WorldWideScience

Sample records for surveys consulting experts

  1. Medical Expert Systems Survey

    OpenAIRE

    Abu-Nasser, Bassem S.

    2017-01-01

    International audience; There is an increase interest in the area of Artificial Intelligence in general and expert systems in particular. Expert systems are rapidly growing technology. Expert system is a branch of Artificial Intelligence which is having a great impact on many fields of human life. Expert systems use human expert knowledge to solve complex problems in many fields such as Health, science, engineering, business, and weather forecasting. Organizations employing the technology of ...

  2. Expert system for skin problem consultation in Thai traditional ...

    African Journals Online (AJOL)

    Materials and Methods: The tool selected for developing the expert system is a software program written in the PHP language. MySQL database is used to work together with PHP for building database of the expert system. The system is ... The developed system was considered good for learning and consultation.

  3. Expert consultation on risk factors for introduction of infectious pathogens into fish farms.

    Science.gov (United States)

    Oidtmann, Birgit C; Peeler, Edmund J; Thrush, Mark A; Cameron, Angus R; Reese, R Allan; Pearce, Fiona M; Dunn, Peter; Lyngstad, Trude M; Tavornpanich, Saraya; Brun, Edgar; Stärk, Katharina D C

    2014-08-01

    An expert consultation was conducted to provide quantitative parameters required to inform risk-based surveillance of aquaculture holdings for selected infectious hazards. The hazards were four fish diseases endemic in some or several European countries: infectious salmon anaemia (ISA), viral haemorrhagic septicaemia (VHS), infectious haematopoietic necrosis (IHN), and koi herpes virus disease (KHD). Experts were asked to provide estimates for the relative importance of 5 risk themes for the hazard to be introduced into and infect susceptible fish at the destination. The 5 risk themes were: (1) live fish and egg movements; (2) exposure via water; (3) on-site processing; (4) short distance mechanical transmission and (5) distance independent mechanical transmission. The experts also provided parameter estimates for hazard transmission pathways within the themes. The expert consultation was undertaken in a 2 step approach: an online survey followed by an expert consultation meeting. The expert opinion indicated that live fish movements and exposure via water were the major relevant risk themes. Experts were recruited from several European countries and thus covered a range of farming systems. Therefore, the outputs from the expert consultation have relevance for the European context. Crown Copyright © 2014. Published by Elsevier B.V. All rights reserved.

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

    NARCIS (Netherlands)

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

    2009-01-01

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

  5. Expert system for skin problem consultation in Thai traditional medicine.

    Science.gov (United States)

    Nopparatkiat, Pornchai; na Nagara, Byaporn; Chansa-ngavej, Chuvej

    2014-01-01

    This paper aimed to demonstrate the research and development of a rule-based expert system for skin problem consulting in the areas of acne, melasma, freckle, wrinkle, and uneven skin tone, with recommended treatments from Thai traditional medicine knowledge. The tool selected for developing the expert system is a software program written in the PHP language. MySQL database is used to work together with PHP for building database of the expert system. The system is web-based and can be reached from anywhere with Internet access. The developed expert system gave recommendations on the skin problem treatment with Thai herbal recipes and Thai herbal cosmetics based on 416 rules derived from primary and secondary sources. The system had been tested by 50 users consisting of dermatologists, Thai traditional medicine doctors, and general users. The developed system was considered good for learning and consultation. The present work showed how such a scattered body of traditional knowledge as Thai traditional medicine and herbal recipes could be collected, organised and made accessible to users and interested parties. The expert system developed herein should contribute in a meaningful way towards preserving the knowledge and helping promote the use of Thai traditional medicine as a practical alternative medicine for the treatment of illnesses.

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

    Science.gov (United States)

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

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

  7. Combining continuing education with expert consultation via telemedicine in Cambodia.

    Science.gov (United States)

    Engle, Xavier; Aird, James; Tho, Ly; Bintcliffe, Fiona; Monsell, Fergal; Gollogly, Jim; Noor, Saqib

    2014-04-01

    Telemedicine has the potential to increase access to both clinical consultation and continuing medical education in Cambodia. We present a Cambodian surgical centre's experience with a collaboration in which complicated orthopaedic cases were presented to a panel of consultants using free online videoconferencing software, providing a combined opportunity for both continuing education and the enhancement of patient care. Effects of the case conference on patient care were examined via a retrospective review and clinician perspectives were elicited via a qualitative survey. The case conference altered patient care in 69% of cases. All Cambodian staff reported learning from the conference and 78% reported changes in their care for patients not presented at the conference. Real-time videoconferencing between consultants in the developed world and physicians in a developing country may be an effective, low-cost and easily replicable means of combining direct benefits to patient care with continuing medical education.

  8. 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.

  9. Towards a consensus definition of maternal sepsis: results of a systematic review and expert consultation.

    Science.gov (United States)

    Bonet, Mercedes; Nogueira Pileggi, Vicky; Rijken, Marcus J; Coomarasamy, Arri; Lissauer, David; Souza, João Paulo; Gülmezoglu, Ahmet Metin

    2017-05-30

    There is a need for a clear and actionable definition of maternal sepsis, in order to better assess the burden of this condition, trigger timely and effective treatment and allow comparisons across facilities and countries. The objective of this study was to review maternal sepsis definitions and identification criteria and to report on the results of an expert consultation to develop a new international definition of maternal sepsis. All original and review articles and WHO documents, as well as clinical guidelines providing definitions and/or identification criteria of maternal sepsis were included. A multidisciplinary international panel of experts was surveyed through an online consultation in March-April 2016 on their opinion on the existing sepsis definitions, including new definition of sepsis proposed for the adult population (2016 Third International Consensus Definitions for Sepsis and Septic Shock) and importance of different criteria for identification of maternal sepsis. The definition was agreed using an iterative process in an expert face-to-face consensus development meeting convened by WHO and Jhpiego. Standardizing the definition of maternal sepsis and aligning it with the current understanding of sepsis in the adult population was considered a mandatory step to improve the assessment of the burden of maternal sepsis by the expert panel. The literature review and expert consultation resulted in a new WHO consensus definition "Maternal sepsis is a life-threatening condition defined as organ dysfunction resulting from infection during pregnancy, child-birth, post-abortion, or post-partum period". Plans are in progress to validate the new WHO definition of maternal sepsis in a large international population. The operationalization of the new maternal sepsis definition requires generation of a set of practical criteria to identify women with sepsis. These criteria should enable clinicians to focus on the timely initiation of actionable elements of

  10. 75 FR 65014 - Science Advisory Board Staff Office Request for Nominations of Experts for the Consultation on...

    Science.gov (United States)

    2010-10-21

    ... AGENCY Science Advisory Board Staff Office Request for Nominations of Experts for the Consultation on... Protection Agency (EPA). ACTION: Notice. SUMMARY: The EPA Science Advisory Board (SAB) Staff Office is... appropriate SAB Staff Office procedural policies. The Federal Inter-Agency Multi-Agency Radiation Survey and...

  11. Analysis and Lessons Learned from an Online, Consultative Dialogue between Community Leaders and Climate Experts

    Science.gov (United States)

    Sylak-Glassman, E.; Clavin, C.

    2016-12-01

    Common approaches to climate resilience planning in the United States rely upon participatory planning approaches and dialogues between decision-makers, science translators, and subject matter experts. In an effort to explore alternative approaches support community climate resilience planning, a pilot of a public-private collaboration called the Resilience Dialogues was held in February and March of 2016. The Resilience Dialogues pilot was an online, asynchronous conversation between community leaders and climate experts, designed to help communities begin the process of climate resilience planning. In order to identify lessons learned from the pilot, we analyzed the discourse of the facilitated dialogues, administered surveys and conducted interviews with participants. Our analysis of the pilot suggests that participating community leaders found value in the consultative dialogue with climate experts, despite limited community-originated requests for climate information. Community leaders most often asked for advice regarding adaptation planning, including specific engineering guidance and advice on how to engage community members around the topic of resilience. Community leaders that had access to downscaled climate data asked experts about how to incorporate the data into their existing planning processes. The guidance sought by community leaders during the pilot shows a large range of hurdles that communities face in using climate information to inform their decision-making processes. Having a forum that connects community leaders with relevant experts and other community leaders who have familiarity with both climate impacts and municipal planning processes would likely help communities accelerate their resilience efforts.

  12. Collaborating to develop joint water, sanitation and hygiene (WASH) and neglected tropical disease (NTD) sector monitoring: an expert consultation.

    Science.gov (United States)

    Waite, Robyn C; Woods, Geordie; Velleman, Yael; Freeman, Matthew C

    2017-07-01

    Joint monitoring between the water, sanitation and hygiene (WASH) and neglected tropical disease (NTD) sectors presents an opportunity for enhanced collaboration and progress towards shared objectives. Taking forward outputs from global WASH and NTD Roundtables, we engaged experts in a consultative process of identifying measurable priority indicators for joint monitoring. We used a Delphi method for conducting expert consultation and developing consensus. Experts were invited to participate through purposive and snowball sampling, and open solicitation at key sector meetings. Participating WASH and NTDs experts represented a diversity of interest groups, including NTD and WASH field staff and government stakeholders from endemic countries, bilateral and multilateral development agencies, non-governmental organizations, and academic institutions. Four rounds of consultation were conducted via online surveys. Between 55 and 69 experts participated in each round of consultation. Seven core measurable indicators emerged as priorities for inclusion in joint monitoring for the NTD sector. Our findings provide insight on the development and implementation of joint monitoring frameworks that can be integrated into existing programme level monitoring.

  13. Energy Efficiency Policy in Arizona Public Participation and Expert Consultation in the Policy Implementation Process

    Science.gov (United States)

    Bryck, Drew

    Many different levels of government, organizations, and programs actively shape the future of energy in Arizona, a state that lacks a comprehensive energy plan. Disparate actions by multiple actors may slow the energy policy process rather than expedite it. The absence of a state energy policy or plan raises questions about how multiple actors and ideas engage with state energy policy development and whether the absence of a comprehensive state plan can be understood. Improving how policy development is conceptualized and giving more focused attention to the mechanisms by which interested parties become involved in shaping Arizona energy policy. To explore these questions, I examine the future energy efficiency. Initially, public engagement mechanisms were examined for their role in policy creation from a theoretical perspective. Next a prominent public engagement forum that was dedicated to the topic of the Arizona's energy future was examined, mapping its process and conclusions onto a policy process model. The first part of this thesis involves an experimental expert consultation panel which was convened to amplify and refine the results of a public forum. The second part utilizes an online follow up survey to complete unfinished ideas from the focus group. The experiment flowed from a hypothesis that formal expert discussion on energy efficiency policies, guided by the recommendations put forth by the public engagement forum on energy in Arizona, would result in an increase in relevance while providing a forum for interdisciplinary collaboration that is atypical in today's energy discussions. This experiment was designed and evaluated utilizing a public engagement framework that incorporated theoretical and empirical elements. Specifically, I adapted elements of three methods of public and expert engagement used in policy development to create a consultation process that was contextualized to energy efficiency stakeholders in Arizona and their unique

  14. What is agenda setting in the clinical encounter? Consensus from literature review and expert consultation.

    Science.gov (United States)

    Gobat, Nina; Kinnersley, Paul; Gregory, John W; Robling, Michael

    2015-07-01

    To establish consensus on the core domains of agenda setting in consultations. We reviewed the healthcare literature and, using a modified Delphi technique to embrace both patient and clinician perspectives, conducted an iterative online survey, with 30 experts in health communication. Participants described agenda setting and rated the importance of proposed domains. Consensus was determined where the group median was ≥5 on a 7-point Likert-like response scale, and the interquartile range fell to within one point on this scale. Relevant publications were identified in three overlapping bodies of healthcare literature. Survey respondents considered that agenda setting involved a process whereby patients and clinicians establish a joint focus for both their conversation and their working relationship. Consensus was obtained on six core domains: identifying patient talk topics, identifying clinician talk topics, agreement of shared priorities, establishing conversational focus, collaboration and engagement. New terminology--agenda mapping and agenda navigation--is proposed. We identified core agenda setting domains that embraced patient and clinician perspectives. An integrated conceptualization of agenda setting may now be used by researchers and educators in both clinician and patient focused interventions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. Do forensic practitioners distinguish between testifying and consulting experts? A pilot study.

    Science.gov (United States)

    Gutheil, Thomas Gordon; Commons, Michael Lamport; Drogin, Eric Y; Hauser, Mark J; Miller, Patrice Marie; Richardson, Andrew Michael

    2012-01-01

    Forensic mental health professionals (n=44) reviewed a series of statements that an attorney might make to a consulting or testifying expert. Each statement was rated for its degree of appropriateness to either the consulting or the testifying role. In light of increasing attention paid to this topic in the forensic practice literature, as well as long-standing distinctions recognized by the legal profession, it was originally hypothesized that participants would differentiate clearly between these roles; however, results of this pilot study indicate that forensic practitioners do not possess a consistent sense of which activities rest most comfortably within testimonial as opposed to consulting duties. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. Papers presented at the Expert Consultation on Economic Incentives and Responsible Fisheries: Rome, 28 November-1 December, 2000

    National Research Council Canada - National Science Library

    2001-01-01

    This document contains the papers submitted by the FAO Secretariat and resource persons to the Expert Consultation on Economic Incentives and Responsible Fisheries, held in Rome form 28 Novembre to 1 December 2000...

  17. A novel AIDS/HIV intelligent medical consulting system based on expert systems.

    Science.gov (United States)

    Ebrahimi, Alireza Pour; Toloui Ashlaghi, Abbas; Mahdavy Rad, Maryam

    2013-01-01

    The purpose of this paper is to propose a novel intelligent model for AIDS/HIV data based on expert system and using it for developing an intelligent medical consulting system for AIDS/HIV. In this descriptive research, 752 frequently asked questions (FAQs) about AIDS/HIV are gathered from numerous websites about this disease. To perform the data mining and extracting the intelligent model, the 6 stages of Crisp method has been completed for FAQs. The 6 stages include: Business understanding, data understanding, data preparation, modelling, evaluation and deployment. C5.0 Tree classification algorithm is used for modelling. Also, rational unified process (RUP) is used to develop the web-based medical consulting software. Stages of RUP are as follows: Inception, elaboration, construction and transition. The intelligent developed model has been used in the infrastructure of the software and based on client's inquiry and keywords related FAQs are displayed to the client, according to the rank. FAQs' ranks are gradually determined considering clients reading it. Based on displayed FAQs, test and entertainment links are also displayed. The accuracy of the AIDS/HIV intelligent web-based medical consulting system is estimated to be 78.76%. AIDS/HIV medical consulting systems have been developed using intelligent infrastructure. Being equipped with an intelligent model, providing consulting services on systematic textual data and providing side services based on client's activities causes the implemented system to be unique. The research has been approved by Iranian Ministry of Health and Medical Education for being practical.

  18. Palliative care consultations in primary care: a cross-sectional survey among Dutch general practitioners.

    Science.gov (United States)

    Hoek, Patrick D; Schers, Henk J; Hendriks, Jan C M; Vissers, Kris C P; Hasselaar, Jeroen G J

    2016-06-17

    Expert consultation supports general practitioners (GPs) in delivering adequate palliative homecare. Insight into consultation practices from a GP's perspective is needed in order to shape consultation services to their wishes and needs. To explore palliative care consultation practices from a GP's perspective. Cross-sectional web-based survey among all GPs (n=235) in the region of Nijmegen, the Netherlands. Our questionnaire contained questions about the delivery of palliative care by GPs, their consultation practices and satisfaction with current services. Questions consisted mainly of 5-point Likert scales. We transformed these scales into numerical values to calculate mean scores. Linear mixed models for repeated measurements were used to study differences in scores. GPs most often consulted informal caregivers (mean score 3.6) or fellow GPs (mean score 3.3). Physical problems were discussed the most (mean score 3.5), while social and existential issues were discussed least (mean score 1.9 for both). In their choice of a particular consultation service, GPs considered the quality of the provided advice to be the most important factor. GPs were satisfied with current consultation services, with fellow GPs receiving the highest satisfaction scores (mean score 4.6). Finally, when recalling their last palliative patient, most GPs started requesting consultation during this patient's last month of life. Next to informal caregivers, GPs preferably seek advice from fellow GPs. Physical issues receive much attention during consultations; however, other vital aspects of palliative care seem to remain relatively neglected, such as social and existential issues and a proactive care approach. 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/

  19. State of the art of expert searching: results of a Medical Library Association survey.

    Science.gov (United States)

    Holst, Ruth; Funk, Carla J

    2005-01-01

    Medical Library Association (MLA) members were surveyed to gather background about the current state of expert searching in institutions. The survey results were intended to guide the recommendations of the Task Force on Expert Searching for promoting the importance of expert searching and implementing those recommendations. MLA members were surveyed, and data obtained from the survey were compiled and analyzed to answer three general questions: what is the perceived value of searching skills to the institution, how do health sciences librarians maintain and improve their searching skills, and how are searching services promoted and/or mandated in the institution. There were 256 responses to the survey. Over 95% of the respondents saw their expert-searching skills were of value to their institutions, primarily through performing mediated searches and search consultations. Over 83% of the respondents believed that their searching skills had improved over the past 10 years. Most indicated that continued training was very important in maintaining and improving their skills. Respondents promoted searching services most frequently through orientations, brochures, and the libraries' Web pages. No respondent's institution mandated expert searching. Less than 2% of respondents' institutions had best practice guidelines related to expert searching, and only about 8% had guidelines or policies that identified situations where expert searching was recommended. The survey supports the belief that health sciences librarians still play a valuable role in searching, particularly in answering questions about treatment options and in providing education. It also highlights the need for more expert searching courses. There has been minimal discussion about the perceived need for expert-searching guidelines in the institutions represented by survey respondents.

  20. 34 CFR 385.46 - What limitations apply to the rate of pay for experts or consultants appointed or serving under...

    Science.gov (United States)

    2010-07-01

    ... or consultants appointed or serving under contract under the Rehabilitation Training program? 385.46... consultants appointed or serving under contract under the Rehabilitation Training program? An expert or... SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION REHABILITATION TRAINING What...

  1. Advanced biofuels: Future perspectives from an expert elicitation survey

    OpenAIRE

    Fiorese, Giulia; Catenacci, Michela; Verdolini, Elena; Bosetti, Valentina

    2012-01-01

    This paper illustrates the main results of an expert elicitation survey on advanced (second and third generation) biofuel technologies. The survey focuses on eliciting probabilistic information on the future costs of advanced biofuels and on the potential role of RD&D (Research, Development and Demonstration) efforts in reducing these costs and in supporting the deployment of biofuels in OECD and non-OECD countries. Fifteen leading experts from different EU member states provide insights on t...

  2. Proceedings of the 3rd Expert Consultation and Planning Meeting on Infant and Young Child Nutrition--(Part 2).

    Science.gov (United States)

    Amarra, Sofia; Chan, Pauline

    2013-04-01

    The Infant and Early Childhood Nutrition Task Force, International Life Sciences Institute Southeast Asia (ILSI SEA) Region, organised the 1st and 2nd Expert Consultation and Planning Meeting on Infant and Early Childhood Nutrition in 2009 and 2011, respectively. The goal of the consultations was "to generate and promote relevant science-based information that will help improve nutritional status, growth and development of infants and young children in Southeast Asia." An Expert Panel Core Group was created whose role is to provide advice and recommendations through a review of current scientific knowledge regarding issues related to early childhood growth and nutrition. The Panel is composed of experts representing 7 countries (China, Indonesia, Malaysia, Philippines, Singapore, Thailand, and Vietnam). In July 2012, the Panel convened the 3rd Expert Consultation and Planning Meeting on Infant and Young Child Nutrition in Singapore. This report presents the highlights of the meeting and recommendations made by the Panel on ways to improve infant and young child nutrition in Southeast Asia. The effective use of WHO indicators for assessing infant and young child feeding practices, mitigating the effects of maternal employment on breastfeeding, using behaviour change communication, updating the education of health personnel, and improving maternal health were considered important actions to be taken. Since current feeding practices in Southeast Asia fall short of WHO recommendations, studies are needed to develop strategies which take into consideration the diverse cultural settings that characterise the region.

  3. Business aspects and sustainability for healthgrids - an expert survey.

    Science.gov (United States)

    Scholz, Stefan; Semler, Sebastian C; Breitner, Michael H

    2009-01-01

    Grid computing initiatives in medicine and life sciences are under pressure to prove their sustainability. While some first business model frameworks were outlined, few practical experiences were considered. This gap has been narrowed by an international survey of 33 grid computing experts with biomedical and non-biomedical background on business aspects. The experts surveyed were cautiously optimistic about a sustainable implementation of grid computing within a mid term timeline. They identified marketable application areas, stated the underlying value proposition, outlined trends and specify critical success factors. From a general perspective of their answers, they provided a stable basis for a road map of sustainable grid computing solutions for medicine and life sciences.

  4. The role of process analysis and expert consultation in implementing an electronic medical record solution for multidrug-resistant tuberculosis

    Directory of Open Access Journals (Sweden)

    Rubeshan Perumal

    2014-03-01

    Full Text Available Background: Process analysis and expert consultation help streamline and optimise processes, but these are underutilised. The World Health Organisation (WHO recommends migration to electronic data collection by 2015, partly in response to multidrug-resistant tuberculosis (MDR-TB. We explore the influence of process analysis and iterative expert consultation, on shaping health information solutions to MDR-TB programmes.Methods: The study employs a two phase design. Phase one involves a process analysis of the South African National Tuberculosis Programme and an electronic medical records (EMR solution and the generation of a detailed process model grounded in the fit between individual task and technology (FITT theoretical framework using ‘business process modelling notation’. Phase two involves a two round Delphi study in the clinical management of tuberculosis and implementers of EMR solutions. Expert opinion is analysed according to emergent thematic content. Analyses and graphical model representation are performed using Microsoft Excel® and Visio® software.Results: A detailed process model is constructed which reveals 54 break points, 12 gaps, 3 risks, 5 wastes. Five participants are included in the Delphi study which support the findings of the process analysis. Thematic analysis identifies five themes: the individual, the process, technology, capacity, and collaboration. The opportunity to include synergistic relations across programmes emerges as a strong theme.Conclusions: Overall, the findings highlight inefficiencies, risk and gaps in the current process and the need for an operational excellence intervention. The study demonstrated the value of process engineering with iterative expert consultation toward developing a meaningful EMR solution consultation in a resource constrained, developing world context.

  5. Short-term leprosy forecasting from an expert opinion survey.

    Directory of Open Access Journals (Sweden)

    Michael S Deiner

    Full Text Available We conducted an expert survey of leprosy (Hansen's Disease and neglected tropical disease experts in February 2016. Experts were asked to forecast the next year of reported cases for the world, for the top three countries, and for selected states and territories of India. A total of 103 respondents answered at least one forecasting question. We elicited lower and upper confidence bounds. Comparing these results to regression and exponential smoothing, we found no evidence that any forecasting method outperformed the others. We found evidence that experts who believed it was more likely to achieve global interruption of transmission goals and disability reduction goals had higher error scores for India and Indonesia, but lower for Brazil. Even for a disease whose epidemiology changes on a slow time scale, forecasting exercises such as we conducted are simple and practical. We believe they can be used on a routine basis in public health.

  6. Operation and Structure of an Artificial Intelligence Expert Consultative System for Reading and Learning.

    Science.gov (United States)

    Balajthy, Ernest

    1989-01-01

    The article examines decision-making expert systems and discusses their implications for diagnosis and prescription of reading difficulties. A detailed description of how a reading diagnostic expert system might operate to aid classroom teachers is followed by a discussion of advantages and limitations of expert systems for educational use.…

  7. Experts' Encounters in Antenatal Diabetes Care: A Descriptive Study of Verbal Communication in Midwife-Led Consultations

    Directory of Open Access Journals (Sweden)

    Christina Furskog Risa

    2012-01-01

    Full Text Available Aim. We regard consultations as cocreated communicatively by the parties involved. In this paper on verbal communication in midwife-led consultations, we consequently focus on the actual conversation taking place between the midwife and the pregnant woman with diabetes, especially on those sequences where the pregnant woman initiated a topic of concern in the conversation. Methods. This paper was undertaken in four hospital outpatient clinics in Norway. Ten antenatal consultations between midwives and pregnant women were audiotaped, transcribed to text, and analyzed using theme-oriented discourse analysis. Two communicative patterns were revealed: an expert's frame and a shared experts' frame. Within each frame, different communicative variations are presented. The topics women initiated in the conversations were (i delivery, time and mode; (ii previous birth experience; (iii labor pain; and (iv breast feeding, diabetes management, and fetal weight. Conclusion. Different ways of communicating seem to create different opportunities for the parties to share each other's perspectives. Adequate responses and a listening attitude as well as an ambiguous way of talking seem to open up for the pregnant women's perspectives. Further studies are needed to investigate the obstacles to, and premises for, providing midwifery care in a specialist outpatient setting.

  8. Expert elicitation survey on future wind energy costs

    Science.gov (United States)

    Wiser, Ryan; Jenni, Karen; Seel, Joachim; Baker, Erin; Hand, Maureen; Lantz, Eric; Smith, Aaron

    2016-10-01

    Wind energy supply has grown rapidly over the last decade. However, the long-term contribution of wind to future energy supply, and the degree to which policy support is necessary to motivate higher levels of deployment, depends—in part—on the future costs of both onshore and offshore wind. Here, we summarize the results of an expert elicitation survey of 163 of the world’s foremost wind experts, aimed at better understanding future costs and technology advancement possibilities. Results suggest significant opportunities for cost reductions, but also underlying uncertainties. Under the median scenario, experts anticipate 24-30% reductions by 2030 and 35-41% reductions by 2050 across the three wind applications studied. Costs could be even lower: experts predict a 10% chance that reductions will be more than 40% by 2030 and more than 50% by 2050. Insights gained through expert elicitation complement other tools for evaluating cost-reduction potential, and help inform policy and planning, R&D and industry strategy.

  9. Expert elicitation survey on future wind energy costs

    Energy Technology Data Exchange (ETDEWEB)

    Wiser, Ryan; Jenni, Karen; Seel, Joachim; Baker, Erin; Hand, Maureen; Lantz, Eric; Smith, Aaron

    2016-09-12

    Wind energy supply has grown rapidly over the last decade. However, the long-term contribution of wind to future energy supply, and the degree to which policy support is necessary to motivate higher levels of deployment, depends -- in part -- on the future costs of both onshore and offshore wind. Here, we summarize the results of an expert elicitation survey of 163 of the world's foremost wind experts, aimed at better understanding future costs and technology advancement possibilities. Results suggest significant opportunities for cost reductions, but also underlying uncertainties. Under the median scenario, experts anticipate 24-30% reductions by 2030 and 35-41% reductions by 2050 across the three wind applications studied. Costs could be even lower: experts predict a 10% chance that reductions will be more than 40% by 2030 and more than 50% by 2050. Insights gained through expert elicitation complement other tools for evaluating cost-reduction potential, and help inform policy and planning, R&D and industry strategy.

  10. Consulting: A Survey on the Role of Consultants in the Formation of Organizational Strategy

    Directory of Open Access Journals (Sweden)

    Antonio de Souza Silva Júnior

    2012-06-01

    Full Text Available The formulation of organizational strategy earns prominence as a tool since what is done through repetition and social acceptance is practicing strategy or strategizing. Thus, organizational strategy is a situated activity, socially constructed by individuals’ interacting, connected with the context in which it happens. In this context, Whittington (2006 points out the importance of third consultants or partners in the process of setting up the strategy by restructuring, transferring, or introducing new practices. Given this, this qualitative study aims to analyze the role of the consultant in the formation of organizational strategy, based on studies of strategy as practice. Results show the process of strategy consulting cannot be seen as applying a pre-established methodology, but should help the clients reflect on their practice, so that they, independently, could become able to diagnose and solve their own problems. To this end, the consultant needs to study the experiences of professionals and understand the actions that constitute reality in making strategy for the process of formulating, implementing and communicating. The consultant should develop several strategic activities, organizational contexts legitimized by extra or intra-organizational, for the professionals of the contracting organization to reflect on their practice and adapt while exploiting their diversity.

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

    Science.gov (United States)

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

    2015-04-03

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

  12. On Tour with the "Accidental" Expert: Ethical Dilemmas of the Development Consultant.

    Science.gov (United States)

    Basile, Michael L.

    This paper explores Max Weber's study of the origins of the secularization of the Puritan work ethic and examines the hybridized category of secular science expert. The hybrid construct provides an opening for the critical analysis of the concrete activity of development from two perspectives, the structural and the individual. The individual…

  13. Increasing the use of e-consultation in primary care: Results of an online survey among non-users of e-consultation

    NARCIS (Netherlands)

    Nijland, N.; van Gemert-Pijnen, Julia E.W.C.; Boer, Hendrik; Steehouder, M.F.; Seydel, E.R.

    2009-01-01

    Objective To identify factors that can enhance the use of e-consultation in primary care. We investigated the barriers, demands and motivations regarding e-consultation among patients with no e-consultation experience (non-users). Methods We used an online survey to gather data. Via online banners

  14. A Survey of Expert Opinion Regarding Rotator Cuff Repair.

    Science.gov (United States)

    Acevedo, Daniel C; Paxton, E Scott; Williams, Gerald R; Abboud, Joseph A

    2014-07-16

    Many patients with rotator cuff tears have questions for their surgeons regarding the surgical procedure, perioperative management, restrictions, therapy, and ability to work after a rotator cuff repair. The purpose of our study was to determine common clinical practices among experts regarding rotator cuff repair and to assist them in counseling patients. We surveyed 372 members of the American Shoulder and Elbow Surgeons (ASES) and the Association of Clinical Elbow and Shoulder Surgeons (ACESS); 111 members (29.8%) completed all or part of the survey, and 92.8% of the respondents answered every question. A consensus response (>50% agreement) was achieved on 49% (24 of 49) of the questions. Variability in responses likely reflects the fact that clinical practices have evolved over time based on clinical experience. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

  15. Proceedings of the FAO Expert Consultation on Fish Technology in Africa: Accra, Ghana, 22-25 October 1991 = Compte rendu de la Consultation d'experts FAO sur la technologie du poisson en Afrique : Accra, Ghana, 22-25 octobre 1991

    National Research Council Canada - National Science Library

    1993-01-01

    .... Cette publication contient 49 contributions et resumes de contributions presentes a la Consultation d'experts FAO sur la technologie du poisson en Afrique qui s'est tenue a Accra, Ghana, du 22 au 25 octobre 1991...

  16. Improvement Research Priorities: USA Survey and Expert Consensus

    Directory of Open Access Journals (Sweden)

    Kathleen R. Stevens

    2013-01-01

    Full Text Available The purpose of this study was to identify stakeholder views about national priorities for improvement science and build agreement for action in a national improvement and implementation research network in the USA. This was accomplished using three stages of identification and consensus. (1 Topics were identified through a multipronged environmental scan of the literature and initiatives. (2 Based on this scan, a survey was developed, and stakeholders (n=2,777 were invited to rate the resulting 33-topic, 9-category list, via an online survey. Data from 560 respondents (20% response were analyzed. (3 An expert panel used survey results to further refine the research priorities through a Rand Delphi process. Priorities identified were within four categories: care coordination and transitions, high-performing clinical systems and microsystems improvement approaches, implementation of evidence-based improvements and best practices, and culture of quality and safety. The priorities identified were adopted by the improvement science research network as the research agenda to guide strategy. The process and conclusions may be of value to quality improvement research funding agencies, governments, and research units seeking to concentrate their resources on improvement topics where research is capable of yielding timely and actionable answers as well as contributing to the knowledge base for improvement.

  17. Experts' attitudes towards medical futility: an empirical survey from Japan

    Directory of Open Access Journals (Sweden)

    Asai Atsushi

    2006-06-01

    Full Text Available Abstract Background The current debate about medical futility is mostly driven by theoretical and personal perspectives and there is a lack of empirical data to document experts and public attitudes towards medical futility. Methods To examine the attitudes of the Japanese experts in the fields relevant to medical futility a questionnaire survey was conducted among the members of the Japan Association for Bioethics. A total number of 108 questionnaires returned filled in, giving a response rate of 50.9%. Among the respondents 62% were healthcare professionals (HCPs and 37% were non-healthcare professionals (Non-HCPs. Results The majority of respondents (67.6 % believed that a physician's refusal to provide or continue a treatment on the ground of futility judgment could never be morally justified but 22.2% approved such refusal with conditions. In the case of physiologically futile care, three-quarters believed that a physician should inform the patient/family of his futility judgment and it would be the patient who could decide what should be done next, based on his/her value judgment. However more than 10% said that a physician should ask about a patient's value and goals, but the final decision was left to the doctor not the patient. There was no statistically significant difference between HCPs and Non-HCPs (p = 0.676. Of respondents 67.6% believed that practical guidelines set up by the health authority would be helpful in futility judgment. Conclusion The results show that there is no support for the physicians' unilateral decision- making on futile care. This survey highlights medical futility as an emerging issue in Japanese healthcare and emphasizes on the need for public discussion and policy development.

  18. 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.

