away from the hospital they may be or how late in the day it is. However, the adoption and usage of e-Consultation is still far from satisfactory. Therefore, understanding why and when patients use e-Consultation services are important research questions. Considering that the choice of a healthcare provider is a serious decision, this research uses the trust perspective to explain the e-Consultation service adoption phenomenon. Specifically, trust is conceptualized as a second-order construct consisting of two dimensions: competence and integrity. In addition, e-Consultation is viewed as a supplementary resource to traditional off-line consultation services, and disease type as a contextual factor is hypothesized to focus the context where e-Consultation services are more suitable. A scenario-based survey was conducted to test the proposed research model. We obtained a total of 190 valid questionnaires. Our results indicated that trust (p e-Consultation service. Meanwhile, our results also indicated that the higher the disease is in rarity (p e-Consultation service. Trust is the major driving force of an e-Consultation service adoption. When the disease is high in rarity, severity, or urgency, an off-line healthcare provider is less capable of providing meaningful, qualified, and immediate service. Therefore, there is a decreased positive effect of trust on the intention to use an e-Consultation service for those diseases.

Consultation and the TADS Experience. Occasional Paper Number 1.

Science.gov (United States)

Trohanis, Pascal L.; And Others

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

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

OpenAIRE

Campion, P D; Gabriel, J

1984-01-01

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

Impact of telephone nursing education program for equity in healthcare

OpenAIRE

H?glund, Anna T.; Carlsson, Marianne; Holmstr?m, Inger K.; Kaminsky, Elenor

2016-01-01

Background The Swedish Healthcare Act prescribes that healthcare should be provided according to needs and with respect for each person?s human dignity. The goal is equity in health for the whole population. In spite of this, studies have revealed that Swedish healthcare is not always provided equally. This has also been observed in telephone nursing. Therefore, the aim of the present study was to investigate if and how an educational intervention can improve awareness of equity in healthcare...

Consulting Whom? Lessons from the Toronto Urban Aboriginal Strategy

Directory of Open Access Journals (Sweden)

Mai T. Nguyen

2014-04-01

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

There is no place like @home!: The value of home consultations in paediatric rehabilitation.

Science.gov (United States)

van Maren-Suir, I; Ketelaar, M; Brouns, B; van der Sanden, K; Verhoef, M

2018-07-01

Family-centred services (FCS) is widely regarded as the best practice approach in early interventions. Creating a therapeutic environment, which also stimulates collaboration between parents and service professionals, is a way to conform to the principles of FCS. The present paper describes the project entitled @home, involving the implementation of home consultations by a specialized team working with children aged 0-5 years at our rehabilitation centre in the Netherlands. The objectives of this article are to (a) describe the development and implementation of home consultations as part of regular care and (b) share the experiences of parents and service providers with home consultations. The implementation process was divided into 3 steps: (1) interviewing experts, (2) adjusting current rehabilitation trajectories, and (3) service providers offering consultations to children at home. The experiences with the home consultations were immediately incorporated in the system, making the implementation an iterative process. In 82% of the 133 home conducted consultations, the service professionals reported that it was more valuable to offer home consultations than seeing the child at the rehabilitation centre. The semistructured interviews revealed that parents and service providers found that they received and provided more tailored advice, perceived a more equal partnership between service professionals and parents, and reported that the home consultations provided a good natural therapeutic environment where a child can be itself and where the child performs best. By using the @home system based on the 3 service models, home consultations are now part of the regular paediatric rehabilitation system at our rehabilitation centre. © 2018 John Wiley & Sons Ltd.

An empirical study of multidimensional fidelity of COMPASS consultation.

Science.gov (United States)

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

2018-06-01

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

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

Science.gov (United States)

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

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

Science.gov (United States)

Fiester, Autumn

2015-01-01

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

Telephone Coaching to Enhance a Home-Based Physical Activity Program for Knee Osteoarthritis: A Randomized Clinical Trial.

Science.gov (United States)

Bennell, Kim L; Campbell, Penny K; Egerton, Thorlene; Metcalf, Ben; Kasza, Jessica; Forbes, Andrew; Bills, Caroline; Gale, Janette; Harris, Anthony; Kolt, Gregory S; Bunker, Stephen J; Hunter, David J; Brand, Caroline A; Hinman, Rana S

2017-01-01

To investigate whether simultaneous telephone coaching improves the clinical effectiveness of a physiotherapist-prescribed home-based physical activity program for knee osteoarthritis (OA). A total of 168 inactive adults ages ≥50 years with knee pain on a numeric rating scale ≥4 (NRS; range 0-10) and knee OA were recruited from the community and randomly assigned to a physiotherapy (PT) and coaching group (n = 84) or PT-only (n = 84) group. All participants received five 30-minute consultations with a physiotherapist over 6 months for education, home exercise, and physical activity advice. PT+coaching participants also received 6-12 telephone coaching sessions by clinicians trained in behavioral-change support for exercise and physical activity. Primary outcomes were pain (NRS) and physical function (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC; score range 0-68]) at 6 months. Secondary outcomes were these same measures at 12 and 18 months, as well as physical activity, exercise adherence, other pain and function measures, and quality of life. Analyses were intent-to-treat with multiple imputation for missing data. A total of 142 (85%), 136 (81%), and 128 (76%) participants completed 6-, 12-, and 18-month measurements, respectively. The change in NRS pain (mean difference 0.4 unit [95% confidence interval (95% CI) -0.4, 1.3]) and in WOMAC function (1.8 [95% CI -1.9, 5.5]) did not differ between groups at 6 months, with both groups showing clinically relevant improvements. Some secondary outcomes related to physical activity and exercise behavior favored PT+coaching at 6 months but generally not at 12 or 18 months. There were no between-group differences in most other outcomes. The addition of simultaneous telephone coaching did not augment the pain and function benefits of a physiotherapist-prescribed home-based physical activity program. © 2016, American College of Rheumatology.

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

OpenAIRE

Joseph Lampel; Ajay Bhalla; Kaivalya Vishnu

2010-01-01

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

Digital audio recordings improve the outcomes of patient consultations

DEFF Research Database (Denmark)

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

2017-01-01

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

Industrial Buying Behavior Related to Human Resource Consulting Services

DEFF Research Database (Denmark)

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

2013-01-01

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

The impact of using computer decision-support software in primary care nurse-led telephone triage: interactional dilemmas and conversational consequences.

Science.gov (United States)

Murdoch, Jamie; Barnes, Rebecca; Pooler, Jillian; Lattimer, Valerie; Fletcher, Emily; Campbell, John L

2015-02-01

Telephone triage represents one strategy to manage demand for face-to-face GP appointments in primary care. Although computer decision-support software (CDSS) is increasingly used by nurses to triage patients, little is understood about how interaction is organized in this setting. Specifically any interactional dilemmas this computer-mediated setting invokes; and how these may be consequential for communication with patients. Using conversation analytic methods we undertook a multi-modal analysis of 22 audio-recorded telephone triage nurse-caller interactions from one GP practice in England, including 10 video-recordings of nurses' use of CDSS during triage. We draw on Goffman's theoretical notion of participation frameworks to make sense of these interactions, presenting 'telling cases' of interactional dilemmas nurses faced in meeting patient's needs and accurately documenting the patient's condition within the CDSS. Our findings highlight troubles in the 'interactional workability' of telephone triage exposing difficulties faced in aligning the proximal and wider distal context that structures CDSS-mediated interactions. Patients present with diverse symptoms, understanding of triage consultations, and communication skills which nurses need to negotiate turn-by-turn with CDSS requirements. Nurses therefore need to have sophisticated communication, technological and clinical skills to ensure patients' presenting problems are accurately captured within the CDSS to determine safe triage outcomes. Dilemmas around how nurses manage and record information, and the issues of professional accountability that may ensue, raise questions about the impact of CDSS and its use in supporting nurses to deliver safe and effective patient care. Copyright © 2014 Elsevier Ltd. All rights reserved.

Alternative health care consultations in Ontario, Canada: A geographic and socio-demographic analysis

Directory of Open Access Journals (Sweden)

Eby Jeanette

2011-06-01

Full Text Available Abstract Background An important but understudied component of Canada's health system is alternative care. The objective of this paper is to examine the geographic and socio-demographic characteristics of alternative care consultation in Ontario, Canada's largest province. Methods Data is drawn from the Canadian Community Health Survey (CCHS Cycle 3.1, 2005 for people aged 18 or over (n = 32,598 who had a consultation with an alternative health care provider. Four groups of consultations are examined: (1 all consultations (2 massage therapy (3 acupuncture, and (4 homeopath/naturopath. Descriptive statistics, mapping and logistic regression modeling are employed to analyze the data and to compare modalities of alternative health care use. Results In 2005, more than 1.2 million adults aged 18 or over consulted an alternative health care provider, representing about 13% of the total population of Ontario. The analysis revealed a varied geographic pattern of consultations across the province. Consultations were fairly even across the urban to rural continuum and rural residents were just as likely to consult a provider as their urban counterparts. From a health perspective, people with a chronic condition, lower health status and self-perceived unmet health care needs were more likely to see an alternative health provider. Women with chronic conditions such as fibromyalgia, high blood pressure, chronic fatigue syndrome and chemical sensitivities were more likely to see an alternative provider if they felt their health care needs were not being met. Conclusions The analysis revealed that geography is not a factor in determining alternative health care consultations in Ontario. By contrast, there is a strong association between these consultations and socio-demographic characteristics particularly age, sex, education, health and self-perceived unmet health care needs. The results underscore the importance of women's health needs as related to

Bioethics Consultations and Resources

OpenAIRE

Thomas, Jennie

2011-01-01

Making difficult healthcare decisions is often helped by consultation with a bioethics committee. This article reviews the main bioethics principles, when it is appropriate and how to call a bioethics consult, ethical concerns, and members of the consult team. Bioethics resources are included.

Comparing online and telephone survey results in the context of a skin cancer prevention campaign evaluation.

Science.gov (United States)

Hollier, L P; Pettigrew, S; Slevin, T; Strickland, M; Minto, C

2017-03-01

A large proportion of health promotion campaign evaluation research has historically been conducted via telephone surveys. However, there are concerns about the continued viability of this form of surveying in providing relevant and representative data. Online surveys are an increasingly popular alternative, and as such there is a need to assess the comparability between data collected using the two different methods to determine the implications for longitudinal comparisons. The present study compared these survey modes in the context of health promotion evaluation research. Data were collected via computer-assisted telephone interviewing and an online panel. In total, 688 and 606 respondents aged between 14 and 45 years completed the online and telephone surveys, respectively. Online respondents demonstrated higher awareness of the advertisement, rated the advertisement as more personally relevant and had better behavioural outcomes compared with the telephone respondents. The results indicate significant differences between the telephone and online surveys on most measures used to assess the effectiveness of a health promotion advertising campaign. Health promotion practitioners could consider the combination of both methods to overcome the deterioration in telephone survey response rates and the likely differences in respondent outcomes. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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

International Nuclear Information System (INIS)

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

Implementing a computer-assisted telephone interview (CATI) system to increase colorectal cancer screening: a process evaluation.

Science.gov (United States)

White, Mary Jo; Stark, Jennifer R; Luckmann, Roger; Rosal, Milagros C; Clemow, Lynn; Costanza, Mary E

2006-06-01

Computer-assisted telephone interviewing (CATI) systems used by telephone counselors (TCs) may be efficient mechanisms to counsel patients on cancer and recommended preventive screening tests in order to extend a primary care provider's reach to his/her patients. The implementation process of such a system for promoting colorectal (CRC) cancer screening using a computer-assisted telephone interview (CATI) system is reported in this paper. The process evaluation assessed three components of the intervention: message production, program implementation and audience reception. Of 1181 potentially eligible patients, 1025 (87%) patients were reached by the TCs and 725 of those patients (71%) were eligible to receive counseling. Five hundred eighty-two (80%) patients agreed to counseling. It is feasible to design and use CATI systems for prevention counseling of patients in primary care practices. CATI systems have the potential of being used as a referral service by primary care providers and health care organizations for patient education.

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

Science.gov (United States)

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

2012-01-01

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

Observations of sexually transmitted disease consultations in India.

Science.gov (United States)

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

1998-03-01

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

[Psychometric validation of the telephone memory test].

Science.gov (United States)

Ortiz, T; Fernández, A; Martínez-Castillo, E; Maestú, F; Martínez-Arias, R; López-Ibor, J J

1999-01-01

Several pathologies (i.e. Alzheimer's disease) that courses with memory alterations, appears in a context of impaired cognitive status and mobility. In recent years, several investigations were carried out in order to design short batteries that detect those subjects under risk of dementia. Some of this batteries were also design to be administrated over the telephone, trying to overcome the accessibility limitations of this patients. In this paper we present a battery (called Autotest de Memoria) essentially composed by episodic and semantic memory tests, administered both over the telephone and face to face. This battery was employed in the cognitive assessment of healthy controls and subjects diagnosed as probable Alzheimer's disease patients. Results show the capability of this battery in order to discriminate patients and healthy controls, a great sensibility and specificity, and a nearly absolute parallelism of telephone and face to face administrations. These data led us to claim the usefulness and practicality of our so called Memoria>.

47 CFR 42.6 - Retention of telephone toll records.

Science.gov (United States)

2010-10-01

... whether it is billing its own toll service customers for toll calls or billing customers for another... Section 42.6 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES... telephone toll records. Each carrier that offers or bills toll telephone service shall retain for a period...

Brain tumour risk in relation to mobile telephone use

DEFF Research Database (Denmark)

Johansen, Christoffer

2010-01-01

The rapid increase in mobile telephone use has generated concern about possible health risks related to radiofrequency electromagnetic fields from this technology.......The rapid increase in mobile telephone use has generated concern about possible health risks related to radiofrequency electromagnetic fields from this technology....

Improving access to urologists through an electronic consultation service

Science.gov (United States)

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

2017-01-01

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

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

Science.gov (United States)

2013-08-08

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

3 CFR - Tribal Consultation

Science.gov (United States)

2010-01-01

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

Interactive water monitoring system accessible by cordless telephone

Science.gov (United States)

Volpicelli, Richard; Andeweg, Pierre; Hagar, William G.

1985-12-01

A battery-operated, microcomputer-controlled monitoring device linked with a cordless telephone has been developed for remote measurements. This environmental sensor is self-contained and collects and processes data according to the information sent to its on-board computer system. An RCA model 1805 microprocessor forms the basic controller with a program encoded in memory for data acquisition and analysis. Signals from analog sensing devices used to monitor the environment are converted into digital signals and stored in random access memory of the microcomputer. This remote sensing system is linked to the laboratory by means of a cordless telephone whose base unit is connected to regular telephone lines. This offshore sensing system is simply accessed by a phone call originating from a computer terminal in the laboratory. Data acquisition is initiated upon request: Information continues to be processed and stored until the computer is reprogrammed by another phone call request. Information obtained may be recalled by a phone call after the desired environmental measurements are finished or while they are in progress. Data sampling parameters may be reset at any time, including in the middle of a measurement cycle. The range of the system is limited only by existing telephone grid systems and by the transmission characteristics of the cordless phone used as a communications link. This use of a cordless telephone, coupled with the on-board computer system, may be applied to other field studies requiring data transfer between an on-site analytical system and the laboratory.

Requests from professional care providers for consultation with palliative care consultation teams.

NARCIS (Netherlands)

Groot, M.F. de; Vernooy-Dassen, M.J.F.J.; Courtens, A.M.; Kuin, A.; Linden, B.A. van der; Zuylen, L. van; Crul, B.J.P.; Grol, R.P.T.M.

2005-01-01

GOALS OF WORK: Professional care providers need a substantial basis of competence and expertise to provide appropriate palliative care. Little is known about the problems professionals experience in their palliative care provision in daily practice or about the nature of the advice and support they

A Critical Review of Videoconferencing Software to Support School Consultation

Science.gov (United States)

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

2018-01-01

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

Working with boundaries in systems psychodynamic consulting

Directory of Open Access Journals (Sweden)

Henk Struwig

2012-03-01

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

'Putting Life in Years' (PLINY) telephone friendship groups research study: pilot randomised controlled trial.

Science.gov (United States)

Mountain, Gail A; Hind, Daniel; Gossage-Worrall, Rebecca; Walters, Stephen J; Duncan, Rosie; Newbould, Louise; Rex, Saleema; Jones, Carys; Bowling, Ann; Cattan, Mima; Cairns, Angela; Cooper, Cindy; Edwards, Rhiannon Tudor; Goyder, Elizabeth C

2014-04-24

Loneliness in older people is associated with poor health-related quality of life (HRQoL). We undertook a parallel-group randomised controlled trial to evaluate the effectiveness and cost-effectiveness of telephone befriending for the maintenance of HRQoL in older people. An internal pilot tested the feasibility of the trial and intervention. Participants aged >74 years, with good cognitive function, living independently in one UK city were recruited through general practices and other sources, then randomised to: (1) 6 weeks of short one-to-one telephone calls, followed by 12 weeks of group telephone calls with up to six participants, led by a trained volunteer facilitator; or (2) a control group. The main trial required the recruitment of 248 participants in a 1-year accrual window, of whom 124 were to receive telephone befriending. The pilot specified three success criteria which had to be met in order to progress the main trial to completion: recruitment of 68 participants in 95 days; retention of 80% participants at 6 months; successful delivery of telephone befriending by local franchise of national charity. The primary clinical outcome was the Short Form (36) Health Instrument (SF-36) Mental Health (MH) dimension score collected by telephone 6 months following randomisation. We informed 9,579 older people about the study. Seventy consenting participants were randomised to the pilot in 95 days, with 56 (80%) providing valid primary outcome data (26 intervention, 30 control). Twenty-four participants randomly allocated to the research arm actually received telephone befriending due to poor recruitment and retention of volunteer facilitators. The trial was closed early as a result. The mean 6-month SF-36 MH scores were 78 (SD 18) and 71 (SD 21) for the intervention and control groups, respectively (mean difference, 7; 95% CI, -3 to 16). Recruitment and retention of participants to a definitive trial with a recruitment window of 1 year is feasible. For

Preparation + consultation = better regulation

International Nuclear Information System (INIS)

Bines, W.

2001-01-01

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

49 CFR 195.52 - Telephonic notice of certain accidents.

Science.gov (United States)

2010-10-01

... 49 Transportation 3 2010-10-01 2010-10-01 false Telephonic notice of certain accidents. 195.52... TRANSPORTATION OF HAZARDOUS LIQUIDS BY PIPELINE Annual, Accident, and Safety-Related Condition Reporting § 195.52 Telephonic notice of certain accidents. (a) At the earliest practicable moment following discovery of a...

Reliability and validity of using telephone calls for post-discharge surveillance of surgical site infection following caesarean section at a tertiary hospital in Tanzania

Directory of Open Access Journals (Sweden)

Boniface Nguhuni

2017-05-01

Full Text Available Abstract Background Surgical site infection (SSI is a common post-operative complication causing significant morbidity and mortality. Many SSI occur after discharge from hospital. Post-discharge SSI surveillance in low and middle income countries needs to be improved. Methodology We conducted an observational cohort study in Dodoma, Tanzania to examine the sensitivity and specificity of telephone calls to detect SSI after discharge from hospital in comparison to a gold standard of clinician review. Women undergoing caesarean section were enrolled and followed up for 30 days. Women providing a telephone number were interviewed using a structured questionnaire at approximately days 5, 12 and 28 post-surgery. Women were then invited for out-patient review by a clinician blinded to the findings of telephone interview. Results A total of 374 women were enrolled and an overall SSI rate of 12% (n = 45 was observed. Three hundred and sixteen (84% women provided a telephone number, of which 202 had at least one telephone interview followed by a clinical review within 48 h, generating a total of 484 paired observations. From the clinical reviews, 25 SSI were diagnosed, of which telephone interview had correctly identified 18 infections; telephone calls did not incorrectly identify SSI in any patients. The overall sensitivity and specificity of telephone interviews as compared to clinician evaluation was 72 and 100%, respectively. Conclusion The use of telephone interview as a diagnostic tool for post-discharge surveillance of SSI had moderate sensitivity and high specificity in Tanzania. Telephone-based detection may be a useful method for SSI surveillance in low-income settings with high penetration of mobile telephones.

Consultation in the Gifted-Education Arena: Old Wine in a New Skin

Science.gov (United States)

Worrell, Frank C.

2007-01-01

In this commentary, I provide a brief overview of definitions and types of consultation, as well as a discussion of the distinction between consultation and collaboration. I then apply the information from this review to the four articles on consulting about gifted and talented students. Using Caplan's framework, I argue that these papers contain…

Automatic Smoker Detection from Telephone Speech Signals

DEFF Research Database (Denmark)

Poorjam, Amir Hossein; Hesaraki, Soheila; Safavi, Saeid

2017-01-01

This paper proposes an automatic smoking habit detection from spontaneous telephone speech signals. In this method, each utterance is modeled using i-vector and non-negative factor analysis (NFA) frameworks, which yield low-dimensional representation of utterances by applying factor analysis...... method is evaluated on telephone speech signals of speakers whose smoking habits are known drawn from the National Institute of Standards and Technology (NIST) 2008 and 2010 Speaker Recognition Evaluation databases. Experimental results over 1194 utterances show the effectiveness of the proposed approach...... for the automatic smoking habit detection task....

Is there a bias against telephone interviews in qualitative research?

Science.gov (United States)

Novick, Gina

2008-08-01

Telephone interviews are largely neglected in the qualitative research literature and, when discussed, they are often depicted as a less attractive alternative to face-to-face interviewing. The absence of visual cues via telephone is thought to result in loss of contextual and nonverbal data and to compromise rapport, probing, and interpretation of responses. Yet, telephones may allow respondents to feel relaxed and able to disclose sensitive information, and evidence is lacking that they produce lower quality data. This apparent bias against telephone interviews contrasts with a growing interest in electronic qualitative interviews. Research is needed comparing these modalities, and examining their impact on data quality and their use for studying varying topics and populations. Such studies could contribute evidence-based guidelines for optimizing interview data. 2008 Wiley Periodicals, Inc

Bandwidth Extension of Telephone Speech Aided by Data Embedding

Directory of Open Access Journals (Sweden)

Sagi Ariel

2007-01-01

Full Text Available A system for bandwidth extension of telephone speech, aided by data embedding, is presented. The proposed system uses the transmitted analog narrowband speech signal as a carrier of the side information needed to carry out the bandwidth extension. The upper band of the wideband speech is reconstructed at the receiving end from two components: a synthetic wideband excitation signal, generated from the narrowband telephone speech and a wideband spectral envelope, parametrically represented and transmitted as embedded data in the telephone speech. We propose a novel data embedding scheme, in which the scalar Costa scheme is combined with an auditory masking model allowing high rate transparent embedding, while maintaining a low bit error rate. The signal is transformed to the frequency domain via the discrete Hartley transform (DHT and is partitioned into subbands. Data is embedded in an adaptively chosen subset of subbands by modifying the DHT coefficients. In our simulations, high quality wideband speech was obtained from speech transmitted over a telephone line (characterized by spectral magnitude distortion, dispersion, and noise, in which side information data is transparently embedded at the rate of 600 information bits/second and with a bit error rate of approximately . In a listening test, the reconstructed wideband speech was preferred (at different degrees over conventional telephone speech in of the test utterances.

Bandwidth Extension of Telephone Speech Aided by Data Embedding

Directory of Open Access Journals (Sweden)

David Malah

2007-01-01

Full Text Available A system for bandwidth extension of telephone speech, aided by data embedding, is presented. The proposed system uses the transmitted analog narrowband speech signal as a carrier of the side information needed to carry out the bandwidth extension. The upper band of the wideband speech is reconstructed at the receiving end from two components: a synthetic wideband excitation signal, generated from the narrowband telephone speech and a wideband spectral envelope, parametrically represented and transmitted as embedded data in the telephone speech. We propose a novel data embedding scheme, in which the scalar Costa scheme is combined with an auditory masking model allowing high rate transparent embedding, while maintaining a low bit error rate. The signal is transformed to the frequency domain via the discrete Hartley transform (DHT and is partitioned into subbands. Data is embedded in an adaptively chosen subset of subbands by modifying the DHT coefficients. In our simulations, high quality wideband speech was obtained from speech transmitted over a telephone line (characterized by spectral magnitude distortion, dispersion, and noise, in which side information data is transparently embedded at the rate of 600 information bits/second and with a bit error rate of approximately 3⋅10−4. In a listening test, the reconstructed wideband speech was preferred (at different degrees over conventional telephone speech in 92.5% of the test utterances.

Disparities in the Use of Internet and Telephone Medication Refills among Linguistically Diverse Patients.

Science.gov (United States)

Moreno, Gerardo; Lin, Elizabeth H; Chang, Eva; Johnson, Ron L; Berthoud, Heidi; Solomon, Cam C; Morales, Leo S

2016-03-01

Health systems are increasingly implementing remote telephone and Internet refill systems to enhance patient access to medication refills. Remote refill systems may provide an effective approach for improving medication non-adherence, but more research is needed among patients with limited English proficiency with poor access to remote refill systems. To compare the use of remote medication refill systems among limited-English-proficiency (LEP) and English-proficient (EP) patients with chronic conditions. Cross-sectional survey in six languages/dialects (English, Cantonese, Mandarin, Korean, Vietnamese, and Spanish) of 509 adults with diabetes, hypertension, or hyperlipidemia. Primary study outcomes were self-reported use of 1) Internet refills, 2) telephone refills, and 3) any remote refill system. LEP was measured by patient self-identification of a primary language other than English and a claims record of use of an interpreter. Other measures were age, gender, education, years in the U.S., insurance, health status, chronic conditions, and number of prescribed medications. Analyses included multivariable logistic regression weighted for survey non-response. Overall, 33.1 % of patients refilled their medications by telephone and 31.6 % by Internet. Among LEP patients (n = 328), 31.5 % refilled by telephone and 21.2 % by Internet, compared with 36.7 % by telephone and 52.7 % by Internet among EP patients (n = 181). Internet refill by language groups were as follows: English (52.7 %), Cantonese (34.9 %), Mandarin (17.4 %), Korean (16.7 %), Vietnamese (24.4 %), and Spanish (12.6 %). Compared to EP patients, LEP patients had lower use of any remote refill system (adjusted odds ratio [AOR] 0.18; p use any remote medication refill system. Increased reliance on current systems for remote medication refills may increase disparities in health outcomes affecting LEP patients with poor access to telephone and Internet medication refills.

Development and Evaluation of a Novel Survey Tool Assessing Inpatient Consult Service Performance.

Science.gov (United States)

Miloslavsky, Eli M; Chang, Yuchiao

2017-12-01

Subspecialty consultation in inpatient medicine is increasing, and enhancing performance of consultation services may have a broad-reaching impact. Multisource feedback is an important tool in assessing competence and improving performance. A mechanism for primary team resident feedback on performance of consult services has not been described. We developed and evaluated an instrument designed to assess internal medicine (IM) subspecialty inpatient consult service performance. We hypothesized that the instrument would be feasible to administer and provide important information to fellowship directors. The instrument was administered in 2015 and 2016 at a single academic center. All IM residents were invited to evaluate 10 IM subspecialty consult services on 4 items and an overall satisfaction rating. The instrument allowed for free-text feedback to fellows. Program directors completed another survey assessing the impact of the consult service evaluation. A total of 113 residents responded (47 in 2015 and 66 in 2016, for a combined response rate of 35%). Each of the 4 items measured (communication, professionalism, teaching, and pushback) correlated significantly with the overall satisfaction rating in univariate and multivariate analyses. There were no differences in ratings across postgraduate year or year of administration. There was considerable variation in ratings among the services evaluated. The 7 program directors who provided feedback found the survey useful and made programmatic changes following evaluation implementation. A primary team resident evaluation of inpatient medicine subspecialty consult services is feasible, provides valuable information, and is associated with changes in consult service structure and curricula.

39 CFR 6.4 - Attendance by conference telephone call.

Science.gov (United States)

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Attendance by conference telephone call. 6.4 Section 6.4 Postal Service UNITED STATES POSTAL SERVICE THE BOARD OF GOVERNORS OF THE U.S. POSTAL SERVICE MEETINGS (ARTICLE VI) § 6.4 Attendance by conference telephone call. For regularly scheduled meetings of...

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

OpenAIRE

Hartley, Jeanette

2017-01-01

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

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

International Nuclear Information System (INIS)

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

2016-01-01

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

Evaluating telephone follow-up of a mail survey of community pharmacies.

Science.gov (United States)

Westrick, Salisa C; Mount, Jeanine K

2007-06-01

Mail and telephone are commonly used modes of survey with pharmacists. Research conducted using general population surveys consistently describes mail surveys as being less expensive but yielding lower response rates than telephone surveys. However, findings obtained from the general population may not be generalizable to pharmacist surveys. This study evaluates the effectiveness of telephone follow-up of mail survey nonrespondents by comparing the 2 survey modes on response rates, cooperation rates, cost per sample unit, and cost per usable response and evaluating potential nonresponse bias in the context of immunization activities. A census mail survey of 1,143 Washington State community pharmacies and a follow-up telephone survey of 262 randomly selected mail survey nonrespondents were compared. Both surveys included the same 15 yes/no-type questions to ask respondents about their pharmacy's involvement in immunization activities. The mail survey yielded a response rate 1 of 26.7% and a cooperation rate 1 of 26.7%, compared with 83.6% and 87.8%, respectively, for the follow-up telephone survey. With respect to cost per sample unit, the mail survey was the least expensive option ($1.20). However, when comparing cost per usable response, the mail survey was the most expensive ($4.37), and the follow-up telephone survey without an advance notification was the least expensive ($1.99). Furthermore, results suggest the presence of nonresponse bias: compared with pharmacies participating in the follow-up telephone survey, pharmacies participating in the mail survey were more likely to be involved in in-house immunization services but less likely to be involved in outsourced services. The telephone survey achieved higher outcome rates with reduced cost per usable response. A telephone survey is a viable mode that holds promise in pharmacy practice research. Maximizing response rates and assessing potential nonresponse bias should be a standard practice among pharmacy

76 FR 79607 - Local Number Portability Porting Interval and Validation Requirements; Telephone Number Portability

Science.gov (United States)

2011-12-22

... customer's account; a positive indication that the new service provider has the authority from the customer... comments. Email: [email protected] , and include the following words in the body of the message, ``get form.'' A... telephone number associated with the customer's account; a positive indication that the new service provider...

Standardization Versus Innovation In Management Consultancy

Directory of Open Access Journals (Sweden)

Ciumara Tudor

2011-12-01

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

Behavior Analytic Consultation for Academic Referral Concerns

Science.gov (United States)

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

2016-01-01

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

Delivering an MBA Management Consulting Experience

Science.gov (United States)

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

2017-01-01

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

Minimizing the legal risk with 'curbside' consultation.