  19. A National Survey of U.S. Internists’ Experiences with Ethical Dilemmas and Ethics Consultation

    Science.gov (United States)

    DuVal, Gordon; Clarridge, Brian; Gensler, Gary; Danis, Marion

    2004-01-01

    OBJECTIVE To identify the ethical dilemmas that internists encounter, the strategies they use to address them, and the usefulness of ethics consultation. DESIGN National telephone survey. SETTING Doctors’ offices. PARTICIPANTS General internists, oncologists, and critical care/pulmonologists (N = 344, 64% response rate). MEASUREMENTS Types of ethical dilemmas recently encountered and likelihood of requesting ethics consultation; satisfaction with resolution of ethical dilemmas with and without ethics consultation. RESULTS Internists most commonly reported dilemmas regarding end-of-life decision making, patient autonomy, justice, and conflict resolution. General internists, oncologists, and critical care specialists reported participating in an average of 1.4, 1.3, and 4.1 consultations in the preceding 2 years, respectively (P ethics training had the least access to and participated in the fewest ethics consultations; 19% reported consultation was unavailable at their predominant practice site. Dilemmas about end-of-life decisions and patient autonomy were often referred for consultation, while dilemmas about justice, such as lack of insurance or limited resources, were rarely referred. While most physicians thought consultations yielded information that would be useful in dealing with future ethical dilemmas (72%), some hesitated to seek ethics consultation because they believed it was too time consuming (29%), might make the situation worse (15%), or that consultants were unqualified (11%). CONCLUSIONS While most internists recall recent ethical dilemmas in their practices, those with the least preparation and experience have the least access to ethics consultation. Health care organizations should emphasize ethics educational activities to prepare physicians for handling ethical dilemmas on their own and should improve the accessibility and responsiveness of ethics consultation when needed. PMID:15009780

  20. BIM IMPLEMENTATION IN A NEW ZEALAND CONSULTING QUANTITY SURVEYING PRACTICE

    OpenAIRE

    Curtis Harrison; Derek Thurnell

    2015-01-01

    5D BIM – generating cost data via the building information modelling (BIM) process- has the potential to be used by quantity surveyors (QSs) to streamline their workflows and increase their provision of quality service. Consultant QSs experienced in the use 5D BIM, from the New Zealand office of one large global practice, were interviewed on their perceptions of the benefits of, and barriers to, 5D BIM implementation within their firm. Findings suggest that 5D BIM has numerous benefits over t...

  1. The expert's guide to mealtime interventions - A Delphi method survey.

    Science.gov (United States)

    Conchin, Simone; Carey, Sharon

    2017-09-27

    Prevalence of malnutrition and a myriad of barriers to adequate oral diet in hospitalised patients warrants further investment to improve the patient mealtime experience. The aim of this study was to explore barriers and enablers to implementing effective mealtime interventions and develop a process framework to guide clinicians and researchers in the area. Potential experts in the area of hospital mealtime intervention were identified as having published in this field of work within the Australasian setting. Further information was sought by email and telephone communication on professional background; research experience; interest; and capacity to participate. Recruited participants were surveyed using a modified Delphi method to establish opinion and experience in the area of mealtime interventions. Results were collated and content was coded using a thematic analysis approach by the primary researcher and two additional reviewers. Thirty-two Australian authors in the area of mealtime interventions within the hospital environment were identified from publication. Twenty-one participants were able to be contacted and nineteen of these consented to enrol in the study. Participants included those from a dietetic (n = 14), nursing (n = 4) and medical (n = 1) background. Participants were deemed to have expert knowledge if they had significant involvement in the published research and demonstrated a deep level of understanding of hospital mealtime interventions. All participants provided key insights into barriers to oral intake in the hospital environment and suggestions for interventions to address these barriers. From the survey, an eight step framework to guide mealtime interventions was developed. Hospital mealtime interventions are complex processes. Interventions should be implemented after careful consideration of the local context and baseline data; and tailored to address barriers. Roles and responsibilities for nutrition care should be clear and

  2. The future prospect of PV and CSP solar technologies: An expert elicitation survey

    OpenAIRE

    Bosetti, Valentina; Catenacci, Michela; Fiorese, Giulia; Verdolini, Elena

    2012-01-01

    In this paper we present and discuss the results of an expert elicitation survey on solar technologies. Sixteen leading European experts from the academic world, the private sector and international institutions took part in this expert elicitation survey on Photovoltaic (PV) and Concentrated Solar Power (CSP) technologies. The survey collected probabilistic information on (1) how Research, Development and Demonstration (RD&D) investments will impact the future costs of solar technologies and...

  3. BIM IMPLEMENTATION IN A NEW ZEALAND CONSULTING QUANTITY SURVEYING PRACTICE

    Directory of Open Access Journals (Sweden)

    Curtis Harrison

    2015-07-01

    Full Text Available 5D BIM – generating cost data via the building information modelling (BIM process- has the potential to be used by quantity surveyors (QSs to streamline their workflows and increase their provision of quality service. Consultant QSs experienced in the use 5D BIM, from the New Zealand office of one large global practice, were interviewed on their perceptions of the benefits of, and barriers to, 5D BIM implementation within their firm. Findings suggest that 5D BIM has numerous benefits over traditional methods, chiefly through the increased efficiency and visualization that BIM provides, along with the rapid identification of design changes. However, realization of these perceived benefits limited to date, due to several barriers hindering 5D BIM implementation: incomplete design and insufficient model object data in the BIM model; a lack of standards to facilitate electronic measurement; legal issues, and a lack of government support. However, participants perceived that 5D BIM implementation will achieve these benefits to a far greater extent in the future. Further research is recommended to identify the BIM skills which QSs will need in the future to reach the full potential of 5D BIM

  4. Survey of Experts on Climate Change Awareness and Public Participation in China

    OpenAIRE

    Berthold Kuhn; Freie Universität Berlin; Yangyong Zhang; Xiamen University

    2014-01-01

    "Climate protection issues are receiving more attention in China. Responding to this survey, 133 environmental and climate protection experts indicated that the government is a key factor in raising awareness of climate protection in China. Experts participating in the survey also referred to the role of the media - in particular social media - NGOs and educational institutions in spreading climate protection awareness. Additionally, interviews were carried out with 40 of the experts, who wer...

  5. The public, experts and deliberations. Consultations about final disposal of nuclear waste; Allmaenhet, expertis och deliberation. Samraad om slutfoervar av kaernavfall

    Energy Technology Data Exchange (ETDEWEB)

    Soneryd, Linda [Stockholms Univ. (Sweden); Lidskog, Rolf [OerebrUniv. (Sweden). Man-Technology-Environment Research Centre

    2006-10-15

    The Swedish process for consultations are studied in order to gain knowledge about the relation between experts and the general public in processes that involve complex scientific and technological issues. The following questions are discussed: How to delimit and define 'the general public' and which methods are used for doing this? Which arenas for dialog are created, and which are the institutional conditions for participation. Are there mechanisms that support or counteract negotiations about the boundaries of the expertise? How do actors that participate in consultation activities relate to experts? How are local and cross-border environment consequences discussed in consultations? The empirical material used in the study consists of observation, formal and informal interviews and documents. Conclusions drawn are that the organisation of consultations puts a special focus on the municipalities, the local population and local environmental issues. SKB has, after advice from consultation participants taken measures to change the process. This has not, however, changed the institutional conditions for participating as given on the different arenas. SKB's local information and communication activity create good relationships but have only weak mechanisms to counteract the dominating role of SKB. The process holds mechanisms that both support and counteract discussions and negotiations about the expertise's boundaries. A counteracting mechanism is when participants relate to EIS as a legal tool and make references to law interpretations that support their own position. The expertise's boundaries are challenged through views and comments about the long time aspects that are involved in the repository question. During consultations, no systematic discussion is pursued about values related to different disposal solutions and images of the future or about which roles citizens have in the consultation process, in their function of municipality

  6. Reconceptualizing children's complex discharge with health systems theory: novel integrative review with embedded expert consultation and theory development.

    Science.gov (United States)

    Noyes, Jane; Brenner, Maria; Fox, Patricia; Guerin, Ashleigh

    2014-05-01

    To report a novel review to develop a health systems model of successful transition of children with complex healthcare needs from hospital to home. Children with complex healthcare needs commonly experience an expensive, ineffectual and prolonged nurse-led discharge process. Children gain no benefit from prolonged hospitalization and are exposed to significant harm. Research to enable intervention development and process evaluation across the entire health system is lacking. Novel mixed-method integrative review informed by health systems theory. DATA  CINAHL, PsychInfo, EMBASE, PubMed, citation searching, personal contact. REVIEW  Informed by consultation with experts. English language studies, opinion/discussion papers reporting research, best practice and experiences of children, parents and healthcare professionals and purposively selected policies/guidelines from 2002-December 2012 were abstracted using Framework synthesis, followed by iterative theory development. Seven critical factors derived from thirty-four sources across five health system levels explained successful discharge (new programme theory). All seven factors are required in an integrated care pathway, with a dynamic communication loop to facilitate effective discharge (new programme logic). Current health system responses were frequently static and critical success factors were commonly absent, thereby explaining ineffectual discharge. The novel evidence-based model, which reconceptualizes 'discharge' as a highly complex longitudinal health system intervention, makes a significant contribution to global knowledge to drive practice development. Research is required to develop process and outcome measures at different time points in the discharge process and future trials are needed to determine the effectiveness of integrated health system discharge models. © 2013 John Wiley & Sons Ltd.

  7. Matching Individuals to Weight Loss Treatments: A Survey of Obesity Experts.

    Science.gov (United States)

    Schwartz, Marlene B.; Brownell, Kelly D.

    1995-01-01

    Identified factors for matching individuals to treatments by surveying experts in the field of obesity about the indications and contraindications of 11 common approaches to weight loss. Experts provided 170 client characteristics as possible matching factors. Discusses potential variables for studies on matching individuals to treatments along…

  8. Communicating Chemical Risks for Social Learning: Findings from an Expert Opinion Survey

    Science.gov (United States)

    Lyytimaki, Jari; Assmuth, Timo; Hilden, Mikael

    2009-01-01

    Environmental and health risks caused by chemical substances have been intensively debated in various arenas of science and policy, and in news media. The impacts of risk debates on the public have been widely studied, while less attention has been paid to expert views. We present results from a cross-national survey charting expert views on the…

  9. A Survey of Algorithms and Systems for Expert Location in Social Networks

    Science.gov (United States)

    Lappas, Theodoros; Liu, Kun; Terzi, Evimaria

    Given a particular task and a set of candidates, one often wants to identify the right expert (or set of experts) that can perform the given task. We call this problem the expert-location problem and we survey its different aspects as they arise in practice. For example, given the activities of candidates within a context (e.g., authoring a document, answering a question), we first describe methods for evaluating the level of expertise for each of them. Often, experts are organized in networks that correspond to social networks or organizational structures of companies. We next devote part of the chapter for describing algorithms that compute the expertise level of individuals by taking into account their position in such a network. Finally, complex tasks often require the collective expertise of more than one experts. In such cases, it is more realistic to require a team of experts that can collaborate towards a common goal. We describe algorithms that identify effective expert teams within a network of experts. The chapter is a survey of different algorithms for expertise evaluation and team identification. We highlight the basic algorithmic problems and give some indicative algorithms that have been developed in the literature. We conclude the chapter by providing a comprehensive overview of real-life systems for expert location.

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

    Directory of Open Access Journals (Sweden)

    Röösli Martin

    2006-10-01

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

  11. Emergency department management of early sepsis: a national survey of emergency medicine and intensive care consultants.

    Science.gov (United States)

    Jiwaji, Zoeb; Brady, Shirin; McIntyre, Lauralyn A; Gray, Alasdair; Walsh, Timothy S

    2014-12-01

    Early goal-directed therapy (EGDT) is recommended for sepsis management in current guidelines, but the underpinning evidence is controversial. Clinician beliefs and the capacity to implement all recommended elements of EGDT in emergency departments (EDs) are uncertain. Our study aimed to explore self-reported management of early sepsis by Scottish emergency medicine (EM) and intensive care medicine (ICM) consultants, delineate important differences and determine the guideline recommendations rated most important and deliverable within the ED. A postal survey using a hypothetical patient with septic shock was sent to all EM and ICM consultants practising in Scotland. 67% (76/114) EM and 61% (96/157) ICM consultants responded. Normal saline was preferred by EM respondents ('always/often used': EM 86%, ICM 23%, pHartmann's solution (EM 42%, ICM 72%, p=0.0164), gelofusin (EM 10%, ICM 63%, p<0.0001) and starch (EM 0%, ICM 24%, p<0.0001). More ICM respondents indicated they used central venous pressure and invasive arterial pressure monitoring in the ED, and initiated vasopressors (EM 57%, ICM 90%, p<0.0001). More ICM consultants used specific haemoglobin transfusion triggers (48% EM, 77% ICM, p=0.0002), but marked variation in haemoglobin triggers and targets was reported. Lactate was rated the most important single resuscitation parameter by both specialties; no ED and only two ICM consultants rated ScVO2 most important. Differences in early fluid and vasopressor management of sepsis exist between Scottish ICM and EM consultants. Transfusion practice is highly variable, suggesting clinical uncertainty. Lactate is considered more important than ScVO2 measurement. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  12. Foodborne proportion of gastrointestinal illness: estimates from a Canadian expert elicitation survey.

    Science.gov (United States)

    Ravel, André; Davidson, Valerie J; Ruzante, Juliana M; Fazil, Aamir

    2010-12-01

    The study used a structured expert elicitation survey to derive estimates of the foodborne attributable proportion for nine illnesses caused by enteric pathogens in Canada. It was based on a similar study conducted in the United States and focused on Campylobacter, Escherichia coli O157:H7, Listeria monocytogenes, nontyphoidal Salmonella enterica, Shigella spp., Vibrio spp., Yersinia enterocolitica, Cryptosporidium parvum, and Norwalk-like virus. For each pathogen, experts were asked to provide their best estimate and low and high limits for the proportion of foodborne illness relative to total cases. In addition, they provided background information with regard to food safety experience, including self-evaluated expertise for each pathogen on a 5-point scale. A snowball approach was used to identify 152 experts within Canada. The experts' background details were summarized using descriptive statistics. Factor analysis was used to determine whether the variability in best estimates was related to self-assessed level of expertise or other background information. Cluster analysis followed by beta function fitting was undertaken on best estimates from experts who self-evaluated their expertise 3 or higher. In parallel, Monte Carlo resampling was run using triangular distributions based on each expert's best estimate and its limits. Sixty-six experts encompassing various academic backgrounds, fields of expertise, and experiences relevant to food safety provided usable data. Considerable variation between experts in their estimated foodborne attributable proportions was observed over all diseases, without any relationship to the expert's background. Uncertainty about their estimate (measured by the low and high limits) varied between experts and between pathogens as well. Both cluster analysis and Monte Carlo resampling clearly indicated disagreement between experts for Campylobacter, E. coli O157, L. monocytogenes, Salmonella, Vibrio, and Y. enterocolitica. In the

  13. Ischemic Heart Disease and Work Disability in Patients Treated at the Internal Medicine Consultation and Assessed by the Expert Medical Labor Commission

    Directory of Open Access Journals (Sweden)

    Belkis Vicente Sánchez

    2016-02-01

    Full Text Available Background: ischemic heart disease represents a major challenge given the large number of people affected by this condition, its increasing contribution to overall mortality, the frequent disability resulting from it, and the complexity and high cost of its treatment. Objective: to describe the work disability caused by ischemic heart disease in patients treated at the internal medicine consultation and assessed by the Expert Medical Labor Commission of Cienfuegos municipality. Methods: a cross-sectional study was conducted including all patients with ischemic heart disease treated at the internal medicine consultation and assessed by the Expert Medical Labor Commission of Cienfuegos municipality from October 2012 to July 2013. The variables analyzed were: age, sex, occupation, years of work and accrued salary, clinical diagnosis, length of time the condition had been present and associated chronic diseases; existence of prior assessment by an Expert Medical Labor Commission and decision reached, previous days of sick leave and current decision of the commission. The data were analyzed using SPSS (version 18.0 and the results are shown in tables and graphs as numbers and percentages. Results: a predominance of men was observed. Forty two point nine percent were service workers and the average number of years of work was 24.60. Forty two point nine percent were previously assessed by the commission. Two hundred one point thirteen days of sick leave were granted and social security expenditure in a month was high. Diabetes mellitus was the most common chronic disease followed by hypertension, obesity and dyslipidemia. Of the workers previously assessed, half received permanent and temporary disability benefits. Conclusions: ischemic heart disease causes different degrees of disability. Its costs in terms of social security are increasing.

  14. Survey of Expert Opinion on Intelligence: Causes of International Differences in Cognitive Ability Tests.

    Science.gov (United States)

    Rindermann, Heiner; Becker, David; Coyle, Thomas R

    2016-01-01

    Following Snyderman and Rothman (1987, 1988), we surveyed expert opinions on the current state of intelligence research. This report examines expert opinions on causes of international differences in student assessment and psychometric IQ test results. Experts were surveyed about the importance of culture, genes, education (quantity and quality), wealth, health, geography, climate, politics, modernization, sampling error, test knowledge, discrimination, test bias, and migration. The importance of these factors was evaluated for diverse countries, regions, and groups including Finland, East Asia, sub-Saharan Africa, Southern Europe, the Arabian-Muslim world, Latin America, Israel, Jews in the West, Roma (gypsies), and Muslim immigrants. Education was rated by N = 71 experts as the most important cause of international ability differences. Genes were rated as the second most relevant factor but also had the highest variability in ratings. Culture, health, wealth, modernization, and politics were the next most important factors, whereas other factors such as geography, climate, test bias, and sampling error were less important. The paper concludes with a discussion of limitations of the survey (e.g., response rates and validity of expert opinions).

  15. A satisfaction survey conducted on patients of a medico-legal consultation.

    Science.gov (United States)

    Romain-Glassey, Nathalie; Gut, Melody; Cathieni, Federico; Hofner, Marie-Claude; Mangin, Patrice

    2011-05-01

    In 2006, a medico-legal consultation service devoted to adult victims of interpersonal violence was set up at the Lausanne University Hospital Centre, Switzerland: the Violence Medical Unit. Patients are received by forensic nurses for support, forensic examination (in order to establish medical report) and community orientation. In 2008, a telephone survey was conducted on patients. The objectives of the survey were to estimate the degree of patients' satisfaction and to document the use of the medical report by six questions. Among the 476 patients admitted to the VMU in 2007, 132 were interviewed. Their overall satisfaction was high with an average mark of 8.7/10. The medical report was used extensively by the interviewed victims (81%) for its primary function - to be produced as evidence. As the consultations are financed by public funds, these results were of interest for advocacy of long-lasting financial support. Copyright © 2011 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  16. Probability encoding of hydrologic parameters for basalt. Elicitation of expert opinions from a panel of five consulting hydrologists

    Energy Technology Data Exchange (ETDEWEB)

    Runchal, A.K.; Merkhofer, M.W.; Olmsted, E.; Davis, J.D.

    1984-11-01

    The Columbia River basalts underlying the Hanford Site in Washington State are being considered as a possible location for a geologic repository for high-level nuclear waste. To investigate the feasibility of a repository at this site, the hydrologic parameters of the site must be evaluated. Among hydrologic parameters of particular interest are the effective porosity of the Cohassett basalt flow top and flow interior and the vertical-to-horizontal hydraulic conductivity, or anisotropy ratio, of the Cohassett basalt flow interior. The Cohassett basalt flow is the prime candidate horizon for repository studies. Site-specific data for these hydrologic parameters are currently inadequate for the purpose of preliminary assessment of candidate repository performance. To obtain credible, auditable, and independently derived estimates of the specified hydrologic parameters, a panel of five nationally recognized hydrologists was assembled. Their expert judgments were quantified during two rounds of Delphi process by means of a probability encoding method developed to estimate the probability distributions of the selected hydrologic variables. The results indicate significant differences of expert opinion for cumulative probabilities of less than 10% and greater than 90%, but relatively close agreement in the middle ranges of values. The principal causes of the diversity of opinion are believed to be the lack of site-specific data and the absence of a single, widely accepted, conceptual or theoretical basis for analyzing these variables.

  17. Expert opinion survey on the impacts of air pollutants on forests of the USA

    Science.gov (United States)

    J.M. Pye; J.E. de Steiguer; C. Love

    1988-01-01

    A panel of experts was surveyed to obtain five air pollutants (SO2 NO2, O3, H2SO4, and HNO3) on growth, mortality, and leaf area of forests of the continental U.S. for later input to economic analysis. Results from the first two of three...

  18. A Delphi survey on expert opinion on key signs for clinical diagnosis ...

    African Journals Online (AJOL)

    A Delphi survey on expert opinion on key signs for clinical diagnosis of bovine trypanosomosis, tick-borne diseases and helminthoses. ... For theileriosis, they included lymph node enlargement, pyrexia, age, breed and reduced milk yield. For trypanosomosis, they included, anaemia, weightloss, staring coat, lymph node ...

  19. Increased demand for E-mail health consultation service: analysis of a Web survey.

    Science.gov (United States)

    Klinar, Ivana; Balazin, Ana; Basić, Martina; Plantas, Igor; Biskupić, Kresimir

    2010-06-01

    The aim of the study was to explore characteristics of the users of the Interactive Service "Your Questions" that is based on E-mail health consultations. We wanted to find out what motivated users to use it, were they satisfied with it and what were its impacts on their health behavior. Therefore, we developed a Web survey and invited 2,747 users to take part in it. 919 (33.5%) of users responded. Results showed that the majority of respondents were women (79.1%) and that most hold at least a college degree (52.4%). The Service was mostly used for obtaining information about certain medical symptoms or medical conditions (50.1%), for a second opinion on a diagnosis (18.6%) and for more information about medical treatment (14.4%). In terms of Service features, it was used because of its convenience with regard to time (38.7%) and a sense of privacy (25.7%). Before posting a question to the Service, 93.2% of the respondents searched for health articles on the PLIVAzdravlje portal while 90% of them read the Questions and Answers database. Over half of them (61.8%) posted their question after they already visited their physicians on that particular issue. Nevertheless, 48% of them were encouraged to visit their physicians after they received the answer. The results show an important trend of increased demand for e-mail health consultation and the need for reliable medical information, with one thousand questions submitted to the Service in the observed period of 40 days. If the source of medical information is reliable, as in case of our Service as well as other forms of e-mail health consultations, it can have positive impact on valuable physician-patient communication based on knowledge and mutual understanding.

  20. Towards Automated Annotation of Benthic Survey Images: Variability of Human Experts and Operational Modes of Automation.

    Science.gov (United States)

    Beijbom, Oscar; Edmunds, Peter J; Roelfsema, Chris; Smith, Jennifer; Kline, David I; Neal, Benjamin P; Dunlap, Matthew J; Moriarty, Vincent; Fan, Tung-Yung; Tan, Chih-Jui; Chan, Stephen; Treibitz, Tali; Gamst, Anthony; Mitchell, B Greg; Kriegman, David

    2015-01-01

    Global climate change and other anthropogenic stressors have heightened the need to rapidly characterize ecological changes in marine benthic communities across large scales. Digital photography enables rapid collection of survey images to meet this need, but the subsequent image annotation is typically a time consuming, manual task. We investigated the feasibility of using automated point-annotation to expedite cover estimation of the 17 dominant benthic categories from survey-images captured at four Pacific coral reefs. Inter- and intra- annotator variability among six human experts was quantified and compared to semi- and fully- automated annotation methods, which are made available at coralnet.ucsd.edu. Our results indicate high expert agreement for identification of coral genera, but lower agreement for algal functional groups, in particular between turf algae and crustose coralline algae. This indicates the need for unequivocal definitions of algal groups, careful training of multiple annotators, and enhanced imaging technology. Semi-automated annotation, where 50% of the annotation decisions were performed automatically, yielded cover estimate errors comparable to those of the human experts. Furthermore, fully-automated annotation yielded rapid, unbiased cover estimates but with increased variance. These results show that automated annotation can increase spatial coverage and decrease time and financial outlay for image-based reef surveys.

  1. Towards Automated Annotation of Benthic Survey Images: Variability of Human Experts and Operational Modes of Automation.

    Directory of Open Access Journals (Sweden)

    Oscar Beijbom

    Full Text Available Global climate change and other anthropogenic stressors have heightened the need to rapidly characterize ecological changes in marine benthic communities across large scales. Digital photography enables rapid collection of survey images to meet this need, but the subsequent image annotation is typically a time consuming, manual task. We investigated the feasibility of using automated point-annotation to expedite cover estimation of the 17 dominant benthic categories from survey-images captured at four Pacific coral reefs. Inter- and intra- annotator variability among six human experts was quantified and compared to semi- and fully- automated annotation methods, which are made available at coralnet.ucsd.edu. Our results indicate high expert agreement for identification of coral genera, but lower agreement for algal functional groups, in particular between turf algae and crustose coralline algae. This indicates the need for unequivocal definitions of algal groups, careful training of multiple annotators, and enhanced imaging technology. Semi-automated annotation, where 50% of the annotation decisions were performed automatically, yielded cover estimate errors comparable to those of the human experts. Furthermore, fully-automated annotation yielded rapid, unbiased cover estimates but with increased variance. These results show that automated annotation can increase spatial coverage and decrease time and financial outlay for image-based reef surveys.

  2. Guidelines for the verification and validation of expert system software and conventional software: Survey and documentation of expert system verification and validation methodologies. Volume 3

    Energy Technology Data Exchange (ETDEWEB)

    Groundwater, E.H.; Miller, L.A.; Mirsky, S.M. [Science Applications International Corp., McLean, VA (United States)

    1995-03-01

    This report is the third volume in the final report for the Expert System Verification and Validation (V&V) project which was jointly sponsored by the Nuclear Regulatory Commission and the Electric Power Research Institute. The ultimate objective is the formulation of guidelines for the V&V of expert systems for use in nuclear power applications. The purpose of this activity was to survey and document techniques presently in use for expert system V&V. The survey effort included an extensive telephone interviewing program, site visits, and a thorough bibliographic search and compilation. The major finding was that V&V of expert systems is not nearly as established or prevalent as V&V of conventional software systems. When V&V was used for expert systems, it was almost always at the system validation stage after full implementation and integration usually employing the non-systematic dynamic method of {open_quotes}ad hoc testing.{close_quotes} There were few examples of employing V&V in the early phases of development and only weak sporadic mention of the possibilities in the literature. There is, however, a very active research area concerning the development of methods and tools to detect problems with, particularly, rule-based expert systems. Four such static-testing methods were identified which were not discovered in a comprehensive review of conventional V&V methods in an earlier task.

  3. Expert Consultation on the Utilization of the Experience and Competence of the Elderly in the Education of Youth and Adults (Wuhan, People's Republic of China, November 21-25, 1989). Final Report.

    Science.gov (United States)

    United Nations Educational, Scientific, and Cultural Organization, Paris (France).

    A consultation was conducted in China to examine the use of the experience and competence of the elderly in the education of youth and adults; the education of the elderly was also studied. Participants were 15 experts from Australia, Germany, Hong Kong, Japan, the United States, the Sudan, France, the Soviet Union, and China, along with…

  4. The EU’s Contribution to Common Global Rules : Challenges in an Age of Power Shift, Summary of Findings of the Expert Consultation in the Framework of the EU Strategic Review Process

    NARCIS (Netherlands)

    Buitelaar, T.; Larik, J.E.; Matta, A.

    2015-01-01

    On 8 and 9 December 2015, The Hague Institute for Global Justice, in collaboration with the Ministry of Foreign Affairs of the Netherlands, organized both a public high-level discussion and a closed expert consultation on the EU’s forthcoming Global Strategy on Foreign and Security Policy. The

  5. Milk Donation Awareness of Parents, Health Workers and Lactation Consultants: Survey Findings

    Directory of Open Access Journals (Sweden)

    Olga L. Lukoyanova

    2016-01-01

    Full Text Available Background. Today, in Russia there is no practice of using donor milk in hospitals, while abroad it is a common technique of caring for premature and low-weight infants.Objective: Our aim was to study the milk donation awareness of parents of children under the age of 1, health workers and lactation consultants.Methods. A sample survey was carried out.Results. The study involved 2,332 respondents from 13 medical institutions in 11 cities and towns located in 6 federal districts of the Russian Federation, including 1,134 mothers, 413 fathers, 692 health workers, and 93 lactation consultants. 1,007 (65.1% parents (mothers and fathers and 541 (68.9% specialists (health workers and lactation consultants believe that feeding of a sick newborn with donor milk is useful in the absence of breast milk. Only 609 (39.4% parents and 363 (46.2% professionals would agree to use donor milk for their children in the absence or lack of mother’s milk. Only 1/3 of the respondents — 560 (36.2% parents and 259 (33.0% professionals — believe that donor milk is safe. 565 (36.5% parents and 475 (60.5% professionals have heard something about breast milk banks and 1,013 (65.5% parents and 449 (57.2% professionals believe that the establishment of such banks is reasonable. Most of the mothers (830; 73.2% involved in the study would agree to become breast milk donors, and 219 (53% fathers would approve their wives’ decision to become donors.Conclusion. The study has revealed low respondents’ awareness of the use and safety of donor milk. However, most of the mothers are willing to become breast milk donors. More than half of the parents and professionals involved in the study believe that it is reasonable to create milk banks.

  6. Young people's views on the potential use of telemedicine consultations for sexual health: results of a national survey

    Directory of Open Access Journals (Sweden)

    Fairley Christopher K

    2011-10-01

    Full Text Available Abstract Background Young people are disproportionately affected by sexually transmissible infections in Australia but face barriers to accessing sexual health services, including concerns over confidentiality and, for some, geographic remoteness. A possible innovation to increase access to services is the use of telemedicine. Methods Young people's (aged 16-24 pre-use views on telephone and webcam consultations for sexual health were investigated through a widely-advertised national online survey in Australia. Descriptive statistics were used to describe the study sample and chi-square, Mann-Whitney U test, or t-tests were used to assess associations. Multinomial logistic regression was used to explore the association between the three-level outcome variable (first preference in person, telephone or webcam, and demographic and behavioural variables; odds ratios and 95%CI were calculated using in person as the reference category. Free text responses were analysed thematically. Results A total of 662 people completed the questionnaire. Overall, 85% of the sample indicated they would be willing to have an in-person consultation with a doctor, 63% a telephone consultation, and 29% a webcam consultation. Men, respondents with same-sex partners, and respondents reporting three or more partners in the previous year were more willing to have a webcam consultation. Imagining they lived 20 minutes from a doctor, 83% of respondents reported that their first preference would be an in-person consultation with a doctor; if imagining they lived two hours from a doctor, 51% preferred a telephone consultation. The main objections to webcam consultations in the free text responses were privacy and security concerns relating to the possibility of the webcam consultation being recorded, saved, and potentially searchable and retrievable online. Conclusions This study is the first we are aware of that seeks the views of young people on telemedicine and access to

  7. Young people's views on the potential use of telemedicine consultations for sexual health: results of a national survey.