Science.gov (United States)

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

2008-01-01

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

The Dream Consultant

DEFF Research Database (Denmark)

Muhr, Sara Louise; Kirkegaard, Line

2013-01-01

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

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

Science.gov (United States)

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

2011-09-01

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

76 FR 27859 - 8(a) Business Development Program Regulation Changes; Tribal Consultation

Science.gov (United States)

2011-05-13

... the same tribe, ANC, NHO or CDC will submit identical data describing the benefits provided by the tribe, ANC, NHO or CDC. II. Tribal Consultation Meetings The purpose of these tribal consultation...

Uniqueness of family therapists as family business systems consultants: a cross-disciplinary investigation.

Science.gov (United States)

Lee, Jinhee; Danes, Sharon M

2012-06-01

The purpose of this study is to address how the consulting approaches of family therapists working with family businesses differ from those of business consultants. The logic of analytic induction was used to analyze qualitative data from family business consultants with and without training in family therapy. Consultants were asked to respond to two vignettes: one emphasized primarily family system problems, whereas the other emphasized business problems with influencing issues at the family/business intersection. Both similarities and differences were found in reference to problem assessment, consulting goal orientation, intervention strategy focus, consultant role and function, and consulting setting preference between consultants with and without family therapy training. Results indicate that consultants of each discipline provide a unique perspective and expertise that allow them to successfully address the spectrum of issues that family firms face. Further, findings highlight the unique contribution of family therapists to an interdisciplinary consulting team. © 2012 American Association for Marriage and Family Therapy.

Applying research to practice: generalist and specialist (visual ergonomics) consultancy.

Science.gov (United States)

Long, Jennifer; Long, Airdrie

2012-01-01

Ergonomics is a holistic discipline encompassing a wide range of special interest groups. The role of an ergonomics consultant is to provide integrated solutions to improve comfort, safety and productivity. In Australia, there are two types of consultants--generalists and specialists. Both have training in ergonomics but specialist knowledge may be the result of previous education or work experience. This paper presents three projects illustrating generalist and specialist (visual ergonomics) consultancy: development of a vision screening protocol, solving visual discomfort in an office environment and solving postural discomfort in heavy industry. These case studies demonstrate how multiple ergonomics consultants may work together to solve ergonomics problems. It also describes some of the challenges for consultants, for those engaging their services and for the ergonomics profession, e.g. recognizing the boundaries of expertise, sharing information with business competitors, the costs-benefits of engaging multiple consultants and the risk of fragmentation of ergonomics knowledge and solutions. Since ergonomics problems are often multifaceted, ergonomics consultants should have a solid grounding in all domains of ergonomics, even if they ultimately only practice in one specialty or domain. This will benefit the profession and ensure that ergonomics remains a holistic discipline.

Consulting in Electronic Commerce

Directory of Open Access Journals (Sweden)

Florentina Loredana Tache

2010-10-01

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

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

Science.gov (United States)

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

2014-07-01

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

Call Us: Development of a Library Telephone Enquiry Service

Science.gov (United States)

Burke, Liz; Beranek, Lea

2006-01-01

The authors detail the trial and piloting of a telephone enquiry service (TES) at the Bundoora Campus Library at La Trobe University in order to attempt to resolve the balance between telephone and face-to-face enquiries at the library service desk. They investigated various options throughout 2001 and 2002 and settled on a centralised service…

Attracting Child Psychiatrists to a Televideo Consultation Service: The TeleLink Experience.

Science.gov (United States)

Volpe, Tiziana; Boydell, Katherine M; Pignatiello, Antonio

2013-01-01

Objective. Identify aspects of psychiatry work that are rewarding, as well as those that are challenging, from the perspective of psychiatrists and residents participating in televideo consultation services. Method. A web-based survey was distributed to psychiatrists within the Division of Child Psychiatry at the University of Toronto. Also, semistructured interviews were conducted with six child psychiatrists providing services to a telepsychiatry program. Finally, a focus group interview was held with four psychiatry residents. Results. Child psychiatrists are very comfortable conducting assessments via televideo. Factors identified as being important in the decision to participate in telepsychiatry include assisting underserved communities, supportive administrative staff, enhanced rural provider capacity, financial incentives, and convenience. The study's qualitative phase identified four themes in the decision to participate in telepsychiatry: (1) organizational, (2) shared values, (3) innovation, and (4) the consultation model. Conclusion. The success of televideo consultation programs in attracting child psychiatrists to provide consultation services to underresourced communities makes an important contribution to psychiatric workforce shortages. Understanding what aspects of telepsychiatry are most appreciated by consulting psychiatrists and residents offers useful strategies to telepsychiatry administrators and medical school educators seeking to attract, train, and retain psychiatry practitioners.

Attracting Child Psychiatrists to a Televideo Consultation Service: The TeleLink Experience

Directory of Open Access Journals (Sweden)

Tiziana Volpe

2013-01-01

Full Text Available Objective. Identify aspects of psychiatry work that are rewarding, as well as those that are challenging, from the perspective of psychiatrists and residents participating in televideo consultation services. Method. A web-based survey was distributed to psychiatrists within the Division of Child Psychiatry at the University of Toronto. Also, semistructured interviews were conducted with six child psychiatrists providing services to a telepsychiatry program. Finally, a focus group interview was held with four psychiatry residents. Results. Child psychiatrists are very comfortable conducting assessments via televideo. Factors identified as being important in the decision to participate in telepsychiatry include assisting underserved communities, supportive administrative staff, enhanced rural provider capacity, financial incentives, and convenience. The study’s qualitative phase identified four themes in the decision to participate in telepsychiatry: (1 organizational, (2 shared values, (3 innovation, and (4 the consultation model. Conclusion. The success of televideo consultation programs in attracting child psychiatrists to provide consultation services to underresourced communities makes an important contribution to psychiatric workforce shortages. Understanding what aspects of telepsychiatry are most appreciated by consulting psychiatrists and residents offers useful strategies to telepsychiatry administrators and medical school educators seeking to attract, train, and retain psychiatry practitioners.

75 FR 21979 - NRC Region II Address and Main Telephone Number Changes

Science.gov (United States)

2010-04-27

... Region II Address and Main Telephone Number Changes AGENCY: Nuclear Regulatory Commission. ACTION: Final... address for its Region II office and to update the main telephone number. The Region II office move and... update the NRC Region II office street address and office main telephone number. The physical location of...

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

Science.gov (United States)

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

2016-01-01

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

Can Smartphones Enhance Telephone-Based Cognitive Assessment (TBCA)?

OpenAIRE

Rick Yiu-Cho Kwan; Claudia Kam-Yuk Lai

2013-01-01

TBCA has emerged to solve the limitations of administering cognitive assessments face-to-face. The recent development of telephones and knowledge advances in the area of cognitive impairment may affect the development of TBCA. The purpose of this paper is to discuss how smartphones can be used to enhance the applicability of TBCA, which has previously been administered by conventional telephone. This paper will first review, describe and critique the existing TBCA instruments. It will then di...

The association between question type and the outcomes of a Dermatology eConsult service.

Science.gov (United States)

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.

Simulated consultations: a sociolinguistic perspective.

Science.gov (United States)

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

2016-01-15

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

Cordless telephone use: implications for mobile phone research.

Science.gov (United States)

Redmayne, Mary; Inyang, Imo; Dimitriadis, Christina; Benke, Geza; Abramson, Michael J

2010-04-01

Cordless and mobile (cellular) telephone use has increased substantially in recent years causing concerns about possible health effects. This has led to much epidemiological research, but the usual focus is on mobile telephone radiofrequency (RF) exposure only despite cordless RF being very similar. Access to and use of cordless phones were included in the Mobile Radiofrequency Phone Exposed Users Study (MoRPhEUS) of 317 Year 7 students recruited from Melbourne, Australia. Participants completed an exposure questionnaire-87% had a cordless phone at home and 77% owned a mobile phone. There was a statistically significant positive relationship (r = 0.38, p < 0.01) between cordless and mobile phone use. Taken together, this increases total RF exposure and its ratio in high-to-low mobile users. Therefore, the design and analysis of future epidemiological telecommunication studies need to assess cordless phone exposure to accurately evaluate total RF telephone exposure effects.

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

Science.gov (United States)

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

2015-12-01

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

‘Putting Life in Years’ (PLINY) telephone friendship groups research study: pilot randomised controlled trial

Science.gov (United States)

2014-01-01

Background Loneliness in older people is associated with poor health-related quality of life (HRQoL). We undertook a parallel-group randomised controlled trial to evaluate the effectiveness and cost-effectiveness of telephone befriending for the maintenance of HRQoL in older people. An internal pilot tested the feasibility of the trial and intervention. Methods Participants aged >74 years, with good cognitive function, living independently in one UK city were recruited through general practices and other sources, then randomised to: (1) 6 weeks of short one-to-one telephone calls, followed by 12 weeks of group telephone calls with up to six participants, led by a trained volunteer facilitator; or (2) a control group. The main trial required the recruitment of 248 participants in a 1-year accrual window, of whom 124 were to receive telephone befriending. The pilot specified three success criteria which had to be met in order to progress the main trial to completion: recruitment of 68 participants in 95 days; retention of 80% participants at 6 months; successful delivery of telephone befriending by local franchise of national charity. The primary clinical outcome was the Short Form (36) Health Instrument (SF-36) Mental Health (MH) dimension score collected by telephone 6 months following randomisation. Results We informed 9,579 older people about the study. Seventy consenting participants were randomised to the pilot in 95 days, with 56 (80%) providing valid primary outcome data (26 intervention, 30 control). Twenty-four participants randomly allocated to the research arm actually received telephone befriending due to poor recruitment and retention of volunteer facilitators. The trial was closed early as a result. The mean 6-month SF-36 MH scores were 78 (SD 18) and 71 (SD 21) for the intervention and control groups, respectively (mean difference, 7; 95% CI, -3 to 16). Conclusions Recruitment and retention of participants to a definitive trial with a

Telephone-administered psychotherapy in combination with antidepressant medication for the acute treatment of major depressive disorder.

Science.gov (United States)

Corruble, Emmanuelle; Swartz, Holly A; Bottai, Thierry; Vaiva, Guillaume; Bayle, Frank; Llorca, Pierre-Michel; Courtet, Philippe; Frank, Ellen; Gorwood, Philip

2016-01-15

Telephone-administered psychotherapies (T-P) provided as an adjunct to antidepressant medication may improve response rates in major depressive disorder (MDD). The goal of this study was to compare telephone-administered social rhythm therapy (T-SRT) and telephone-administered intensive clinical management (T-ICM) as adjuncts to antidepressant medication for MDD. A secondary goal was to compare T-P with Treatment as Usual (TAU) as adjunctive treatment to medication for MDD. 221 adult out-patients with MDD, currently depressed, were randomly assigned to 8 sessions of weekly T-SRT (n=110) or T-ICM (n=111), administered as an adjunct to agomelatine. Both psychotherapies were administered entirely by telephone, by trained psychologists who were blind to other aspects of treatment. The 221 patients were a posteriori matched with 221 depressed outpatients receiving TAU (controls). The primary outcome measure was the percentage of responders at 8 weeks post-treatment. No significant differences were found between T-SRT and T-ICM. But T-P was associated with higher response rates (65.4% vs 54.8%, p=0.02) and a trend toward higher remission rates (33.2% vs 25.1%; p=0.06) compared to TAU. Short term study. This study is the first assessing the short-term effects of an add-on, brief, telephone-administered psychotherapy in depressed patients treated with antidepressant medication. Eight sessions of weekly telephone-delivered psychotherapy as an adjunct to antidepressant medication resulted in improved response rates relative to medication alone. Copyright © 2015 Elsevier B.V. All rights reserved.

Starting a nursing consultation practice.

Science.gov (United States)

Schulmeister, L

1999-03-01

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

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

Science.gov (United States)

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

2000-01-01

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

Telephone-Directory Program

Science.gov (United States)

Vlahos, William

2005-01-01

eDirectory is a computer program that makes it possible to view entries in the Jet Propulsion Laboratory (JPL) telephone directory by use of PalmPilot(TradeMark) (or equivalent) personal digital assistants. When one uses eDirectory, a single click causes the downloading of a current copy of the directory (which is updated nightly) from a server. The downloaded directory data can be sorted and searched. The program can append a "JPL" category and save directory information in a file that can be imported into the Palm Desktop(TradeMark) software.

An inquiry into chiropractors' intention to treat adolescent idiopathic scoliosis: a telephone survey.

Science.gov (United States)

Feise, R J

2001-01-01

The primary aim of this study was to (1) determine the clinical management approach of practicing chiropractors with regard to patients with adolescent idiopathic scoliosis and (2) measure the response rate of a telephone survey. A survey instrument was developed and pretested, and a case-specific clinical vignette was generated for a hypothetical typical 12-year-old girl with adolescent idiopathic scoliosis. The instrument addressed 3 domains: the specific management of idiopathic scoliosis, elements guiding the general selection of treatment recommendations, and demographics of respondents. The sample frame consisted of 62,000 US chiropractors, of whom 165 were randomly selected for the survey sample. Interviews were conducted by telephone through use of the tested survey instrument. The response rate was 69% (114/165). Of the 51 nonrespondents, 15 did not have a listed business telephone number and 24 were not in active practice. The response rate of those who met the inclusion criteria (practicing chiropractor with a listed telephone number) was 90% (114/126). The gender, chiropractic college, and years in practice of respondents in this survey were similar to those of respondents in 3 other national surveys. In general, the respondents would provide 6 months of "intensive" chiropractic therapy, then follow the patient for 4 years (near skeletal maturity). Eighty-two percent of respondents named diversified technique as their primary adjustive treatment, 87% would use exercise, and 30% would use electric muscle stimulation as an adjunct to manual therapy. Most surveyed chiropractors would use similar methods (frequency and length of treatment, manipulation technique, and exercise) in the treatment of patients with adolescent idiopathic scoliosis. A high response rate to a national survey can be achieved through use of telephone contact.

Efficiency principles of consulting entrepreneurship

OpenAIRE

Moroz Yustina S.; Drozdov Igor N.

2015-01-01

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

Emotion Analysis of Telephone Complaints from Customer Based on Affective Computing.

Science.gov (United States)

Gong, Shuangping; Dai, Yonghui; Ji, Jun; Wang, Jinzhao; Sun, Hai

2015-01-01

Customer complaint has been the important feedback for modern enterprises to improve their product and service quality as well as the customer's loyalty. As one of the commonly used manners in customer complaint, telephone communication carries rich emotional information of speeches, which provides valuable resources for perceiving the customer's satisfaction and studying the complaint handling skills. This paper studies the characteristics of telephone complaint speeches and proposes an analysis method based on affective computing technology, which can recognize the dynamic changes of customer emotions from the conversations between the service staff and the customer. The recognition process includes speaker recognition, emotional feature parameter extraction, and dynamic emotion recognition. Experimental results show that this method is effective and can reach high recognition rates of happy and angry states. It has been successfully applied to the operation quality and service administration in telecom and Internet service company.

Emotion Analysis of Telephone Complaints from Customer Based on Affective Computing

Directory of Open Access Journals (Sweden)

Shuangping Gong

2015-01-01

Full Text Available Customer complaint has been the important feedback for modern enterprises to improve their product and service quality as well as the customer’s loyalty. As one of the commonly used manners in customer complaint, telephone communication carries rich emotional information of speeches, which provides valuable resources for perceiving the customer’s satisfaction and studying the complaint handling skills. This paper studies the characteristics of telephone complaint speeches and proposes an analysis method based on affective computing technology, which can recognize the dynamic changes of customer emotions from the conversations between the service staff and the customer. The recognition process includes speaker recognition, emotional feature parameter extraction, and dynamic emotion recognition. Experimental results show that this method is effective and can reach high recognition rates of happy and angry states. It has been successfully applied to the operation quality and service administration in telecom and Internet service company.

International telemedicine consultations for neurodevelopmental disabilities.

Science.gov (United States)

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

2014-06-01

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

The art of consultation.

Science.gov (United States)

Bhangoo, Kulwant S

2014-05-01

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

78 FR 8032 - Misuse of Internet Protocol (IP) Captioned Telephone Service; Telecommunications Relay Services...

Science.gov (United States)

2013-02-05

... providers to ensure that equipment and software used in conjunction with their service have a default...] Misuse of Internet Protocol (IP) Captioned Telephone Service; Telecommunications Relay Services and Speech-to-Speech Services for Individuals With Hearing and Speech Disabilities AGENCY: Federal...

Tribal Consultation Tracking System

Data.gov (United States)

U.S. Environmental Protection Agency — The consultation-related information the AIEO Consultation Team working with our Tribal Portal contractors has developed a Lotus Notes Database that is capable of...

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

Science.gov (United States)

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

2015-01-01

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

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

Directory of Open Access Journals (Sweden)

Patrick Hoek

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

[Screening for dementia using telephone interviews. An evaluation and reliability study of the Telephone Interview for Cognitive Status (TICS) in its modified German version].

Science.gov (United States)

Matrisch, M; Trampisch, U; Klaassen-Mielke, R; Pientka, L; Trampisch, H J; Thiem, U

2012-04-01

To assess cognitive impairment or dementia in epidemiologic studies using telephone interviews for data acquisition, valid, reliable and short instruments suitable for telephone administration are required. For the Telephone Interview for Cognitive Status (TICS) in its modified German version, the only instrument used in Germany so far, more data on reliability and practicability are needed. Participants were recruited in the offices of nine primary care physicians. Data from 197 participants (115 females, mean age 78.5±4.1 years) who were tested by telephone and in the office by means of the Mini-Mental State Examination (MMSE) were used for the evaluation. For assessing reliability, a group of 91 participants (55 females, mean age 78.1±4.1 years) was contacted twice during 30 days to be tested during a telephone interview by means of the TICS in its modified German version. The intraclass correlation coefficient (ICC), a measure of reliability, was 0.67 [95% confidence interval (CI): 0.53; 0.77]. The Bland-Altman plot did not reveal any relationship between the variability of the difference between repeated measures and the total amount of the measure. For the overall TICS score, no differences were found between repeated measurements. However, the tasks recall of the word list and counting backwards showed some improvement in the repeated tests. TICS and MMSE showed only moderate correlation, with a correlation coefficient of 0.48 (95% CI: 0.36; 0.58). TICS values were dependent on age and educational level of the person tested. The TICS in its modified German version appears to be of acceptable reliability for the assessment of cognitive impairment during a telephone interview. TICS values depend on age and educational level of the person tested. TICS and MMSE correlate only moderately.

Openings and Closings in Telephone Conversations between Native Spanish Speakers.

Science.gov (United States)

Coronel-Molina, Serafin M.

1998-01-01

A study analyzed the opening and closing sequences of 11 dyads of native Spanish-speakers in natural telephone conversations conducted in Spanish. The objective was to determine how closely Hispanic cultural patterns of conduct for telephone conversations follow the sequences outlined in previous research. It is concluded that Spanish…

Maintenance of the telephone exchange in building 40

CERN Multimedia

2006-01-01

In order to secure the power supply of the telephone exchange in building 40, a maintenance will be done on the 18th of December from 7.30 am to 8 am. During this intervention, the fixed telephony services in building 39 and 40 will be interrupted. The fixed telephony services in other CERN buildings won't be affected by this maintenance. The mobile telephony services (GSM) won't be affected. For more details, please send your questions to Standard.Telephone@cern.ch Telecom Services IT/CS

The art of consultation

Directory of Open Access Journals (Sweden)

Kulwant S Bhangoo

2014-01-01

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

Ethics in Management Consulting

OpenAIRE

Carlo Vallini

2007-01-01

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

Why do people consult the doctor?

Science.gov (United States)

Campbell, S M; Roland, M O

1996-02-01

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

Starting a business as a nurse consultant: practical considerations.

Science.gov (United States)

Papp, E M

2000-03-01

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

Maintenance of CERN telephone exchanges

CERN Multimedia

2005-01-01

A maintenance of CERN telephone exchanges will be performed on 21st, 22nd, 23rd, 24th of September from 7 p.m. to 9 p.m. Disturbances or even interruptions of telephony services may occur during this lapse of time. We apology in advance for any inconveniences that this may cause.

Tumour risk associated with use of cellular telephones or cordless desktop telephones

OpenAIRE

Hardell, Lennart; Mild, Kjell Hansson; Carlberg, Michael; Söderqvist, Fredrik

2006-01-01

Abstract Background The use of cellular and cordless telephones has increased dramatically during the last decade. There is concern of health problems such as malignant diseases due to microwave exposure during the use of these devices. The brain is the main target organ. Methods Since the second part of the 1990's we have performed six case-control studies on this topic encompassing use of both cellular and cordless phones as well as other exposures. Three of the studies concerned brain tumo...

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

Science.gov (United States)

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

2018-01-01

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

Influence of Critical Success Factors on Business Development in IT Consulting

Directory of Open Access Journals (Sweden)

Roman Vasiliev

2015-08-01

Full Text Available This study is intended to explore identification and usage of critical success factors in the activity of IT consulting service providers. Critical success factors and their measures are identified at the industrial level. For the corporate level, the study provides recommendations on elaboration of critical success factors for their further usage. Particular attention is paid to the role of critical success factors in activities of IT consulting service providers involving strategic management, project management, partnership and client relations. This issue has become the subject of the study.

Development of a radiation protection competency framework, a consultancies perspective

International Nuclear Information System (INIS)

Bryant, P A

2016-01-01

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

Testing a Model of Functional Impairment in Telephone Crisis Support Workers.

Science.gov (United States)

Kitchingman, Taneile A; Wilson, Coralie J; Caputi, Peter; Wilson, Ian; Woodward, Alan

2017-11-01

It is well known that helping professionals experience functional impairment related to elevated symptoms of psychological distress as a result of frequent empathic engagement with distressed others. Whether telephone crisis support workers are impacted in a similar way is not currently reported in the literature. The purpose of this study was to test a hypothesized model of factors contributing to functional impairment in telephone crisis support workers. A national sample of 210 telephone crisis support workers completed an online survey including measures of emotion regulation, symptoms of general psychological distress and suicidal ideation, intentions to seek help for symptoms, and functional impairment. Structural equation modeling was used to test the fit of the data to the hypothesized model. Goodness-of-fit indices were adequate and supported the interactive effects of emotion regulation, general psychological distress, suicidal ideation, and intentions to seek help for ideation on functional impairment. These results warrant the deliberate management of telephone crisis support workers' impairment through service selection, training, supervision, and professional development strategies. Future research replicating and extending this model will further inform the modification and/or development of strategies to optimize telephone crisis support workers' well-being and delivery of support to callers.

GYNOTEL: telephone advice to gynaecological surgical patients after discharge.

Science.gov (United States)

Caljouw, Monique A A; Hogendorf-Burgers, Marja E H J

2010-12-01

To investigate in surgical gynaecological patients the types of health problems arising or persisting up to six weeks after discharge and the effectiveness of telephone advice. The decreasing length of hospital stay has increased the need for specific instructions about the postdischarge period. Telephone advice could be a valuable tool to address this problem. To our knowledge, postdischarge health problems and the value of telephone advice have not been investigated among gynaecological patients. Randomised controlled trial. Gynaecological patients expected to stay in the ward longer than 24 hour were invited to participate. A pilot study showed that wound healing, pain, mobility, urination, defecation and vaginal bleeding were the most common health problems postdischarge. Based on that information, guidelines were formulated that were used by trained nurses to give telephone advice to the intervention group (n=235), in addition to the usual care. The control group of gynaecological patients (n=233) received usual care only. Of all 468 participants, about 50% were operated for general gynaecology. At discharge, wound pain (56%), mobility problems (54%) and constipation (27%) were the most frequently mentioned problems in both groups. Participants who completely followed the advice with regard to wound healing (p=0.02), pain (p=0.01), vaginal bleeding (p=0.03) and mobility (p=0.04) experienced greater improvement than participants who did not follow, or only partly followed, the advice. The telephone advice appears to make a significant contribution to help gynaecological surgical patients to solve or reduce their postdischarge health problems. The positive effect of such advice can be interpreted as an improvement in the quality of life of the postoperative gynaecological patient. © 2010 Blackwell Publishing Ltd.

Low-Income Demand for Local Telephone Service: Effects of Lifeline and Linkup

OpenAIRE

Daniel Ackerberg; Michael Riordan; Gregory Rosston; Bradley Wimmer

2008-01-01

A comprehensive data set on local telephone service prices is used to evaluate the effect of Lifeline and Linkup programs on the telephone penetration rates of low-income households in the United States. Lifeline and Linkup programs respectively subsidize the monthly subscription and initial installation charges of eligible low-income households. Telephone penetration rates are explained by an estimated nonlinear function of local service characteristics (including subsidized prices) and the ...

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

Science.gov (United States)

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

2015-05-01

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

Survey on the Use of Mobile Telephone for Micro and Small ...

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

Survey on the Use of Mobile Telephone for Micro and Small Business ... In Ghana, as in other developing countries, mobile telephones are pervasive, and used ... to announce that the first call for applications for the new Early Career Women.

Gesturing on the Telephone: Independent Effects of Dialogue and Visibility

Science.gov (United States)

Bavelas, Janet; Gerwing, Jennifer; Sutton, Chantelle; Prevost, Danielle

2008-01-01

Speakers often gesture in telephone conversations, even though they are not visible to their addressees. To test whether this effect is due to being in a dialogue, we separated visibility and dialogue with three conditions: face-to-face dialogue (10 dyads), telephone dialogue (10 dyads), and monologue to a tape recorder (10 individuals). For the…

Telephone switchboard closure | 19 December

CERN Multimedia

2014-01-01

Exceptionally, the telephone switchboard will close at 4 p.m. on Friday, 19 December, instead of the usual time of 6 p.m., to allow time for closing all systems properly before the annual closure. Therefore, switchboard operator assistance to transfer calls from/to external lines will stop. All other phone services will run as usual.

Impact of telephone nursing education program for equity in healthcare.

Science.gov (United States)

Höglund, Anna T; Carlsson, Marianne; Holmström, Inger K; Kaminsky, Elenor

2016-09-21

The Swedish Healthcare Act prescribes that healthcare should be provided according to needs and with respect for each person's human dignity. The goal is equity in health for the whole population. In spite of this, studies have revealed that Swedish healthcare is not always provided equally. This has also been observed in telephone nursing. Therefore, the aim of the present study was to investigate if and how an educational intervention can improve awareness of equity in healthcare among telephone nurses. The study had a quasi-experimental design, with one intervention group and one control group. A base-line measurement was performed before an educational intervention and a follow-up measurement was made afterwards in both groups, using a study specific questionnaire in which fictive persons of different age, gender and ethnicity were assessed concerning, e.g., power over one's own life, quality of life and experience of discrimination. The educational intervention consisted of a web-based lecture, literature and a seminar, covering aspects of inequality in healthcare related to gender, age and ethnicity, and gender and intersectionality theories as explaining models for these conditions. The results showed few significant differences before and after the intervention in the intervention group. Also in the control group few significant differences were found in the second measurement, although no intervention was performed in that group. The reason might be that the instrument used was not sensitive enough to pick up an expected raised awareness of equity in healthcare, or that solely the act of filling out the questionnaire can create a sort of intervention effect. Fictive persons born in Sweden and of young age were assessed to have a higher Good life-index than the fictive persons born outside Europe and of higher age in all assessments. The results are an imperative that equity in healthcare still needs to be educated and discussed in different healthcare

Speech perception and communication ability over the telephone by Mandarin-speaking children with cochlear implants.

Science.gov (United States)

Wu, Che-Ming; Liu, Tien-Chen; Wang, Nan-Mai; Chao, Wei-Chieh

2013-08-01

(1) To understand speech perception and communication ability through real telephone calls by Mandarin-speaking children with cochlear implants and compare them to live-voice perception, (2) to report the general condition of telephone use of this population, and (3) to investigate the factors that correlate with telephone speech perception performance. Fifty-six children with over 4 years of implant use (aged 6.8-13.6 years, mean duration 8.0 years) took three speech perception tests administered using telephone and live voice to examine sentence, monosyllabic-word and Mandarin tone perception. The children also filled out a questionnaire survey investigating everyday telephone use. Wilcoxon signed-rank test was used to compare the scores between live-voice and telephone tests, and Pearson's test to examine the correlation between them. The mean scores were 86.4%, 69.8% and 70.5% respectively for sentence, word and tone recognition over the telephone. The corresponding live-voice mean scores were 94.3%, 84.0% and 70.8%. Wilcoxon signed-rank test showed the sentence and word scores were significantly different between telephone and live voice test, while the tone recognition scores were not, indicating tone perception was less worsened by telephone transmission than words and sentences. Spearman's test showed that chronological age and duration of implant use were weakly correlated with the perception test scores. The questionnaire survey showed 78% of the children could initiate phone calls and 59% could use the telephone 2 years after implantation. Implanted children are potentially capable of using the telephone 2 years after implantation, and communication ability over the telephone becomes satisfactory 4 years after implantation. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

The effect of telephone support on depressive symptoms among HIV-infected pregnant women in Thailand: an embedded mixed methods study.

Science.gov (United States)

Ross, Ratchneewan; Sawatphanit, Wilaiphan; Suwansujarid, Tatirat; Stidham, Andrea W; Drew, Barbara L; Creswell, John W

2013-01-01

Depressive symptoms negatively impact the lives of HIV-infected individuals and are correlated with faster progression to AIDS. Our embedded mixed methods study examined and described the effects of telephone support on depressive symptoms in a sample of HIV-infected pregnant Thai women. HIV-infected pregnant Thai women (n = 40) were randomly assigned to either the control or the intervention group. A registered nurse provided telephone support to the intervention group. Depressive symptoms were measured at three points in both groups. In-depth interviews were conducted at Time 2 and Time 3. Results show that depressive symptoms in the intervention group decreased over time. Qualitative results describe how telephone support can work, but also reveal that telephone support did not work for everyone. We recommend that a larger mixed methods study be conducted to examine the effects of telephone support on depressive symptoms among HIV-infected women, including the costs and benefits of such support. Copyright © 2013 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Some observations of a psychiatric consultant to a hospice.