    Science.gov (United States)

    Garrett, Cameryn C; Hocking, Jane; Chen, Marcus Y; Fairley, Christopher K; Kirkman, Maggie

    2011-10-25

    Young people are disproportionately affected by sexually transmissible infections in Australia but face barriers to accessing sexual health services, including concerns over confidentiality and, for some, geographic remoteness. A possible innovation to increase access to services is the use of telemedicine. Young people's (aged 16-24) pre-use views on telephone and webcam consultations for sexual health were investigated through a widely-advertised national online survey in Australia. Descriptive statistics were used to describe the study sample and chi-square, Mann-Whitney U test, or t-tests were used to assess associations. Multinomial logistic regression was used to explore the association between the three-level outcome variable (first preference in person, telephone or webcam, and demographic and behavioural variables); odds ratios and 95%CI were calculated using in person as the reference category. Free text responses were analysed thematically. A total of 662 people completed the questionnaire. Overall, 85% of the sample indicated they would be willing to have an in-person consultation with a doctor, 63% a telephone consultation, and 29% a webcam consultation. Men, respondents with same-sex partners, and respondents reporting three or more partners in the previous year were more willing to have a webcam consultation. Imagining they lived 20 minutes from a doctor, 83% of respondents reported that their first preference would be an in-person consultation with a doctor; if imagining they lived two hours from a doctor, 51% preferred a telephone consultation. The main objections to webcam consultations in the free text responses were privacy and security concerns relating to the possibility of the webcam consultation being recorded, saved, and potentially searchable and retrievable online. This study is the first we are aware of that seeks the views of young people on telemedicine and access to sexual health services. Although only 29% of respondents were willing

  8. Incongruous consultation behaviour: results from a UK-wide population survey

    Directory of Open Access Journals (Sweden)

    Elliott Alison M

    2012-03-01

    Full Text Available Abstract Background Symptom characteristics are strong drivers of care seeking. Despite this, incongruous consultation behaviour occurs and has implications for both individuals and health-care services. The aim of this study was to determine how frequently incongruous consultation behaviour occurs, to examine whether it is more common for certain types of symptoms and to identify the factors associated with being an incongruous consulter. Methods An age and sex stratified random sample of 8,000 adults was drawn from twenty UK general practices. A postal questionnaire was used to collect detailed information on the presence and characteristics of 25 physical and psychological symptoms, actions taken to manage the symptoms, general health, attitudes to symptom management and demographic/socio-economic details. Two types of incongruous consultation behaviour were examined: i consultation with a GP for symptoms self-rated as low impact and ii no consultation with a GP for symptoms self-rated as high impact. Results A fifth of all symptoms experienced resulted in consultation behaviour which was incongruous based on respondents' own rating of the symptoms' impact. Low impact consultations were not common, although symptoms indicative of a potentially serious condition resulted in a higher proportion of low impact consultations. High impact non-consultations were more common, although there was no clear pattern in the type of associated symptoms. Just under half of those experiencing symptoms in the previous two weeks were categorised as an incongruous consulter (low impact consulter: 8.3%, high impact non-consulter: 37.1%. Employment status, having a chronic condition, poor health, and feeling that reassurance or advice from a health professional is important were associated with being a low impact consulter. Younger age, employment status, being an ex-smoker, poor health and feeling that not wasting the GPs time is important were associated with

  9. A Child’s Concept of Pain: An International Survey of Pediatric Pain Experts

    Science.gov (United States)

    Hush, Julia M.; Hancock, Mark J.; Moseley, G. Lorimer; Butler, David S.; Pacey, Verity

    2018-01-01

    A child’s ‘concept of pain’ refers to how they understand what pain actually is, what function pain serves, and what biological processes are thought to underpin it. We aimed to determine pediatric pain experts’ opinions of: (1) the importance and usefulness of assessing a child’s concept of pain in clinical and/or research settings; (2) the usefulness of the content of items within currently published adult-targeted resources for assessing a child’s concept of pain; and (3) important domains of a child’s concept of pain to assess. Forty-nine pediatric pain experts (response rate = 75.4%) completed an online survey. Descriptive statistics and frequency of responses were analyzed. Experts from all included disciplines reported that assessing a child’s concept of pain is important and useful both clinically and in a research setting (>80% reported very or extremely useful for each item). Experts considered that the content of 13 items from currently published adult-targeted resources was useful, but the wording was too complex for children aged 8–12 years. Experts considered that all seven of the proposed domains of a child’s concept of pain was important to assess. The findings can be used to inform the development of an assessment tool for a child’s concept of pain. PMID:29342976

  10. A Survey of Dutch Expert Opinion on Climatic Drivers of Infectious Disease Risk in Western Europe

    Directory of Open Access Journals (Sweden)

    Su-Mia Akin

    2014-11-01

    Full Text Available Climate change is considered to be a significant influence for infectious disease risk in Western Europe. Climatic and non-climatic developments act together resulting in current and future infectious disease risk. This study uses a survey to explore Dutch expert perspectives on climate change induced infectious disease risk. The results show that the experts consider temperature change, precipitation change, humidity change, and climate change induced habitat change to be relatively important for water-related infectious disease risk, vector-borne disease risk excluding zoonoses, and the risk of zoonoses. The climatic drivers are seen as relatively less important for food-related infectious disease risk. The experts rate many non-climatic drivers to be highly important for infectious disease risk. Comparatively, the majority of the non-climatic drivers assessed are seen as more important than climate change drivers. The degree of uncertainty in the future development of climatic drivers is viewed as moderate to high, and for non-climatic drivers mostly as moderate. An analysis of subsamples based on professional backgrounds reveals differences in experts’ opinions for e.g., socio-cultural drivers, and similarities. Diversity and consensus amongst expert perspectives on climate change and infectious diseases can have implications for policy. Further research to uncover and compare prevailing perspectives is necessary.

  11. Oral contraception and menstrual bleeding during treatment of venous thromboembolism: Expert opinion versus current practice Combined results of a systematic review, expert panel opinion and an international survey

    NARCIS (Netherlands)

    Klok, F. A.; Schreiber, K.; Stach, K.; Ageno, W.; Middeldorp, S.; Eichinger, S.; Delluc, A.; Blondon, M.; Ay, C.

    2017-01-01

    Introduction: The optimal management of oral contraception and menstrual bleeding during treatment of venous thromboembolism (VTE) is largely unknown. We aimed to elicit expert opinion and compare that to current practice as assessed by a world-wide international web-based survey among physicians.

  12. Medical Student Experiences on Consultation-Liaison Psychiatry Rotations: A Nationwide Survey.

    Science.gov (United States)

    Meyer, Fremonta; Abbasi, Omair; Kasick, David; Lee, Kewchang; Pelic, Christine; Zinser, Jennifer; Harris, Thomas; Funk, Margo

    Consultation-liaison (C-L) psychiatry clerkship rotations may improve medical students' understanding of psychiatric principles relevant to the settings in which they will ultimately practice. This study aimed to characterize students' experiences on C-L rotations. This cross-sectional survey study, sponsored by the Academy of Psychosomatic Medicine Subcommittee on Medical Student Education, was conducted at 5 US medical schools between 2012 and 2016. After the C-L rotation, students completed a voluntary 17-item survey. A total of 235 surveys were collected (mean response rate = 92%). The most frequently endorsed benefit of C-L was learning to manage psychiatric disorders in the context of medical illness (89%). The most frequently endorsed drawback was inconsistent/excessively variable workload (40%). Overall, 82% of respondents recommended C-L to other students; 80% reported that the ideal clerkship would include exposure to both C-L and inpatient psychiatry. Overall, 38% reported that their C-L experience increased their interest in psychiatry as a career. Effect of C-L on interest in psychiatry did not differ by study site, age, sex, clerkship length, or time spent on C-L. Respondents who noted more positive role-modeling on C-L compared to other clerkship rotations were more likely to report increased interest in a psychiatry career (odds ratio = 2.70). Most medical students perceive C-L rotations favorably. Positive role modeling may increase their consideration of psychiatry specialization. The findings that C-L rotation length did not correlate with attitudes and that most students preferred exposure to both inpatient and C-L psychiatry suggest that C-L exposure can beneficially be integrated into core clerkships containing other elements. Copyright © 2018 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  13. Towards Horizon 2020: challenges and advances for clinical mental health research - outcome of an expert survey.

    Science.gov (United States)

    van der Feltz-Cornelis, Christina M; van Os, Jim; Knappe, Susanne; Schumann, Gunter; Vieta, Eduard; Wittchen, Hans-Ulrich; Lewis, Shôn W; Elfeddali, Iman; Wahlbeck, Kristian; Linszen, Donald; Obradors-Tarragó, Carla; Haro, Josep Maria

    2014-01-01

    The size and increasing burden of disease due to mental disorders in Europe poses substantial challenges to its population and to the health policy of the European Union. This warrants a specific research agenda concerning clinical mental health research as one of the cornerstones of sustainable mental health research and health policy in Europe. The aim of this research was to identify the top priorities needed to address the main challenges in clinical research for mental disorders. The research was conducted as an expert survey and expert panel discussion during a scientific workshop. Eighty-nine experts in clinical research and representing most European countries participated in this survey. Identified top priorities were the need for new intervention studies, understanding the diagnostic and therapeutic implications of mechanisms of disease, and research in the field of somatic-psychiatric comorbidity. The "subjectivity gap" between basic neuroscience research and clinical reality for patients with mental disorders is considered the main challenge in psychiatric research, suggesting that a shift in research paradigms is required. Innovations in clinical mental health research should bridge the gap between mechanisms underlying novel therapeutic interventions and the patient experience of mental disorder and, if present, somatic comorbidity. Clinical mental health research is relatively underfunded and should receive specific attention in Horizon 2020 funding programs.

  14. Towards the development of a paediatric biopharmaceutics classification system: Results of a survey of experts.

    Science.gov (United States)

    Batchelor, Hannah; Ernest, Terry; Flanagan, Talia; Klein, Sandra; Turner, Roy; Fotaki, Nikoletta; Storey, David

    2016-09-25

    The aim of this research survey was to understand current global thinking around the need for and development of a paediatric biopharmaceutics classification system (pBCS) to be used for the development of paediatric medicines and regulatory purposes (e.g. Biowaivers). A literature review highlighted the paucity of data in this area and therefore a survey was developed to better understand this topic to identify areas of common thinking and highlight future research needs. Global experts in paediatric biopharmaceutics were identified from existing networks and public forums. An online survey was developed and circulated broadly to maximise participation. Sixty individuals (including academics, health care professionals, pharmaceutical industry scientists and regulators) completed the survey, bringing together their views on the need for a pBCS. The results highlighted that the area of greatest concern was the definition of BCS II and IV drugs within this population and additional research is required to generate evidence to underpin this issue. In questions relating to permeability and dissolution consensus was generally reached within the expert population suggesting that little additional research is required to define suitable criteria. More than 90% of those experts who participated agreed that a pBCS would be useful for paediatric populations with a greater need identified for the younger populations (newborn and infants compared to adolescents). The results presented will facilitate further discussion and research into the evidence to underpin a relevant pBCS. These results highlight the need for additional evidence and guidance in this area. Copyright © 2016. Published by Elsevier B.V.

  15. Current experience and attitudes to biomedical scientist cut-up: results of an online survey of UK consultant histopathologists.

    Science.gov (United States)

    Simmons, E J V; Sanders, D S A; Carr, R A

    2011-04-01

    To assess the current utilisation of biomedical scientist (BMS) surgical specimen cut-up in the UK and attitudes of consultant histopathologists to the practice. Email invitations were sent to all UK consultant histopathologists to participate in an online survey (SurveyMonkey) assessing attitudes to and utilisation of BMS surgical specimen cut-up. 463 individual replies were received (35% response rate) from 1320 invitations to participate, covering 181 UK histopathology departments. A majority of the respondents were either fully in favour of BMS cut-up (52.7%), or in favour but with some reservation (46.2%). Only five respondents (1.1%) were completely opposed to BMS cut-up. 267 (57.7%) respondents reported that their BMS staff loaded biopsies only. 148 (32%) reported BMS cut-up of more complex benign specimens, and 83 (17.9%) reported BMS handling of orientated skin specimens. Only 39 (8.4%) reported that BMS staff in their departments currently cut-up larger cancer resections. This survey is representative of current BMS cut-up practice in the UK. The majority of UK consultant histopathologists replying to this survey support BMS cut-up to some degree, but utilisation of BMS cut-up is rather limited and patchy at present. Cost, staffing constraints, perceived quality issues and individual consultant preferences are cited as reasons for limited uptake currently. Recognised benefits of promoting BMS cut-up include better use of consultant time, enhanced team working, BMS job satisfaction and career progression, and better adherence to standard operating procedures.

  16. Climate Change and Infectious Disease Risk in Western Europe: A Survey of Dutch Expert Opinion on Adaptation Responses and Actors.

    Science.gov (United States)

    Akin, Su-Mia; Martens, Pim; Huynen, Maud M T E

    2015-08-18

    There is growing evidence of climate change affecting infectious disease risk in Western Europe. The call for effective adaptation to this challenge becomes increasingly stronger. This paper presents the results of a survey exploring Dutch expert perspectives on adaptation responses to climate change impacts on infectious disease risk in Western Europe. Additionally, the survey explores the expert sample's prioritization of mitigation and adaptation, and expert views on the willingness and capacity of relevant actors to respond to climate change. An integrated view on the causation of infectious disease risk is employed, including multiple (climatic and non-climatic) factors. The results show that the experts consider some adaptation responses as relatively more cost-effective, like fostering interagency and community partnerships, or beneficial to health, such as outbreak investigation and response. Expert opinions converge and diverge for different adaptation responses. Regarding the prioritization of mitigation and adaptation responses expert perspectives converge towards a 50/50 budgetary allocation. The experts consider the national government/health authority as the most capable actor to respond to climate change-induced infectious disease risk. Divergence and consensus among expert opinions can influence adaptation policy processes. Further research is necessary to uncover prevailing expert perspectives and their roots, and compare these.

  17. SU-F-T-244: Radiotherapy Risk Estimation Based On Expert Group Survey

    Energy Technology Data Exchange (ETDEWEB)

    Koo, J; Yoon, M [Korea University, Seoul (Korea, Republic of); Chung, W; Chung, M; Kim, D [Kyung Hee University Hospital at Gangdong, Gangdong-gu, Seoul (Korea, Republic of)

    2016-06-15

    Purpose: To evaluate the reliability of RPN (Risk Priority Number) decided by expert group and to provide preliminary data for adapting FMEA in Korea. Methods: 1163 Incidents reported in ROSIS for 11 years were used as a real data to be compared with, and were categorized into 146 items. The questionnaire was composed of the 146 items and respondents had to valuate ‘occurrence (O)’, ‘severity (S)’, ‘detectability (D)’ of each item on a scale from 1 to 10 according to the proposed AAPM TG-100 rating scales. 19 medical physicists from 19 different organizations in Korea had participated in the survey. Because the number of ROSIS items was not evenly spread enough to be classified into 10 grades, 1–5 scale was chosen instead of 1–10 and survey result was also fit to 5 grades to compare. Results: The average O,S,D were 1.77, 3.50, 2.13, respectively and the item which had the highest RPN(32) was ‘patient movement during treatment’ in the survey. When comparing items ranked in the top 10 of each survey(O) and ROSIS database, two items were duplicated and ‘Simulation’ and ’Treatment’ were the most frequently ranked RT process in top 10 of survey and ROSIS each. The Chronbach α of each RT process were ranged from 0.74 to 0.99 and p-value was <0.001. When comparing O*D, the average difference was 1.4. Conclusion: This work indicates the deviation between actual risk and expectation. Considering that the respondents were Korean and ROSIS is mainly composed of incidents happened in European countries and some of the top 10 items of ROSIS cannot be applied in radiotherapy procedure in Korea, the deviation could have been came from procedural difference. Moreover, if expert group was consisted of experts from various parts, expectation might have been more accurate. Therefore, further research on radiotherapy risk estimation is needed.

  18. Attitudes towards terminal sedation: an empirical survey among experts in the field of medical ethics

    Directory of Open Access Journals (Sweden)

    Hinz José

    2007-04-01

    Full Text Available Abstract Background "Terminal sedation" regarded as the use of sedation in (pre-terminal patients with treatment-refractory symptoms is controversially discussed not only within palliative medicine. While supporters consider terminal sedation as an indispensable palliative medical treatment option, opponents disapprove of it as "slow euthanasia". Against this background, we interviewed medical ethics experts by questionnaire on the term and the moral acceptance of terminal sedation in order to find out how they think about this topic. We were especially interested in whether experts with a professional medical and nursing background think differently about the topic than experts without this background. Methods The survey was carried out by questionnaire; beside the provided answering options free text comments were possible. As test persons we chose the 477 members of the German Academy for Ethics in Medicine, an interdisciplinary society for medical ethics. Results 281 completed questionnaires were returned (response rate = 59%. The majority of persons without medical background regarded "terminal sedation" as an intentional elimination of consciousness until the patient's death occurs; persons with a medical background generally had a broader understanding of the term, including light or intermittent forms of sedation. 98% of the respondents regarded terminal sedation in dying patients with treatment-refractory physical symptoms as acceptable. Situations in which the dying process has not yet started, in which untreatable mental symptoms are the indication for terminal sedation or in which life-sustaining measures are withdrawn during sedation were evaluated as morally difficult. Conclusion The survey reveals a great need for research and discussion on the medical indication as well as on the moral evaluation of terminal sedation. Prerequisite for this is a more precise terminology which describes the circumstances of the sedation.

  19. Training manual for energy consultants. Learning aid, examination questions and updating of the expert knowledge; Trainingshandbuch fuer Energieberater. Lernhilfe, Pruefungsfragen und Aktualisierung des Fachwissens

    Energy Technology Data Exchange (ETDEWEB)

    Maas, Anton; Vaupel, Karin

    2011-07-01

    The demand for energy consultancy will continue to increase. Energy consultants have to establish specific expertises. The training manual under consideration provides an excellent foundation for self-study and the review of already existing knowledge. From the content: building physics, energy balancing, building materials, insulation materials and insulation systems, costs for remediation, evaluation of amortization, measurement acquisition of energy performance indicators.

  20. Feng Shui Consultation for 0047

    OpenAIRE

    Bergman, Aeron; Salinas, Alejandra

    2013-01-01

    Separatutstilling. Samarbeidspartner: Alejandra Salinas. Feng Shui Consultation for 0047 by Experts Gabriella Chow and Christina Aas (Performance by Aeron Bergman/Alejandra Salinas) 0047, Oslo November 18, 2011

  1. Laser Safety in Isotretinoin Use: A Survey of Expert Opinion and Practice.

    Science.gov (United States)

    Prather, Heidi B; Alam, Murad; Poon, Emily; Arndt, Kenneth A; Dover, Jeffrey S

    2017-03-01

    Reports of poor wound healing in the setting of isotretinoin treatment have created a conservative standard of care in which laser and phototherapy treatment of patients receiving isotretinoin is relatively contraindicated. A survey of 220 nationally recognized experts in cutaneous laser surgery was conducted to evaluate physician experience and opinion pertaining to laser and light procedures in patients treated with isotretinoin, including perceived risk and actual complications. There was a 42% response rate. Seventy-six percent of respondents have never seen in their own clinical practices any cases of complications arising in patients treated with laser while receiving isotretinoin or within 6 months of completing a course of therapy. Almost half of respondents have treated patients in this subpopulation with laser, although only a small minority have done so with ablative devices. Common concerns among respondents regarding isotretinoin patients are the risks of poor wound healing and scarring, but the most often reported concern is medicolegal risk (74%). It would seem that the risk of performing laser procedures on patients receiving isotretinoin or having recently completed a course, as estimated and observed by cutaneous laser experts, is lower than the currently perceived risk among the general medical community.

  2. Priorities and challenges for skin cancer prevention in Europe: an expert survey.

    Science.gov (United States)

    Forsea, Ana-Maria; Del Marmol, Veronique; Geller, Alan C

    2013-08-01

    The incidence, mortality, and survival rates of melanoma vary significantly across Europe, likely related to persistent inequalities between European countries in the areas of skin cancer early detection, case registration, and prevention. To enhance the planning of prevention strategies for skin cancer in Europe, we solicited the direct opinion of European experts in the field of dermato-oncology on the main obstacles, needs, and priorities for the reduction of the skin cancer burden on this continent. We surveyed European dermatologists with leading positions in European and international organizations active in skin cancer prevention by means of written, single-choice and multiple-choice questionnaires. Fifty-two dermatologists from 32 European countries completed the survey (response rate 80%). Fewer respondents in Eastern Europe compared with Western Europe reported the presence of governmental (12 vs. 46%) or nongovernmental (35 vs. 65%) initiatives for skin cancer prevention. Most respondents in Eastern (73%) and Western Europe (69%) reported the existence of national cancer registries, but the confidence in the accuracy of melanoma registration was low. Public and professional education for early detection were top priorities for skin cancer campaigns across Europe and the perceived obstacles were similar in both regions: the lack of a national program of public education, insufficient public authority initiatives, and insufficient training of physicians on skin cancer. Our survey highlighted several areas requiring intervention for skin cancer prevention and found that the main issues and obstacles appear to be similar across Europe, creating the premise for coordinated, pan-European action.

  3. A Delphi Survey and Analysis of Expert Perspectives on One Health in Australia.

    Science.gov (United States)

    Degeling, Chris; Johnson, Jane; Ward, Michael; Wilson, Andrew; Gilbert, Gwendolyn

    2017-08-22

    One Health (OH) is an interdisciplinary approach aiming to achieve optimal health for humans, animals and their environments. Case reports and systematic reviews of success are emerging; however, discussion of barriers and enablers of cross-sectoral collaboration are rare. A four-phase mixed-method Delphi survey of Australian human and animal health practitioners and policymakers (n = 52) explored areas of consensus and disagreement over: (1) the operational definition of OH; (2) potential for cross-sectoral collaboration; and (3) key priorities for shaping the development of an OH response to significantly elevated zoonotic disease risk. Participants agreed OH is essential for effective infectious disease prevention and control, and on key priorities for outbreak responses, but disagreed over definitions and the relative priority of animal health and welfare and economic considerations. Strong support emerged among Australian experts for an OH approach. There was also recognition of the need to ensure cross-sectoral differences are addressed.

  4. [Psychiatric consultation-liaison in Sweden surveyed: A patchwork of reimbursement schemes, organizational structures and levels of ambition].

    Science.gov (United States)

    Wahlström, Lars

    2003-01-16

    In order to make a survey of consultation-liaison (c-l) psychiatric activity a questionnaire was distributed to all psychiatric departments in Sweden. Questions were asked concerning organization, reimbursement and indicators of the quality level of services. 42 of 72 possible responders returned the questionnaire (58%). The department-affiliated services work with few exceptions at a basic level of consultation, and existing liaison activities seldom have any organizational connection to the psychiatric departments. There is no commonly accepted organizational model and the use of professional categories other than psychiatrists is rare. Five psychiatric departments have special c-l units and research is pursued almost exclusively at these. A majority of respondents express a need for expansion. So far, the services have been working at a level of gentlemen's agreement between clinics, but a number of compensatory schemes are under way.

  5. A national survey of restorative consultants' treatment provision for head and neck oncology patients.

    Science.gov (United States)

    Calvert, G; Barclay, S C; Owens, J S; Alani, A

    2014-11-01

    To investigate current UK practices in the treatment of head and neck oncology patients by consultants in restorative dentistry. A postal questionnaire requesting details of surgical and restorative head and neck oncology care from diagnosis to oral rehabilitation was circulated to all 315 consultants in restorative dentistry in the UK. If a reply was not received within 12 weeks a follow up was sent. One hundred and thirty-two (43%) completed questionnaires were returned. On average 46% of respondents treated head and neck oncology patients, this varied with geographical location. Sixty percent of consultants' weekly workload was less than 25% oncology related, while 13% indicated more than 75%. Of the cohort providing oncology care only 12% thought there was always time for dental screening pre-radiotherapy, furthermore 67% had difficulty liaising with primary care. Within the UK great variety existed between attendance at multidisciplinary team meetings, dental care professional support, and provision of dental implant reconstruction including timing, manufacturer, operator, and funding. Significant variation in dental input into head and neck oncology patients' pathways exists, most notably with pre-radiotherapy screening. This study highlights a change in trend for patient rehabilitation with dental implants, and an increase to 52% of restorative dentistry consultants' attendance during a multidisciplinary team meeting.

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

    Directory of Open Access Journals (Sweden)

    Mosinkie Phillip I

    2008-12-01

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

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

    Science.gov (United States)

    MacFarlane, Anne; Glynn, Liam G; Mosinkie, Phillip I; Murphy, Andrew W

    2008-12-22

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

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

    LENUS (Irish Health Repository)

    MacFarlane, Anne

    2008-01-01

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

  9. Sustainable building design in practice – survey among Danish DGNB consultants

    DEFF Research Database (Denmark)

    Brunsgaard, Camilla; Bejder, Anne Kirkegaard

    2017-01-01

    needed. Further, it confirms the importance of multidisciplinary collaboration, including the DGNB consultant, from the early design stages. The research suggests further investigations of challenges regarding design process and decision-making on a more common level to verify the findings on a more...... general level. The objective of the study presented in this paper, is to investigate the challenges related to the design process experienced by practice when designing sustainable buildings using the Danish DGNB certification scheme. Questionnaires are sent to all Danish DGNB consultant and auditors...... to be able to cover a wide variety of projects and level of experience with the DGNB scheme. The preliminary results show that DGNB projects require a large amount of documentation and the design process requires a large amount of manual data input in different tools handles by different stakeholders, e...

  10. Reasons for consulting a doctor on the Internet: Web survey of users of an Ask the Doctor service.

    Science.gov (United States)

    Umefjord, Göran; Petersson, Göran; Hamberg, Katarina

    2003-10-22

    In 1998 the Swedish noncommercial public health service Infomedica opened an Ask the Doctor service on its Internet portal. At no charge, anyone with Internet access can use this service to ask questions about personal health-related and disease-related matters. To study why individuals choose to consult previously-unknown doctors on the Internet. Between November 1, 2001, and January 31, 2002 a Web survey of the 3622 Ask the Doctor service users, 1036 men (29%) and 2586 (71%) women, was conducted. We excluded 186 queries from users. The results are based on quantitative and qualitative analysis of the answers to the question "Why did you choose to ask a question at Infomedica's 'Ask the Doctor' service?" 1223 surveys were completed (response rate 36 %). Of the participants in the survey 322 (26%) were male and 901 (74%) female. As major reasons for choosing to consult previously-unknown doctors on the Internet participants indicated: convenience (52%), anonymity (36%), "doctors too busy" (21%), difficult to find time to visit a doctor (16%), difficulty to get an appointment (13%), feeling uncomfortable when seeing a doctor (9%), and not being able to afford a doctors' visit (3%). Further motives elicited through a qualitative analysis of free-text answers were: seeking a second opinion, discontent with previous doctors and a wish for a primary evaluation of a medical problem, asking embarrassing or sensitive questions, seeking information on behalf of relatives, preferring written communication, and (from responses by expatriates, travelers, and others) living far away from regular health care. We found that that an Internet based Ask the Doctor service is primarily consulted because it is convenient, but it may also be of value for individuals with needs that regular health care services have not been able to meet.

  11. Occupational stress in consultants in accident and emergency medicine: a national survey of levels of stress at work.

    Science.gov (United States)

    Burbeck, R; Coomber, S; Robinson, S M; Todd, C

    2002-05-01

    To assess levels of occupational stress in UK accident and emergency (A&E) consultants. Postal survey of complete enumeration of UK consultants. GHQ-12 and SCL-D, and respondents' reported perceptions of stressors. Of 371 valid respondents (78%), 21 declined to participate. Of the remaining 350, 154 (44.4%) had GHQ-12 scores over the threshold for distress, which is much higher than found in other studies of doctors. Levels of depression as measured by the SCL-D at 18% (n=63) were slightly higher than other groups. Thirty four (10%) reported suicidal ideation. Women had significantly higher SCL-D scores than men (U=6604, pGHQ-12 scores) (rho=0.126, pGHQ identified caseness, while "the effect of stress on family life" (OR=1.53), low prestige of specialty (OR=1.20), and "dealing with management" (OR=1.28) predicted SCL-D scores. There are high levels of psychological distress among doctors working in A&E compared with other groups of doctors. There is likely to be an effect on staff morale and career longevity. Interventions to improve the working lives of A&E consultants are required, in particular a reduction in hours worked.

  12. How should complementary and alternative medicine be taught to medical students in Switzerland? A survey of medical experts and students.

    Science.gov (United States)

    Nicolao, Marie; Täuber, Martin G; Heusser, Peter

    2010-01-01

    In Switzerland and in the whole western world, the growing popularity of CAM is calling for its implementation in the undergraduate medical curriculum. To determine whether medical experts and medical students are favorable to complementary and alternative medicine (CAM) education at Swiss medical schools and to investigate their opinion about its form, content and goals. Experts in the fields of conventional medicine (COM, n = 106), CAM experts (n = 29) and senior medical students (n = 640) were surveyed by an online questionnaire. 48.7% of the COM experts, 100% of the CAM experts, and 72.6% of the students are favorable to CAM education at Swiss medical schools. The most requested disciplines are acupuncture, phytotherapy, and homeopathy; the most recommended characteristics of CAM education are elective courses, during the clinical years, in the format of seminars and lectures. For the CAM experts, the priority is to improve the students' knowledge of CAM, whereas for the COM experts and the students, the priority is to analyze efficiency, security, interactions, and secondary effects of CAM. CAM courses should be informative, giving the students sufficient knowledge to provide a critical analysis of efficiency and security of different CAM modalities.

  13. Characterization of the unhealthy and hazardous situations under the forensic expert survey and safety management in quarries

    Directory of Open Access Journals (Sweden)

    Ricardo Guimarães de Paula

    Full Text Available Abstract In the typical activities of quarries, it is common for the employees to be exposed to diverse risk factors, pertaining to their health or physical integrity. This kind of exposition, in Brazil, entitles these employees to additional payments, defined in law from different technical parameters. The controversies concerning the payment of these premiums between the employers and the employees, like the other conflicts between capital and labor, are solved in Brazil by the Labor Courts, and the forensic expert survey is one of the main tools used by the judges. This study aimed to characterize the unhealthy or hazardous situations in quarries using the forensic expert survey, focusing on the concepts and the legal definitions of the unhealthy or hazardous situations in labor activities, as well as the main aspects of the expert evidence technique and the judicial proceeding. This analysis revealed that most of the functions in quarries mean exposure to hazards, requiring appropriate management

  14. Assessing the Economics of Dengue: Results from a Systematic Review of the Literature and Expert Survey.

    Science.gov (United States)

    Constenla, Dagna; Garcia, Cristina; Lefcourt, Noah

    2015-11-01

    The economics of dengue is complex and multifaceted. We performed a systematic review of the literature to provide a critical overview of the issues related to dengue economics research and to form a background with which to address the question of cost. Three literature databases were searched [PubMed, Embase and Latin American and Caribbean Health Sciences Literature (LILACS)], covering a period from 1980 to 2013, to identify papers meeting preset inclusion criteria. Studies were reviewed for methodological quality on the basis of a quality checklist developed for this purpose. An expert survey was designed to identify priority areas in dengue economics research and to identify gaps between the methodology and actual practice. Survey responses were combined with the literature review findings to determine stakeholder priorities in dengue economics research. The review identified over 700 papers. Forty-two of these papers met the selection criteria. The studies that were reviewed presented results from 32 dengue-endemic countries, underscoring the importance of dengue as a global public health problem. Cost analyses were the most common, with 21 papers, followed by nine cost-effectiveness analyses and seven cost-of-illness studies, indicating a relatively strong mix of methodologies. Dengue annual overall costs (in 2010 values) ranged from US$13.5 million (in Nicaragua) to $56 million (in Malaysia), showing cost variations across countries. Little consistency exists in the way costs were estimated and dengue interventions evaluated, making generalizations around costs difficult. The current evidence suggests that dengue costs are substantial because of the cost of hospital care and lost earnings. Further research in this area will broaden our understanding of the true economic impact of dengue.

  15. [Barriers to Digitalisation of Healthcare in Germany: A Survey of Experts].

    Science.gov (United States)

    Nohl-Deryk, Pascal; Brinkmann, Jesaja Kenneth; Gerlach, Ferdinand Michael; Schreyögg, Jonas; Achelrod, Dmitrij

    2018-01-04

    Digital health is a growing area in healthcare with a huge potential. Nevertheless, the degree of digitalization in German healthcare is low when compared internationally and with other German industries. Despite political efforts, certain barriers seem to strongly impede the process of digitalization process in healthcare. We surveyed 18 representative healthcare experts from various sectors with semi-structured interviews on barriers and solutions for digital health. Thematic analysis by Braun and Clarke was used for interpretation. The interviewees identified barriers that were stakeholder-specific and across stakeholders. Self-regulatory bodies and the medical profession were found to lack willingness and organizational structure for digitalization. Lack of evidence and missing interoperability represented primary obstacles, while current legislation and financial regulations were rarely mentioned. In particular, infrastructure expansion and interoperability would require a coordinated, state intervention. Positive communication on possibilities and benefits of digital solutions was also considered important. A strong political will, an overarching strategy accompanied by a communication concept seems to be necessary in order for digital health to succeed. Regarding legislation, binding specifications, deadlines and sanctions may be needed for self-regulatory bodies, while also involving users in the development process at an early stage and creating positive incentives for using digital solutions. © Georg Thieme Verlag KG Stuttgart · New York.

  16. Nurses' expert opinions of workplace interventions for a healthy working environment: a Delphi survey.

    Science.gov (United States)

    Doran, Diane; Clarke, Sean; Hayes, Laureen; Nincic, Vera

    2014-09-01

    Much has been written about interventions to improve the nursing work environment, yet little is known about their effectiveness. A Delphi survey of nurse experts was conducted to explore perceptions about workplace interventions in terms of feasibility and likelihood of positive impact on nurse outcomes such as job satisfaction and nurse retention. The interventions that received the highest ratings for likelihood of positive impact included: bedside handover to improve communication at shift report and promote patient-centred care; training program for nurses in dealing with violent or aggressive behaviour; development of charge nurse leadership team; training program focused on creating peer-supportive atmospheres and group cohesion; and schedule that recognizes work balance and family demands. The overall findings are consistent with the literature that highlights the importance of communication and teamwork, nurse health and safety, staffing and scheduling practices, professional development and leadership and mentorship. Nursing researchers and decision-makers should work in collaboration to implement and evaluate interventions for promoting practice environments characterized by effective communication and teamwork, professional growth and adequate support for the health and well-being of nurses.

  17. Planning and Designing Academic Library Learning Spaces: Expert Perspectives of Architects, Librarians, and Library Consultants. Project Information Literacy Research Report. The Practitioner Series

    Science.gov (United States)

    Head, Alison J.