Science.gov (United States)

Shanfield, S B

1983-01-01

The experience of a psychiatric consultant to the inpatient and bereavement components of a hospice is reported. The bulk of the consultation is to the hospice staff. Activities of the consultant include attendance at a weekly patient care meeting and patient and staff groups, consultation with the bereavement team and the administrative leadership, and the evaluation of patients. Clarification of the inevitable psychologic problems that arise in dealing with the mostly elderly very ill patients with end-stage cancer as well as with their families is a major function. Many of the problems special to the hospice relate to loss, mourning, and death. Psychiatric diagnostic input has been helpful in the treatment of organic and functional psychiatric disorders including the treatment of the emotional components of pain and disordered grief which is manifest as depression. Consultation is provided to individuals at risk of problems in the bereavement period. The psychiatric consultant to a hospice is helpful in establishing and maintaining a sensitive therapeutic system of care for the patient and family. He provides an important presence and a forum for the discussion of psychologic issues for the staff. In addition, he has an important role in clarifying the psychodynamic issues involved with death, loss, and mourning for the patient, family, and staff. He provides input around the treatment of functional and organic psychiatric problems seen in the patient and family. Such activities require the continuing membership and leadership of a psychiatrist on the hospice team. The hospice is a laboratory for the understanding of death, loss, and mourning. Although they have been the subject of much inquiry, these issues can be studied fruitfully at the hospice because of the accessibility to dying patients and the bereaved, both before and after the death of their loved one (Kubler-Ross, 1970; Parkes, 1972; Schoenberg, Carr, Kutscher, Peretz, and Goldberg, 1974; Jacobs and

Microwave radiation safety assessment around mobile telephone base station (MTBS) in Peninsular Malaysia

International Nuclear Information System (INIS)

Mohd Yusof Mohd Ali; Rozaimah Abd Rahim; Roha Tukimin; Mohd Anuar Abd Majid; Mohamad Amirul Nizam Mohamad Thari; Ahmad Fazli Ahmad Sanusi; Roslan Md Dan; Sahirudden Mohd Nor

2006-01-01

Mobile telephone is one of the fastest popular consumer product introduced in the market. Since more people are using mobile telephone, the number of mobile telephone base station (MTBS) in Malaysia had also increased in order to provide a better coverage services to consumer. The antennas that are required for the mobile (or cellular) telephone network are located at MTBS. This antenna emits radio frequency (RF) and microwave (MW) radiation. Due to the concerns that has been raised by the people that are living or working nearby to MTBS about the possibility of adverse health effects that might occur due to the exposure of this radiation, a project of microwave radiation safety assessment around MTBS by MINT was carried out (September 2003 - January 2006). It was involved with 128 MTBS from three biggest service providers in Malaysia. This assessment is required to establish a baseline data in term of pattern and trend of the radiation emission from the facilities as well as to develop a public confident. In this paper, it will describe the fact that radiation is critical to the MTBS system and without the radiation, the MTBS system is functionless. It will also highlight the result of the assessment's work that has been carried out by MINT around MTBS mounted on the rooftops and towers. The average reading varies between the detection limit of the instrument 2 ( 2 (7.204 V/m). The highest average reading corresponds to about 2.0% of the Suruhanjaya Komunikasi dan Multimedia Malaysia (MCMC) exposure limit for public. The finding of this measurement confirms that the presence of RF and MW radiation in public accessible area around the base station was very low and comparable to the radiation levels in other places away from MTBS. There is also no evidence, from any laboratory or epidemiology studies that the exposure to RF energy levels recommended limits has any health significance for humans. (Author)

An Examination of Behavioral Rehearsal During Consultation as a Predictor of Training Outcomes

OpenAIRE

Edmunds, Julie M.; Kendall, Philip C.; Ringle, Vanesa A.; Read, Kendra L.; Brodman, Douglas A.; Pimentel, Sandra S.; Beidas, Rinad S.

2013-01-01

The training literature suggests that ongoing support following initial therapist training enhances training outcomes, yet little is known about what occurs during ongoing support and what accounts for its effectiveness. The present study examined consultation sessions provided to 99 clinicians following training in cognitive-behavioral therapy for youth anxiety. The 104 recorded consultation sessions were coded for content and consultative methods. It was hypothesized that behavioral rehears...

Creating a Business Plan for a Start-up Business Consultancy in Namibia

OpenAIRE

von Wietersheim, Julia

2011-01-01

The objective of this Thesis is to investigate the process of creating an extensive Business Plan and thereby to practically apply the theory studied during the Degree Programme of International Business. To achieve this objective, a practical business plan for a start-up Business Consultancy in Namibia (called VW-Business Consulting) is created, which at the same time provides a deeper understanding of the current demand for, and awareness of, business consulting companies in Namibia. An...

PhysioDirect: Supporting physiotherapists to deliver telephone assessment and advice services within the context of a randomised trial

Science.gov (United States)

Bishop, Annette; Gamlin, Jill; Hall, Jeanette; Hopper, Cherida; Foster, Nadine E.

2013-01-01

Physiotherapy-led telephone assessment and advice services for patients with musculoskeletal problems have been developed in many services in the UK, but high quality trial data on clinical and cost effectiveness has been lacking. In order to address this ‘The PhysioDirect trial’ (ISRCTN55666618), was a pragmatic randomised trial of a PhysioDirect telephone assessment and advice service. This paper describes the PhysioDirect system used in the trial and how physiotherapists were trained and supported to use the system and deliver the PhysioDirect service. The PhysioDirect system used in the trial was developed in Huntingdon and now serves a population of 350,000 people. When initiating or providing physiotherapy-led telephone assessment and advice services training and support for physiotherapists delivering care in this way is essential. An enhanced skill set is required for telephone assessment and advice particularly in listening and communication skills. In addition to an initial training programme, even experienced physiotherapists benefit from a period of skill consolidation to become proficient and confident in assessing patients and delivering care using the telephone. A computer-based system assists the delivery of a physiotherapy-led musculoskeletal assessment and advice service. Clinical Trials Registration Number (ISRCTN55666618). PMID:23219629

Examining adherence to components of cognitive-behavioral therapy for youth anxiety after training and consultation.

Science.gov (United States)

Edmunds, Julie M; Brodman, Douglas M; Ringle, Vanesa A; Read, Kendra L; Kendall, Philip C; Beidas, Rinad S

2017-02-01

The present study examined 115 service providers' adherence to components of cognitive-behavioral therapy (CBT) for youth anxiety prior to training, post workshop training, and after three months of weekly consultation. Adherence was measured using a role-play with a trained actor. We examined differences in individual adherence to CBT components across time and the relationship between number of consultation sessions attended and adherence ratings following consultation. Findings indicated that somatic arousal identification and relaxation were the most used treatment components prior to training. Adherence to all components of CBT increased following workshop training, except the usage of problem-solving. Adherence to problem-solving, positive reinforcement, the identification of anxious self-talk, and the creation of coping thoughts increased following consultation but usage of problem-solving remained low compared to other treatment components. Overall adherence remained less than optimal at the final measurement point. Number of consultation sessions attended predicted post-consultation adherence to identification of somatic arousal, identification of anxious self-talk, and positive reinforcement. Implications include tailoring future training based on baseline levels of adherence and spending more time during training and consultation on underutilized CBT components, such as problem-solving. Limitations of the present study, including how adherence was measured, are discussed. This study adds to the implementation science literature by providing more nuanced information on changes in adherence over the course of training and consultation of service providers.

75 FR 13471 - Telephone Consumer Protection

Science.gov (United States)

2010-03-22

... Consumer Protection Act (TCPA) that would harmonize those rules with the Federal Trade Commission's (FTC's... Consumer Protection Act (TCPA) that would harmonize those rules with the Federal Trade Commission's (FTC's...] Telephone Consumer Protection AGENCY: Federal Communications Commission. ACTION: Proposed rule. SUMMARY: In...

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

Science.gov (United States)

Barker, Randolph T.; Gower, Kim

2009-01-01

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

Evaluation of a telephone advice nurse in a nursing faculty managed pediatric community clinic.

Science.gov (United States)

Beaulieu, Richard; Humphreys, Janice

2008-01-01

Nurse-managed health centers face increasing obstacles to financial viability. Efficient use of clinic resources and timely and appropriate patient care are necessary for sustainability. A registered nurse with adequate education and support can provide high-quality triage and advice in community-based practice sites. The purpose of this program evaluation was to examine the effect of a telephone advice nurse service on parent/caregiver satisfaction and access to care. A quasi-experimental separate pre-post sample design study investigated parent/caregiver satisfaction with a telephone advice nurse in an urban pediatric nurse-managed health center. The clinic medical information system was used to retrieve client visit data prior to the service and in the first year of the program. Statistically significant differences were found on two items from the satisfaction with the advice nurse survey: the reason for calling (P decision making (P nurse may increase both parent/caregiver and provider satisfaction and access to care.

47 CFR 22.925 - Prohibition on airborne operation of cellular telephones.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Prohibition on airborne operation of cellular... CARRIER SERVICES PUBLIC MOBILE SERVICES Cellular Radiotelephone Service § 22.925 Prohibition on airborne operation of cellular telephones. Cellular telephones installed in or carried aboard airplanes, balloons or...

Recruiting to Clinical Trials on the Telephone - a randomized controlled trial

DEFF Research Database (Denmark)

Foss, Kim Thestrup; Kjærgaard, Jesper; Stensballe, Lone Graff

2016-01-01

BACKGROUND: Informed consent is an essential element of clinical research. Obtaining consent, however, may be challenging. The use of the telephone for giving information and obtaining consent may be practical but little formal research has been done. METHODS: We examined the use of the telephone...

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

NARCIS (Netherlands)

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

Consultation on urological specimens from referred cancer patients using real-time digital microscopy: Optimizing the workflow

Directory of Open Access Journals (Sweden)

Henrik Holten-Rossing

2016-01-01

Full Text Available Introduction: Centralization of cancer treatment entails a reassessment of the diagnostic tissue specimens. Packaging and shipment of glass slides from the local to the central pathology unit means that the standard procedure is time-consuming and that it is difficult to comply with governmental requirements. The aim was to evaluate whether real-time digital microscopy for urological cancer specimens during the primary diagnostic process can replace subsequent physical slide referral and reassessment without compromising diagnostic safety. Methods: From May to October 2014, tissue specimens from 130 patients with urological cancer received at Næstved Hospital′s Pathology Department, and expected to be referred for further treatment at cancer unit of a university hospital, were diagnosed using standard light microscopy. In the event of diagnostic uncertainty, the VisionTek digital microscope (Sakura Finetek was employed. The Pathology Department at Næstved Hospital was equipped with a digital microscope and three consultant pathologists were stationed at Rigshospitalet with workstations optimized for digital microscopy. Representative slides for each case were selected for consultation and live digital consultation took place over the telephone using remote access software. Time of start and finish for each case was logged. For the physically referred cases, time from arrival to sign-out was logged in the national pathology information system, and time spent on microscopy and reporting was noted manually. Diagnosis, number of involved biopsies, grade, and stage were compared between digital microscopy and conventional microscopy. Results: Complete data were available for all 130 cases. Standard procedure with referral of urological cancer specimens took a mean of 8 min 56 s for microscopy, reporting and sign-out per case. For live digital consultations, a mean of 18 min 37 s was spent on each consultation with 4 min 43 s for each case

The Price per Prospective Consumer of Providing Therapist Training and Consultation in Seven Evidence-Based Treatments within a Large Public Behavioral Health System: An Example Cost-Analysis Metric

Directory of Open Access Journals (Sweden)

Kelsie H. Okamura

2018-01-01

Full Text Available ObjectivePublic-sector behavioral health systems seeking to implement evidence-based treatments (EBTs may face challenges selecting EBTs given their limited resources. This study describes and illustrates one method to calculate cost related to training and consultation to assist system-level decisions about which EBTs to select.MethodsTraining, consultation, and indirect labor costs were calculated for seven commonly implemented EBTs. Using extant literature, we then estimated the diagnoses and populations for which each EBT was indicated. Diagnostic and demographic information from Medicaid claims data were obtained from a large behavioral health payer organization and used to estimate the number of covered people with whom the EBT could be used and to calculate implementation-associated costs per consumer.ResultsFindings suggest substantial cost to therapists and service systems related to EBT training and consultation. Training and consultation costs varied by EBT, from Dialectical Behavior Therapy at $238.07 to Cognitive Behavioral Therapy at $0.18 per potential consumer served. Total cost did not correspond with the number of prospective consumers served by an EBT.ConclusionA cost-metric that accounts for the prospective recipients of a given EBT within a given population may provide insight into how systems should prioritize training efforts. Future policy should consider the financial burden of EBT implementation in relation to the context of the population being served and begin a dialog in creating incentives for EBT use.

Evaluation of a wireless audio streaming accessory to improve mobile telephone performance of cochlear implant users.

Science.gov (United States)

Wolfe, Jace; Morais Duke, Mila; Schafer, Erin; Cire, George; Menapace, Christine; O'Neill, Lori

2016-01-01

The objective of this study was to evaluate the potential improvement in word recognition in quiet and in noise obtained with use of a Bluetooth-compatible wireless hearing assistance technology (HAT) relative to the acoustic mobile telephone condition (e.g. the mobile telephone receiver held to the microphone of the sound processor). A two-way repeated measures design was used to evaluate differences in telephone word recognition obtained in quiet and in competing noise in the acoustic mobile telephone condition compared to performance obtained with use of the CI sound processor and a telephone HAT. Sixteen adult users of Nucleus cochlear implants and the Nucleus 6 sound processor were included in this study. Word recognition over the mobile telephone in quiet and in noise was significantly better with use of the wireless HAT compared to performance in the acoustic mobile telephone condition. Word recognition over the mobile telephone was better in quiet when compared to performance in noise. The results of this study indicate that use of a wireless HAT improves word recognition over the mobile telephone in quiet and in noise relative to performance in the acoustic mobile telephone condition for a group of adult cochlear implant recipients.

75 FR 78269 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Telephone...

Science.gov (United States)

2010-12-15

... for OMB Review; Comment Request; Telephone Point of Purchase Survey ACTION: Notice. SUMMARY: The... information collection request (ICR) titled, ``Telephone Point of Purchase Survey,'' to the Office [email protected] . SUPPLEMENTARY INFORMATION: The purpose of the Telephone Point of Purchase Survey is to...

CONFUSION WITH TELEPHONE NUMBERS

CERN Multimedia

Telecom Service

2002-01-01

he area code is now required for all telephone calls within Switzerland. Unfortunately this is causing some confusion. CERN has received complaints that incoming calls intended for CERN mobile phones are being directed to private subscribers. This is caused by mistakenly dialing the WRONG code (e.g. 022) in front of the mobile number. In order to avoid these problems, please inform your correspondents that the correct numbers are: 079 201 XXXX from Switzerland; 0041 79 201 XXXX from other countries. Telecom Service

Data collection in consultation-liaison psychiatry: an evaluation of Casemix.

Science.gov (United States)

Ellen, Steven; Lacey, Cameron; Kouzma, Nadya; Sauvey, Nick; Carroll, Rhonda

2006-03-01

To evaluate the usefulness of Casemix as a data collection system for consultation-liaison psychiatry services. Health information staff were requested to code psychiatric assessments and diagnosis prospectively for admissions to the Alfred Hospital, Melbourne, between July 2002 and June 2004 using Casemix. Psychiatric assessments were requested on 2.5% of all hospital admissions (n = 2575). Casemix provided extensive demographic and hospital unit data for referred patients, is easy to set up, and is cost-free for the psychiatry service. Casemix can provide extensive meaningful data for consultation-liaison psychiatry services that could assist in the argument for greater funding of these services.

Time to go global: a consultation on global health competencies for postgraduate doctors

Science.gov (United States)

Walpole, Sarah C.; Shortall, Clare; van Schalkwyk, May CI; Merriel, Abi; Ellis, Jayne; Obolensky, Lucy; Casanova Dias, Marisa; Watson, Jessica; Brown, Colin S.; Hall, Jennifer; Pettigrew, Luisa M.; Allen, Steve

2016-01-01

Background Globalisation is having profound impacts on health and healthcare. We solicited the views of a wide range of stakeholders in order to develop core global health competencies for postgraduate doctors. Methods Published literature and existing curricula informed writing of seven global health competencies for consultation. A modified policy Delphi involved an online survey and face-to-face and telephone interviews over three rounds. Results Over 250 stakeholders participated, including doctors, other health professionals, policymakers and members of the public from all continents of the world. Participants indicated that global health competence is essential for postgraduate doctors and other health professionals. Concerns were expressed about overburdening curricula and identifying what is ‘essential’ for whom. Conflicting perspectives emerged about the importance and relevance of different global health topics. Five core competencies were developed: (1) diversity, human rights and ethics; (2) environmental, social and economic determinants of health; (3) global epidemiology; (4) global health governance; and (5) health systems and health professionals. Conclusions Global health can bring important perspectives to postgraduate curricula, enhancing the ability of doctors to provide quality care. These global health competencies require tailoring to meet different trainees' needs and facilitate their incorporation into curricula. Healthcare and global health are ever-changing; therefore, the competencies will need to be regularly reviewed and updated. PMID:27241136

Assessment of real exposure to GSM mobile telephones using the SYRPOM

International Nuclear Information System (INIS)

Picard, D.; Fouquet, L.; Chauvin, S.

2013-01-01

A mobile telephone user's exposure to the radio-frequency electromagnetic field depends heavily on the power their telephone radiates, which can vary widely according to requests from the base station. This study presents the design and development of a system called System for Radiated Power Measurement (SYRPOM), which measures the power radiated by a mobile telephone. This study also describes the tests carried out on the system itself and gives the results of two measuring campaigns it has been possible to perform in this way. The first such campaign consisted of assessing the mean power received by a typical mobile telephone user carrying out various activities. The second campaign was aimed at (1) comparing the mean radiated power when stationary and when moving and (2) assessing and contrasting different models of handsets in terms of the mean radiated power. The SYRPOM has proved to be a flexible, easy-to-use high-performance and innovative tool for carrying out this kind of studies. (authors)

Research in medical imaging and the role of the consultant radiographer: A discussion

International Nuclear Information System (INIS)

Reeves, Pauline J.

2008-01-01

This article examines the need for research in radiography as a means to provide the evidence base for radiographic practice. The review examines the role of the consultant radiographer in providing potential research leadership and outlines possible avenues for research. The article uses three main themes to set out its proposals: - The need for patient focus. - The need for a greater mix of research methods and, specifically, more studies which utilise qualitative methods. - The need for consultant leadership in research and some potential studies. The article concludes by arguing the need for a greater academic community in radiography with consultant radiographers stepping up to play their part in that community

Establishing specialized health services for professional consultation in euthanasia: experiences in the Netherlands and Belgium

Directory of Open Access Journals (Sweden)

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

Dynamics of psychological crisis experience with psychological consulting by gestalt therapy methods.

Science.gov (United States)

Fahrutdinova, Liliya Raifovna; Nugmanova, Dzhamilia Renatovna

2015-01-01

Dynamics of experience as such and its corporeal, emotional and cognitive elements in the situation of psychological consulting provisioning is covered. The aim of research was to study psychological crisis experience dynamics in the situation when psychological consulting by gestalt therapy methods is provided. Theoretical analysis of the problem of crisis situations, phenomenon and structural, and dynamic organization of experience of the subject of consulting have been carried out. To fulfill research project test subjects experience crisis situation have been selected, studied in the situation when they provided psychological consulting by methods of gestalt therapy, and methodology of study of crisis situations experience has been prepared. Specifics of psychological crisis experience have been revealed and its elements in different stages of psychological consulting by gestalt therapy methods. Dynamics of experience of psychological crisis and its structural elements have been revealed and reliable changes in it have been revealed. Dynamics of psychological crisis experience and its structural elements have been revealed and reliable changes in it have been revealed. "Desiccation" of experience is being observed, releasing its substantiality of negative impression to the end of consulting and development of the new experience of control over crisis situation. Interrelations of structural elements of experience in the process of psychological consulting have been shown. Effecting one structure causes reliable changes in all others structural elements of experience. Giving actual psychological help to clients in crisis situation by methods of gestalt therapy is possible as it was shown in psychological consulting sessions. Structure of client's request has been revealed - problems of personal sense are fixed as the most frequent cause of clients' applications, as well as absence of choices, obtrusiveness of negative thoughts, tend to getting stuck on events

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

Directory of Open Access Journals (Sweden)

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.

78 FR 78389 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Telephone...

Science.gov (United States)

2013-12-26

... for OMB Review; Comment Request; Telephone Point of Purchase Survey ACTION: Notice. SUMMARY: The... request (ICR) revision titled, ``Telephone Point of Purchase Survey,'' to the Office of Management and... seeks to make minor modifications to the Telephone Point of Purchase Survey (TPOPS) and extend its PRA...

Investigating the validity and usability of an interactive computer programme for assessing competence in telephone-based mental health triage.

Science.gov (United States)

Sands, Natisha; Elsom, Stephen; Keppich-Arnold, Sandra; Henderson, Kathryn; King, Peter; Bourke-Finn, Karen; Brunning, Debra

2016-02-01

Telephone-based mental health triage services are frontline health-care providers that operate 24/7 to facilitate access to psychiatric assessment and intervention for people requiring assistance with a mental health problem. The mental health triage clinical role is complex, and the populations triage serves are typically high risk; yet to date, no evidence-based methods have been available to assess clinician competence to practice telephone-based mental health triage. The present study reports the findings of a study that investigated the validity and usability of the Mental Health Triage Competency Assessment Tool, an evidence-based, interactive computer programme designed to assist clinicians in developing and assessing competence to practice telephone-based mental health triage. © 2015 Australian College of Mental Health Nurses Inc.

Factors influencing the current practice of self-medication consultations in Eastern Indonesian community pharmacies: a qualitative study.

Science.gov (United States)

Brata, Cecilia; Fisher, Colleen; Marjadi, Brahmaputra; Schneider, Carl R; Clifford, Rhonda M

2016-05-13

Research has shown that the current practice of pharmacy staff when providing self-medication consultations in Indonesia is suboptimal. To improve the performance of pharmacy staff when providing self-medication consultations in community pharmacies, the factors that influence current practice need to be understood. The aim of this study is to identify the factors that influence current practice of pharmacy staff when handling self-medication consultations in Eastern Indonesian community pharmacies. Fifteen in-depth interviews were conducted with pharmacists, pharmacy technicians, pharmacy owners, and counter attendants. Thematic analysis was used to generate findings. The current practice of pharmacy staff when handling self-medication consultations is directly influenced by the professionalism of pharmacy staff and patient responses to the consultations. These factors are in turn affected by the organisational context of the pharmacy and the external pharmacy environment. The organisational context of the pharmacy includes staffing, staff affordability, and the availability of time and facilities in which to provide consultations. The external pharmacy environment includes the number of trained pharmacy staff in the research setting, the relevance of pharmacy education to the needs of pharmacy practice, the support offered by the Indonesian Pharmacists Association, a competitive business environment, and the policy environment. Complex and inter-related factors influence the current practice of pharmacy staff when providing self-medication consultations in community pharmacies in this research setting. Multiple strategies will be required to improve consultation practices.

Validation of a telephone screening test for Alzheimer's disease.

Science.gov (United States)

Camozzato, Ana Luiza; Kochhann, Renata; Godinho, Claudia; Costa, Amanda; Chaves, Marcia L

2011-03-01

Financial constraints, mobility issues, medical conditions, crime in local areas can make cognitive assessment difficult for elders and telephone interviews can be a good alternative. This study was carried out to evaluate the reliability, validity and clinical utility of a Brazilian telephone version of the Mini Mental State Examination (Braztel-MMSE) in a community sample of healthy elderly participants and AD patients. The MMSE and the Braztel-MMSE were applied to 66 AD patients and 67 healthy elderly participants. The test-retest reliability was strong and significant (r = .92, p = .01), and the correlation between the Braztel-MMSE and the MMSE were significant (p = .01) and strong (r = .92). The general screening ability of the Braztel-MMSE was high (AUC = 0.982; CI95% = 0.964-1.001). This telephone version can therefore be used as a screening measure for dementia in older adults that need neuropsychological screening and cannot present for an evaluation.

CONFUSION WITH TELEPHONE NUMBERS

CERN Multimedia

Telecom Service

2002-01-01

The area code is now required for all telephone calls within Switzerland. Unfortunately this is causing some confusion. CERN has received complaints that incoming calls intended for CERN mobile phones are being directed to private subscribers. This is caused by mistakenly dialing the WRONG code (e.g. 022) in front of the mobile number. In order to avoid these problems, please inform your correspondents that the correct numbers are: 079 201 XXXX from Switzerland; 0041 79 201 XXXX from other countries. Telecom Service  

Effects of a Mail and Telephone Intervention on Breast Health Behaviors

Science.gov (United States)

Bowen, Deborah J.; Powers, Diane

2010-01-01

This study evaluated a mail and telephone intervention to improve breast health behaviors while maintaining quality of life. Women recruited from the general public were randomized to a stepped-intensity intervention consisting of mailings, telephone calls, and counseling (if requested or appropriate given a woman's genetic risk for breast cancer)…

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

OpenAIRE

Wiertelak, Eric P.

2012-01-01

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

Breastfeeding knowledge, attitudes, and practices among providers in a medical home.

Science.gov (United States)

Szucs, Kinga A; Miracle, Donna J; Rosenman, Marc B

2009-03-01

Breastfeeding offers numerous health advantages to children, mothers, and society. From obstetrics to pediatrics, breastfeeding dyads come in contact with a wide range of healthcare providers. The American Academy of Pediatrics (AAP) calls for pediatricians to support breastfeeding enthusiastically and for all children to have a medical home. We studied an inner-city healthcare system with a Dyson Community Pediatrics Training Initiative Model Medical Home clinic, to explore how a breastfeeding/baby-friendly medical home might be built upon this framework. We describe breastfeeding knowledge, attitudes, and practices among a full range of providers and healthcare system-level barriers to effective and coordinated breastfeeding services. We conducted eight focus groups using semistructured interviews: (1) pediatricians; (2) obstetricians; (3) pediatric nurses and allied health professionals; (4) obstetric nurses and allied health professionals; (5) 24-hour telephone triage answering service nurses; (6) public health nurses; (7) Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) personnel; and (8) lactation consultants and peer counselors. We identified gaps in providers' breastfeeding knowledge, counseling skills, and professional education and training. Providers' cultures and attitudes affect breastfeeding promotion and support. Providers used their own breastfeeding experiences to replace evidence-based knowledge and AAP policy statement recommendations for breastfeeding dyads. There were communication disconnects between provider groups. Providers underestimated their own, and overestimated others', influence on breastfeeding. The system lacked a coordinated breastfeeding mission. This study illuminated key disconnectedness challenges (and, hence, opportunities) for a model medical home in fostering continuous, comprehensive, coordinated, culturally effective, and evidence-based breastfeeding promotion and support.

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

CERN Multimedia

Ignacio Reguero, IT Department

2016-01-01

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

34 CFR 75.191 - Consultation costs.

Science.gov (United States)

2010-07-01

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

Weighting Strategies for Combining Data from Dual-Frame Telephone Surveys: Emerging Evidence from Australia

Directory of Open Access Journals (Sweden)

Baffour Bernard

2016-09-01

Full Text Available Until quite recently, telephone surveys have typically relied on landline telephone numbers. However, with the increasing popularity and affordability of mobile phones, there has been a surge in households that do not have landline connections. Additionally, there has been a decline in the response rates and population coverage of landline telephone surveys, creating a challenge to collecting representative social data. Dual-frame telephone surveys that use both landline and mobile phone sampling frames can overcome the incompleteness of landline-only telephone sampling. However, surveying mobile phone users introduces new complexities in sampling, nonresponse measurement and statistical weighting. This article examines these issues and illustrates the consequences of failing to include mobile-phone-only users in telephone surveys using data from Australia. Results show that there are significant differences in estimates of populations’ characteristics when using information solely from the landline or mobile telephone sample. These biases in the population estimates are significantly reduced when data from the mobile and landline samples are combined and appropriate dual-frame survey estimators are used. The optimal choice of a dual-frame estimation strategy depends on the availability of good-quality information that can account for the differential patterns of nonresponse by frame.

The role of culture in the general practice consultation process.

Science.gov (United States)

Ali, Nasreen; Atkin, Karl; Neal, Richard

2006-11-01

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

Academic Development for Careers in Management Consulting

Science.gov (United States)

Adams, Susan M.; Zanzi, Alberto

2004-01-01

Explores the extent to which academic offerings are serving the consulting industry and identifies ways that academia can help. The numbers of management consulting courses, field experiences in consulting and consulting concentrations by graduate business schools were tracked over a three-year period to assess the current state of offerings. A…

Consultations

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

IDRC CRDI

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

Using Videoconferencing Technology to Provide Breastfeeding Support to Low-Income Women: Connecting Hospital-Based Lactation Consultants with Clients Receiving Care at a Community Health Center.

Science.gov (United States)

Friesen, Carol A; Hormuth, Laura J; Petersen, Devan; Babbitt, Tina

2015-11-01

The Tele-Lactation Pilot Project (TLPP), 1 of 13 community-based breastfeeding projects implemented in Indiana in 2013 using Centers for Disease Control and Prevention grant funds, explored the feasibility of using videoconferencing technology to provide breastfeeding education and support to low-income women by a centrally located International Board Certified Lactation Consultant (IBCLC). The IBCLC was housed at the Breastfeeding Center at the hospital where the women would deliver; the women receiving the education and support were located at an inner-city community health center (CHC) where they received their primary care. The videoconferencing sessions were juxtaposed with the women's regularly scheduled prenatal and postnatal visits at the CHC. After delivery, the lactation consultant visited the mother and infant in person at the hospital to offer additional support. Overall, 35 mothers were served by the TLPP during the 9-month project period. A total of 134 visits (30-45 minutes each) were conducted (3.8 sessions per woman). At the conclusion of the project, interviews with key participants indicated that the tele-lactation videoconferencing sessions were easy to implement, allowed the IBCLC to reach a wider client base, and allowed the women to receive expert support that they might not have otherwise received. Comments indicated that, in addition to providing education and increasing the women's confidence, the tele-lactation sessions appeared to have decreased the mothers' anxiety about the birthing process and the hospital experience. The TLPP demonstrated that incorporating videoconferencing technology into routine care can help foster collaboration among health care providers and provide mothers with continuous, easily accessible breastfeeding education and support. © The Author(s) 2015.

15 CFR 923.57 - Continuing consultation.

Science.gov (United States)

2010-01-01

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

Learning to consult with computers.

Science.gov (United States)

Liaw, S T; Marty, J J

2001-07-01

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

Improving Posthospital Discharge Telephone Reach Rates Through Prehospital Discharge Face-to-Face Meetings.

Science.gov (United States)

Vergara, Franz H; Sheridan, Daniel J; Sullivan, Nancy J; Budhathoki, Chakra

The purpose of this study was to determine whether a face-to-face meeting with patients by a telephonic case manager prehospital discharge would result in increased telephone follow-up (TFU) reach rates posthospital discharge. Acute care adult medicine inpatient units. A quasiexperimental design was utilized. Two adult inpatient medicine units were selected as the intervention and comparison groups. The framework of the study is the transitions theory. A convenience sampling technique was used, whereby 88 eligible patients on the intervention unit received face-to-face meetings prehospital discharge whereas 123 patients on the comparison unit received standard care (no face-to-face meetings). Cross-tabulation and chi-square tests were employed to examine the association of face-to-face meeting intervention and TFU reach rates. Implementing brief (face-to-face meetings by a telephonic case manager prehospital discharge resulted in a TFU reach rate of 87% on the intervention unit, whereas the comparison unit only had a 58% TFU reach rate (p communication with more patients posthospital discharge. A brief prehospital discharge face-to-face meeting with patients assisted them to understand the reasons for a posthospital discharge telephone call, identified the best times to call using accurate telephone numbers, and taught patients how best to prepare for the call. In addition, by meeting patients face-to-face, the telephonic case manager was no longer an unknown person on the telephone asking them questions about their medical condition. These factors combined may have significantly helped to increase TFU reach rates.