    2016-01-01

    This paper identifies approaches, challenges, and best practices related to planning and designing today's academic library learning spaces. As part of the Project Information Literacy (PIL) Practitioner Series, qualitative data is presented from 49 interviews conducted with a sample of academic librarians, architects, and library consultants.…

  18. Consulting the Delphi: A New Idea for Collecting Student Feedback through the Two Survey Method (TSM)

    Science.gov (United States)

    Finelli, Cynthia J.; Wright, Mary C.; Pinder-Grover, Tershia

    2010-01-01

    The Two Survey Method (TSM) is a new time-efficient tool for gathering formative student feedback. Based on the Delphi technique, the TSM uses iterative surveys to develop student consensus about key strengths and suggestions for instruction. Evaluation data indicate that both faculty and students are satisfied with the method's efficiency and the…

  19. Hemostatic assessment, treatment strategies, and hematology consultation in massive postpartum hemorrhage: results of a quantitative survey of obstetrician-gynecologists

    Directory of Open Access Journals (Sweden)

    James AH

    2015-11-01

    Full Text Available Andra H James,1 David L Cooper,2 Michael J Paidas31Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Duke University, Durham, NC, 2Novo Nordisk Inc., Princeton, NJ, 3Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale Women and Children’s Center for Blood Disorders and Preeclampsia Advancement, Yale University, New Haven, CT, USAObjective: To assess potential diagnostic and practice barriers to successful management of massive postpartum hemorrhage (PPH, emphasizing recognition and management of contributing coagulation disorders.Study design: A quantitative survey was conducted to assess practice patterns of US obstetrician-gynecologists in managing massive PPH, including assessment of coagulation.Results: Nearly all (98% of the 50 obstetrician-gynecologists participating in the survey reported having encountered at least one patient with “massive” PPH in the past 5 years. Approximately half (52% reported having previously discovered an underlying bleeding disorder in a patient with PPH, with disseminated intravascular coagulation (88%, n=23/26 being identified more often than von Willebrand disease (73%, n=19/26. All reported having used methylergonovine and packed red blood cells in managing massive PPH, while 90% reported performing a hysterectomy. A drop in blood pressure and ongoing visible bleeding were the most commonly accepted indications for rechecking a “stat” complete blood count and coagulation studies, respectively, in patients with PPH; however, 4% of respondents reported that they would not routinely order coagulation studies. Forty-two percent reported having never consulted a hematologist for massive PPH.Conclusion: The survey findings highlight potential areas for improved practice in managing massive PPH, including earlier and more consistent assessment, monitoring of coagulation studies, and consultation with a hematologist.Keywords: acquired hemophilia, blood

  20. Graduate attributes in the disciplines of Medicine, Dentistry and Veterinary Medicine: a survey of expert opinions.

    Science.gov (United States)

    Laidlaw, Anita; Guild, Simon; Struthers, Julie

    2009-06-05

    This study was completed as part of a project for the Quality Assurance Agency on the enhancement theme of 'Research teaching linkages: enhancing graduate attributes' in the disciplines of Medicine, Dentistry and Veterinary Medicine. The aims of this investigation were to elucidate a list of desirable research related graduate attributes for the disciplines of Medicine, Dentistry and Veterinary Medicine and provide evidence as to how they could be covered within such curricula. Semi structured interviews, symposium breakout sessions and conference workshops were used to define and rank attributes suggested by curricula design experts from the three disciplines. Students graduating from a BSc Medical Science degree program were surveyed to determine how well they felt the curriculum and associated final year project equipped them with the identified attributes. A list of seven high level attributes which were desirable in graduates wishing to pursue either a professional or research career were identified. 105 students reported that a final year project was particularly effective at developing an understanding of the need to have an inquiring mind and critical appraisal skills whilst other components of their degree course covered team working skills, core knowledge and an understanding of ethics and governance. This study identified desirable attributes from graduates from medical, dental and veterinary degree programs and provides evidence to support the case for student projects helping to achieve both clinical and research related graduate attributes in medical undergraduates. The project also provides a focus for debate amongst those involved in curriculum design as to whether the attributes identified are those desirable in their graduates and to examine their current curriculum to determine coverage.

  1. Graduate attributes in the disciplines of Medicine, Dentistry and Veterinary Medicine: a survey of expert opinions

    Directory of Open Access Journals (Sweden)

    Laidlaw Anita

    2009-06-01

    Full Text Available Abstract Background This study was completed as part of a project for the Quality Assurance Agency on the enhancement theme of 'Research teaching linkages: enhancing graduate attributes' in the disciplines of Medicine, Dentistry and Veterinary Medicine. The aims of this investigation were to elucidate a list of desirable research related graduate attributes for the disciplines of Medicine, Dentistry and Veterinary Medicine and provide evidence as to how they could be covered within such curricula. Methods Semi structured interviews, symposium breakout sessions and conference workshops were used to define and rank attributes suggested by curricula design experts from the three disciplines. Students graduating from a BSc Medical Science degree program were surveyed to determine how well they felt the curriculum and associated final year project equipped them with the identified attributes. Results A list of seven high level attributes which were desirable in graduates wishing to pursue either a professional or research career were identified. 105 students reported that a final year project was particularly effective at developing an understanding of the need to have an inquiring mind and critical appraisal skills whilst other components of their degree course covered team working skills, core knowledge and an understanding of ethics and governance. Conclusion This study identified desirable attributes from graduates from medical, dental and veterinary degree programs and provides evidence to support the case for student projects helping to achieve both clinical and research related graduate attributes in medical undergraduates. The project also provides a focus for debate amongst those involved in curriculum design as to whether the attributes identified are those desirable in their graduates and to examine their current curriculum to determine coverage.

  2. The usefulness of in vitro models to predict the bioavailability of iron and zinc: A consensus statement from the HarvestPlus expert consultation

    NARCIS (Netherlands)

    Fairweather-Tait, S.; Lynch, S.; Hotz, C.; Hurrell, R.; Abrahamse, L.; Beebe, S.; Bering, S.; Bukhave, K.; Glahn, R.; Hambidge, M.; Hunt, J.; Lonnerdal, B.; Miller, D.; Mohktar, N.; Nestel, P.; Reddy, M.; Sandberg, A.S.; Sharp, P.; Teucher, B.; Trinidad, T.P.

    2005-01-01

    A combination of dietary and host-related factors determines iron and zinc absorption, and several in vitro methods have been developed as preliminary screening tools for assessing bioavailability. An expert committee has reviewed evidence for their usefulness and reached a consensus. Dialyzability

  3. Bioethics consultation practices and procedures: a survey of a large Canadian community of practice.

    Science.gov (United States)

    Greenberg, R A; Anstey, K W; Macri, R; Heesters, A; Bean, S; Zlotnik Shaul, R

    2014-06-01

    The literature fails to reflect general agreement over the nature of the services and procedures provided by bioethicists, and the training and core competencies this work requires. If bioethicists are to define their activities in a consistent way, it makes sense to look for common ground in shared communities of practice. We report results of a survey of the services and procedures among bioethicists affiliated with the University of Toronto Joint Centre for Bioethics (JCB). This is the largest group of bioethicists working in healthcare organizations in Canada. The results suggest there are many common services and procedures of JCB bioethicists. This survey can serve as a baseline for further exploration of the work of JCB bioethicists. Common practices exist with respect to the domains of practice, individual reporting relationships, service availability within business hours and the education and training of the bioethicist.

  4. Guidance for contact tracing of cases of Lassa fever, Ebola or Marburg haemorrhagic fever on an airplane: results of a European expert consultation.

    Science.gov (United States)

    Gilsdorf, Andreas; Morgan, Dilys; Leitmeyer, Katrin

    2012-11-21

    Travel from countries where viral haemorrhagic fevers (VHF) are endemic has increased significantly over the past decades. In several reported VHF events on airplanes, passenger trace back was initiated but the scale of the trace back differed considerably. The absence of guidance documents to help the decision on necessity and scale of the trace back contributed to this variation.This article outlines the recommendations of an expert panel on Lassa fever, Ebola and Marburg haemorrhagic fever to the wider scientific community in order to advise the relevant stakeholders in the decision and scale of a possible passenger trace back. The evidence was collected through review of published literature and through the views of an expert panel. The guidance was agreed by consensus. Only a few events of VHF cases during air travel are reported in literature, with no documented infection in followed up contacts, so that no evidence of transmission of VHF during air travel exists to date. Based on this and the expert opinion, it was recommended that passenger trace back was undertaken only if: the index case had symptoms during the flight; the flight was within 21 days after detection of the event; and for Lassa fever if exposure of body fluid has been reported. The trace back should only be done after confirmation of the index case. Passengers and crew with direct contact, seat neighbours (+/- 1 seat), crew and cleaning personal of the section of the index case should be included in the trace back. No evidence has been found for the transmission of VHF in airplanes. This information should be taken into account, when a trace back decision has to be taken, because such a measure produces an enormous work load. The procedure suggested by the expert group can guide decisions made in future events, where a patient with suspected VHF infection travelled on a plane. However, the actual decision on start and scale of a trace back always lies in the hands of the responsible people

  5. Guidance for contact tracing of cases of Lassa fever, Ebola or Marburg haemorrhagic fever on an airplane: results of a European expert consultation

    Directory of Open Access Journals (Sweden)

    Gilsdorf Andreas

    2012-11-01

    Full Text Available Abstract Background Travel from countries where viral haemorrhagic fevers (VHF are endemic has increased significantly over the past decades. In several reported VHF events on airplanes, passenger trace back was initiated but the scale of the trace back differed considerably. The absence of guidance documents to help the decision on necessity and scale of the trace back contributed to this variation. This article outlines the recommendations of an expert panel on Lassa fever, Ebola and Marburg haemorrhagic fever to the wider scientific community in order to advise the relevant stakeholders in the decision and scale of a possible passenger trace back. Method The evidence was collected through review of published literature and through the views of an expert panel. The guidance was agreed by consensus. Results Only a few events of VHF cases during air travel are reported in literature, with no documented infection in followed up contacts, so that no evidence of transmission of VHF during air travel exists to date. Based on this and the expert opinion, it was recommended that passenger trace back was undertaken only if: the index case had symptoms during the flight; the flight was within 21 days after detection of the event; and for Lassa fever if exposure of body fluid has been reported. The trace back should only be done after confirmation of the index case. Passengers and crew with direct contact, seat neighbours (+/− 1 seat, crew and cleaning personal of the section of the index case should be included in the trace back. Conclusion No evidence has been found for the transmission of VHF in airplanes. This information should be taken into account, when a trace back decision has to be taken, because such a measure produces an enormous work load. The procedure suggested by the expert group can guide decisions made in future events, where a patient with suspected VHF infection travelled on a plane. However, the actual decision on start and scale

  6. Lymphedema and employability - Review and results of a survey of Austrian experts.

    Science.gov (United States)

    Neubauer, Markus; Schoberwalter, Dieter; Cenik, Fadime; Keilani, Mohammad; Crevenna, Richard

    2017-03-01

    Literature about lymphedema and its influence on the ability to work and employability is limited. The aim of the present study was to investigate the opinion of Austrian experts on factors influencing the ability to work and employability in patients suffering from lymphedema. A self-administered questionnaire consisting of 6 questions was sent to 12 Austrian lymphedema experts with 6 different specializations from May to August 2016. These experts were asked about suitable and unsuitable professions, the possible influence of lymphedema on the ability to work and employability as well as about existing and additional measures to improve the return to work. The reply rate was 100% (12 out of 12). All experts agreed that lymphedema can restrict the ability to work and employability. The leading reason for limited ability to work and employability was restricted mobility or function of the affected limb along with time-consuming therapeutic modalities, pain and psychological stress. The most suitable job named was teacher and the most unsuitable job named was cook. As easements for return to work, early rehabilitation, self-management, coping strategies, patient education, employer's goodwill and employer's cooperation were reported. Furthermore, experts stressed the need for an adjustment of the legal framework as well as low-barrier and more therapy offers. Adjusted work demands seem to be of greater importance to support the ability to work and employability than recommendations for specific job profiles alone. Experts suggest an adjustment of the legal framework for affected patients, claiming a right for early rehabilitation as well as for life-long therapy. Even though some clinically useful conclusions may be drawn from this article, further research in the field is warranted.

  7. Towards a job competency profile for agricultural extension instructors: A survey of views of experts

    NARCIS (Netherlands)

    Karbasioun, M.; Mulder, M.; Biemans, H.J.A.

    2007-01-01

    A project is carried out for instructors in the agricultural extension service in Esfahan. Part of the project is study, conducted to inform the process of competency profile development for the instructors. The study, reported in this contribution, focuses on views of experts about competencies

  8. Routine diagnostic procedures for chronic encephalopathy induced by solvents: survey of experts

    NARCIS (Netherlands)

    van der Hoek, J. A.; Verberk, M. M.; van der Laan, G.; Hageman, G.

    2001-01-01

    To study the routine diagnostic procedures used in different countries for chronic toxic encephalopathy (CTE) induced by solvents. By means of a postal questionnaire selected international experts were asked about the methods they use to diagnose patients suspected of having CTE induced by solvents,

  9. Carbapenemase-producing Enterobacteriaceae in Europe : a survey among national experts from 39 countries, February 2013

    NARCIS (Netherlands)

    Glasner, C; Albiger, B; Buist, Girbe; Tambić Andrasević, A; Canton, R; Carmeli, Y; Friedrich, A W; Giske, C G; Glupczynski, Y; Gniadkowski, M; Livermore, D M; Nordmann, P; Poirel, L; Rossolini, G M; Seifert, H; Vatopoulos, A; Walsh, T; Woodford, N; Donker, T; Monnet, D L; Grundmann, H

    2013-01-01

    The spread of carbapenemase-producing Enterobacteriaceae (CPE) is a threat to healthcare delivery, although its extent differs substantially from country to country. In February 2013, national experts from 39 European countries were invited to self-assess the current epidemiological situation of CPE

  10. Towards Horizon 2020: challenges and advances for clinical mental health research – outcome of an expert survey

    Science.gov (United States)

    van der Feltz-Cornelis, Christina M; van Os, Jim; Knappe, Susanne; Schumann, Gunter; Vieta, Eduard; Wittchen, Hans-Ulrich; Lewis, Shôn W; Elfeddali, Iman; Wahlbeck, Kristian; Linszen, Donald; Obradors-Tarragó, Carla; Haro, Josep Maria

    2014-01-01

    Background The size and increasing burden of disease due to mental disorders in Europe poses substantial challenges to its population and to the health policy of the European Union. This warrants a specific research agenda concerning clinical mental health research as one of the cornerstones of sustainable mental health research and health policy in Europe. The aim of this research was to identify the top priorities needed to address the main challenges in clinical research for mental disorders. Methods The research was conducted as an expert survey and expert panel discussion during a scientific workshop. Results Eighty-nine experts in clinical research and representing most European countries participated in this survey. Identified top priorities were the need for new intervention studies, understanding the diagnostic and therapeutic implications of mechanisms of disease, and research in the field of somatic-psychiatric comorbidity. The “subjectivity gap” between basic neuroscience research and clinical reality for patients with mental disorders is considered the main challenge in psychiatric research, suggesting that a shift in research paradigms is required. Conclusion Innovations in clinical mental health research should bridge the gap between mechanisms underlying novel therapeutic interventions and the patient experience of mental disorder and, if present, somatic comorbidity. Clinical mental health research is relatively underfunded and should receive specific attention in Horizon 2020 funding programs. PMID:25061300

  11. Forensic medicine experts' opinion on medico-legal autopsies in hospital deaths: a questionnaire survey.

    Science.gov (United States)

    D'Souza, Deepak Herald; Pant, Sadip; Menezes, Ritesh George

    2013-10-01

    Medico-legal autopsy is conducted routinely in some countries and selectively in others in hospital deaths. This study was conducted to evaluate the views of the forensic medicine experts regarding this matter. A questionnaire pro forma was sent to sixty-five forensic medicine experts practicing in different medical institutions all around India. Designations and experiences of the participants were noted by requests in the same questionnaire. Their specific experience in conducting medico-legal autopsy in hospital deaths was also requested for. Responses were charted in frequency distribution tables and analyzed using SPSS, version 17.0. One-third of the participants felt that a medico-legal autopsy was necessary in all the hospital death cases as defined in the present study. Ten percent of the participants opined that a medico-legal autopsy was unnecessary in hospital deaths. The majority of the experts mentioned finding the cause of death, followed by finding the manner of death and collecting the evidentiary materials, as the reasons for medico-legal autopsy in hospital deaths. Twenty percent of the participants felt that internal findings at autopsy poorly matched with the case records. All the experts agreed that external autopsy findings matched with the hospital case records. Nearly two-third of the participants felt that it was difficult in some cases to interpret the autopsy findings without case records from the hospital where the deceased was treated. Our findings suggest that the exercise of carrying out medico-legal autopsy routinely in every hospital death as evident in the Indian framework is often unnecessary as per the experts' opinion. Autopsy findings in hospital deaths often correlate with hospital case records.

  12. Identifying competencies in vulvar disorder management for medical students and residents: a survey of US vulvar disorder experts.

    Science.gov (United States)

    Venkatesan, Aruna; Farsani, Taraneh; O'Sullivan, Patricia; Berger, Tim

    2012-10-01

    The study aimed to perform a content validation process by surveying vulvar disorder experts to identify evidence-based competencies appropriate for use in developing vulvar curricula for medical trainees. We identified 65 potential vulvar disorder competencies from literature review and expert opinions. Survey participants rated these competencies from 1 (not at all important) to 4 (highly important) in the training of 3 different groups of learners as follows: medical students, obstetrics and gynecology residents, and dermatology residents. We administered the survey to all US-based clinical members of the International Society for the Study of Vulvovaginal Disease as of September 2008 (n = 90). The content validity index and asymmetric CI were calculated for each curricular competency for each group of learners separately and used to identify competencies for use in curricula development. Forty-seven surveys were returned, yielding a response rate of 52.2%. Obstetrician-gynecologists represented 66% of the study sample, followed by dermatologists (15%), and nurse practitioners (9%). Seventy-nine percent of experts received their training by self-teaching, which included mentored experiences (62%) and attending conferences or courses (62%). Only 19% received vulvar training during residency and 11% during fellowship. Four curricular competencies met content validity criteria for medical students, 60 competencies for obstetrics and gynecology residents, and 47 competencies for dermatology residents. The differences between the 2 groups of residents focused on vulvovaginal pain and infection, examination, and procedures of the vagina. The competencies identified in this study can aid in the development of targeted curricula for medical students, obstetrics and gynecology residents, and dermatology residents.

  13. Advancing scoping study methodology: a web-based survey and consultation of perceptions on terminology, definition and methodological steps.

    Science.gov (United States)

    O'Brien, Kelly K; Colquhoun, Heather; Levac, Danielle; Baxter, Larry; Tricco, Andrea C; Straus, Sharon; Wickerson, Lisa; Nayar, Ayesha; Moher, David; O'Malley, Lisa

    2016-07-26

    Scoping studies (or reviews) are a method used to comprehensively map evidence across a range of study designs in an area, with the aim of informing future research practice, programs and policy. However, no universal agreement exists on terminology, definition or methodological steps. Our aim was to understand the experiences of, and considerations for conducting scoping studies from the perspective of academic and community partners. Primary objectives were to 1) describe experiences conducting scoping studies including strengths and challenges; and 2) describe perspectives on terminology, definition, and methodological steps. We conducted a cross-sectional web-based survey with clinicians, educators, researchers, knowledge users, representatives from community-based organizations, graduate students, and policy stakeholders with experience and/or interest in conducting scoping studies to gain an understanding of experiences and perspectives on the conduct and reporting of scoping studies. We administered an electronic self-reported questionnaire comprised of 22 items related to experiences with scoping studies, strengths and challenges, opinions on terminology, and methodological steps. We analyzed questionnaire data using descriptive statistics and content analytical techniques. Survey results were discussed during a multi-stakeholder consultation to identify key considerations in the conduct and reporting of scoping studies. Of the 83 invitations, 54 individuals (65 %) completed the scoping questionnaire, and 48 (58 %) attended the scoping study meeting from Canada, the United Kingdom and United States. Many scoping study strengths were dually identified as challenges including breadth of scope, and iterative process. No consensus on terminology emerged, however key defining features that comprised a working definition of scoping studies included the exploratory mapping of literature in a field; iterative process, inclusion of grey literature; no quality

  14. Implementing Real-Time Video Consultation in Plastic Surgery.

    Science.gov (United States)

    Westra, I; Niessen, F B

    2015-10-01

    The Dutch government, hospitals, and health insurance companies have agreed on concentrating all specialist care in a few expert centers. This should lead to lower healthcare costs, but might also cause less accessible healthcare for patients living at a considerable distance from expert centers. A way to overcome less accessible healthcare, while maintaining reduced costs of medical care, is by using telemedicine between physician and patient. In a randomized controlled trial, follow-up consultation between the patient and physician via a secured real-time video connection 6 weeks after plastic surgery of the face was compared to traditional in-person consultation after the same time interval. After the consultation, patients received an invite to fill in an online survey, which consisted of questionnaires assessing patient satisfaction (PSQ-18, TSQ) and communication experiences (PEQ), as well as questions about the time spent on different aspects of the consultations. Thirty-one patients participated. Overall satisfaction was equal for both groups, but a significant difference in the dimensions 'general satisfaction' (online consultation group more satisfied) and 'accessibility and convenience' (online consultation group less satisfied) was found. Patients reported significantly lower satisfaction in patient-physician communication in online consultation than in traditional in-person consultations. Patients were satisfied with the online consultation, and were willing to use the system again. Patients in the online consultation group experienced significantly less waiting time, and spent less time in total for the appointment. Overall patients are equally satisfied with traditional consultation or real-time video consultation in plastic surgery. Online consultation is found to be a time-saving alternative to traditional consultation. However, online consultation is perceived by some patients as a negative influence on communication with the physician. Dedicated

  15. Perception of Corruption in 36 Major Chinese Cities: Based on Survey of 1,642 Experts

    Science.gov (United States)

    Song, Xuguang; Cheng, Wenhao

    2012-01-01

    Perception surveys remain an important tool to measure corruption. However, most existing perception surveys only analyze corruption at the national or international level, and do not provide information about corruption at local levels. But it is corruption in local areas that really influences the everyday life of ordinary people. In order to…

  16. Informational and analytical support of the state bodies activities (on the example of expert surveys in APR countries

    Directory of Open Access Journals (Sweden)

    L S Ruban

    2016-12-01

    Full Text Available Based on the expert surveys conducted within the international project “Dialogue Partnership as a Factor of Stability and Integration” (“Bridge between East and West” over ten years (2005-2014 and control interviews conducted in 2009 and 2015 in the longitude format (70% of experts were the same the author provides a comprehensive analysis of the situation in the Asia-Pacific region with the help of highly qualified experts and VIP-persons - decision-makers from 16 Asian-Pacific countries: Brunei-Darussalam, Vietnam, India, Indonesia, the People’s Republic of China, Republic of Korea, Mongolia, Myanmar, Nepal, the Russian Federation, Singapore, USA, Thailand, the Philippines and Japan. This study is not abstract or theoretical; it is a tool for informational and analytical support of the relevant state bodies of the Russian Federation responsible for the development of the situation in the Asia-Pacific region. The author analyzes the geopolitical balance of power and leadership in the region, its economic and energy situation, the level of security, risks and threats, the possibility of a military conflict so as to identify possible ways for the effective cooperation and coordination of interests of various countries in the region.

  17. The Mathematics Attitudes and Perceptions Survey: an instrument to assess expert-like views and dispositions among undergraduate mathematics students

    Science.gov (United States)

    Code, Warren; Merchant, Sandra; Maciejewski, Wes; Thomas, Matthew; Lo, Joseph

    2016-08-01

    One goal of an undergraduate education in mathematics is to help students develop a productive disposition towards mathematics. A way of conceiving of this is as helping mathematical novices transition to more expert-like perceptions of mathematics. This conceptualization creates a need for a way to characterize students' perceptions of mathematics in authentic educational settings. This article presents a survey, the Mathematics Attitudes and Perceptions Survey (MAPS), designed to address this need. We present the development of the MAPS instrument and its validation on a large (N = 3411) set of student data. Results from various MAPS implementations corroborate results from analogous instruments in other STEM disciplines. We present these results and highlight some in particular: MAPS scores correlate with course grades; students tend to move away from expert-like orientations over a semester or year of taking a mathematics course; and interactive-engagement type lectures have less of a negative impact, but no positive impact, on students' overall orientations than traditional lecturing. We include the MAPS instrument in this article and suggest ways in which it may deepen our understanding of undergraduate mathematics education.

  18. Identifying Transition Teacher Competencies through Literature Review and Surveys of Experts and Practitioners

    Science.gov (United States)

    Morgan, Robert L.; Callow-Heusser, Catherine A.; Horrocks, Erin L.; Hoffmann, Audrey N.; Kupferman, Scott

    2014-01-01

    We first conducted a synthesis of literature to identify essential transition teacher competencies to guide curriculum development for a personnel preparation program. The synthesis yielded a list of 67 competencies needed by transition teachers. Using the 67 competencies, we next created an electronic survey in which respondents were asked to…

  19. Demand for specialised training for the obese trauma patient: National ATLS expert group survey results.

    Science.gov (United States)

    Pucher, Philip H; Tanno, Lulu; Hewage, Kalon; Bagnall, N Mark

    2017-05-01

    The growing incidence of obesity in Western populations continues to place new stressors on health systems. Obese trauma patients present particular challenges across the entirety of the patient care pathway, and are at risk of higher lengths of stay, morbidity, and mortality. This study sought to assess a national group of trauma experts' opinions and knowledge regarding the management of obese trauma. A questionnaire was circulated to a trauma training providers and national steering committee members at a UK national Advance Trauma Life Support meeting. Demographic, knowledge, and opinion data was collected and collated for analysis. 109 questionnaires were returned (73% response rate). Broad agreement was reached that obese trauma patients were more challenging to manage (96.2% agreement) and suffered worse outcomes (89.9%). Only 22.2% felt their hospitals possessed appropriate resources to facilitate management. Up to a third of respondents had personally witnesses errors in care due to patient obesity. 90% believed specialist training for obese trauma could improve care. There is broad consensus amongst UK trauma providers that obese trauma patients are at risk of poorer outcomes and errors in care. Knowledge and preparedness of centres to manage these patients is variable. There was broad consensus that specialist training for the management of obese trauma patients may improve outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Competencies for infant mental health therapists: A survey of expert opinion.

    Science.gov (United States)

    Quay, Herbert C; Hogan, Anne E; Donohue, Keith F

    2009-03-01

    We report on data provided by a nationwide panel of 23 infant mental health (IMH) experts who provided numerical ratings of the relative importance of 143 competencies desirable for licensed mental health therapists working with infants/children birth to 5 years of age and their families/caregivers. The competencies were developed based on prior state and national efforts and our own experience in training IMH therapists. The competencies were grouped conceptually into seven areas: (a) Normal infant and toddler development; (b) Atypical development (perturbations in development); (c) Emotional/behavioral disorders in infants and young children; (d) Assessment; (e) Intervention; (f) Community resources and referrals; and (g) Organization, communication, and collaboration. We calculated means, SDs, 95% confidence intervals to rank order each competency. We conducted reliability analyses and tested for mean differences in ratings for the seven areas. Interrater and intraclass correlations were modest, likely the result of restriction of range in the ratings. The seven areas showed high levels of internal consistency and, with few exceptions, did not significantly differ in the means of their ratings. The utility of the competencies are discussed as a framework for training and professional development for IMH clinicians. Copyright © 2009 Michigan Association for Infant Mental Health.

  1. Timing of anticoagulant re-initiation following intracerebral hemorrhage in mechanical heart valves: Survey of neurosurgeons and thrombosis experts.

    Science.gov (United States)

    AlKherayf, Fahad; Xu, Yan; Westwick, Harrison; Moldovan, Ioana Doina; Wells, Philip S

    2017-03-01

    While oral anticoagulation (OAC) is universally indicated for patients with mechanical heart valves (MHVs), OAC resumption following anticoagulant-associated intracerebral hemorrhage (ICH) is an area of uncertainty. We sought to determine the practice preferences of North American neurosurgeons and thrombosis experts on optimal timing of OAC re-initiation. A cross-sectional survey was disseminated to North American members of the American Association of Neurological Surgeons and the International Society for Thrombosis and Haemostasis. Demographic factors, as well as a clinical scenario with 14 modifiable clinical risk factors were included in the survey. 504 physicians completed our survey (response rate 34.3%). Majority of participants were affiliated with academic centres, and managed≤10 ICH patients with MHV per year. There was wide distribution in response in optimal timing for OAC resumption following an ICH: 59% and 60% preferred to re-start OAC between 3 and 14 days following the hemorrhagic event (median of 6-7 days). Smaller hemorrhages (valve prosthesis, caged-ball valves and multiple valves prompted earlier OAC resumption. Wide variation in the current practice of neurosurgeons and thrombosis specialists exist when they encounter patients with ICH and MHV, though decisions were influenced by patient- and valve-related factors. As our observed variation likely reflects the immense gap in current evidence, prospective randomized trials in this population are therefore urgently needed. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Nanoparticles in facade coatings: a survey of industrial experts on functional and environmental benefits and challenges

    Energy Technology Data Exchange (ETDEWEB)

    Hincapié, Ingrid [EMPA Swiss Federal Laboratories for Materials Science and Technology, Technology and Society Laboratory (Switzerland); Künniger, Tina [EMPA Swiss Federal Laboratories for Materials Science and Technology, Applied Wood Materials Laboratory (Switzerland); Hischier, Roland [EMPA Swiss Federal Laboratories for Materials Science and Technology, Technology and Society Laboratory (Switzerland); Cervellati, Dario [GFC Chimica S.r.l (Italy); Nowack, Bernd; Som, Claudia, E-mail: claudia.som@empa.ch [EMPA Swiss Federal Laboratories for Materials Science and Technology, Technology and Society Laboratory (Switzerland)

    2015-07-15

    Integrating engineered nanoparticles (ENPs) into facade coatings is expected to offer considerable potential for improved or novel functionality, or even several functionalities at the same time (multifunctional materials). Little information is available about the tangible use of ENPs in facade coatings and the real improvements that their functionalities provide. In order to increase this information, we carried out a survey among selected coating manufacturers and ENP producers in Europe. We asked them about the improved functionalities enabled by ENPs, the quality of nano-enhanced facade coatings in comparison to conventional ones, and the handling of waste. The survey results indicated that the ENPs most frequently used in facade coatings in Europe were silver, titanium dioxide, and silicon dioxide. The most frequently mentioned potential benefits were ultraviolet-protection, water and dirt repellency (easy to clean), and antimicrobial properties. Improving environmental performance through the use of nano-enhanced facade coatings did not appear to be a focus for innovation. The survey also revealed mixed results in the comparison between nano-enhanced and conventional facade coatings: 36 % of respondents saw a notable improvement, 27 % noted a gradual improvement of functionalities, and 37 % detected no improvement over traditional materials. Some respondents mentioned a variety of tests that can be applied to investigate the quality of coating functionalities. These tests could be valuable in helping us to better understand the tangible improvements of nano-enhanced facade coating functionalities. Respondents were uncertain about how to properly handle the wastes resulting from nano-enhanced products.

  3. Gypsum plasterboard walls: inspection, pathological characterization and statistical survey using an expert system

    Directory of Open Access Journals (Sweden)

    Gaião, C.

    2012-06-01

    Full Text Available This paper presents an expert system to support the inspection and diagnosis of partition walls or wall coverings mounted using the Drywall (DW construction method. This system includes a classification of anomalies in DW and their probable causes. This inspection system was used in a field work that included the observation of 121 DWs. This paper includes a statistical analysis of the anomalies observed during these inspections and their probable causes. The correlation between anomalies and causes in the sample is also thoroughly analyzed. Anomalies are also evaluated for area affected, size, repair urgency and aesthetic value of the affected area. The conclusions of the statistical analysis allowed the creation of an inventory of preventive measures to be implemented in the design, execution and use phases in order to lessen the magnitude or eradicate the occurrence of anomalies in DW. These measures could directly help improve the quality of construction.

    Este trabajo presenta un sistema experto de apoyo a la inspección y diagnóstico de tabiques o revestimientos de yeso laminado. Dicho sistema, que permite la clasificación de las anomalías del yeso laminado y sus causas probables, se empleó en un trabajo de campo en el que se estudiaron 121 elementos construidos con este material. El trabajo incluye el análisis estadístico de las anomalías detectadas durante las inspecciones y sus motivos probables. También se analizó en detalle la correlación entre las anomalías y sus causas, evaluándose aquellas en función de la superficie afectada, la urgencia de las reparaciones y el valor estético de la zona implicada. Las conclusiones del análisis estadístico permitieron la elaboración de un inventario de medidas preventivas que deberían implantarse en las fases de proyecto, ejecución y utilización de estos elementos a fin de erradicar la aparición de anomalías en el yeso laminado o reducir su frecuencia. Dichas

  4. Training in Clinical Oncology and the Transition from Trainee to Consultant: Results of the Royal College of Radiologists' 2015 Post-Certificate of Completion of Training Survey.

    Science.gov (United States)

    Dickson, J; Liu, D; Bloomfield, D

    2017-03-01

    To seek feedback from clinical oncologists as to their experiences of specialty training and, where applicable, the transition to working as a consultant in the National Health Service. All clinical oncologists gaining a Certificate of Completion of Training between 1 July 2012 and 30 June 2014 were identified through records held by the Royal College of Radiologists and approached in May 2015 to take part in an online survey. The survey was completed by 38 of 80 clinical oncologists invited to take part (48% response rate). Most respondents (>87%) agreed that specialty training equipped them well with clinical skills in radiotherapy planning, systemic therapy and tumour site diagnosis and treatment. This fell to 58% with advanced radiotherapy techniques. Of the non-clinical skills, respondents felt training had equipped them less to deal with leadership and management (53%) and research (48%) than clinical governance (61%). Despite wanting to do so, 42% of respondents did not undertake any out-of-programme (OOP) activity to gain new skills. Most of those respondents who did undertake OOP activity agreed that it helped to prepare them for their first consultant post. There is broad support for the FRCR Examination. The First FRCR Examination modules in physics, pharmacology, tumour biology and radiobiology were seen to be very relevant to clinical practice by 50% or more of respondents. The Final FRCR Examination was seen as essential in a technical specialty like clinical oncology by 92% of respondents. Working as a new consultant, the survey revealed a heavy workload for most respondents, with 69% always or almost always working beyond contracted hours. Other issues of concern identified were discrepancies in advertised consultant job plans and ineffectiveness of the job plan review process. The trainee-consultant transition is often a difficult time, yet only 19% of respondents were allocated a formal mentor. Most respondents had to rely on informal arrangements

  5. Individual Consultations

    OpenAIRE

    Ian Walkinshaw; Todd Milford; Keri Freeman

    2015-01-01

    Responding to calls for research into measurable English language outcomes from individual language support consultations at universities, this study investigated the effect of individual consultations (ICs) on the academic writing skills and lexico-grammatical competence of students who speak English as an additional language (EAL). Attendance by 31 EAL students at ICs was recorded, and samples of their academic writi...

  6. Experts views' on Digital Competence

    NARCIS (Netherlands)

    Janssen, José; Stoyanov, Slavi

    2013-01-01

    Janssen, J., & Stoyanov, S. (2012, 20 November). Online Consultation for a Digital Competence Framework: Experts' views on Digital Competence. Workshop presentation at the Institute for Prospective Technological Studies, Seville, Spain.

  7. Global Grid Telemedicine System: Expert Consult Manager

    Science.gov (United States)

    2000-10-01

    REPB REPAIR-BLOOD-VESSEL-OTHER-THAN-FOR- FISTULA -WTH-OR-WITHOUT-PATCH-ANGIOPLASTY 0 2 D% REPA REPAIR- ARTERIOVENOUS - FISTULA 2 5 40% PERI PERICAROIUM...that the conceptual model of 5.1.1 together with the domain knowledge of 5.1.3 represented as in 5.1.2 is capable of functioning as an effective and...critical for system acceptance and functionality . The primary risk of our strategy is that what we learn from a narrow application domain may not

  8. Physiotherapy movement based classification approaches to low back pain: comparison of subgroups through review and developer/expert survey

    Directory of Open Access Journals (Sweden)

    Karayannis Nicholas V

    2012-02-01

    Full Text Available Abstract Background Several classification schemes, each with its own philosophy and categorizing method, subgroup low back pain (LBP patients with the intent to guide treatment. Physiotherapy derived schemes usually have a movement impairment focus, but the extent to which other biological, psychological, and social factors of pain are encompassed requires exploration. Furthermore, within the prevailing 'biological' domain, the overlap of subgrouping strategies within the orthopaedic examination remains unexplored. The aim of this study was "to review and clarify through developer/expert survey, the theoretical basis and content of physical movement classification schemes, determine their relative reliability and similarities/differences, and to consider the extent of incorporation of the bio-psycho-social framework within the schemes". Methods A database search for relevant articles related to LBP and subgrouping or classification was conducted. Five dominant movement-based schemes were identified: Mechanical Diagnosis and Treatment (MDT, Treatment Based Classification (TBC, Pathoanatomic Based Classification (PBC, Movement System Impairment Classification (MSI, and O'Sullivan Classification System (OCS schemes. Data were extracted and a survey sent to the classification scheme developers/experts to clarify operational criteria, reliability, decision-making, and converging/diverging elements between schemes. Survey results were integrated into the review and approval obtained for accuracy. Results Considerable diversity exists between schemes in how movement informs subgrouping and in the consideration of broader neurosensory, cognitive, emotional, and behavioural dimensions of LBP. Despite differences in assessment philosophy, a common element lies in their objective to identify a movement pattern related to a pain reduction strategy. Two dominant movement paradigms emerge: (i loading strategies (MDT, TBC, PBC aimed at eliciting a phenomenon

  9. Physiotherapy movement based classification approaches to low back pain: comparison of subgroups through review and developer/expert survey

    Science.gov (United States)

    2012-01-01

    Background Several classification schemes, each with its own philosophy and categorizing method, subgroup low back pain (LBP) patients with the intent to guide treatment. Physiotherapy derived schemes usually have a movement impairment focus, but the extent to which other biological, psychological, and social factors of pain are encompassed requires exploration. Furthermore, within the prevailing 'biological' domain, the overlap of subgrouping strategies within the orthopaedic examination remains unexplored. The aim of this study was "to review and clarify through developer/expert survey, the theoretical basis and content of physical movement classification schemes, determine their relative reliability and similarities/differences, and to consider the extent of incorporation of the bio-psycho-social framework within the schemes". Methods A database search for relevant articles related to LBP and subgrouping or classification was conducted. Five dominant movement-based schemes were identified: Mechanical Diagnosis and Treatment (MDT), Treatment Based Classification (TBC), Pathoanatomic Based Classification (PBC), Movement System Impairment Classification (MSI), and O'Sullivan Classification System (OCS) schemes. Data were extracted and a survey sent to the classification scheme developers/experts to clarify operational criteria, reliability, decision-making, and converging/diverging elements between schemes. Survey results were integrated into the review and approval obtained for accuracy. Results Considerable diversity exists between schemes in how movement informs subgrouping and in the consideration of broader neurosensory, cognitive, emotional, and behavioural dimensions of LBP. Despite differences in assessment philosophy, a common element lies in their objective to identify a movement pattern related to a pain reduction strategy. Two dominant movement paradigms emerge: (i) loading strategies (MDT, TBC, PBC) aimed at eliciting a phenomenon of centralisation of

  10. Physiotherapy movement based classification approaches to low back pain: comparison of subgroups through review and developer/expert survey.

    Science.gov (United States)

    Karayannis, Nicholas V; Jull, Gwendolen A; Hodges, Paul W

    2012-02-20

    Several classification schemes, each with its own philosophy and categorizing method, subgroup low back pain (LBP) patients with the intent to guide treatment. Physiotherapy derived schemes usually have a movement impairment focus, but the extent to which other biological, psychological, and social factors of pain are encompassed requires exploration. Furthermore, within the prevailing 'biological' domain, the overlap of subgrouping strategies within the orthopaedic examination remains unexplored. The aim of this study was "to review and clarify through developer/expert survey, the theoretical basis and content of physical movement classification schemes, determine their relative reliability and similarities/differences, and to consider the extent of incorporation of the bio-psycho-social framework within the schemes". A database search for relevant articles related to LBP and subgrouping or classification was conducted. Five dominant movement-based schemes were identified: Mechanical Diagnosis and Treatment (MDT), Treatment Based Classification (TBC), Pathoanatomic Based Classification (PBC), Movement System Impairment Classification (MSI), and O'Sullivan Classification System (OCS) schemes. Data were extracted and a survey sent to the classification scheme developers/experts to clarify operational criteria, reliability, decision-making, and converging/diverging elements between schemes. Survey results were integrated into the review and approval obtained for accuracy. Considerable diversity exists between schemes in how movement informs subgrouping and in the consideration of broader neurosensory, cognitive, emotional, and behavioural dimensions of LBP. Despite differences in assessment philosophy, a common element lies in their objective to identify a movement pattern related to a pain reduction strategy. Two dominant movement paradigms emerge: (i) loading strategies (MDT, TBC, PBC) aimed at eliciting a phenomenon of centralisation of symptoms; and (ii) modified

  11. Flipping the History Classroom with an Embedded Writing Consultant: Synthesizing Inverted and WAC Paradigms in a University History Survey Course

    Science.gov (United States)

    Murphree, Daniel

    2015-01-01

    "Flipping" the Classroom techniques and the use of Embedded Writing Consultants (EWC) in institutions of higher education have been the subject of scholarly research in recent years. However, it appears that no studies have examined the simultaneous use of both "tools" in an introductory History course at the university level.…

  12. Global priorities for research and the relative importance of different research outcomes: an international Delphi survey of malaria research experts.

    Science.gov (United States)

    Mulligan, Jo-Ann; Conteh, Lesong

    2016-12-06

    As global research investment increases, attention inevitably turns to assessing and measuring the outcomes and impact from research programmes. Research can have many different outcomes such as producing advances in scientific knowledge, building research capacity and, ultimately, health and broader societal benefits. The aim of this study was to test the use of a Delphi methodology as a way of gathering views from malaria research experts on research priorities and eliciting relative valuations of the different types of health research impact. An international Delphi survey of 60 malaria research experts was used to understand views on research outcomes and priorities within malaria and across global health more widely. The study demonstrated the application of the Delphi technique to eliciting views on malaria specific research priorities, wider global health research priorities and the values assigned to different types of research impact. In terms of the most important past research successes, the development of new anti-malarial drugs and insecticide-treated bed nets were rated as the most important. When asked about research priorities for future funding, respondents ranked tackling emerging drug and insecticide resistance the highest. With respect to research impact, the panel valued research that focuses on health and health sector benefits and informing policy and product development. Contributions to scientific knowledge, although highly valued, came lower down the ranking, suggesting that efforts to move research discoveries to health products and services are valued more highly than pure advances in scientific knowledge. Although the Delphi technique has been used to elicit views on research questions in global health this was the first time it has been used to assess how a group of research experts value or rank different types of research impact. The results suggest it is feasible to inject the views of a key stakeholder group into the research

  13. Shared consultant physician posts.

    Science.gov (United States)

    Cooke, J; Molefe, C; Carew, S; Finucane, P; Clinch, D

    2009-01-01

    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 (pposts can be broadly acceptable and cost efficient in Ireland.

  14. [Quality assurance in basic psychosomatic care. Report of an expert survey within the scope of the Federal Public Health Administration instigated pilot project].

    Science.gov (United States)

    Sandholzer, H; Pelz, J

    1996-08-01

    This article outlines a nationwide quality improvement project in counselling funded by the German Ministry of Health. To develop the project, expert surveys and consensus conferences are currently organized by the coordination center. A questionnaire with mainly open questions was sent to 32 teachers in general practice. Counselling for psychiatric, psychosomatic and psychosocial problems in primary care was regarded as an important field for quality assurance. The experts believed short psychotherapy to be an integral part of family medicine as some 30% of our patients present with complaints caused by psychosocial or psychological reasons. However, only some 70% of patients receive a specific treatment. The experts rated better recognition of psychosomatic problems as the most important area for quality improvement. Suitable interventions to improve the physicians' ability in the area mentioned were continuing medical education, balint groups, quality circles and flexible guidelines. The experts made invaluable contributions to the development of a practice documentation for psychosocial problems.

  15. The Desired Learning Outcomes of School-Based Nutrition/Physical Activity Health Education: A Health Literacy Constructed Delphi Survey of Finnish Experts

    Science.gov (United States)

    Ormshaw, Michael James; Kokko, Sami Petteri; Villberg, Jari; Kannas, Lasse

    2016-01-01

    Purpose: The purpose of this paper is to utilise the collective opinion of a group of Finnish experts to identify the most important learning outcomes of secondary-level school-based health education, in the specific domains of physical activity and nutrition. Design/ Methodology/ Approach: The study uses a Delphi survey technique to collect the…

  16. [Expert Opinions in Court: Liability of the Expert].

    Science.gov (United States)

    Schiltenwolf, Marcus; Beckmann, Nickolas; Gaidzik, Peter

    2017-12-01

    Experts in criminal, civil and, increasingly, in social court cases have to present their expert opinions in court. This should be regarded not only as a burden, even if this may at times appear superfluous to the expert, perhaps because the discussion is mere repetition of the opinion he has already written, or because the questions appear to be biased against the expert. Nonetheless, the expert is always advised to appear calm and objective during the interrogation by judges and parties or participants and their legal representatives, and should not allow himself or herself to be provoked by questioning. Furthermore, it may be necessary to correct the written expert statement in the course of the interrogation, but this can be a sign of a truly competent medical expert. The expert consulted can be held liable for adverse health effects resulting from the interrogation and investigation, as well as for deliberate or grossly faulty reports. Georg Thieme Verlag KG Stuttgart · New York.

  17. Do Consultation Psychiatrists, Forensic Psychiatrists, Psychiatry Trainees, and Health Care Lawyers Differ in Opinion on Gray Area Decision-Making Capacity Cases? A Vignette-Based Survey.

    Science.gov (United States)

    Armontrout, James; Gitlin, David; Gutheil, Thomas

    2016-01-01

    Previous research in the area of medical decision-making capacity has demonstrated relatively poor agreement between experienced evaluators in "gray area" cases. We performed a survey to determine the level of agreement about gray area decision-making capacity case scenarios within and between individuals of different professional backgrounds. Participants received a survey consisting of 3 complicated decision-making capacity vignettes with an accompanying "yes/no" question regarding capacity and a certainty scale for each vignette. Participants were identified from mailing lists of professional organizations and local hospitals. We received responses from psychiatry trainees, consultation-liaison psychiatrists, forensic psychiatrists, and lawyers with experience in health care law. Results were analyzed using SPSS. Across the 3 vignettes, the percentage agreeing that the individual described had capacity to refuse medical treatment ranged between 35% and 40% for trainees, 33% and 67% for consult psychiatrists, 41% and 76% for forensic psychiatrists, and 40% and 83% for health care lawyers. Only question 2 reached significance between-group differences (Pearson χ(2) = 11.473, p opinions on capacity. Copyright © 2016 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  18. Fiscal 2000 survey report on overseas geological structure, etc. Project for exchanging experts - Exploration technology (Indonesia); 2000 nendo kaigai chishitsu kozo to chosa hokokusho. Gijutsusha koryu jigyo - Tansa gijutsu bunya (Indonesia)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-03-01

    For the stabilization of coal supply/demand in the APEC (Asia-Pacific Economic Cooperation Conference) region and for the stable supply of coal to Japan, Japanese engineers and experts were dispatched to Indonesia, where coal production was remarkably increasing and efforts were being actively exerted to develop new coal mining fields, for training Indonesian specialists there, and Indonesian specialists were invited to Japan for training here. Japanese instructors on dispatch delivered lectures on coal geology, exploration, and exploitation at the human resource development center of Bandung City during the period July 20 through August 4, 2000, which was followed by a coal outcrop survey training session in the field. The trainees were from Kalimantan, Sumatra, Java, etc., and numbered 30. The trainees invited to Japan received lectures and training related to coal geology, exploration, and mining programs during the period October 19 through November 18, 2000, at the Geological Survey of Japan, Agency of Industrial Science and Technology, Ministry of International Trade and Industry; Matsushima Coal Mining Co., Ltd.; Enzan Plant, Tone Corporation; DIA Consultants Co., Ltd.; and Mitsubishi Materials Corporation. (NEDO)

  19. How do health services researchers understand the concept of patient-centeredness? Results from an expert survey

    Directory of Open Access Journals (Sweden)

    Scholl I

    2014-08-01

    indicator for the fuzziness of a theoretical concept. All in all, this study has shown that the conceptual ambiguity found in the literature on patient-centeredness is partly reflected in the conceptualizations of German researchers working in that field. This calls for more conceptual work, eg, developing an integrative model on patient-centeredness grounded in the international literature. Keywords: patient-centered care, concept analysis, expert survey

  20. Variation in number of general practitioner consultations before hospital referral for cancer: findings from the 2010 National Cancer Patient Experience Survey in England.

    Science.gov (United States)

    Lyratzopoulos, Georgios; Neal, Richard D; Barbiere, Josephine M; Rubin, Gregory P; Abel, Gary A

    2012-04-01

    Information from patient surveys can help to identify patient groups and cancers with the greatest potential for improvement in the experience and timeliness of cancer diagnosis. We aimed to examine variation in the number of pre-referral consultations with a general practitioner between patients with different cancers and sociodemographic characteristics. We analysed data from 41,299 patients with 24 different cancers who took part in the 2010 National Cancer Patient Experience Survey in England. We examined variation in the number of general practitioner consultations with cancer symptoms before hospital referral to diagnose cancer. Logistic regression was used to identify independent predictors of three or more pre-referral consultations, adjusting for cancer type, age, sex, deprivation quintile, and ethnic group. We identified wide variation between cancer types in the proportion of patients who had visited their general practitioner three or more times before hospital referral (7·4% [625 of 8408] for breast cancer and 10·1% [113 of 1124] for melanoma; 41·3% [193 of 467] for pancreatic cancer and 50·6% [939 of 1854] for multiple myeloma). In multivariable analysis, with patients with rectal cancer as the reference group, those with subsequent diagnosis of multiple myeloma (odds ratio [OR] 3·42, 95% CI 3·01-3·90), pancreatic cancer (2·35, 1·91-2·88), stomach cancer (1·96, 1·65-2·34), and lung cancer (1·68, 1·48-1·90) were more likely to have had three or more pre-referral consultations; conversely patients with subsequent diagnosis of breast cancer (0·19; 0·17-0·22), melanoma (0·34, 0·27-0·43), testicular cancer (0·47, 0·33-0·67), and endometrial cancer (0·59, 0·49-0·71) were more likely to have been referred to hospital after only one or two consultations. The probability of three or more pre-referral consultations was greater in young patients (OR for patients aged 16-24 years vs 65-74 years 2·12, 95% CI 1·63-2·75; pcancer type

  1. 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.

  2. Setting priorities for non-regulatory animal health in Ireland: results from an expert Policy Delphi study and a farmer priority identification survey.

    Science.gov (United States)

    More, Simon J; McKenzie, Ken; O'Flaherty, Joe; Doherty, Michael L; Cromie, Andrew R; Magan, Mike J

    2010-07-01

    Agriculture is a very important contributor to the Irish economy. In Ireland, national animal health services have been a government, rather than an industry, responsibility. In 2009, Animal Health Ireland (AHI) was established to provide a partnership approach to national leadership of non-regulatory animal health issues (those not subject to national and/or EU regulation). The objectives of this study were to elicit opinion from experts and farmers about non-regulatory animal health issues facing Irish livestock industries, including prioritisation of animal health issues and identification of opportunities to maximise the effective use of AHI resources. The study was conducted with experts using Policy Delphi methodology over three rounds, and with farmers using a priority identification survey. Non-regulatory bovine diseases/conditions were prioritised by both experts and farmers based on impact and international competitiveness. For each high-priority disease/condition, experts were asked to provide an assessment based on cost, impact, international perception, impediment to international market access and current resource usage effectiveness. Further information was also sought from experts about resource allocation preferences, methods to improve education and coordination, and innovative measures to improve prevention and management. There was close agreement between responses from experts and dairy farmers: each gave highest priority to 3 diseases with a biosecurity risk (subsequently termed 'biosecure diseases') (bovine viral diarrhoea [BVD], infectious bovine rhinotracheitis [IBR], paratuberculosis) and 4 diseases/conditions generally without a biosecurity risk ('non-biosecure diseases/conditions') (fertility, udder health/milk quality, lameness, calf health). Beef farmers also prioritised parasitic conditions and weanling pneumonia. The adverse impact of biosecure diseases is currently considered relatively minor by experts, but would increase

  3. Optimisation of flux calculation in rivers from discrete water quality surveys, a step towards an expert system

    Science.gov (United States)

    Raymond, S.; Moatar, F.; Meybeck, M.; Bustillo, V.

    2009-04-01

    ) including a quadratic runoff module (Bustillo, 2005), 1 linear interpolation method and 2 discharge-weighted concentration methods ("M18", "M19", Philipps et al, 1999). As expected, based on 55 stations and 430 years, SPM fluxes are the most uncertain ones with maximum biases determined on annual fluxes (monthly sampling simulations). ranging at stations from -75% to +55% by the classical rating-curves approach ("M1", "M2") droping to -60% to +5% for the M18 method. At this frequency, biases are much less for Ptot and PO4-3 (-30% to +10%), nitrate (-5% to +10%) and are negligible for TDS. For higher frequencies, the biases are reduced: for instance for weekly surveys they drop to -25% for SPM and to -20% to 5% for Ptot for the M18 method. The river basin size is influencing the performance of calculations methods: SPM flux errors are much higher for smaller basins (103 to 104 km2) than for larger ones (> 104 km2), probably in relation with the flow duration in 2% of time which is a key control factor of flux duration in 2% of time (Moatar et al, 2006). This indicator based on daily flow (Q) records is generally available at water quality stations. Other indicators based on discrete water quality surveys are being tested to explain the performance of flux methods for each variable: concentrations (C) variability, C vs Q relationship, concentration seasonality. For each variable and each station the optimal flux calculation method will be derived from the future expert system. BUSTILLO V., Biogéochimie et hydroclimatologie appliquées à l'aménagement des bassins fluviaux .PhD Thesis, INP Toulouse,232 p+annexes (2005). FERGUSON R.I., Accuracy and precision of methods for estimating river loads. Earth Surface Processes and Landforms, vol. 12,95-104 (1987). MOATAR F., PERSON G., MEYBECK M., COYNEL A., ETCHEBER H., CROUZET P., The influence of contrasting suspended particulate matter transport regimes on the bias and precision of flux estimates Science of the Total Environment

  4. Introduction to expert systems

    Energy Technology Data Exchange (ETDEWEB)

    Jackson, P.

    1986-01-01

    Expert systems have become one of the most exciting applications within the domain of artificial intelligence. Further interest has been provoked by Japan's Fifth Generation Project, which identifies expert or knowledge-based systems as a key element in the computer systems of the future. This book presents an introduction to expert systems at a level suited to the undergraduate student and the interested layman. It surveys the three main techniques for knowledge representation - rules, frames and logic. and describes in detail the expert systems which employ them. Contents: Expert systems and artificial intelligence; Formalisms for knowledge representation; MYCIN; Medical diagnosis using rules. MYCIN derivatives; TEIRESIAS, EMYCIN, and GUIDON; RI: recognition as a problem-solving strategy; CENTAUR: a combination of frames metalevel inference and commonsense reasoning in MECHO; Tools for building expert systems; Summary and conclusions; Exercises.

  5. Assessment of biosecurity and control measures to prevent incursion and to limit spread of emerging transboundary animal diseases in Europe: An expert survey.

    Science.gov (United States)

    Léger, Anaïs; De Nardi, Marco; Simons, Robin; Adkin, Amie; Ru, Giuseppe; Estrada-Peña, Agustín; Stärk, Katharina D C

    2017-10-20

    Decision-makers and risk managers are often called upon to prioritise on and recommend suitable measures to prevent the risk of introduction and spread of pathogens. The main objective of this study was to assess the perceptions of experts in Italy, Switzerland and the United Kingdom concerning the importance, effectiveness, feasibility, costs and acceptability of selected biosecurity measures to prevent the introduction and limit the spread of rabies, blue tongue (BT) and classical swine fever (CSF). After identifying the most relevant measures by the project team, an expert knowledge elicitation was implemented through a questionnaire. After preliminary descriptive analyses, a number of statistical calculations were performed such as weighted medians, Spearman rank correlation tests, Wilcoxon comparison tests and ranking of measures. Three experts from each country completed the questionnaires, one expert for each disease. The mean answer rates for CSF, BT and rabies were 73%, 100% and 99% respectively. "Tracing system for live animal trade" was highlighted as very relevant in all diseases. The implementation of a "restriction zone after a suspicion or confirmation" was also rated as a relevant measure, especially for CSF. We identified generally a small correlation between costs and the other criteria. Among the rabies experts, measures related to "zoonotic risk" were rated highly, supporting the idea of a One Health approach. Disagreement among experts concerned 43 measures for the three pathogens: the debated measures were "control of the wildlife CSF status", "arthropod-vector control" and "rabies vaccination for domestic animals". Facing budget restriction, decision-makers need to prioritise their actions and make efficient prevention choices. With this study, we aimed to provide elements for reflection and to inform priority setting. The results can be applied through the implementation of similar surveys or directly from the knowledge already gathered in

  6. Experts' opinions on the benefit of an incidental prenatal diagnosis of sex chromosomal aneuploidy: a qualitative interview survey

    NARCIS (Netherlands)

    Pieters, J.J.P.M.; Verhaak, C.M.; Braat, D.D.M.; Leeuwen, E. van; Smits, A.P.T.

    2012-01-01

    OBJECTIVE: Incidental findings in prenatal diagnostic testing may or may not have clear prognostic significance for the phenotype. We studied experts' opinions of the benefit and disadvantage of an incidental prenatal diagnosis of a sex chromosomal aneuploidy (SCA). METHODS: We interviewed 16

  7. Survey of consultants in restorative dentistry in the UK regarding ongoing care of patients provided with dental implants.

    Science.gov (United States)

    Beddis, H P; Durey, K A; Chan, M F W Y

    2017-08-25

    Background Funding for implant-based treatment within secondary care is limited, and acceptance criteria are determined locally according to funding agreements with NHS England. Indefinite review of all patients in secondary care is unlikely to be feasible due to limitations on departmental capacity. The increasing number of patients provided with implant-based treatment in secondary care has resulted in a growing maintenance burden, raising the question of who should provide this care. Management of some complications within primary care would facilitate patients' access to treatment, although no specific provision for maintenance of implant-retained prostheses is made within the NHS Dental Charges Regulations.Materials and methods An online survey was carried out to review services provided within restorative dentistry departments across the UK, investigating departmental protocols for review and maintenance of patients provided with dental implants.Results There was no consensus view on review protocols, discharge or provision of maintenance following implant placement. Fifty-seven percent would indefinitely carry out remake of implant-retained overdentures when clinically indicated, replace worn inserts, housings or abutments. Sixty-one percent would manage loose/lost screw- or cement-retained restorations and 68% would manage fractured restorations. Re-referral for peri-implant disease would be accepted by 64% of respondents. The lack of clear NHS funding for the management of complications was of concern to respondents in this survey.

  8. Consultancy and innovation the business service revolution in Europe

    CERN Document Server

    Wood, Peter

    2003-01-01

    Consultancy and Innovation links two important aspects of European economic development in the past thirty years: the pace of technical and management innovation, and the growing significance of technical and business consultancy. This book includes detailed studies of consultancy activities or 'knowledge intensive services' (KIS) in eight EU countries, written by national experts in the field.

  9. Management of stroke patients submitted to botulinum toxin type A therapy: a Delphi survey of an Italian expert panel of specialist injectors.

    Science.gov (United States)

    Franceschini, M; Iocco, M; Molteni, F; Santamato, A; Smania, N

    2014-10-01

    Spasticity is a common disabling symptom of several neurological conditions including stroke. Botulinum toxin type A (BTX-A) injection represents the gold standard therapy for focal spasticity. Post-stroke management of patients receiving BTX-A therapy has been variously investigated, but general agreement on how and when to implement rehabilitation is lacking. To perform a national survey of experts on the most appropriate rehabilitation procedures after BTX-A therapy for the focal treatment of spasticity. The study employed the Delphi technique through the COSMO project (Consensus on Post-Injection Management in Post-stroke Spasticity). Italian neurologists and physiatrists with experience in BTX-A therapy were selected to participate in the survey. Their anonymous opinions on key issues in treatment strategies in post-stroke spasticity were collected in three sequential rounds facilitated by a web platform. Consensus on a given issue was defined as agreed opinion by at least 66% of the survey participants. In all, 44 Italian experts were involved. Positive consensus was reached on the need to start rehabilitation during the first week after BTX-A injection therapy, with a rehabilitation program comprising both stretching combined with electrical stimulation and exercise therapy. Functional surgery may be considered only after 12-24 months in cases of BTX-A therapy failure. The use of commercial or custom-made orthoses in selected cases was recommended. The appropriate time interval between two BTX-A injections is 3-6 months, and clinical assessment should be performed 1 month after injection. The results of this national survey confirm that clinical experts on the use of BTX-A therapy for spasticity after stroke agree on the need to initiate rehabilitation treatment immediately after BTX-A injection: muscle stretching exercises, eventually combined with neuromuscular electrical stimulation, may enhance the effect of BTX-A therapy. Outcome after BTX-A therapy

  10. Perceived incivility during emergency department phone consultations.

    Science.gov (United States)

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

    2016-06-01

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

  11. Global priorities for research and the relative importance of different research outcomes: an international Delphi survey of malaria research experts

    OpenAIRE

    Mulligan, J; Conteh, L

    2016-01-01

    Background As global research investment increases, attention inevitably turns to assessing and measuring the outcomes and impact from research programmes. Research can have many different outcomes such as producing advances in scientific knowledge, building research capacity and, ultimately, health and broader societal benefits. The aim of this study was to test the use of a Delphi methodology as a way of gathering views from malaria research experts on research priorities and eliciting rela...

  12. Pre- and Postoperative Chemotherapy in Localized Extremity Soft Tissue Sarcoma: A European Organization for Research and Treatment of Cancer Expert Survey.

    Science.gov (United States)

    Rothermundt, Christian; Fischer, Galina F; Bauer, Sebastian; Blay, Jean-Yves; Grünwald, Viktor; Italiano, Antoine; Kasper, Bernd; Kollár, Attila; Lindner, Lars H; Miah, Aisha; Sleijfer, Stefan; Stacchiotti, Silvia; Putora, Paul Martin

    2017-11-30

    The management of localized extremity soft tissue sarcomas (STS) is challenging and the role of pre- and postoperative chemotherapy is unclear and debated among experts. Medical oncology experts of the European Organization for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group were asked to participate in this survey on the use of pre- and postoperative chemotherapy in STS. Experts from 12 centers in Belgium, France, Germany, Great Britain, Italy, Switzerland, and The Netherlands agreed to participate and provided their treatment algorithm. Answers were converted into decision trees based on the objective consensus methodology. The decision trees were used as a basis to identify consensus and discrepancies. Several criteria used for decision-making in extremity STS were identified: chemosensitivity, fitness, grading, location, and size. In addition, resectability and resection status were relevant in the pre- and postoperative setting, respectively. Preoperative chemotherapy is considered in most centers for marginally resectable tumors only. Yet, in some centers, neoadjuvant chemotherapy is used routinely and partially combined with hyperthermia. Although most centers do not recommend postoperative chemotherapy, some offer this treatment on a regular basis. Radiotherapy is an undisputed treatment modality in extremity STS. Due to lacking evidence on the utility of pre- and postoperative chemotherapy in localized extremity STS, treatment strategies vary considerably among European experts. The majority recommended neoadjuvant chemotherapy for marginally resectable grade 2-3 tumors; the majority did not recommend postoperative chemotherapy in any setting. The management of localized extremity soft tissue sarcomas (STS) is challenging and the role of pre- and postoperative chemotherapy is unclear and debated among experts. This study analyzed the decision-making process among 12 European experts on systemic therapy for STS. A wide range of

  13. Key priorities in the prevention and control of healthcare-associated infection: a survey of European and other international infection prevention experts.

    Science.gov (United States)

    Dettenkofer, Markus; Humphreys, Hilary; Saenz, Henri; Carlet, Jean; Hanberger, Håkan; Ruef, Christian; Widmer, Andreas; Wolkewitz, Martin; Cookson, Barry

    2016-12-01

    Prevention and control of healthcare-associated infection (HCAI) are important within and beyond Europe. However, it is unclear which areas are considered important by HCAI prevention and control professionals. This study assesses the priorities in the prevention and control of HCAI as judged by experts in the field. A survey was conducted by the European Society of Clinical Microbiology and Infectious Diseases focussing on seven topics using SurveyMonkey(®). Through a newsletter distributed by email, about 5000 individuals were targeted throughout the world in February and March 2013. Participants were asked to rate the importance of particular topics from one (low importance) to ten (extraordinary importance), and there was no restriction on giving equal importance to more than one topic. A total of 589 experts from 86 countries participated including 462 from Europe (response rate: 11.8 %). Physicians accounted for 60 % of participants, and 57 % had ten or more years' experience in this area. Microbial epidemiology/resistance achieved the highest priority scoring with 8.9, followed by surveillance 8.2, and decolonisation/disinfection/antiseptics with 7.9. Under epidemiology/resistance, highly resistant Gram-negative bacilli scored highest (9.0-9.2). The provision of computerised healthcare information systems for the early detection of outbreaks was accorded the top priority under surveillance. The prevention of surgical site and central line infections ranked highest under the category of specific HCAI and HCAI in certain settings. Differences between regions are described. These findings reflect the concerns of experts in HCAI prevention and control. The results from this survey should inform national and international agencies on future action and research priorities.

  14. [Expert investigation on food safety standard system framework construction in China].

    Science.gov (United States)

    He, Xiang; Yan, Weixing; Fan, Yongxiang; Zeng, Biao; Peng, Zhen; Sun, Zhenqiu

    2013-09-01

    Through investigating food safety standard framework among food safety experts, to summarize the basic elements and principles of food safety standard system, and provide policy advices for food safety standards framework. A survey was carried out among 415 experts from government, professional institutions and the food industry/enterprises using the National Food Safety Standard System Construction Consultation Questionnaire designed in the name of the Secretariat of National Food Safety Standard Committee. Experts have different advices in each group about the principles of food product standards, food additive product standards, food related product standards, hygienic practice, test methods. According to the results, the best solution not only may reflect experts awareness of the work of food safety standards situation, but also provide advices for setting and revision of food safety standards for the next. Through experts investigation, the framework and guiding principles of food safety standard had been built.