Role of Laryngological Consultation in the Intervention of Dysphonia

Science.gov (United States)

Stone, Ed.; And Others

1978-01-01

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

Mapping crime scenes and cellular telephone usage

CSIR Research Space (South Africa)

Schmitz, Peter MU

2000-12-01

Full Text Available This paper describes a method that uses a desktop geographical information system (GIS) to plot cellular telephone conversations made when crimes are committed, such as hijackings, hostage taking, kidnapping, rape and murder. The maps produced...

Making consultations run smoothly

DEFF Research Database (Denmark)

Jespersen, Astrid Pernille; Elgaard Jensen, Torben

2012-01-01

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

Assessing the quality of pharmacist answers to telephone drug information questions.

Science.gov (United States)

Woodward, C T; Stevenson, J G; Poremba, A

1990-04-01

A quality assurance (QA) program is described in which frontline pharmacists were asked test drug information questions via anonymous telephone calls. The program was instituted at a university hospital that began providing decentralized pharmaceutical services in 1985. Questions were developed on the basis of a pilot study conducted to determine the types and complexity of drug information questions received by frontline pharmacists at the hospital. Data on departmental clinical productivity were used to determine the number of questions that would be posed during each shift in the various service areas. The questions were posed during a 10-day period; the pharmacists were aware of the program, but the callers did not identify their affiliation with it. In response to 105 questions asked, 86 were judged to have been answered correctly, 13 answers were deemed incomplete, and 6 were judged incorrect. Pharmacists were more likely to respond incorrectly to complex questions and questions posed during the night shift. As a result of the audit, staff members with advanced clinical knowledge were asked to help less experienced pharmacists, the position of assistant director for drug information and staff development was created, and educational programs were instituted. The QA audit has been repeated twice. Posing test drug information questions via anonymous telephone calls is effective in assessing the quality of drug information provided by pharmacists in patient-care areas.

76 FR 18457 - Regulatory Review Schedule; Tribal Consultation

Science.gov (United States)

2011-04-04

... that the NIGC provide tribal gaming commissions access to licensing information via an online database... DEPARTMENT OF THE INTERIOR National Indian Gaming Commission 25 CFR Chapter III Regulatory Review Schedule; Tribal Consultation AGENCY: National Indian Gaming Commission. ACTION: Notice of Regulatory...

Consultation document Energy Market Concentrations

International Nuclear Information System (INIS)

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

2006-06-01

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

Which Benefits and Harms of Using Fenugreek as a Galactogogue Need to Be Discussed during Clinical Consultations? A Delphi Study among Breastfeeding Women, Gynecologists, Pediatricians, Family Physicians, Lactation Consultants, and Pharmacists

Science.gov (United States)

Qiblawi, Sara; Ghanayem, Haifa

2018-01-01

Background Breastfeeding women with hypogalactia are commonly recommended to use fenugreek as a galactogogue. This study aimed to achieve formal consensus among breastfeeding women and healthcare providers on which potential harms and benefits of using fenugreek need to be communicated and discussed during clinical consultations. Methods A two-iterative round Delphi technique was used in two separate panels of breastfeeding women (n = 65) and healthcare providers (n = 56) to achieve formal consensus on a list of 24 and 16 items related to potential harms and benefits of fenugreek. Results About 70% of the healthcare providers recommended quite often herbal remedies for breastfeeding women and about 68% of the women had been recommended to use herbal remedies many times by their healthcare providers. Consensus was achieved on 21 potential harms and 14 potential benefits of using fenugreek to enhance human milk supply that need to be discussed with breastfeeding women during consultations. Conclusion Probably, potential harms and benefits of recommending fenugreek as herbal galactogogue for breastfeeding women seeking recommendations to increase their human milk supply need to be discussed during clinical consultations. Further observational studies are needed to assess what is being discussed in daily consultations when herbal remedies are recommended. PMID:29849697

Postpartum consultation: Occurrence, requirements and expectations

Directory of Open Access Journals (Sweden)

Carlgren Ingrid

2008-07-01

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

Knowledge Sharing in IT Consultant and SME Interactions

Directory of Open Access Journals (Sweden)

Adrian Bradshaw

2015-10-01

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

Work on the CERN telephone exchanges

CERN Multimedia

2006-01-01

Corrective maintenance work on the CERN telephone exchanges will be carried out on 13th March 2006, resulting in service interruptions across the west area of the Meyrin site between 9.00 p.m. and 11.00 p.m. We apologise for any inconvenience this may cause. CERN TELECOM Service Tel.: 76111 GSM: 160101

Maintenance of CERN telephone exchanges - erratum

CERN Document Server

2005-01-01

The next maintenance of CERN telephone exchanges will be performed on 19th, 20th, 21st, and 22nd of September from 7 p.m. to 9 p.m. Disturbances or even interruptions of telephony services may occur during this lapse of time. We apology in advance for any inconveniences that this may cause.

47 CFR 36.331 - Information origination/termination expenses-Account 6310 (Class B telephone companies); Accounts...

Science.gov (United States)

2010-10-01

... telephone companies). (a) The expenses in this account are classified as follows: (1) Other Information... 47 Telecommunication 2 2010-10-01 2010-10-01 false Information origination/termination expenses-Account 6310 (Class B telephone companies); Accounts 6311, 6341, 6351, and 6362 (Class A telephone...

Political consultation and large-scale research

International Nuclear Information System (INIS)

Bechmann, G.; Folkers, H.

1977-01-01

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

Telephone operator change: your questions answered

CERN Multimedia

CERN Bulletin

2015-01-01

CERN will be changing mobile telephone operators on 24 June. As the community prepares for the summer switchover, everyone has questions. What brought on the change? Why are we losing our old phone numbers? What kind of improvements will we see? "Just as with every contract at CERN, we issue calls for tenders every few years to ensure we are still receiving the best possible service," explains Tony Cass, from the Communication Systems group within the IT department. "As we came to the end of our contract with Sunrise, we put out a call for tenders, which was won by Swisscom. Not only is their pricing more competitive, they will also be providing better service conditions." The scope of these new service conditions is multifaceted: there will be improvements to the redundancy and reliability of the network as well as modern 4G network coverage in the LHC tunnel. "People will also see their mobile phone bills decrease," says Tony. "This will esp...

DESIGN AND DEVELOPMENT OF A REMOTE MEDICAL CONSULTATION SYSTEM

Directory of Open Access Journals (Sweden)

"A. Delrobaee

2006-05-01

Full Text Available Telemedicine is an indispensable tool in the hands of doctors to accelerate and facilitate the process of data interchange. To publicize and distribute the culture of utilizing this technology and providing the necessary equipment for this purpose and also to commence some useful activities in this field of science in Iran, the researchers group have designed and performed a telemedicine internet site with the goal of medical consultation. Software was designed and prepared, which is accessible to three groups of users with definite level of access for each one: normal users, doctors and site administrators. There are four main forums on this website with the following titles: medical consultation (Q&A, doctors’ special forum, scientific and research centers and also special disease groups, and the forum of graduates and medical students. Ultimately, we could achieve a new horizon to expand telemedicine activities in the field of medical consultation. A free web-based system was developed through the address of www.teleteb.com with the aim of remote medical consultation, developing the public health services and creating a powerful scientific and research link in the society of medicine.

Understanding the consultation processes

International Nuclear Information System (INIS)

Laing, A.C.

1998-01-01

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

Practical and ethical considerations for using social media in community consultation and public disclosure activities.

Science.gov (United States)

Galbraith, Kyle L

2014-10-01

Social media are becoming increasingly integrated into both the clinical and the research dimensions of emergency medicine. They can provide methods for sharing crucial information to targeted individuals or groups in a rapid fashion. As a result, investigators conducting emergency research under the exception from prospective informed consent requirements are beginning to turn to social media platforms as they engage in required community consultation and public disclosure activities before their research begins. At present, there are limited data regarding how effectively social media have been used for performing those consultation and disclosure activities. This article offers investigators four specific areas to consider before using social media in consultation and outreach efforts. First, understand the forms of outreach social media platforms can provide. Second, recognize how those outreach methods relate to the specific goals of community consultation and public disclosure. Third, consider whether or not the intended audiences of community consultation and public disclosure will be available via social media. Finally, think about how social media outreach efforts will be measured and assessed before consultation and disclosure activities are under way. © 2014 by the Society for Academic Emergency Medicine.

Telephone Crisis Support Workers' Intentions to Use Recommended Skills While Experiencing Functional Impairment.

Science.gov (United States)

Kitchingman, Taneile A; Wilson, Coralie J; Woodward, Alan; Caputi, Peter; Wilson, Ian

2018-05-01

Empathic engagement with distressed others can lead to elevated symptoms of psychological distress and functional impairment, which preclude helping professionals' delivery of optimal patient care. Whether telephone crisis support workers are impacted in a similar way is not currently reported in the literature. This study examined the relationship between functional impairment and intentions to use recommended support skills in a representative national sample of 210 telephone crisis support workers. Participants completed an online survey including measures of functional impairment and intentions to use recommended telephone crisis support skills with callers reporting suicidal ideation, symptoms of depression, and anxiety. As a group, participants who experienced greater functional impairment during the past month reported significantly lower intentions to use recommended support skills with callers than those who reported lower functional impairment. Future research is needed to clarify the extent to which results generalize to telephone crisis support workers from other organizations. Results warrant further research to (a) identify determinants of telephone crisis support workers' functional impairment, and (b) for the deliberate management of telephone crisis support workers' functional impairment through developing and/or modifying existing service strategies to optimize workers' psychological well-being and delivery of support to callers.

Communication and Consultation with Interested Parties by the Regulatory Body. General Safety Guide

International Nuclear Information System (INIS)

2017-01-01

This Safety Guide provides recommendations on meeting the safety requirements concerning communication and consultation with the public and other interested parties by the regulatory body about the possible radiation risks associated with facilities and activities, and about processes and decisions of the regulatory body. The Safety Guide can be used by authorized parties in circumstances where there are regulatory requirements placed on them for communication and consultation. It may also be used by other organizations or individuals considering their responsibilities for communication and consultation with interested parties.

Interventions before consultations for helping patients address their information needs.

Science.gov (United States)

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

2007-07-18

patient satisfaction (SMD 0.09 (95% CI 0.03 to 0.16)). There was a notable but not statistically significant decrease in patient anxiety before consultations (weighted mean difference (WMD) -1.56 (95% CI -7.10 to 3.97)). There were small and not statistically significant changes in patient anxiety after consultations (reduced) (SMD -0.08 (95%CI -0.22 to 0.06)), patient knowledge (reduced) (SMD -0.34 (95% CI -0.94 to 0.25)), and consultation length (increased) (SMD 0.10 (95% CI -0.05 to 0.25)). Further analyses showed that both coaching and written materials produced similar effects on question asking but that coaching produced a smaller increase in consultation length and a larger increase in patient satisfaction. Interventions immediately before consultations led to a small and statistically significant increase in consultation length, whereas those implemented some time before the consultation had no effect. Both interventions immediately before the consultation and those some time before it led to small increases in patient satisfaction, but this was only statistically significant for those immediately before the consultation. There appear to be no clear benefits from clinician training in addition to patient interventions, although the evidence is limited. Interventions before consultations designed to help patients address their information needs within consultations produce limited benefits to patients. Further research could explore whether the quality of questions is increased, whether anxiety before consultations is reduced, the effects on other outcomes and the impact of training and the timing of interventions. More studies need to consider the timing of interventions and possibly the type of training provided to clinicians.

Nuclear consultant - a new profession

International Nuclear Information System (INIS)

Hardung von Hardung, H.

1976-01-01

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

Nuclear consultant: a new profession

Energy Technology Data Exchange (ETDEWEB)

Hardung von Hardung, H

1976-02-01

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

Mobile and cordless telephones, serum transthyretin and the blood-cerebrospinal fluid barrier: a cross-sectional study

Directory of Open Access Journals (Sweden)

Carlberg Michael

2009-04-01

Full Text Available Abstract Background Whether low-intensity radiofrequency radiation damages the blood-brain barrier has long been debated, but little or no consideration has been given to the blood-cerebrospinal fluid barrier. In this cross-sectional study we tested whether long-term and/or short-term use of wireless telephones was associated with changes in the serum transthyretin level, indicating altered transthyretin concentration in the cerebrospinal fluid, possibly reflecting an effect of radiation. Methods One thousand subjects, 500 of each sex aged 18–65 years, were randomly recruited using the population registry. Data on wireless telephone use were assessed by a postal questionnaire and blood samples were analyzed for serum transthyretin concentrations determined by standard immunonephelometric techniques on a BN Prospec® instrument. Results The response rate was 31.4%. Logistic regression of dichotomized TTR serum levels with a cut-point of 0.31 g/l on wireless telephone use yielded increased odds ratios that were statistically not significant. Linear regression of time since first use overall and on the day that blood was withdrawn gave different results for males and females: for men significantly higher serum concentrations of TTR were seen the longer an analogue telephone or a mobile and cordless desktop telephone combined had been used, and in contrast, significantly lower serum levels were seen the longer an UMTS telephone had been used. Adjustment for fractions of use of the different telephone types did not modify the effect for cumulative use or years since first use for mobile telephone and DECT, combined. For women, linear regression gave a significant association for short-term use of mobile and cordless telephones combined, indicating that the sooner blood was withdrawn after the most recent telephone call, the higher the expected transthyretin concentration. Conclusion In this hypothesis-generating descriptive study time since first

30 CFR 56.12069 - Lightning protection for telephone wires and ungrounded conductors.

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Lightning protection for telephone wires and... NONMETAL MINES Electricity § 56.12069 Lightning protection for telephone wires and ungrounded conductors... lightning shall be equipped with suitable lightning arrestors of approved type within 100 feet of the point...

30 CFR 57.12069 - Lightning protection for telephone wires and ungrounded conductors.

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Lightning protection for telephone wires and... AND NONMETAL MINES Electricity Surface Only § 57.12069 Lightning protection for telephone wires and... exposed to lightning shall be equipped with suitable lightning arrestors of approved type within 100 feet...

Engineering Consultancy: An Assessment of IT-enabled International Delivery of Services

DEFF Research Database (Denmark)

Baark, Erik

1999-01-01

The delivery of engineering consultancy services in global markets has been dominated by a small group of firms located in Europe and the US. Like many other service industries, engineering consultants have depended on the movement of highly qualified people and establishment of local affiliates...... services in arms-length transactions across national borders does not appear to have been significantly exploited. Nevertheless, IT-enabled delivery of engineering consultancy services opens up possibilities for business process reengineering that may provide some firms new competitive advantages in global...... markets and lead to further integration of design and construction in partnerships or project consortia, or in the strengthening of design-build approaches in project execution....

Vascular neurology nurse practitioner provision of telemedicine consultations.