  15. Expert Witness

    African Journals Online (AJOL)

    Adele

    discipline that permits them to testify to an opinion that will aid a judge or jury in resolving a question that is beyond the understanding or competence of laypersons. An expert witness is an expert who makes his or her knowledge available to a court (a tribunal or any other forum where formal rules of evidence apply) to help ...

  16. Expert System

    DEFF Research Database (Denmark)

    Hildebrandt, Thomas Troels; Cattani, Gian Luca

    2016-01-01

    An expert system is a computer system for inferring knowledge from a knowledge base, typically by using a set of inference rules. When the concept of expert systems was introduced at Stanford University in the early 1970s, the knowledge base was an unstructured set of facts. Today the knowledge...... base of expert systems is often given in terms of an ontology, extracted and built from various data sources by employing natural language-processing and statistics. To emphasize such capabilities, the term “expert” is now often replaced by “cognitive,” “knowledge,” “knowledge-based,” or “intelligent......” system. With very few exceptions, general-purpose expert systems have failed to emerge so far. However, expert systems are applied in specialized domains, particularly in healthcare. The increasing availability of large quantities of data to organizations today provides a valuable opportunity...

  17. Subjective and clinical assessment criteria suggestive for five clinical patterns discernible in nonspecific neck pain patients. A Delphi-survey of clinical experts.

    Science.gov (United States)

    Dewitte, Vincent; Peersman, Wim; Danneels, Lieven; Bouche, Katie; Roets, Arne; Cagnie, Barbara

    2016-12-01

    Nonspecific neck pain patients form a heterogeneous group with different musculoskeletal impairments. Classifying nonspecific neck pain patients into subgroups based on clinical characteristics might lead to more comprehensive diagnoses and can guide effective management. To establish consensus among a group of experts regarding the clinical criteria suggestive of a clinical dominance of 'articular', 'myofascial', 'neural', 'central' and 'sensorimotor control' dysfunction patterns distinguishable in patients with nonspecific neck pain. Delphi study. A focus group with 10 academic experts was organized to elaborate on the different dysfunction patterns discernible in neck pain patients. Consecutively, a 3-round online Delphi-survey was designed to obtain consensual symptoms and physical examination findings for the 5 distinct dysfunction patterns resulting from the focus group. A total of 21 musculoskeletal physical therapists from Belgium and the Netherlands experienced in assessing and treating neck pain patients completed the 3-round Delphi-survey. Respectively, 33 (response rate, 100.0%), 27 (81.8%) and 21 (63.6%) respondents replied to rounds 1, 2 and 3. Eighteen 'articular', 16 'myofascial', 20 'neural', 18 'central' and 10 'sensorimotor control' clinical indicators reached a predefined ≥80% consensus level. These indicators suggestive of a clinical dominance of 'articular', 'myofascial', 'neural', 'central', and 'sensorimotor control' dysfunction patterns may help clinicians to assess and diagnose patients with nonspecific neck pain. Future validity testing is needed to determine how these criteria may help to improve the outcome of physical therapy interventions in nonspecific neck pain patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. A national survey of consultants, specialists and specialist registrars in restorative dentistry for the assessment and treatment planning of oral cancer patients.

    Science.gov (United States)

    Dewan, K; Kelly, R D; Bardsley, P

    2014-06-01

    To investigate the approach of restorative dentists towards the assessment and treatment planning of oral cancer patients in the UK. The survey was conducted at the annual meeting of the Association of Consultants in Restorative Dentistry (ACSRD) and Specialist Registrar in Restorative Dentistry group (SRRDG) in September 2011. Delegates were requested to fill in a two-section questionnaire; the first section included 16 questions, evaluating cancer service provision in their units, and the second included five questions based on a clinical scenario evaluating dental management of a patient undergoing pre-radiotherapy treatment. Ninety-four questionnaires were distributed; 65 (69.1%) were returned. Thirty (46.1%) respondents were consultants, 27 (41.5%) were specialist registrars and the remaining 8 (12.3%) were either specialist practitioners or trust grade dentists working in the speciality of restorative dentistry. Forty-eight (73%) of the respondents worked in NHS posts and the remaining 17 (27%) worked in academic posts. A total of 50 (77%) respondents carried out clinical work which regularly included the dental assessment or treatment of head and neck (H&N) oncology patients, before or post radiotherapy. Among the respondents who were involved in the dental assessment of oncology patients, 32% of them did not have a protocol for review appointments in their units. Ninety-one percent of respondents said that they used dental implants for rehabilitation post cancer surgery and 80% also used implants either always or sometimes in irradiated bone. Answers to scenario questions highlighted that all the respondents would extract very poorly prognostic tooth (that is, root stumps) before radiotherapy, irrespective of it being at the side of the planned radiotherapy field. Fifty-eight percent of respondents preferred to extract a non-functional, heavily restored, non-carious, distal maxillary molar tooth which was not in the area of radiotherapy beam and the

  19. Evaluating a web-based health risk assessment with tailored feedback: what does an expert focus group yield compared to a web-based end-user survey?

    Science.gov (United States)

    Vosbergen, Sandra; Mahieu, Guy R; Laan, Eva K; Kraaijenhagen, Roderik A; Jaspers, Monique Wm; Peek, Niels

    2014-01-02

    Increasingly, Web-based health applications are developed for the prevention and management of chronic diseases. However, their reach and utilization is often disappointing. Qualitative evaluations post-implementation can be used to inform the optimization process and ultimately enhance their adoption. In current practice, such evaluations are mainly performed with end-user surveys. However, a review approach by experts in a focus group may be easier to administer and might provide similar results. The aim of this study was to assess whether industrial design engineers in a focus group would address the same issues as end users in a Web-based survey when evaluating a commercial Web-based health risk assessment (HRA) with tailored feedback. Seven Dutch companies used the HRA as part of their corporate health management strategy. Employees using the HRA (N=2289) and 10 independent industrial designers were invited to participate in the study. The HRA consisted of four components: (1) an electronic health questionnaire, (2) biometric measurements, (3) laboratory evaluation, and (4) individually tailored feedback generated by decision support software. After participating in the HRA as end users, both end users and designers evaluated the program. End users completed an evaluation questionnaire that included a free-text field. Designers participated in a focus group discussion. Constructs from user satisfaction and technology acceptance theories were used to categorize and compare the remarks from both evaluations. We assessed and qualitatively analyzed 294 remarks of 189 end users and 337 remarks of 6 industrial designers, pertaining to 295 issues in total. Of those, 137 issues were addressed in the end-user survey and 148 issues in the designer focus group. Only 7.3% (10/137) of the issues addressed in the survey were also addressed in the focus group. End users made more remarks about the usefulness of the HRA and prior expectations that were not met. Designers made

  20. 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...

  1. Capital Expert System

    Science.gov (United States)

    Dowell, Laurie; Gary, Jack; Illingworth, Bill; Sargent, Tom

    1987-05-01

    Gathering information, necessary forms, and financial calculations needed to generate a "capital investment proposal" is an extremely complex and difficult process. The intent of the capital investment proposal is to ensure management that the proposed investment has been thoroughly investigated and will have a positive impact on corporate goals. Meeting this requirement typically takes four or five experts a total of 12 hours to generate a "Capital Package." A Capital Expert System was therefore developed using "Personal Consultant." The completed system is hybrid and as such does not depend solely on rules but incorporates several different software packages that communicate through variables and functions passed from one to another. This paper describes the use of expert system techniques, methodology in building the knowledge base, contexts, LISP functions, data base, and special challenges that had to be overcome to create this system. The Capital Expert System is the successful result of a unique integration of artificial intelligence with business accounting, financial forms generation, and investment proposal expertise.

  2. Substitution of prescribing tasks from doctors to nurses: an international expert survey on forces, conditions and jurisdictional control.

    NARCIS (Netherlands)

    Kroezen, M.; Francke, A.L.; Groenewegen, P.P.; Dijk, L. van

    2011-01-01

    Background: Nurse prescribing is highly relevant in the current climate of cost containment and task substitution in health care, and is being introduced in a growing number of countries. However, international comparisons are scarce. This survey aims to provide a comprehensive and recent overview

  3. Perspectives of Feedstock Supply for Biomass-Based Energy Plant Development in India: Views from an Expert Survey

    Directory of Open Access Journals (Sweden)

    Md. Kamrul Hassan

    2015-04-01

    Full Text Available Utilization of renewable energy resources is imperative due to energy access, energy security, and energy sustainability coupled with the rising environmental concern. India is one of the largest land mass countries in the world and amply bestowed with biomass resources. Investigations on biomass supply potential, socio-economic challenges, local people attitudes, current bioenergy markets, and technologies are prerequisite while seeking to develop sustainable energy plants. The study aimed to assess expert attitudes on wood-based energy development in India. This assessment was based on the opinions of Indian Forest Service (IFS officers who are involved in managing wood-based biomass resources in different parts of the country. The study gave emphasis to the advantages, problems, and directions of the biomass based energy development in the country. The results showed that the development of biomass-based energy plants involves a number of challenges both locally and nationally. In addition, the study also highlighted the possible benefits of developing biomass based energy plants at local and national levels. The outcomes of this study provide useful information to the policy decision makers, energy entrepreneurs, and other stakeholders in the development of biomass based energy in India.

  4. Consultant radiographers: Profile of the first generation

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-11-15

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

  5. Antecedents of open source software adoption in health care organizations: a qualitative survey of experts in Canada.

    Science.gov (United States)

    Marsan, Josianne; Paré, Guy

    2013-08-01

    Open source software (OSS) adoption and use in health care organizations (HCOs) is relatively low in developed countries, but several contextual factors have recently encouraged the consideration of the possible role of OSS in information technology (IT) application portfolios. This article aims at developing a research model for investigating the antecedents of OSS adoption decisions in HCOs. Based on a conceptual framework derived from a synthesis of the literature on IT adoption in organizations, we conducted 18 semi-structured interviews with IT experts from all levels of the Province of Quebec's health and social services sector in Canada. We also interviewed 10 IT suppliers in the province. A qualitative data analysis of the interviews was performed to identify major antecedents of OSS adoption decisions in HCOs. Eight factors associated with three distinct theoretical perspectives influence OSS adoption. More specifically, they are associated with the classical diffusion of innovations theory, the theory of resources, as well as institutional theory and its spin-off, the organizing vision theory. The factors fall under three categories: the characteristics of OSS as an innovation, the characteristics of the HCO with respect to its ability to absorb OSS, and the characteristics of the external environment with respect to institutional pressures and public discourse surrounding OSS. We shed light on two novel factors that closely interact with each other: (1) interest of the health care community in the public discourse surrounding OSS, and (2) clarity, consistency and richness of this discourse, whether found in magazines or other media. OSS still raises many questions and presents several challenges for HCOs. It is crucial that the different factors that explain an HCO's decision on OSS adoption be considered simultaneously. Doing so allows a better understanding of HCOs' rationale when deciding to adopt, or not to adopt, OSS. Copyright © 2013 Elsevier

  6. Survey of expert opinions and related recommendations regarding bridging therapy using hypomethylating agents followed by allogeneic transplantation for high-risk MDS.

    Science.gov (United States)

    Sohn, Sang Kyun; Moon, Joon Ho

    2015-08-01

    According to current guidelines on therapeutic strategies for myelodysplastic syndrome (MDS), cytoreductive therapies before allogeneic stem cell transplantation (SCT) are not widely recommended for patients with high-risk MDS or refractory anemia with excess blasts (RAEB) who are eligible for allogeneic SCT because of controversial evidence on the role of such therapies. Yet, while treatment with hypomethylating agents (HMAs) has a critical limitation in eradicating MDS clones, the use of HMA treatment as a bridge to allogeneic SCT has become a focus with the hope of improving the SCT outcome based on the chance of achieving complete remission or reducing the blast percentage safely and effectively before allogeneic SCT. However, a consensus needs to be established on the use of HMAs as a bridging therapy for high-risk MDS or RAEB. Thus, the Korean AML/MDS working party group surveyed 34 Korean MDS experts on their bridging therapies for high-risk MDS. Accordingly, this paper presents the survey questionnaire and resulting data, along with a summary of the consensus and related recommendations regarding strategies using HMA treatment and allogeneic SCT based on reported studies and the current survey results. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  7. Consulting about Consulting: Young People's Views of Consultation

    Science.gov (United States)

    Woolfson, Richard C.; Harker, Michael; Lowe, Dorothy; Shields, Mary; Banks, Margaret; Campbell, Lindsay; Ferguson, Ellen

    2006-01-01

    The increasing recognition that children and young people should be consulted and involved in decision-making about their lives is reflected in national and international legislation. A great deal of this legislation, stemming from the UN convention on the Rights of the Child (1989), requires education authorities to consult children and young…

  8. Nationwide survey to evaluate the decision-making process in euthanasia requests in Belgium: do specifically trained 2nd physicians improve quality of consultation?

    Science.gov (United States)

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

    2014-07-16

    Following the 2002 enactment of the Belgian law on euthanasia, which requires the consultation of an independent second physician before proceeding with euthanasia, the Life End Information Forum (LEIF) was founded which provides specifically trained physicians who can act as mandatory consultants in euthanasia requests. This study assesses quality of consultations in Flanders and Brussels and compares these between LEIF and non-LEIF consultants. A questionnaire was sent in 2009 to a random sample of 3,006 physicians in Belgium from specialties likely involved in the care of dying patients. Several questions about the last euthanasia request of one of their patients were asked. As LEIF serves the Flemish speaking community (i.e. region of Flanders and the bilingual Brussels Capital Region) and no similar counterpart is present in Wallonia, analyses were limited to Flemish speaking physicians in Flanders and Brussels. Response was 34%. Of the 244 physicians who indicated having received a euthanasia request seventy percent consulted a second physician in their last request; in 30% this was with a LEIF physician. Compared to non-LEIF physicians, LEIF physicians were more often not a colleague (69% vs 42%) and not a co-attending physician (89% vs 66%). They tended to more often discuss the request with the attending physician (100% vs 95%) and with the family (76% vs 69%), and also more frequently helped the attending physician with performing euthanasia (44% vs 24%). No significant differences were found in the extent to which they talked to the patient (96% vs 93%) and examined the patient file (94% vs 97%). In cases of explicit euthanasia requests in Belgium, the consultation procedure of another physician by the attending physician is not optimal and can be improved. Training and putting at disposal consultants through forums such as LEIF seems able to improve this situation. Adding stipulations in the law about the necessary competencies and tasks of consulting

  9. Learning technology in Scottish higher education - a survey of the views of senior managers, academic staff and 'experts'

    Directory of Open Access Journals (Sweden)

    Jeff Haywood

    2000-12-01

    Full Text Available Central concerns within the field of learning technology in higher education have been the promotion of institutional change and staff awareness and development. This focus on the need to bring about a 'culture shift' and the importance of 'change agents' is reflected in the Dearing Report (DfEE, 1997 and in Funding Council initiatives such as TLTP and TLTSN (Davies, 1995. It is common for many of us who work in this area to feel that although we see clearly the task ahead, we have little at our disposal by way of evidence about how far we have come. Much of the evidence which does exist, and which has been incorporated into lectures and reports, is anecdotal, local and small scale, although there have been some larger studies, notably the Information Technology Assisted Teaching and Learning project (ITATL, 1997, and a 1999 study of C&IT materials funded by the Funding Councils (HEFCE, 1999a, and in the United States the national survey of desktop computing and IT in higher education (Green, 1989-99. These showed a rapidly increasing use of learning technology in higher education, and some of the limitations and restrictions which staff feel, such as technical support. However, there had been no indepth study of the subject and institution-specific influences on academic staff use of, and attitudes to, learning technology.

  10. A cross-sectional survey of current treatment and symptom burden of patients with COPD consulting for routine care according to GOLD 2014 classifications

    Directory of Open Access Journals (Sweden)

    Ding B

    2017-05-01

    Full Text Available Bo Ding,1 Mark Small,2 Ulf Holmgren3 1Medical Evidence and Observational Research, AstraZeneca Gothenburg, Mölndal, Sweden; 2Real World Research (Respiratory, Adelphi Real World, Bollington, UK; 3Global Payer Evidence and Pricing, AstraZeneca Gothenburg, Mölndal, Sweden Background: As part of the Respiratory Disease Specific Program (DSP conducted to provide observations of clinical practice from a physician and matched patient viewpoint, this study aimed to establish how patients with COPD are treated according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD classification system and to quantify the symptom burden.Methods: Data were obtained from the Respiratory DSP, a cross-sectional survey of patients with a diagnosis of COPD consulting for routine care in France, Germany, Italy, Spain, the UK, and the USA during the third quarter of 2013. Patients’ exacerbation risk and symptom data were used for classification into GOLD groups A-D based on GOLD 2014 criteria. Prescribing practices were stratified by physician type and time since patient diagnosis.Results: A total of 903 physicians participated in the Respiratory DSP, with data from 1,641 patients included in this analysis. Most patients were classified into GOLD groups B (n=742; 45.2% and D (n=704; 42.9%. Patients in groups A and D were most likely to be treated in line with GOLD recommendations (61.5% and 77.5%, respectively, compared with 40.1% for group B. Patients with a diagnosis within the past 12 months were more likely to be treated according to recommendations. Inhaled corticosteroids (ICSs in combination with one or more long-acting bronchodilator were prescribed across all GOLD groups. Patterns of treatment were, in general, similar for patients treated by a primary care physician or a pulmonologist. COPD assessment test scores ≥10 indicating a high symptom burden were reported for >80% of patients.Conclusion: This analysis confirmed a high symptom

  11. Unsaturated Zone Flow Model Expert Elicitation Project

    Energy Technology Data Exchange (ETDEWEB)

    Coppersmith, K. J.

    1997-05-30

    This report presents results of the Unsaturated Zone Flow Model Expert Elicitation (UZFMEE) project at Yucca Mountain, Nevada. This project was sponsored by the US Department of Energy (DOE) and managed by Geomatrix Consultants, Inc. (Geomatrix), for TRW Environmental Safety Systems, Inc. The objective of this project was to identify and assess the uncertainties associated with certain key components of the unsaturated zone flow system at Yucca Mountain. This assessment reviewed the data inputs, modeling approaches, and results of the unsaturated zone flow model (termed the ''UZ site-scale model'') being developed by Lawrence Berkeley National Laboratory (LBNL) and the US Geological Survey (USGS). In addition to data input and modeling issues, the assessment focused on percolation flux (volumetric flow rate per unit cross-sectional area) at the potential repository horizon. An understanding of unsaturated zone processes is critical to evaluating the performance of the potential high-level nuclear waste repository at Yucca Mountain. A major goal of the project was to capture the uncertainties involved in assessing the unsaturated flow processes, including uncertainty in both the models used to represent physical controls on unsaturated zone flow and the parameter values used in the models. To ensure that the analysis included a wide range of perspectives, multiple individual judgments were elicited from members of an expert panel. The panel members, who were experts from within and outside the Yucca Mountain project, represented a range of experience and expertise. A deliberate process was followed in facilitating interactions among the experts, in training them to express their uncertainties, and in eliciting their interpretations. The resulting assessments and probability distributions, therefore, provide a reasonable aggregate representation of the knowledge and uncertainties about key issues regarding the unsaturated zone at the Yucca

  12. Expert systems in treating substance abuse.

    Science.gov (United States)

    Wesson, D R; Hink, R H

    1990-05-01

    Computer programs can assist humans in solving complex problems that cannot be solved by traditional computational techniques using mathematic formulas. These programs, or "expert systems," are commonly used in finance, engineering, and computer design. Although not routinely used in medicine at present, medical expert systems have been developed to assist physicians in solving many kinds of medical problems that traditionally require consultation from a physician specialist. No expert systems are available specifically for drug abuse treatment, but at least one is under development. Where access to a physician specialist in substance abuse is not available for consultation, this expert system will extend specialized substance abuse treatment expertise to nonspecialists. Medical expert systems are a developing technologic tool that can assist physicians in practicing better medicine.

  13. ExpertFOAF recommends experts

    DEFF Research Database (Denmark)

    Iofcu, Tereza; Diederich, Joerg; Dolog, Peter

    2007-01-01

    the GrowBag approach [1]. The main assumption is that such user profiles can provide good hints about users' expertise. Such extended FOAF files (called ExpertFOAF) can be published on a user's home page, on web pages of institutions or conferences to characterize them. They can be crawled by distributed...

  14. Patient Access, Unmet Medical Need, Expected Benefits, and Concerns Related to the Utilisation of Biosimilars in Eastern European Countries: A Survey of Experts

    Directory of Open Access Journals (Sweden)

    Andras Inotai

    2018-01-01

    Full Text Available This policy research aims to map patient access barriers to biologic treatments, to explore how increased uptake of biosimilars may lower these hurdles and to identify factors limiting the increased utilisation of biosimilars. A policy survey was developed to review these questions in 10 Central and Eastern European (CEE and Commonwealth of Independent States (CIS countries. Two experts (one public and one private sector representative from each country completed the survey. Questions were related to patient access, purchasing, clinical practice, and real-world data collection on both original biologics and biosimilars. Restrictions on the number of patients that can be treated and related waiting lists were reported as key patient access barriers. According to respondents, for both clinicians and payers the primary benefit of switching patients to biosimilars would be to treat more patients. However, concerns with therapeutic equivalence and fear of immunogenicity may reduce utilisation of biosimilars. Similar limitations in patient access to both original biologics and biosimilars raise concerns about the appropriateness and success of current biosimilar policies in CEE and CIS countries. The conceptual framework for additional real-world data collection exists in all countries which may provide a basis for future risk-management activities including vigorous pharmacovigilance data collection.

  15. Computer Guided Educational Diagnosis: A Prototype Expert System.

    Science.gov (United States)

    Colbourn, Marlene; McLeod, John

    1983-01-01

    The article reviews some recent literature pertaining to development and use of expert systems (automated consulting systems, which provide expert advice within particular domains). The design and implementation of an expert system developed to guide a teacher diagnostician through the various stages of diagnosing reading difficulities are…

  16. Assessing quality of maternity care in Hungary: expert validation and testing of the mother-centered prenatal care (MCPC) survey instrument.

    Science.gov (United States)

    Rubashkin, Nicholas; Szebik, Imre; Baji, Petra; Szántó, Zsuzsa; Susánszky, Éva; Vedam, Saraswathi

    2017-11-16

    Instruments to assess quality of maternity care in Central and Eastern European (CEE) region are scarce, despite reports of poor doctor-patient communication, non-evidence-based care, and informal cash payments. We validated and tested an online questionnaire to study maternity care experiences among Hungarian women. Following literature review, we collated validated items and scales from two previous English-language surveys and adapted them to the Hungarian context. An expert panel assessed items for clarity and relevance on a 4-point ordinal scale. We calculated item-level Content Validation Index (CVI) scores. We designed 9 new items concerning informal cash payments, as well as 7 new "model of care" categories based on mode of payment. The final questionnaire (N = 111 items) was tested in two samples of Hungarian women, representative (N = 600) and convenience (N = 657). We conducted bivariate analysis and thematic analysis of open-ended responses. Experts rated pre-existing English-language items as clear and relevant to Hungarian women's maternity care experiences with an average CVI for included questions of 0.97. Significant differences emerged across the model of care categories in terms of informal payments, informed consent practices, and women's perceptions of autonomy. Thematic analysis (N = 1015) of women's responses identified 13 priority areas of the maternity care experience, 9 of which were addressed by the questionnaire. We developed and validated a comprehensive questionnaire that can be used to evaluate respectful maternity care, evidence-based practice, and informal cash payments in CEE region and beyond.

  17. Implementing and managing self-management skills training within primary care organisations: a national survey of the expert patients programme within its pilot phase

    Directory of Open Access Journals (Sweden)

    Rogers Anne

    2006-02-01

    Full Text Available Abstract A key element of the United Kingdom (UK health policy reform in relation to chronic disease management is the introduction of a national programme seeking to promote self-care from within the National Health Service (NHS. The mainstay of the Expert Patients Programme (EPP is a six-week training course that provides the opportunity for anyone with a long-term condition to develop new skills to manage their condition better on a day-to-day basis. The course forms part of the NHS self-care support programme, is administered by Primary Care Trusts (PCTs and delivered by people who have personal experience of living with a long-term condition. The NHS' official Expert Patients Programme website presently states that, "Pilot EPP courses began at 26 NHS PCT sites across England in May 2002, and by May 2004 approximately 300 PCTs had either actively implemented pilot courses or had committed to joining. The majority of PCTs are now coming to the end of the pilot phase, with many implementing plans to make EPP sustainable for the long-term." The NHS website heralds the pilot "a success." A national, postal survey of PCT EPP Leads was undertaken in order to examine both the evolvement of EPP during its pilot stage and future plans for the programme. A questionnaire was sent out to the 299 PCTs known to have committed to the EPP pilot, and an excellent 100% response rate was obtained over a 3-month period (April-July 2005. One marker of success of the Expert Patients Programme implementation is the actual running of courses by the Primary Care Trusts. This paper explores the extent to which the implementation of the pilot can indeed be viewed as a "success," primarily in terms of the number of courses run, and considers the extent to which PCTs have carried out all that they were committed to do. Findings suggest that the more time an EPP Lead dedicates to the Programme, the more likely it is that EPP has run successfully in the past, and the more

  18. Operational expert system applications in Europe

    CERN Document Server

    Zarri, Gian Piero

    1992-01-01

    Operational Expert System Applications in Europe describes the representative case studies of the operational expert systems (ESs) that are used in Europe.This compilation provides examples of operational ES that are realized in 10 different European countries, including countries not usually examined in the standard reviews of the field.This book discusses the decision support system using several artificial intelligence tools; expert systems for fault diagnosis on computerized numerical control (CNC) machines; and expert consultation system for personal portfolio management. The failure prob

  19. Results from the First Year of Implementation of CONSULT: Consultation with Novel Methods and Simulation for UME Longitudinal Training.

    Science.gov (United States)

    Carter, Keme; Golden, Andrew; Martin, Shannon; Donlan, Sarah; Hock, Sara; Babcock, Christine; Farnan, Jeanne; Arora, Vineet

    2015-11-01

    An important area of communication in healthcare is the consultation. Existing literature suggests that formal training in consultation communication is lacking. We aimed to conduct a targeted needs assessment of third-year students on their experience calling consultations, and based on these results, develop, pilot, and evaluate the effectiveness of a consultation curriculum for different learner levels that can be implemented as a longitudinal curriculum. Baseline needs assessment data were gathered using a survey completed by third-year students at the conclusion of the clinical clerkships. The survey assessed students' knowledge of the standardized consultation, experience and comfort calling consultations, and previous instruction received on consultation communication. Implementation of the consultation curriculum began the following academic year. Second-year students were introduced to Kessler's 5 Cs consultation model through a didactic session consisting of a lecture, viewing of "trigger" videos illustrating standardized and informal consults, followed by reflection and discussion. Curriculum effectiveness was assessed through pre- and post- curriculum surveys that assessed knowledge of and comfort with the consultation process. Fourth-year students participated in a consultation curriculum that provided instruction on the 5 Cs model and allowed for continued practice of consultation skills through simulation during the Emergency Medicine clerkship. Proficiency in consult communication in this cohort was assessed using two assessment tools, the Global Rating Scale and the 5 Cs Checklist. The targeted needs assessment of third-year students indicated that 93% of students have called a consultation during their clerkships, but only 24% received feedback. Post-curriculum, second-year students identified more components of the 5 Cs model (4.04 vs. 4.81, pconsultation process (0% vs. 69%, pstudents scored higher in all criteria measuring consultation

  20. 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.

  1. Consulting to summer camps.

    Science.gov (United States)

    Ditter, Bob

    2007-10-01

    There has been an increased need for consultation to summer camps from the allied health/mental health fields because camps are available to children with medical and psychological illnesses. Factors in camp programs that are necessary for effective consultation and the various roles a consultant may serve within the camp community are discussed in this article.

  2. The Contemporary Consultant

    DEFF Research Database (Denmark)

    Olson, Thomas; Poulfelt, Flemming; Greiner, Larry

    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...

  3. Gap analysis: assessing the value perception of consultant pharmacist services and the performance of consultant pharmacists.

    Science.gov (United States)

    Clark, Thomas R

    2008-09-01

    To understand the importance of services provided by consultant pharmacists and to assess perception of their performance of services. Cross-sectional; nursing facility team. Random e-mail survey of consultant pharmacists; phone survey of team members. 233 consultant pharmacists (practicing in a nursing facility); 540 team members (practicing in a nursing facility, interacting with > or = 1 consultant pharmacist): 120 medical directors, 210 directors of nursing, 210 administrators. Consultant pharmacists, directors of nursing, medical directors, and administrators rating importance/performance of 21 services. Gap between teams' ratings of importance and consultant pharmacists' performance is assessed to categorize services. Importance/performance ranked on five-point scale. Mean scores used for gap analysis to cluster services into four categories. Per combined group, six services categorized as "Keep It Up" (important, good performance), consensus with individual groups, except discrepancy with medical directors, for one service. Six services each categorized as "Improve" (important, large gap) and "Improve Second" (lower importance, large gap), with varied responses by individual groups. Three different services were categorized into "Don't Worry," with consensus within individual groups. Consensus from all groups found 5 of 21 services are important and performed well by consultant pharmacists, indicating to maintain performance of services. For three services, consultant pharmacists do not need to worry about their performance. Thirteen services require improvement in consultant pharmacists' performance; various groups differ on extent of improvement needed. Results can serve as benchmark comparisons with results obtained by consultant pharmacists in their own facilities.

  4. Calculation of Appropriate Minimum Size of Isolation Rooms based on Questionnaire Survey of Experts and Analysis on Conditions of Isolation Room Use

    Science.gov (United States)

    Won, An-Na; Song, Hae-Eun; Yang, Young-Kwon; Park, Jin-Chul; Hwang, Jung-Ha

    2017-07-01

    After the outbreak of the MERS (Middle East Respiratory Syndrome) epidemic, issues were raised regarding response capabilities of medical institutions, including the lack of isolation rooms at hospitals. Since then, the government of Korea has been revising regulations to enforce medical laws in order to expand the operation of isolation rooms and to strengthen standards regarding their mandatory installation at hospitals. Among general and tertiary hospitals in Korea, a total of 159 are estimated to be required to install isolation rooms to meet minimum standards. For the purpose of contributing to hospital construction plans in the future, this study conducted a questionnaire survey of experts and analysed the environment and devices necessary in isolation rooms, to determine their appropriate minimum size to treat patients. The result of the analysis is as follows: First, isolation rooms at hospitals are required to have a minimum 3,300mm minor axis and a minimum 5,000mm major axis for the isolation room itself, and a minimum 1,800mm minor axis for the antechamber where personal protective equipment is donned and removed. Second, the 15 ㎡-or-larger standard for the floor area of isolation rooms will have to be reviewed and standards for the minimum width of isolation rooms will have to be established.

  5. Considering the Role of Physical Therapists Within the Treatment and Rehabilitation of Individuals With Eating Disorders: An International Survey of Expert Clinicians.

    Science.gov (United States)

    Soundy, Andy; Stubbs, Brendon; Probst, Michel; Gyllensten, Amanda Lundvik; Skjaerven, Liv Helvik; Catalan-Matamoros, Daniel; Vancampfort, Davy

    2016-12-01

    Recent research has demonstrated that physical therapy may benefit the physical and mental health of people with eating disorders (EDs). Because this is a new and developing field, this study aimed to investigate the experience, practices and knowledge of international physical therapy experts to inform clinical practice, education and research. An international cross-sectional survey design was undertaken with experienced physical therapists within the field of EDs. Physical therapist responses were analysed with descriptive statistics and thematic analysis as appropriate. Twenty-eight international physical therapists participated. On average, participants had 6.9 years (95% confidence interval: 3.1-10.7, n = 27) of clinical experience working in ED settings and devoted approximately 39.3% (95% confidence interval: 23.8-54.8, n = 27) of their time to treating individuals with EDs. Participants reported that physical therapy interventions have a diverse range of benefits on the physical, mental and disease-specific factors (e.g. binges) in people with EDs. The key role of physical therapists includes improving body awareness, especially during physical activity combined with psycho-education about healthy doses of physical activity. Physical therapists were able to identify a range of barriers and facilitators to physical activity in people with EDs. This paper provides a first step towards understanding the role and value of physical therapists working with individuals with EDs. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  6. Guidelines for the verification and validation of expert system software and conventional software: Survey and assessment of conventional software verification and validation methods. Volume 2

    Energy Technology Data Exchange (ETDEWEB)

    Mirsky, S.M.; Groundwater, E.H.; Hayes, J.E.; Miller, L.A. [Science Applications International Corp., McLean, VA (United States)

    1995-03-01

    By means of a literature survey, a comprehensive set of methods was identified for the verification and validation of conventional software. The 153 methods so identified were classified according to their appropriateness for various phases of a developmental life-cycle -- requirements, design, and implementation; the last category was subdivided into two, static testing and dynamic testing methods. The methods were then characterized in terms of eight rating factors, four concerning ease-of-use of the methods and four concerning the methods` power to detect defects. Based on these factors, two measurements were developed to permit quantitative comparisons among methods, a Cost-Benefit metric and an Effectiveness Metric. The Effectiveness Metric was further refined to provide three different estimates for each method, depending on three classes of needed stringency of V&V (determined by ratings of a system`s complexity and required-integrity). Methods were then rank-ordered for each of the three classes by terms of their overall cost-benefits and effectiveness. The applicability was then assessed of each for the identified components of knowledge-based and expert systems, as well as the system as a whole.