Science.gov (United States)

Demaerschalk, Bart M; Kiernan, Terri-Ellen J; Investigators, Starr

2010-01-01

Objective. The objective was to define and evaluate a role for the Vascular Neurology-Nurse Practitioner (VN-NP) in the delivery of telemedicine consultations in partnership with a vascular neurologist. Methods. Prospective stroke alert patients at participating hospitals underwent a two-way audio video telemedicine consultation with a VN-NP at a remotely located stroke center in partnership with a vascular neurologist. Demographic information, National Institutes of Health Stroke Scale (NIHSS) scores, diagnoses, CT contraindications to thrombolysis, thrombolysis eligibility, and time interval data were collected. The inter-rater agreement between VN-NP and vascular neurologist assessments was calculated. Results. Ten patients were evaluated. Four were determined to have ischemic stroke, one had a transient ischemic attack, two had intracerebral hemorrhages, and three were stroke mimics. Overall, three patients received thrombolysis. The inter-rater agreement between VN-NP and vascular neurologist assessments were excellent, ranging from 0.9 to 1.0. The duration of VN-NP consultation was 53.2 +/- 9.0 minutes, which included the vascular neurologist supervisory evaluation time of 12.0 +/- 9.6 minutes. Conclusion. This study illustrated that a stroke center VN-NP, in partnership with a vascular neurologist, could deliver timely telemedicine consultations, accurate diagnoses, and correct treatments in acute stroke patients who presented to remotely located rural emergency departments within a hub and spoke network. VN-NPs may fulfill the role of a telestroke provider.

SOME INDICATORS OF CONSULTATIVE SERVICES DEVELOPMENT IN SERBIA

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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.

Consultation with First Nations stakeholders : an Alberta perspective

Energy Technology Data Exchange (ETDEWEB)

Rutwind, S. [Alberta Justice, Edmonton, AB (Canada). Aboriginal Law

2005-07-01

Aboriginal issues present risks and challenges to resource development in Alberta. This paper provided an overview of significant precedents and acts which may impact on oil and gas activities. The Constitution Act of 1982 acknowledged that existing Aboriginal and treaty rights of the Aboriginal peoples of Canada were recognized and confirmed. In the case of R v. Sparrow, justification was established where there was a valid legislative objective, such as conservation and resource management, and a precedent was set regarding the interpretation of disputes of section 35 subsection 1 concerning legal restriction of the exercise of treaty rights, such as hunting and fishing. In R v. Badger, the Supreme Court of Canada (SCC) advised that the framework applied to treaty rights as well as Aboriginal rights. The Natural Resources Transfer Agreement transferred powers over natural resources from Canada to Alberta in relation to hunting rights. Proof of rights issues were discussed in Taku River Tlingit First Nation v. Tulesequa Chief Mine Project, as well as in Haida Nation v. British Columbia, where it was concluded that an Aboriginal right need not be proven before a duty to consult arises. A review of Alberta's consultation practices was presented, as well as the Aboriginal issues and resource development initiative, which recognizes the importance of consultation with affected Aboriginal people and communities when regulatory and development activities infringe their existing treaty and other constitutional rights, such as the rights to hunt, fish and trap for food. Details of the Consultation Coordination Group were presented. A draft of the Government of Alberta's First Nations Consultation Policy on Land Management and Resource Development was also presented. tabs, figs.

Strangers at the Benchside: Research Ethics Consultation

Science.gov (United States)

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

2008-01-01

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

Aspects of statistical consulting not taught by acedemia

DEFF Research Database (Denmark)

Kenett, R.; Thyregod, Poul

2006-01-01

Education in statistics is preparing for statistical analysis but not necessarily for statistical consulting. The objective of this paper is to explore the phases that precede and follow statistical analysis. Specifically these include: problem elicitation, data collection and, following statisti......Education in statistics is preparing for statistical analysis but not necessarily for statistical consulting. The objective of this paper is to explore the phases that precede and follow statistical analysis. Specifically these include: problem elicitation, data collection and, following...... statistical data analysis, formulation of findings, and presentation of findings, and recommendations. Some insights derived from a literature review and real-life case studies are provided. Areas for joint research by statisticians and cognitive scientists are outlined....

Telephone reminders reduced the non-attendance rate in a gastroenterology outpatient clinic.

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Jeppesen, Maja Haunstrup; Ainsworth, Mark Andrew

2015-06-01

Non-attendance is a global health-care problem. The aim of the present study was 1) to investigate if a telephone reminder could reduce the non-attendance rate, 2) to study reasons for non-attendance and 3) to evaluate if a permanent implementation would be economically advantageous in a gastroenterology outpatient clinic like ours. This was a comparative intervention study with a historical control group in a gastroenterology outpatient clinic. The study lasted six months. Patients with a scheduled appointment in the first three-month period received no reminder (control group, n = 2,705). Patients in the following three-month period were reminded by telephone one weekday in advance of their appointment, when possible (intervention group, n = 2,479). Non-attending patients in the intervention group received a questionnaire. Based on the results, a financial cost-benefit analysis was made. In the intervention group, 1,577 (64%) patients answered the reminder telephone call. The non-attendance rate was significantly lower in the intervention group (6.1%) than in the control group (10.5%) (p < 0.00001). Only 1.3% of the patients who answered the reminder turned out to be non-attendees. The most common explanation for non-attendance in the intervention group was forgetfulness (39%). The reminder telephone call was cost-effective. In this outpatient clinic, telephone reminders were cost-effective and significantly reduced the non-attendance rate by 43%.

Mentoring Alternative Certification Teachers: Implementing an Online Collaborative Consultation Community

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Dukes, Lyman, III; Jones, Brett D.

2007-01-01

Online discussion boards have the potential to provide significant support to beginning teachers; thus, we designed an online collaborative consultation community to provide mentor support to university students enrolled in an alternative certification program. The results suggest that although students in alternative certification programs will…

75 FR 8112 - In the Matter of Certain Mobile Telephones and Wireless Communication Devices Featuring Digital...

Science.gov (United States)

2010-02-23

... importation of certain mobile telephones and wireless communication devices featuring digital cameras, and... importation of certain mobile telephones or wireless communication devices featuring digital cameras, or... INTERNATIONAL TRADE COMMISSION [Inv. No. 337-TA-703] In the Matter of Certain Mobile Telephones...

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

Science.gov (United States)

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

2018-04-01

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

A Mental Health Consultation Program for Project Head Start.

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Kawin, Marjorie R.

The Psychological Center provided a family oriented mental health consultation service to 17 delegate agencies who had contracts with Head Start programs in 1966-67. This paper presents an overview of the services which an interdisciplinary staff of 52 professionals provided to 6,780 families and 1,500 agency staff members. Gerald Caplan's (1964)…

Effects of cellular telephone manipulation on driver`s performance; Jidosha untenchu no keitai denwa shiyo sosa ni kanrensuru mondai no kenkyu

Energy Technology Data Exchange (ETDEWEB)

Tokunaga, R; Ozawa, M; Hagiwara, T [Hokkaido University, Sapporo (Japan); Takagi, H; Shimojo, A [Civil Engineering Research Institute of Hokkaido, Hokkaido (Japan)

1997-10-01

The present evaluates effects of cellular telephone manipulation on driver`s performance. The major independent variables were the reaction time and the mental workload. Hart et al. proposed the concept of the subjective mental workload. Experiments were conduced using a driving simulator without motion. Findings showed that the hands free system may provide less effect than the cellular telephone on the passenger seat on driver`s reaction time and mental workload. 4 refs., 2 tabs., 5 figs.

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

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

2009-06-01

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

Survey of patients' view on functional split of consultant psychiatrists.

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Begum, Millia; Brown, Keith; Pelosi, Anthony; Crabb, Jim; McTaggart, John; Mitchell, Caroline; Julyan, Everett; Donegan, Tony; Gotz, Michael

2013-09-27

The functional split model of consultant psychiatrist care for inpatients has been one of the major service redesign that has occurred in the NHS in the last decade. It is unclear if this new split model offers any advantages over the previous sectorised model of working. More recent evidence has suggested that patients, carers and professionals have varied views regarding the benefits of this model. This survey of patient's views on models of consultant working is the first in Scotland and we have attempted to include a large sample size. The results suggest that after providing sufficient information on both models, the majority of patients from various Scottish health boards have opted for the traditional sectorised model of working. During a four week period consecutive patients across 4 health boards attending the General Adult consultant outpatient clinics and those who were admitted to their inpatient ward were offered a structured questionnaire regarding their views on the functional split versus traditional sectorised model. Space was provided for additional comments. The study used descriptive statistical measures for analysis of its results. Ethical approval was confirmed as not being required for this survey of local services. We had a response rate of 67%. A significant majority (76%) of service users across the four different health boards indicated a preference for the same consultant to manage their care irrespective of whether they were an inpatient or in the community (Chi-squared = 65, df = 1, p survey suggests that most patients prefer the traditional model where they see a single consultant throughout their journey of care. The views of patients should be sought as much as possible and should be taken into account when considering the best way to organize psychiatric services.

Consultancy As Employment Options for Library And Information ...

African Journals Online (AJOL)

If pursued independently it can actually function as an 'employer of labour and developed further to provide services both within and outside the immediate library environment. This paper examines the nature and prospects of consultancy as a suitable employment option for graduates of library and information science.

Improving Indonesian Construction Consulting Services

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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.

Browsing for the Best Internet Access Provider?

Science.gov (United States)

Weil, Marty

1996-01-01

Highlights points to consider when choosing an Internet Service Provider. Serial Line Internet Protocol (SLIP) and Point to Point Protocol (PPP) are compared regarding price, performance, bandwidth, speed, and technical support. Obtaining access via local, national, consumer online, and telephone-company providers is discussed. A pricing chart and…

Structured telephone support or non-invasive telemonitoring for patients with heart failure.

Science.gov (United States)

Inglis, Sally C; Clark, Robyn A; Dierckx, Riet; Prieto-Merino, David; Cleland, John G F

2015-10-31

Specialised disease management programmes for heart failure aim to improve care, clinical outcomes and/or reduce healthcare utilisation. Since the last version of this review in 2010, several new trials of structured telephone support and non-invasive home telemonitoring have been published which have raised questions about their effectiveness. To review randomised controlled trials (RCTs) of structured telephone support or non-invasive home telemonitoring compared to standard practice for people with heart failure, in order to quantify the effects of these interventions over and above usual care. We updated the searches of the Cochrane Central Register of Controlled Trials (CENTRAL), Database of Abstracts of Reviews of Effects (DARE), Health Technology AsseFssment Database (HTA) on the Cochrane Library; MEDLINE (OVID), EMBASE (OVID), CINAHL (EBSCO), Science Citation Index Expanded (SCI-EXPANDED), Conference Proceedings Citation Index- Science (CPCI-S) on Web of Science (Thomson Reuters), AMED, Proquest Theses and Dissertations, IEEE Xplore and TROVE in January 2015. We handsearched bibliographies of relevant studies and systematic reviews and abstract conference proceedings. We applied no language limits. We included only peer-reviewed, published RCTs comparing structured telephone support or non-invasive home telemonitoring to usual care of people with chronic heart failure. The intervention or usual care could not include protocol-driven home visits or more intensive than usual (typically four to six weeks) clinic follow-up. We present data as risk ratios (RRs) with 95% confidence intervals (CIs). Primary outcomes included all-cause mortality, all-cause and heart failure-related hospitalisations, which we analysed using a fixed-effect model. Other outcomes included length of stay, health-related quality of life, heart failure knowledge and self care, acceptability and cost; we described and tabulated these. We performed meta-regression to assess homogeneity (the

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

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La Via, Jennifer; Schiedermayer, David

2012-01-01

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

Hospitalist Perspective of Interactions with Medicine Subspecialty Consult Services.

Science.gov (United States)

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

2018-05-01

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

Compensation Consultants and CEO Pay

NARCIS (Netherlands)

Kabir, Mohammed Rezaul; Minhat, Marizah

2014-01-01

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

The Lawyer-Therapist Consultation Team.

Science.gov (United States)

Korelitz, Ann; Schulder, Diane

1982-01-01

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

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

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van Dulmen Sandra

2010-11-01

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

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

Science.gov (United States)

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

2017-08-01

Consultation of a nephrologist is important in aligning care for patients with chronic kidney disease (CKD) at the primary-secondary care interface. However, current consultation methods come with practical difficulties that can lead to postponed consultation or patient referral instead. This study aimed to investigate whether a web-based consultation platform, telenephrology, led to a lower referral rate of indicated patients. Furthermore, we assessed consultation rate, quality of care, costs and general practitioner (GPs') experiences with telenephrology. Cluster randomized controlled trial with 47 general practices in the Netherlands was randomized to access to telenephrology or to enhanced usual care. A total of 3004 CKD patients aged 18 years or older who were under primary care were included (intervention group n = 1277, control group n = 1727) and 2693 completed the trial. All practices participated in a CKD management course and were given an overview of their CKD patients. The referral rates amounted to 2.3% (n = 29) in the intervention group and 3.0% (n = 52) in the control group, which was a non-significant difference, OR 0.61; 95% CI 0.31 to 1.23. The intervention group's consultation rate was 6.3% (n = 81) against 5.0% (n = 87) (OR 2.00; 95% CI 0.75-5.33). We found no difference in quality of care or costs. The majority of GPs had a positive opinion about telenephrology. The data in our study do not allow for conclusions on the effect of telenephrology on the rate of patient referrals and provider-to-provider consultations, compared to conventional methods. It was positively evaluated by GPs and was non-inferior in terms of quality of care and costs. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Telephone delivered interventions for reducing morbidity and mortality in people with HIV infection.

Science.gov (United States)

Gentry, Sarah; van-Velthoven, Michelle H M M T; Tudor Car, Lorainne; Car, Josip

2013-05-31

This is one of three Cochrane reviews examining the role of the telephone in HIV/AIDS services. Telephone interventions, delivered either by landline or mobile phone, may be useful in the management of people living with HIV (PLHIV) in many situations. Telephone delivered interventions have the potential to reduce costs, save time and facilitate more support for PLHIV. To assess the effectiveness of voice landline and mobile telephone delivered interventions for reducing morbidity and mortality in people with HIV infection. We searched The Cochrane Central Register of Controlled Trials, MEDLINE, PubMed Central, EMBASE, PsycINFO, ISI Web of Science, Cumulative Index to Nursing & Allied Health, World Health Organisation's The Global Health Library and Current Controlled Trials from 1980 to June 2011. We searched the following grey literature sources: Dissertation Abstracts International, Centre for Agriculture Bioscience International Direct Global Health database, The System for Information on Grey Literature Europe, The Healthcare Management Information Consortium database, Google Scholar, Conference on Retroviruses and Opportunistic Infections, International AIDS Society, AIDS Educational Global Information System and reference lists of articles. Randomised controlled trials (RCTs), quasi-randomised controlled trials, controlled before and after studies, and interrupted time series studies comparing the effectiveness of telephone delivered interventions for reducing morbidity and mortality in persons with HIV infection versus in-person interventions or usual care, regardless of demographic characteristics and in all settings. Both mobile and landline telephone interventions were included, but mobile phone messaging interventions were excluded. Two reviewers independently searched, screened, assessed study quality and extracted data. Primary outcomes were change in behaviour, healthcare uptake or clinical outcomes. Secondary outcomes were appropriateness of the

Analyzing empowerment oriented email consultation for parents : Development of the Guiding the Empowerment Process model

NARCIS (Netherlands)

dr. Christa C.C. Nieuwboer

2014-01-01

Background. Online consultation is increasingly offered by parenting practitioners, but it is not clear if it is feasible to provide empowerment oriented support in single session email consultation. Method. Based on empowerment theory we developed the Guiding the Empowerment Process model (GEP

Core Competencies for Training Effective School Consultants

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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…