  7. Breast cancer in Latin America: results of the Latin American and Caribbean Society of Medical Oncology/Breast Cancer Research Foundation expert survey.

    Science.gov (United States)

    Cazap, Eduardo; Buzaid, Antonio Carlos; Garbino, Carlos; de la Garza, Jaime; Orlandi, Francisco Javier; Schwartsmann, Gilberto; Vallejos, Carlos; Guercovich, Andres

    2008-10-15

    The incidence of breast cancer in Latin American countries is lower than that in more developed countries, whereas the mortality rate is higher. These differences probably are related to differences in screening strategies and access to treatment. Population-based data are needed to make informed decisions. A 65-question telephone survey that included 100 breast cancer experts from 12 Latin American countries was conducted in 2006 as an exploratory analysis of the current state of breast cancer treatment in these regions at both at the country level and at the center level. Greater than 90% of countries had no national law or guideline for mammography screening. The access rate to mammography was 66.3% at the country level and 47% at the center level. Variation in care based on level (country vs center) was indicated for the timing of treatment after diagnosis, timing from initial diagnosis to treatment, and the time from surgery to initial chemotherapy. However, the more sophisticated diagnostic testing for hormone receptors and biomarkers were available at most centers (>80%), and, overall, nearly 80% of patients started treatment within 3 months of diagnosis. Variation in care between breast cancer care at the center level versus the country level indicated a need for national cancer care programs. Alternative data collection strategies for understanding the state of breast cancer control programs in developing countries can help identify areas of improvement. (c) 2008 American Cancer Society.

  8. Experts in science and society

    CERN Document Server

    Gigerenzer, Gerd

    2004-01-01

    In today's complex world, we have come to rely increasingly on those who have expertise in specific areas and can bring their knowledge to bear on crucial social, political and scientific questions. Taking the viewpoint that experts are consulted when there is something important at stake for an individual, a group, or society at large, Experts in Science and Society explores expertise as a relational concept. How do experts balance their commitment to science with that to society? How does a society actually determine that a person has expertise? What personal traits are valued in an expert? From where does the expert derive authority? What makes new forms of expertise emerge? These and related questions are addressed from a wide range of areas in order to be inclusive, as well as to demonstrate similarities across areas. Likewise, in order to be culturally comparative, this volume includes examples and discussions of experts in different countries and even in different time periods. The topics include the r...

  9. Dental consultation in patients planned for/undergoing/post radiation therapy for head and neck cancers: A questionnaire-based survey

    Directory of Open Access Journals (Sweden)

    Apeksha Mainali

    2011-01-01

    Full Text Available Background: Mouth and pharyngeal cancers account for approximately 6% of cancers worldwide. Radiotherapy is one of the means of treatment of head and neck cancer. Consultation with a dental team experienced in caring for patients undergoing treatment for head and neck cancer will improve the quality of life of such patients. Aims and Objectives: To evaluate the attitude of oncologists toward dental consultation to patients planning for/prior to/undergoing/post radiation therapy for head and neck cancers and to evaluate the number of radiation oncologists who encounter oral complaints and consider worth referring to a dentist. Materials and Methods: A questionnaire-based study was carried out following mailing of covering letter and self-administered questionnaire comprising 11 items, to 25 radiation oncology centers selected in India based on convenient sampling. Results: Out of the 25 centers, we received response from 20 centers with 60 completely filled questionnaires. Five centers did not respond for further correspondences. Conclusion: The study indicated a need for awareness and education among radiation oncologists regarding dental consultation in patients planned/undergoing /post radiation therapy for head and neck cancer.

  10. Dental consultation in patients planned for/undergoing/post radiation therapy for head and neck cancers: a questionnaire-based survey.

    Science.gov (United States)

    Mainali, Apeksha; Sumanth, K N; Ongole, Ravikiran; Denny, Ceena

    2011-01-01

    Mouth and pharyngeal cancers account for approximately 6% of cancers worldwide. Radiotherapy is one of the means of treatment of head and neck cancer. Consultation with a dental team experienced in caring for patients undergoing treatment for head and neck cancer will improve the quality of life of such patients. To evaluate the attitude of oncologists toward dental consultation to patients planning for/prior to/undergoing/post radiation therapy for head and neck cancers and to evaluate the number of radiation oncologists who encounter oral complaints and consider worth referring to a dentist. A questionnaire-based study was carried out following mailing of covering letter and self-administered questionnaire comprising 11 items, to 25 radiation oncology centers selected in India based on convenient sampling. Out of the 25 centers, we received response from 20 centers with 60 completely filled questionnaires. Five centers did not respond for further correspondences. The study indicated a need for awareness and education among radiation oncologists regarding dental consultation in patients planned/undergoing /post radiation therapy for head and neck cancer.

  11. The communication competency of medical students, residents and consultants

    NARCIS (Netherlands)

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

    Objective: The model of expert performance predicts that neither physicians in training nor experienced physicians will reach an expert level in communication. This study tested this hypothesis. Methods: Seventy-one students, twenty-five residents and fourteen consultants performed a 'breaking bad

  12. Expert judgment-based risk assessment using statistical scenario analysis: a case study-running the bulls in Pamplona (Spain).

    Science.gov (United States)

    Mallor, Fermín; García-Olaverri, Carmen; Gómez-Elvira, Sagrario; Mateo-Collazas, Pedro

    2008-08-01

    In this article, we present a methodology to assess the risk incurred by a participant in an activity involving danger of injury. The lack of high-quality historical data for the case considered prevented us from constructing a sufficiently detailed statistical model. It was therefore decided to generate a risk assessment model based on expert judgment. The methodology is illustrated in a real case context: the assessment of risk to participants in a San Fermin bull-run in Pamplona (Spain). The members of the panel of "experts on the bull-run" represented very different perspectives on the phenomenon: runners, surgeons and other health care personnel, journalists, civil defense workers, security staff, organizers, herdsmen, authors of books on the bull-run, etc. We consulted 55 experts. Our methodology includes the design of a survey instrument to elicit the experts' views and the statistical and mathematical procedures used to aggregate their subjective opinions.

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

    NARCIS (Netherlands)

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

    2008-01-01

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

  14. Ethics in Management Consulting

    OpenAIRE

    Vallini, Carlo

    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...

  15. Making consultations run smoothly

    DEFF Research Database (Denmark)

    Jespersen, Astrid Pernille; Jensen, Torben Elgaard

    2012-01-01

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

  16. The influence of cost-per-DALY information in health prioritisation and desirable features for a registry: a survey of health policy experts in Vietnam, India and Bangladesh.

    Science.gov (United States)

    Teerawattananon, Yot; Tantivess, Sripen; Yamabhai, Inthira; Tritasavit, Nattha; Walker, Damian G; Cohen, Joshua T; Neumann, Peter J

    2016-12-03

    Economic evaluation has been implemented to inform policy in many areas, including coverage decisions, technology pricing, and the development of clinical practice guidelines. However, there are barriers to evidence-based policy in low- and middle-income countries (LMICs) that include limited stakeholder awareness, resources and data availability, as well as the lack of capacity to conduct country-specific economic evaluations. This study aims to survey health policy experts' opinions on barriers to use of cost-effectiveness data in these settings and to obtain their advice on how to make a new cost-per-DALY database being developed by Tufts Medical Center more relevant to LMICs. It also identifies the factors influencing transferability. In-depth interviews were conducted with 32 participants, including policymakers, technical advisors, and researchers in Health Ministries, universities and non-governmental organisations in Bangladesh, India (New Delhi, Tamil Nadu and Karnataka) and Vietnam. The survey revealed that, in all settings, the use of cost-effectiveness information in policy development is lacking, owing to limited knowledge among policymakers and inadequate human resources with health economics expertise in the government sector. Furthermore, researchers in universities do not have close connections with health authorities. In India and Vietnam, the demand for evidence to inform coverage decisions tends to increase as the countries are moving towards universal health coverage. The informants in all countries argue that cost-effectiveness data are useful for decision-makers; however, most of them do not perform data searches by themselves but rely on the information provided by the technical advisor counterparts. Most interviewees were familiar with using evidence from other countries and were also aware of the influences of contextual elements as a limitation of transferability. Finally, strategies to promote the newly developed database include

  17. 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.

  18. CURBSIDE CONSULTATION IN HIP ARTHROPLASTY

    Directory of Open Access Journals (Sweden)

    Scott M. Sporer

    2009-03-01

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

  19. XPLAIN: A System for Creating and Explaining Expert Consulting Programs.

    Science.gov (United States)

    1983-07-01

    potassium (hypokalemia), a high level of serum calcium (hypercalcemia), damage to the heart muscle (cardiomyopathy), and a recent myocardial infarction ...Vision, P.H. Winston (ed), McGraw-Hill, 1975 [Peck73] Peck C.C., Sheiner L.B. et al: "Computer-assisted Digoxin Therapy," New England Journal of Medicine

  20. Methods for combining experts' probability assessments.

    Science.gov (United States)

    Jacobs, R A

    1995-09-01

    This article reviews statistical techniques for combining multiple probability distributions. The framework is that of a decision maker who consults several experts regarding some events. The experts express their opinions in the form of probability distributions. The decision maker must aggregate the experts' distributions into a single distribution that can be used for decision making. Two classes of aggregation methods are reviewed. When using a supra Bayesian procedure, the decision maker treats the expert opinions as data that may be combined with its own prior distribution via Bayes' rule. When using a linear opinion pool, the decision maker forms a linear combination of the expert opinions. The major feature that makes the aggregation of expert opinions difficult is the high correlation or dependence that typically occurs among these opinions. A theme of this paper is the need for training procedures that result in experts with relatively independent opinions or for aggregation methods that implicitly or explicitly model the dependence among the experts. Analyses are presented that show that m dependent experts are worth the same as k independent experts where k < or = m. In some cases, an exact value for k can be given; in other cases, lower and upper bounds can be placed on k.

  1. 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...

  2. The Ethical Consultant.

    Science.gov (United States)

    Minton, Roland

    1991-01-01

    Described are student/consultant reports, turned in as homework, that reflected their abilities to distinguish useful from irrelevant information, solve the underlying calculus extremum problem, and reconcile the individual mathematical solutions with the ethical considerations surrounding the moral dilemma of the hypothetical consulting client.…

  3. Enhanced Management Consulting.

    Science.gov (United States)

    1983-07-01

    December, 1982. m23. Hersey , Paul , Kenneth H. Blanchard, Management of Organizational Behavior : Utilizing Human Resources, Englewood Cliffs, N.J...WORDS (Continue on reverse side if necessary and identify by block number) Organizational development Management consulting Organizational assessment...provides some suggestions for enhancing the management consulting process within the Air Force. Part one contains an overview of organizational

  4. Three models of child abuse consultations: A qualitative study of inpatient child abuse consultation notes.

    Science.gov (United States)

    Keenan, Heather T; Campbell, Kristine A

    2015-05-01

    Child abuse pediatricians have multiple roles in caring for abused children, including prevention, diagnosis, treatment, and, when needed, expert legal opinion. The child physical abuse consultation differs from the traditional medical consultation in that it has medical, investigative and legal audiences, all of whom have different information needs. How child abuse pediatricians approach their cases and how they document their initial inpatient consultations that will be used by such a diverse audience is currently unexplored. We used content analysis to examine 37 child physical abuse consultation notes from a national sample of child abuse pediatricians in order to understand physicians' approaches to these consultations. Three commonly used models of child physical abuse consultation were identified in the data that we named the base model, the investigative model, and the family-dynamic model. While model types overlap, each is distinguished by key features including the approach used to gather information, the information recorded, and the language used in documentation. The base model most closely mirrors the traditional medical approach; the investigative model concentrates on triangulation of sources of information; and, the family-dynamic model concentrates on physician perceptions of family relationships. The three models of consultations for child physical abuse mirror the areas of child abuse pediatrics: diagnostic, forensic and therapeutic. These models are considered in relationship to best practice from other medical specialties with forensic components. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Epilepsy treatment in adults and adolescents: Expert opinion, 2016.

    Science.gov (United States)

    Shih, Jerry J; Whitlock, Julia B; Chimato, Nicole; Vargas, Emily; Karceski, Steven C; Frank, Ryan D

    2017-04-01

    There are over twenty anti-seizure medications and anti-seizure devices available commercially in the United States. The multitude of treatment options for seizures can present a challenge to clinicians, especially those who are not subspecialists in the epilepsy field. Many clinical questions are not adequately answered in double-blind randomized controlled studies. In the presence of a knowledge gap, many clinicians consult a respected colleague with acknowledged expertise in the field. Our survey was designed to provide expert opinions on the treatment of epilepsy in adults and adolescents. We surveyed a group of 42 physicians across the United States who are considered experts based on publication record in the field of epilepsy, or a leadership role in a National Association of Epilepsy Centers comprehensive epilepsy program. The survey consisted of 43 multiple-part patient scenario questions and was administered online using Redcap software. The experts provided their opinion on 1126 treatment options based on a modified Rand 9-point scale. The patient scenarios focused on genetically-mediated generalized epilepsy and focal epilepsy. The scenarios first focused on overall treatment strategy and then on specific pharmacotherapies. Other questions focused on treatment of specific patient populations (pregnancy, the elderly, patients with brain tumors, and post organ transplant patients), epilepsy patients with comorbidities (renal and hepatic disease, depression), and how to combine medications after failure of monotherapy. Statistical analysis of data used the expert consensus method. Valproate was considered a drug of choice in all genetically-mediated generalized epilepsies, except in the population of women of child-bearing age. Ethosuximide was a drug of choice in patient with absence seizures, and levetiracetam was a drug of choice in patients with genetic generalized tonic-clonic seizures and myoclonic seizures. Lamotrigine, levetiracetam and

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

    Science.gov (United States)

    Onwuteaka-Philipsen, B D; van der Wal, G

    2001-10-01

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

  7. Artificial Experts: The Computer as Diagnostician Has Definite Limits.

    Science.gov (United States)

    Pournelle, Jerry

    1984-01-01

    Argues that, although expert systems--which are supposed to give users all the advantages of consulting with human experts--can be useful for medical diagnosis, where tests tend to be reliable, they can be hazardous in such areas as psychological testing, where test reliability is difficult to measure. (MBR)

  8. Can experts judge elections? Testing the validity of expert judgments for measuring election integrity

    NARCIS (Netherlands)

    Martinez i Coma, F.; van Ham, C.T.

    2015-01-01

    Expert surveys have been used to measure a wide variety of phenomena in political science, ranging from party positions, to corruption, to the quality of democracy and elections. However, expert judgments raise important validity concerns, both about the object being measured as well as the experts.

  9. 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.

  10. Coagulation: consultative hemostasis

    NARCIS (Netherlands)

    Hambleton, Julie; Leung, Lawrence L.; Levi, Marcel

    2002-01-01

    Clinical hematologists are frequently consulted for the care of hospitalized patients with complicated coagulopathies. This chapter provides an update on the scientific and clinical advances noted in disseminated intravascular coagulation (DIC) and discusses the challenges in hemostasis

  11. ACF Tribal Consultation Policy

    Data.gov (United States)

    U.S. Department of Health & Human Services — The purpose of the ACF Tribal Consultation Policy is to build meaningful relationships with federally recognized tribes by engaging in open, continuous, and...

  12. Expert witness perceptions of bias in experts.

    Science.gov (United States)

    Commons, Michael Lamport; Miller, Patrice Marie; Gutheil, Thomas G

    2004-01-01

    A pilot study of perceptions of different sources of expert bias, as well as of personal investment in case outcomes, was performed among attendees at a workshop at an annual meeting of the American Academy of Psychiatry and the Law. Participants were asked to rate hypothetical responses by experts to various case outcomes and the biasing potential of different kinds of situations for opposing or other experts. A factor analysis produced two factors. Factor 1 included questions about situations that were obviously biasing (such as working only for the defense). Factor 2 included questions assessing the potential of certain situations to cause bias in experts, or how likely experts thought other experts were to be biased. In general, experts identified only four areas to be overtly biasing. All occurred within situations in which experts worked only for one or the other side of civil or criminal cases. Experts otherwise thought other experts were reasonably bias free and well able to compensate for any bias when it occurred. The data suggest that experts may deal with bias by turning down cases that may cause them personal discomfort.

  13. Computer system in Prolog for legal consultation relating to radiations

    Energy Technology Data Exchange (ETDEWEB)

    Kaminishi, Tokishi; Matsuda, Hideharu; Koshino, Masao

    1988-05-01

    A computer consulting system on legal questions relating to radiations was developed, which system was described with Prolog in BASIC using personal computer. A remarkable feature of this system is easiness and simplicity in its operation. Furthermore the programming for answer is simple and flexible owing to Prolog. This consulting system is similar to CAI rather than Expert System. An outline of the system is described and several examples are shown with the executed results in this report.

  14. 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.

  15. Report for fiscal 1981 on comprehensive survey for nationwide geothermal resources. Survey on radar imaging method - geothermal conception design (Associated material 3 - materials related to U.S. geothermal analysis contractors and consultants); 1981 nendo zenkoku chinetsu shigen sogo chosa hokokusho. Radar eizoho chosa (chinetsu kaiseki gainen sekkei futai shiryo 3 (Beikoku chinetsu kaiseki contractor oyobi consultant kankei shiryo))

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1982-10-01

    This paper summarizes the U.S. geothermal analysis contractors, including the Aero Service Corporation, the EG and G Group, the QEB Group, and the Republic Geothermal, Inc., and the consultants, including the Remote Sensing Consultants. For the Aero Service Corporation, the paper states histories of and books written by major personnel. For the EG and G Group, the paper states the outlines of such companies as EG and G Services, EG and G Geometrics, Mars Associates, Inc., and UURI, as well as histories of and books written by major personnel. For the QEB Group, the paper states the outlines of such companies as QEB, Inc., and Eureka Resource Associates, Inc. as well as histories of and books written by major personnel. For the Republic Geothermal, Inc., the paper states the company outline, histories of and books written by major personnel. For the Remote Sensing Consultants, the paper states the history of and books written by Dr. R.J.P.L. Lyon. (NEDO)

  16. Agricultural consultancy--a career choice for veterinarians.

    Science.gov (United States)

    Taylor, K L; Swan, R A; Chapman, H M

    2000-07-01

    To document the personal, educational and professional skills that characterise veterinarians pursuing careers as agricultural consultants and to determine the future direction for veterinary-related advisory services to agriculture in Australia. Thirty-six veterinarians practising as consultants in agriculture throughout Australia were sent a postal survey in 1994. A descriptive analysis was chosen because of the relatively small population available to sample. Comparisons were made on a percentage basis where appropriate. Twenty-four useable responses to the questionnaire were received. Consultants were mostly men with an agricultural background, aged 31 to 40 years. They considered their undergraduate veterinary studies to be a stepping stone into further education and practical experience and ultimately consultancy. Consultants predicted an increased reliance for their work on corporate farms, private agribusiness, research and development and sub-contracted work, rather than on family-owned farms. Consultants disagreed on the wisdom of combining consultancy activities with alternative businesses (for instance mixed veterinary practice). Only 13 consultants derived greater than 76% of their income from consultancy and 14 combined another business with consulting. The need for continuing education was considered important. Consultants predicted various future prospects for the industry. Many predicted that there would not be enough veterinarians to fulfill the demand for this type of work. IMPLICATIONS FOR THE VETERINARY PROFESSION: Results from this survey suggest that veterinary consulting will extend into finance, agronomy and marketing in addition to current skills in animal nutrition, parasite control and animal reproduction. As clients demand specialised skills and knowledge, the formation of co-operatives or companies of specialists may be beneficial to both client and consultant in the future. The consultant's role can be characterised as one of

  17. Killing Bugs at the Bedside: A prospective hospital survey of how frequently personal digital assistants provide expert recommendations in the treatment of infectious diseases

    Directory of Open Access Journals (Sweden)

    Richardson W Scott

    2004-10-01

    Full Text Available Abstract Background Personal Digital Assistants (PDAS are rapidly becoming popular tools in the assistance of managing hospitalized patients, but little is known about how often expert recommendations are available for the treatment of infectious diseases in hospitalized patients. Objective To determine how often PDAs could provide expert recommendations for the management of infectious diseases in patients admitted to a general medicine teaching service. Design Prospective observational cohort study Setting Internal medicine resident teaching service at an urban hospital in Dayton, Ohio Patients 212 patients (out of 883 patients screened were identified with possible infectious etiologies as the cause for admission to the hospital. Measurements Patients were screened prospectively from July 2002 until October 2002 for infectious conditions as the cause of their admissions. 5 PDA programs were assessed in October 2002 to see if treatment recommendations were available for managing these patients. The programs were then reassessed in January 2004 to evaluate how the latest editions of the software would perform under the same context as the previous year. Results PDAs provided treatment recommendations in at least one of the programs for 100% of the patients admitted over the 4 month period in the 2004 evaluation. Each of the programs reviewed improved from 2002 to 2004, with five of the six programs offering treatment recommendations for over 90% of patients in the study. Conclusion Current PDA software provides expert recommendations for a great majority of general internal medicine patients presenting to the hospital with infectious conditions.

  18. Developing Critical Thinking through Student Consulting Projects

    Science.gov (United States)

    Canziani, Bonnie; Tullar, William L.

    2017-01-01

    The authors present survey results from faculty at 44 universities on the role of student consulting projects in developing business students' critical thinking. They conclude that students can improve critical thinking by engaging in guided primary and secondary research to inform their business assumptions that underpin business planning and…

  19. The communication competency of medical students, residents and consultants

    OpenAIRE

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

    2012-01-01

    Objective: The model of expert performance predicts that neither physicians in training nor experienced physicians will reach an expert level in communication. This study tested this hypothesis. Methods: Seventy-one students, twenty-five residents and fourteen consultants performed a 'breaking bad news' exercise with a simulated patient. Their communication competency was assessed with the CELI instrument. Actor assessments were also obtained. The differences in communication competency betwe...

  20. Behavioral Consultation: Theory and Process

    Science.gov (United States)

    Russell, Michael L.

    1978-01-01

    This model examines the theory, clinical process, and intervention techniques of behavioral consultation in educational and medical settings. Behavioral consultation requires empirical validation of intervention. It also holds the counselee accountable for consultations. The consultant has many techniques, but must be sensitive to interaction…

  1. Survey determinant factors of telemedicine strategic planning from the managers and experts perspective in the health department, isfahan university of medical sciences.

    Science.gov (United States)

    Keshvari, Hamid; Haddadpoor, Asefeh; Taheri, Behjat; Nasri, Mehran; Aghdak, Pezhman

    2014-10-01

    Awareness of Outlook, objectives, benefits and impact of telemedicine technology that can promote services quality, reduce costs, increase access to Specialized and subspecialty services, and immediately guide the health system subconsciously to the introduction greater use of technology. Therefore, the aim of this study was to determine the strengths, weaknesses, opportunities and threats in the telemedicine strategic planning from the managers and experts perspective in the health department, Isfahan University of Medical Sciences, in order to take a step towards facilitating strategic planning and approaching the equity aim in health in the province. This is a descriptive-analytical study, that data collection was done cross-sectional. The study population was composed of all managers and certified experts at the health department in Isfahan university of Medical Sciences. The sample size was 60 patients according to inclusion criteria. Information was collected by interview method. Researcher attempted to use the structured and specific questionnaire Then were investigated the viewpoints of experts and managers about determinative factors (strengths, weaknesses, opportunities and threats) in the strategic planning telemedicine. Data were analyzed using descriptive statistics (frequency, mean) and software SPSS 19. Data analysis showed that change management (100%) and continuity of supply of credit (79/3%) were weakness point within the organization and strengths of the program were, identity and health telemedicine programs (100%), goals and aspirations of the current directors of the organization and its compliance with the goals of telemedicine (100%), human resources interested using computers in daily activities in peripheral levels (93/1%). Also organization in the field of IT professionals, had opportunities, and repayment specialist's rights by insurance organizations is a threat for it. According to the strengths, weaknesses, opportunities and threats

  2. Understanding Vaccine Hesitancy in Canada: Results of a Consultation Study by the Canadian Immunization Research Network.

    Directory of Open Access Journals (Sweden)

    Eve Dubé

    Full Text Available "Vaccine hesitancy" is a concept now frequently used in vaccination discourse. The increased popularity of this concept in both academic and public health circles is challenging previously held perspectives that individual vaccination attitudes and behaviours are a simple dichotomy of accept or reject. A consultation study was designed to assess the opinions of experts and health professionals concerning the definition, scope, and causes of vaccine hesitancy in Canada. We sent online surveys to two panels (1- vaccination experts and 2- front-line vaccine providers. Two questionnaires were completed by each panel, with data from the first questionnaire informing the development of questions for the second. Our participants defined vaccine hesitancy as an attitude (doubts, concerns as well as a behaviour (refusing some / many vaccines, delaying vaccination. Our findings also indicate that both vaccine experts and front-line vaccine providers have the perception that vaccine rates have been declining and consider vaccine hesitancy an important issue to address in Canada. Diffusion of negative information online and lack of knowledge about vaccines were identified as the key causes of vaccine hesitancy by the participants. A common understanding of vaccine hesitancy among researchers, public health experts, policymakers and health care providers will better guide interventions that can more effectively address vaccine hesitancy within Canada.

  3. Oracle Hyperion Interactive Reporting 11 Expert Guide

    CERN Document Server

    Cody, Edward J

    2011-01-01

    This book is written in a simple, easy to understand format with screenshots, code samples, and step-by-step explanations that will guide you through the advanced techniques used by the experts. If you are an Oracle Hyperion Interactive reporting user or developer looking to become an expert in the product, then this book is for you. You will require a basic knowledge of Interactive Reporting, as this book starts with a brief overview and then dives into advanced techniques, functions, and best practices. Beginner users should consult The Business Analyst's Guide to Oracle Hyperion Interactive

  4. Consultation Content not Consultation Length Improves Patient Satisfaction

    Science.gov (United States)

    Lemon, Thomas I.; Smith, Rebecca H.

    2014-01-01

    The suggestion that increased consultation length leads to improved patient satisfaction has some evidence, albeit uncertain. Importantly there are other determinants within the doctor-patient consultation that themselves may be responsible for this improved satisfaction and it is these we investigate in this paper. A systematic review of PubMed and associated papers was carried out using search terms ‘family practice consultation length’, ‘general practice consultation length’, ‘local health authority consultation length’ and ‘primary care consultation length’. 590 papers were originally selected using these search terms, post scoring this number became 9. The results obtained support the idea that consultation length does not directly improve consultation outcome, but rather there are variables integrated within the consultation affecting this. Increased time purely allows a physician to implement management, particularly relating to psychosocial aspects. PMID:25657939

  5. Consultation content not consultation length improves patient satisfaction

    Directory of Open Access Journals (Sweden)

    Thomas I Lemon

    2014-01-01

    Full Text Available The suggestion that increased consultation length leads to improved patient satisfaction has some evidence, albeit uncertain. Importantly there are other determinants within the doctor-patient consultation that themselves may be responsible for this improved satisfaction and it is these we investigate in this paper. A systematic review of PubMed and associated papers was carried out using search terms ′family practice consultation length′, ′general practice consultation length′, ′local health authority consultation length′ and ′primary care consultation length′. 590 papers were originally selected using these search terms, post scoring this number became 9. The results obtained support the idea that consultation length does not directly improve consultation outcome, but rather there are variables integrated within the consultation affecting this. Increased time purely allows a physician to implement management, particularly relating to psychosocial aspects.

  6. Consultation in School Psychology: Changes from 1981 to 1984.

    Science.gov (United States)

    Smith, Douglas K.; Lyon, Mark A.

    1985-01-01

    Compared nationwide survey responses of 225 school psychologists to their responses in 1981-82. Results revealed significant increases in amount of time spent in consultation and amount of time desired for consultation; significant decreases in psychologist-student ratio and overall satisfaction with profession. Sex differences were found for…

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

    NARCIS (Netherlands)

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

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

  8. Consultation expectations among patients with respiratory tract infection symptoms

    DEFF Research Database (Denmark)

    Lauridsen, Gitte Bruun; Sørensen, Mette Sejr; Hansen, Malene Plejdrup

    2017-01-01

    : A questionnaire survey was conducted in Danish primary care during 2014. Patients aged ≥ 18 years were asked about their expectations to the consultation when consulting with symptoms of acute respiratory tract infections. Associations between socio-demographic characteristics, self-reported antibiotic...

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

    African Journals Online (AJOL)

    Consultants in the built environment of South Africa are facing financial risks due to clients' expectations of completing certain portions of work at risk. Thus, consultants would complete projects at risk in return for the possibility of remuneration in the long run. A descriptive survey was conducted among various professional ...

  10. Resistance, Reactance, and Consultation.

    Science.gov (United States)

    Hughes, Jan N.; Falk, Robert S.

    1981-01-01

    Presents a review of techniques for dealing with consultee resistance. Suggests the social psychological theory of reactance is a useful conceptual framework for considering resistance in consultation. Discusses examples of its application, variables that predict the likely effectiveness of a reactance utilization intervention, and ethical issues.…

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

    Directory of Open Access Journals (Sweden)

    Eduard-Gabriel Ceptureanu

    2017-02-01

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

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

    NARCIS (Netherlands)

    Koper, I.; Heide, A.; Janssens, M.J.P.A.; Swart, S.; Perez, R.S.G.M.; Rietjens, J.A.C.

    2014-01-01

    Purpose: Palliative sedation is considered a normal medical practice by the Royal Dutch Medical Association. Therefore, consultation of an expert is not considered mandatory. The European Association of Palliative Care (EAPC) framework for palliative sedation, however, is more stringent: it

  13. Surgeon Reported Outcome Measure for Spine Trauma an International Expert Survey Identifying Parameters Relevant for The Outcome of Subaxial Cervical Spine Injuries

    NARCIS (Netherlands)

    Sadiqi, Said|info:eu-repo/dai/nl/413971198; Verlaan, Jorrit Jan|info:eu-repo/dai/nl/269057285; Lehr, A. M.; Dvorak, Marcel F.; Kandziora, Frank; Rajasekaran, S.; Schnake, Klaus J.; Vaccaro, Alexander R.; Oner, F. C.|info:eu-repo/dai/nl/188615326

    2016-01-01

    STUDY DESIGN.: International web-based survey OBJECTIVE.: To identify clinical and radiological parameters that spine surgeons consider most relevant when evaluating clinical and functional outcomes of subaxial cervical spine trauma patients. SUMMARY OF BACKGROUND DATA.: While an outcome instrument

  14. The communication competency of medical students, residents and consultants.

    Science.gov (United States)

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

    2012-01-01

    The model of expert performance predicts that neither physicians in training nor experienced physicians will reach an expert level in communication. This study tested this hypothesis. Seventy-one students, twenty-five residents and fourteen consultants performed a 'breaking bad news' exercise with a simulated patient. Their communication competency was assessed with the CELI instrument. Actor assessments were also obtained. The differences in communication competency between students, residents and consultants were established. The mean performance scores ranged from bad to adequate. An expert level of performance was seldom reached. Novice students scored lower than the other groups in their competency and in the actor assessment. First-year students scored lower than the consultants in their competency and in the actor assessment. No differences in performance were found between third-year students, interns, residents and consultants. Students acquire a 'satisfactory' level of communication competency early in the curriculum. Communication courses in the curriculum do not enhance this level. Clinical experience has also a limited effect. The learning conditions for deliberate practice must be fulfilled in medical curricula and in postgraduate training in order to provide medical students and physicians the opportunity to attain an expert level in communication. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  15. Expert stakeholder attitudes and support for alternative water sources in a groundwater depleted region.

    Science.gov (United States)

    Boyer, Treavor H; Overdevest, Christine; Christiansen, Lisa; Ishii, Stephanie K L

    2012-10-15

    The main objectives of this research were to quantify the risks/benefits and impacts of alternative water sources (AWSs) as perceived by expert stakeholders and to evaluate the overall support for multiple AWSs by expert stakeholders. The St. Johns River (SJR) basin, FL, USA was chosen as a case study for AWSs because it is a fresh groundwater depleted region and there are ongoing activities related to water supply planning. Expert stakeholders included federal, state, and local governments, public utilities, consulting engineering and industry, and environmental and social non-governmental organizations. AWSs under consideration in the SJR basin include surface water, desalination, water reclamation, and water conservation. A two-phase research approach was followed that focused on expert stakeholders. First, an elicitation study was used to identify salient beliefs about AWSs. Open-ended questions were asked about the risks/benefits of AWSs in terms of the three pillars of sustainability: ecological, economic, and human health impacts. Second, an online survey was constructed using beliefs identified during the elicitation study. The online survey was used to quantify attitudes toward and overall support for AWSs. The salient beliefs of expert stakeholders were dominated by the ecological pillar of sustainability. The support of expert stakeholders for AWSs, from least favorable to most favorable, was surface water withdrawals

  16. The situation of consultation practice in pathology in Turkey

    National Research Council Canada - National Science Library

    Usubütün, Alp; Balci, Serdar; Yörükoğlu, Kutsal

    2012-01-01

    .... There are no standards for consultations in Turkey. The standardization committee of the Federation of Turkish Pathology Societies has conducted a survey to detect the current situation, determine the problematic aspects, compare the situation...

  17. Expert auditors’ services classification

    OpenAIRE

    Jolanta Wisniewska

    2013-01-01

    The profession of an expert auditor is a public trust occupation with a distinctive feature of taking responsibility for actions in the public interest. The main responsibility of expert auditors is performing financial auditing; however, expert auditors are prepared to carry out different tasks which encompass a wide plethora of financial and auditing services for different kinds of institutions and companies. The aim of the article is first of all the description of expert auditors’ service...

  18. [Implementation of clinical ethics consultation in German hospitals].

    Science.gov (United States)

    Schochow, M; May, A T; Schnell, D; Steger, F

    2014-10-01

    There have been different initiatives for the implementation of clinical ethics consultation during the past years. The present study surveys current data. A structured questionnaire was used. Of the 1,858 contacted hospitals throughout Germany 550 answered to that questionnaire (return rate 29,6 %). The survey took place between September 2013 and January 2014. The clinical ethics committee is the mostly implemented structure of clinical ethics consultation. Recommendations to implement those structures (ZEKO 2006, AEM 2010) show less influence than the legally binding standard (HKHG 2011). Structures of clinical ethics consultation are respected as instrument to solving ethical conflicts in clinical routines. Establishing ethics consultation should be promoted. Preferably appropriate legal rules for the implementation of clinical ethics consultation should be developed further as well as their structural framing. © Georg Thieme Verlag KG Stuttgart · New York.

  19. 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

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

    Directory of Open Access Journals (Sweden)

    Dendukuri Nandini

    2005-04-01

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

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

    Science.gov (United States)

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

    2010-12-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

  3. Do palliative consultations improve patient outcomes?

    Science.gov (United States)

    Casarett, David; Pickard, Amy; Bailey, F Amos; Ritchie, Christine; Furman, Christian; Rosenfeld, Ken; Shreve, Scott; Chen, Zhen; Shea, Judy A

    2008-04-01

    To determine whether inpatient palliative consultation services improve outcomes of care. Retrospective telephone surveys conducted with family members of veterans who received inpatient or outpatient care from a Department of Veterans Affairs (VA) medical facility in the last month of life. Five VA Medical Centers or their affiliated nursing homes and outpatient clinics. Veterans had received inpatient or outpatient care from a participating VA in the last month of life. One family member completed each survey. The telephone survey assessed nine aspects of the care the patient received in his or her last month of life: the patient's well-being and dignity (4 items), adequacy of communication (5 items), respect for treatment preferences (2 items), emotional and spiritual support (3 items), management of symptoms (4 items), access to the inpatient facility of choice (1 item), care around the time of death (6 items), access to home care services (4 items), and access to benefits and services after the patient's death (3 items). Interviews were completed with 524 respondents. In a multivariable linear regression model, after adjusting for the likelihood of receiving a palliative consultation (propensity score), palliative care patients had higher overall scores: 65 (95% confidence interval (CI)=62-66) versus 54 (95% CI=51-56; P<.001) and higher scores for almost all domains. Earlier consultations were independently associated with better overall scores (beta=0.003; P=.006), a difference that was attributable primarily to improvements in communication and emotional support. Palliative consultations improve outcomes of care, and earlier consultations may confer additional benefit.

  4. Expert status and performance.

    Directory of Open Access Journals (Sweden)

    Mark A Burgman

    Full Text Available Expert judgements are essential when time and resources are stretched or we face novel dilemmas requiring fast solutions. Good advice can save lives and large sums of money. Typically, experts are defined by their qualifications, track record and experience. The social expectation hypothesis argues that more highly regarded and more experienced experts will give better advice. We asked experts to predict how they will perform, and how their peers will perform, on sets of questions. The results indicate that the way experts regard each other is consistent, but unfortunately, ranks are a poor guide to actual performance. Expert advice will be more accurate if technical decisions routinely use broadly-defined expert groups, structured question protocols and feedback.

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

    Science.gov (United States)

    1991-01-01

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

  6. Human Resource Consulting Education: Professional Development for the Personnel Consulting Industry.

    Science.gov (United States)

    Bone, John

    1996-01-01

    Interviews and surveys of 200 personnel consultants revealed an urgent need for basic and ongoing professional development education and for national competence standards and accreditation. Skill needs clustered in three categories: recruitment, selection, and sales/marketing. Professional education should recognize lifelong learning, take…

  7. Forensic experts' perceptions of expert bias.

    Science.gov (United States)

    Commons, Michael Lamport; Miller, Patrice Marie; Li, Eva Yujia; Gutheil, Thomas Gordon

    2012-01-01

    How do expert witnesses perceive the possible biases of their fellow expert witnesses? Participants, who were attendees at a workshop at the American Academy of Psychiatry and Law were asked to rate for their biasing potential a number of situations that might affect the behavior of an opposing expert. A Rasch analysis produced a linear scale as to the perceived biasing potential of these different kinds of situations from the most biasing to the least biasing. Working for only one side in both civil and criminal cases had large scaled values and also were the first factor. In interesting contrast, a) an opposing expert also serving as the litigant's treater and b) an opposing expert being viewed as a "hired gun" (supplying an opinion only for money) were two situations viewed as not very biasing. Order of Hierarchical Complexity also accounted for items from the 1st, 2nd and 3rd factors. The result suggests that the difficulty in understanding the conceptual basis of bias underlies the perception of how biased a behavior or a situation is. The more difficult to understand the questionnaire item, the less biasing its behavior or situation is perceived by participants. Copyright © 2012 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    Amara, Nabil; Landry, Rejean; Halilem, Norrin

    2013-01-01

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

  9. 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.

  10. Response to the European Commission's consultation on the future of European company law

    NARCIS (Netherlands)

    Böckli, P.; Davies, P.; Ferran, E.; Ferrarini, G.; Garrido, J.; Hopt, K.; Pietrancosta, A.; Pistor, K.; Skog, R.; Soltysinski, S.; Winter, J.; Wymeersch, E.

    2012-01-01

    This paper contains the views of the European Company Law Experts (ECLE) on the future of European company law. The paper accompanies the responses of the European Company Law Experts to the European Commission’s Consultation on the future of European Company Law of spring 2012. In the first part of

  11. The situation of consultation practice in pathology in Turkey.

    Science.gov (United States)

    Usubütün, Alp; Balci, Serdar; Yörükoğlu, Kutsal

    2012-01-01

    There are some suggestions regarding the methods of consultation practice in the literature including which case will be consulted, to whom, by which transport means, the payment methods as well as the ethical issues. There are no standards for consultations in Turkey. The standardization committee of the Federation of Turkish Pathology Societies has conducted a survey to detect the current situation, determine the problematic aspects, compare the situation with international methods and offer methods specific to Turkey. A survey has been prepared to cover all the aspects of consultation practice using the literature and referring to the current methods used in Turkey. The survey has been announced on the internet and 83 replies were collected. Multiple choice questions were evaluated in terms of percentages and open ended questions were grouped according to the answer contents. It was seen that problems could be grouped as follows: absence of written procedures covering each step, means of transport, reaching the consultant, payment, reporting and ethical issues. The absence of procedures and issues regarding the payment methods were the interfering factors for each step of consultation. There are many problematic issues in consultation practice in pathology in Turkey. The basis of these problems is the absence of written regulations for procedural and payment methods. Regulations addressing these issues should be developed.

  12. In-house consultation to support professionals' responses to child abuse and neglect: Determinants of professionals' use and the association with guideline adherence.

    Science.gov (United States)

    Konijnendijk, Annemieke A J; Boere-Boonekamp, Magda M; Kaya, Anna H; Haasnoot, Maria E; Need, Ariana

    2017-07-01

    This study examined the presence and strengths of determinants associated with consultation of an in-house expert on child abuse and neglect (CAN) by preventive child health care professionals who suspect CAN. This study also assessed the relationship between in-house CAN expert consultation and professionals' performance of six recommended activities described in a national guideline on preventing CAN for preventive child health care professionals. A total of 154 professionals met the study's inclusion criteria. They filled in a questionnaire that measured in-house consultation practices and twelve determinants associated with the professional, the in-house expert, and the organizational context. Bivariate and multivariate regression analyses were performed. Almost half of the participants (46.8%) reported to consult the in-house expert in (almost) all of their suspected CAN cases. Professionals who reported better recollection of consulting the in-house expert (i.e. not forgetting to consult the expert) (p=.001), who were more familiar with consultation (p=.002), who had more positive attitudes and beliefs about consultation (p=.011) and who reported being more susceptible to the behavior (p=.001) and expectations/opinions (p=.025) of colleagues regarding in-house expert consultation were more likely to consult the in-house expert. Furthermore, in-house expert consultation was positively associated with two of six key guideline activities: consulting the regional child protection service and monitoring whether support was provided to families. The implications of these results for improving professionals' responses to CAN are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

    OpenAIRE

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

    2005-01-01

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

  14. Malpractice liability for informal consultations.

    Science.gov (United States)

    Olick, Robert S; Bergus, George R

    2003-01-01

    Informal ("curbside") consults are widely used by primary care physicians. These interactions occur in person, by telephone, or even by e-mail. Exposure to malpractice liability is a frequent concern of subspecialty physicians and influences their willingness to engage in this activity. To assess this risk, we reviewed reported judicial opinions involving informal consultation by physicians. A search of the existing medical literature, and of the Westlaw national database was undertaken to identify reported judicial opinions involving informal physician consults that address whether informal consultations create a legal relationship between consulting specialist physicians and patients that gives rise to a legal duty of care owed by the consulting specialist to the patient. Courts have consistently ruled that no physician-patient relationship exists between a consultant and the patient who is the focus of the informal consultation. In the absence of such a relationship, the courts have found no grounds for a claim of malpractice. Malpractice risks associated with informal consultation appear to be minimal, regardless of the method of communication. While "informal consultation" is not a term used by the courts, the courts have applied a consistent set of criteria that help define the legal parameters of this activity.

  15. ICF-CY code set for infants with early delay and disabilities (EDD Code Set) for interdisciplinary assessment: a global experts survey.

    Science.gov (United States)

    Pan, Yi-Ling; Hwang, Ai-Wen; Simeonsson, Rune J; Lu, Lu; Liao, Hua-Fang

    2015-01-01

    Comprehensive description of functioning is important in providing early intervention services for infants with developmental delay/disabilities (DD). A code set of the International Classification of Functioning, Disability and Health: Children and Youth Version (ICF-CY) could facilitate the practical use of the ICF-CY in team evaluation. The purpose of this study was to derive an ICF-CY code set for infants under three years of age with early delay and disabilities (EDD Code Set) for initial team evaluation. The EDD Code Set based on the ICF-CY was developed on the basis of a Delphi survey of international professionals experienced in implementing the ICF-CY and professionals in early intervention service system in Taiwan. Twenty-five professionals completed the Delphi survey. A total of 82 ICF-CY second-level categories were identified for the EDD Code Set, including 28 categories from the domain Activities and Participation, 29 from body functions, 10 from body structures and 15 from environmental factors. The EDD Code Set of 82 ICF-CY categories could be useful in multidisciplinary team evaluations to describe functioning of infants younger than three years of age with DD, in a holistic manner. Future validation of the EDD Code Set and examination of its clinical utility are needed. The EDD Code Set with 82 essential ICF-CY categories could be useful in the initial team evaluation as a common language to describe functioning of infants less than three years of age with developmental delay/disabilities, with a more holistic view. The EDD Code Set including essential categories in activities and participation, body functions, body structures and environmental factors could be used to create a functional profile for each infant with special needs and to clarify the interaction of child and environment accounting for the child's functioning.

  16. In-house consultation to support professionals’ responses to child abuse and neglect : Determinants of professionals’ use and the association with guideline adherence

    NARCIS (Netherlands)

    Konijnendijk, Annemieke Ariënne Johanneke; Boere-Boonekamp, Magdalena M.; Kaya, Anna H.; Haasnoot, Maria E.; Need, Ariana

    2017-01-01

    This study examined the presence and strengths of determinants associated with consultation of an in-house expert on child abuse and neglect (CAN) by preventive child health care professionals who suspect CAN. This study also assessed the relationship between in-house CAN expert consultation and

  17. 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

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

    DEFF Research Database (Denmark)

    Broberg, Ole

    2004-01-01

    between different roles and mobilize different types of knowledge depending on the context; the consultant is a navigator in the sense of knowing how to navigate in the complex organization surrounding the technological change process. The competencies of a political reflective navigator are outlined...... of OHS consultants is placed on the line between an expert and a process consultant. Based on evidence from the cases and on the concepts of actor-network theory on technological development, we suggest a supplementary third role, that of the 'political reflective navigator', where the OHS consultant...

  19. How Expert Designers Design

    NARCIS (Netherlands)

    Dr. Peter Sloep; J. van Merrienboer; C. Carr; P. Kirschner

    2003-01-01

    This paper discusses two studies - the one in a business context, the other in a university context - carried out with expert educational designers. The studies aimed to determine the priorities experts claim to employ when designing competence-based learning environments. Designers in both contexts

  20. Expert Systems in Education.

    Science.gov (United States)

    Hartschuh, Wayne

    This paper argues that the concepts and techniques used in the development of expert systems should be expanded and applied to the field of education, particularly in the area of intelligent tutoring systems. It is noted that expert systems are a well known area of artificial intelligence and have been proven effective in well-defined topic areas.…

  1. Shifting Design Consultancy Identities

    DEFF Research Database (Denmark)

    Larsen, Henry; Huijboom, Nina; Holm Nielsen, Anne

    2014-01-01

    Knowledge-intensive business services, such as design consultancies are perceived as key drivers for innovation and competitiveness. However, many designers create their own companies, which often remain as one-man companies. By interviewing designers who own small design firms we found patterns...... and identities that resonate more with freelancing and portfolio careers than with the intention of creating firms that are intended to expand. We recognized a pattern where freelancers build up their work as a portfolio by moving from one engagement to another, a process that we will call sequential freelancing....... This paper aims to understand the emergence of such identities amongst designers and we suggest that instead of focusing on their individual firms as entities of growth, other strategies such as networking might be more fruitful. If this approach was adopted, we believe that those local authorities who focus...

  2. The Psychiatry Consult Adventure Simulation

    OpenAIRE

    Jachna, John S.; Powsner, Seth M.; McIntyre, Patrick J.; Byck, Robert S.

    1989-01-01

    Evaluating patients on medical and surgical wards for psychiatric problems can be an adventure, from determining the actual reason for the consult request, to finding the medical records and actually interviewing the patient. The PsyConsult Adventure Simulation adapts the excitement of computer adventure game simulations to teaching general hospital psychiatric consultation. The trainee, in the role of a senior medical student, must navigate a simulated hospital environment and deal with mult...

  3. Discovering What Matters: Interrogating Clinician Responses to Ethics Consultation.

    Science.gov (United States)

    Finder, Stuart G; Bartlett, Virginia L

    2017-05-01

    Against the background assumptions that (a) knowing what clinical ethics consultation represents to those with whom ethics consultants work most closely is a necessary component for being responsible in the practice of ethics consultation, and (b) the complexities of soliciting and understanding colleague evaluations require another inherent responsibility for the methods by which ethics consultations are evaluated, in this article we report our experience soliciting, analyzing, and trying to understand retrospective evaluations of our Clinical Ethics Consultation Service. These evaluations were collected through a quality assessment effort at our institution. Drawing from the qualitative elements of our survey instrument, we describe unexpected variations among the requests for ethics consultation and the retrospective reports from those colleagues making the requests. Focusing on just one aspect - the reason for request - raised several core questions about how we should evaluate those retrospective reports, what could be learned from the differences that we were now encountering, and what we could learn about the process of evaluating our practices. Working through these questions, we suggest several issues to consider in ongoing efforts to describe and evaluate clinical ethics consultation: the role of time and memory in evaluating retrospective evaluations, the importance of attending to the language of moral shift or disruption with which our colleagues describe their experiences, and how to understand the role of ethics consultation in creating 'moral space' (a la Margaret Urban Walker's conception) for colleagues to process their moral experiences. © 2017 John Wiley & Sons Ltd.

  4. Delay to orthopedic consultation for isolated limb injury

    Science.gov (United States)

    Rouleau, Dominique M.; Feldman, Debbie Ehrmann; Parent, Stefan

    2009-01-01

    ABSTRACT OBJECTIVE To describe referral mechanisms for referral to orthopedic surgery for isolated limb injuries in a public health care system and to identify factors affecting access. DESIGN Cross-sectional survey. SETTING Orthopedic surgery service in a level 1 trauma centre in Montreal, Que. PARTICIPANTS We conducted a prospective study of 166 consecutive adults (mean age 48 years) referred to orthopedic surgery for isolated limb injuries during a 4-month period. MAIN OUTCOME MEASURES Self-reported data on the nature of the trauma, the elapsed time between injury and orthopedic consultation, the number and type of previous primary care consultations, sociodemographic characteristics, and the level of satisfaction with care. RESULTS Average time between the injury and orthopedic consultation was 89 hours (range 3 to 642), with an average of 68 hours (range 0 to 642) for delay between primary care consultation and orthopedic consultation. A total of 36% of patients with time-sensitive diagnoses had unacceptable delays to orthopedic consultation according to the Quebec Orthopaedic Association guidelines. Lower limb injury, consulting first at another hospital, living far from the trauma centre, patient perception of low severity, and having a soft tissue injury were associated with longer delays. CONCLUSION Identifying gaps and risk factors for slower access might help improve referral mechanisms for orthopedic consultation. PMID:19826162

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

    Science.gov (United States)

    Ingraham, Colette L.

    2017-01-01

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

  6. Expert F# 20

    CERN Document Server

    Syme, Don; Cisternino, Antonio

    2009-01-01

    Expert F# 2.0 is about practical programming in a beautiful language that puts the power and elegance of functional programming into the hands of professional developers. In combination with .NET, F# achieves unrivaled levels of programmer productivity and program clarity. Expert F# 2.0 is * The authoritative guide to F# by the inventor of F# * A comprehensive reference of F# concepts, syntax, and features * A treasury of expert F# techniques for practical, real-world programming F# isn't just another functional programming language. It's a general-purpose language ideal for real-world develop

  7. Benchmarking expert system tools

    Science.gov (United States)

    Riley, Gary

    1988-01-01

    As part of its evaluation of new technologies, the Artificial Intelligence Section of the Mission Planning and Analysis Div. at NASA-Johnson has made timing tests of several expert system building tools. Among the production systems tested were Automated Reasoning Tool, several versions of OPS5, and CLIPS (C Language Integrated Production System), an expert system builder developed by the AI section. Also included in the test were a Zetalisp version of the benchmark along with four versions of the benchmark written in Knowledge Engineering Environment, an object oriented, frame based expert system tool. The benchmarks used for testing are studied.

  8. Neuropsychologist experts and neurolaw: cases, controversies, and admissibility challenges.

    Science.gov (United States)

    Kaufmann, Paul M

    2013-01-01

    Clinical neuropsychologists engage increasingly in forensic consulting activities because such expert opinions are generally relevant, reliable and helpful in resolving certain legal claims, especially those related to traumatic brain injury. Consequently, practitioners of law, medicine and psychology would benefit from understanding the nature of neuropsychological evidence, the standards for its admissibility, and its expanding role in neurolaw. This article reviews important evidentiary rules regulating relevance, preliminary questions, and expert testimony, while tracing federal key court decisions and progeny. Civil and criminal cases are detailed to illustrate the application of these rules and case law to neuropsychological evidence, with suggestions for overcoming motions to exclude such evidence. Expert neuropsychologists have a role in forensic consultation on brain trauma cases, even as the interdisciplinary dialog and understanding among law, medicine, and psychology continues to expand. Copyright © 2013 John Wiley & Sons, Ltd.

  9. The transition to hospital consultant

    DEFF Research Database (Denmark)

    Westerman, Michiel; Teunissen, Pim W.; Jorgensen, Rasmus Lundhus

    2013-01-01

    Danish and Dutch new consultants' perceptions regarding the transition to consultant were compared to gain insight into this period, particularly the influence of contextual factors concerning the organisation of specialty training and health care therein. Preparation for medical and generic comp...... competencies, perceived intensity and burnout were compared. Additionally, effects of differences in working conditions and cultural dimensions were explored....

  10. 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.

  11. Nonclinical competencies for physical therapists consulting with business and industry.

    Science.gov (United States)

    Bryan, J M; Geroy, G D; Isernhagen, S J

    1993-12-01

    Industrial physical therapists (IPTs) are working as external consultants with business and industry to provide injury prevention and/or rehabilitation services. This consulting presents a very new practice setting for therapists and requires specialized nonclinical competencies. The purpose of this study was to identify these nonclinical competencies. The research was based on an evaluation research model using a stakeholder group. Stakeholders represented five groups: 1) IPTs, 2) continuing education providers, 3) business and industry employers of IPTs, 4) safety/risk managers, and 5) human resource development professionals. Thirty-five nonclinical competencies were identified through qualitative analysis of in-depth interviews with 17 subject matter experts representing the five groups. The competencies addressed marketing, program planning, managing the consulting process, training, and understanding organizations. This list of nonclinical competencies may serve as a self-assessment tool that IPTs can use to help plan their professional development. It may also facilitate planning continuing education programs for IPTs.

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

    Directory of Open Access Journals (Sweden)

    Grzegorz Teresiński

    2017-06-01

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

  13. [Polish forensic medicine A.D. 2016 - report of the National Consultant].

    Science.gov (United States)

    Teresiński, Grzegorz

    2016-01-01

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

  14. ADAPTATION OF A MODEL OF RESOURCES ALLOCATION BETWEEN PORTFOLIO PROJECTS IN TERMS OF ITS USE IN CONSULTING IT-COMPANIES

    Directory of Open Access Journals (Sweden)

    Anita V. Sotnikova

    2013-01-01

    Full Text Available The article is devoted to the model of resources allocation between portfolio projects in consulting IT-companies. The adapted model for consulting firms introducing enterprise information systems is represented. The author offers to use expert estimations of employee competence to his work status to assess labour inputs of projects.

  15. ADAPTATION OF A MODEL OF RESOURCES ALLOCATION BETWEEN PORTFOLIO PROJECTS IN TERMS OF ITS USE IN CONSULTING IT-COMPANIES

    OpenAIRE

    Anita V. Sotnikova

    2013-01-01

    The article is devoted to the model of resources allocation between portfolio projects in consulting IT-companies. The adapted model for consulting firms introducing enterprise information systems is represented. The author offers to use expert estimations of employee competence to his work status to assess labour inputs of projects.

  16. A cross-sectional survey of experts' opinions about the relative effectiveness of tobacco control strategies for the general population versus disadvantaged groups: what do we choose in the absence of evidence?

    Science.gov (United States)

    Paul, Christine L; Turon, Heidi; Bonevski, Billie; Bryant, Jamie; McElduff, Patrick

    2013-12-08

    There is a clear disparity in smoking rates according to social disadvantage. In the absence of sufficiently robust data regarding effective strategies for reducing smoking prevalence in disadvantaged populations, understanding the views of tobacco control experts can assist with funding decisions and research agendas. A web-based cross-sectional survey was conducted with 192 respondents (response rate 65%) sampled from the Australian and New Zealand Tobacco Control Contacts list and a literature search. Respondents were asked to indicate whether a number of tobacco control strategies were perceived to be effective for each of: the general population; Aboriginal and Torres Strait Islander people; those with a low income; and people with a mental illness. A high proportion of respondents indicated that mass media and increased tobacco taxation (84% and 89% respectively) were effective for the general population. Significantly lower proportions reported these two strategies were effective for sub-populations, particularly Aboriginal and Torres Strait Islanders (58% and 63% respectively, p's disadvantaged sub-populations compared to the general population. Tailored quit programs and culturally relevant programs were nominated as additional effective strategies for disadvantaged populations. Views about subsidised medications in particular, suggest the need for robust cost-effectiveness data relevant to disadvantaged groups to avoid wastage of scarce tobacco control resources. Strategies perceived to be effective for disadvantaged populations such as tailored or culturally relevant programs require rigorous evaluation so that potential adoption of these approaches is evidence-based.

  17. Current status of epilepsy health care for adult patients from central and eastern European Union countries--a survey of members of the Central Europe Epilepsy Experts Working Group.

    Science.gov (United States)

    Jędrzejczak, Joanna; Marusic, Petr; Haldre, Sulev; Majkowska-Zwolińska, Beata; Bojinova-Tchamova, Veneta; Mameniskiene, Ruta; Mindruta, Ioana; Ravnik, Igor M; Szupera, Zoltan; Sykora, Pavol; Verzbickis, Aleksandrs; Daniluk, Jerzy

    2013-07-01

    The aim of this survey was to review and compare the current approaches to epilepsy management in central and eastern EU (CEEU) countries. The questionnaire was sent to ten invited experts from Bulgaria, Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Romania, Slovakia, and Slovenia. It focused on the treatment of adults. The number of neurologists and epilepsy reference centers is highly variable in CEEU countries. None of the analyzed states has a formal specialization in epileptology. No universal state-approved criteria for reference centers exist in Czech Republic, Estonia, Hungary, Latvia, and Slovenia. Generally, the protocols for epilepsy treatment in CEEU countries, including drug-resistant epilepsy, are in accordance with international guidelines; however, most countries have their own national standards of care and some have local clinical guidelines. Also, the reimbursement systems for antiepileptic drugs in CEEU countries are highly variable. Seven countries have epilepsy surgery centers. The costs of epilepsy surgeries are fully reimbursed, procedures performed abroad may also be covered. The length of time spent on waiting lists for surgery following the completion of preoperative investigations varies from two weeks to three years. The fraction of patients who qualified and were operated on within 12 months ranges from 20% to 100%. The lack of unified procedures pertaining to the evaluation and therapy of epilepsy is reflected by marked differences in access to treatment modalities for patients from CEEU countries. Copyright © 2013 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  18. Comparing Client Outcomes for Two Evidence-Based Treatment Consultation Strategies.

    Science.gov (United States)

    Funderburk, Beverly; Chaffin, Mark; Bard, Elizabeth; Shanley, Jenelle; Bard, David; Berliner, Lucy

    2015-01-01

    Posttraining expert case consultation is a key component of transporting and scaling up evidence-based treatments, and hopefully retaining their efficacy. Live practice observation and in vivo coaching is a strategy used in academic training environments, but is rarely feasible in field settings. Post hoc telephone consultation is a substitute strategy but does not approximate many aspects of live coaching. Live video technology offers a closer approximation but has not yet been sufficiently tested. Using a roll-out experimental design, this study compared client outcomes across doses of two posttraining expert consultation strategies-standard telephone consultation and live video coaching. The study was conducted during a two-state, 30-agency implementation involving 80 therapists and 330 cases receiving Parent-Child Interaction Therapy (PCIT). Child behavior problems fell from well above to below clinical cutoff values, with about a 1 standard deviation improvement in 14 sessions, which is within the range reported in laboratory efficacy trials. Symptom improvement was augmented by increased therapist dose of live video consultations. Phone consultation dose had no association with client level outcomes. PCIT benefits appear to be retained when the model is transported at scale into the field, and live video consultation appeared to offer small but significant advantages over telephone consultation as one element of an overall transport strategy.

  19. Client-consultant ethical relationship considerations within management consulting

    Directory of Open Access Journals (Sweden)

    Alyson Smith

    2003-10-01

    Full Text Available Ethical conduct within consulting has become increasingly important since management consulting has developed into an independent profession. The objective of this research was to determine if differences exist in client consultant relationship ethics within a defined group of management consultancies in South Africa. A questionnaire was developed to assess ethical behaviour across five dimensions, namely the client consultant relationship, financial and contractual concerns, delivery of expectations, orientation and competence of consultants, and ethics in consultant behaviour. Thirty-nine respondents completed the questionnaire. Significant differences on ethical dimensions in relation to job level, between consulting firms, the level of senior management commitment to ethics and the existence of a code of ethics were obtained. Opsomming Namate bestuurskonsultasie as ‘n onafhanklike professie ontwikkel het, het etiese optrede binne hierdie professie algaande belangriker geword. Die doel met hierdie navorsing was om vas te stel of daar verskille ten opsigte van etiek tussen bestuurskonsultasie-ondernemings in Suid-Afrika is sover dit die kliënt-konsultantverhouding aangaan. ‘n Vraelys is ontwikkel om die etiese dimensie van bestuurskonsultasie oor vyf dimensies te beoordeel, naamlik die kliënt-konsultantverhouding, finansiële oorwegings, voldoening aan verwagtinge, oriëntasie en bevoegheid van konsultante, en die etiese gedrag van konsultante. Nege-en-dertig respondente het die vraelys voltooi. Beduidende verskille in die etiese dimensies ten opsigte van posvlak, die konsultasie-onderneming, die graad van senior bestuur se toegewydheid tot etiek, en die bestaan van ‘n etiese kode is gevind.

  20. Soft Expert Sets

    Directory of Open Access Journals (Sweden)

    Shawkat Alkhazaleh

    2011-01-01

    Full Text Available In 1999, Molodtsov introduced the concept of soft set theory as a general mathematical tool for dealing with uncertainty. Many researchers have studied this theory, and they created some models to solve problems in decision making and medical diagnosis, but most of these models deal only with one expert. This causes a problem with the user, especially with those who use questionnaires in their work and studies. In our model, the user can know the opinion of all experts in one model. So, in this paper, we introduce the concept of a soft expert set, which will more effective and useful. We also define its basic operations, namely, complement, union intersection AND, and OR. Finally, we show an application of this concept in decision-making problem.

  1. Expert Oracle application express

    CERN Document Server

    Scott, John Edward

    2011-01-01

    Expert Oracle Application Express brings you groundbreaking insights into developing with Oracle's enterprise-level, rapid-development tool from some of the best practitioners in the field today. Oracle Application Express (APEX) is an entirely web-based development framework that is built into every edition of Oracle Database. The framework rests upon Oracle's powerful PL/SQL language, enabling power users and developers to rapidly develop applications that easily scale to hundreds, even thousands of concurrent users. The 13 authors of Expert Oracle Application Express build their careers aro

  2. Peer consultation on relationship between PAC profile and toxicity of petroleum substances.

    Science.gov (United States)

    Patterson, Jacqueline; Maier, Andrew; Kohrman-Vincent, Melissa; Dourson, Michael L

    2013-11-01

    An expert peer consultation panel reviewed a report by the PAC Analysis Task Group, which hypothesized that systemic, developmental, and reproductive toxicity observed in repeated-dose dermal toxicity studies was related to polycyclic aromatic compound (PAC) content. Peer consultations seek to solicit scientific and technical input from experts on the scientific basis and merits of the subject report. This peer consultation panel included nine scientists with expertise in petroleum chemistry, biostatistics, toxicology, risk assessment, structure activity, and reproductive and developmental toxicology. The panel evaluated the technical quality of the PAC report and provided recommendations for improving the statistical and biological approaches. The PAC report authors revised their methods and documentation, which are published elsewhere in this supplement. A review of the post peer consultation manuscripts confirmed that many of the key suggestions from expert panel members were considered and incorporated. In cases where the PAC report authors did not fully incorporate panel suggestions from the peer consultation, they have provided an explanation and support for their decision. This peer consultation demonstrates the value of formal engagement of peers in development of new scientific methods and approaches. Copyright © 2012 Elsevier Inc. All rights reserved.

  3. From psychosomatic medicine to consultation-liaison psychiatry.

    Science.gov (United States)

    Smith, G C

    To trace the movement from psychosomatic medicine to consultation-liaison psychiatry, the forces at work in shaping the change, and the extent to which the change is reflected in the latest revisions of the International classification of diseases (ICD-10) and the Diagnostic and statistical manual of mental disorders, third revision (DSM-III-R). Identification of important trends in the field was aided by discussions with fellow members of the panel of compilers of the consultation-liaison psychiatry literature review expert list published bi-annually in General Hospital Psychiatry. The expert list is based on appropriate literature searches. Psychosomatic medicine continues as a science, studying the relationships between biological, psychological and social phenomena in health and disease. The main advocates of the clinical application of the concepts and findings of psychosomatic medicine are now the general hospital consultation-liaison psychiatrists and their allied health professional colleagues. The mainstreaming of psychiatry into medicine has accentuated the role of the consultation-liaison psychiatrist. In attempting to translate the advances in the field into a new taxonomy, both ICD-10 and DSM-III-R have created a new language that hinders understanding by a medical profession perhaps now less prone to resistance to holism. There is a need for a valid taxonomy that addresses the most common form of psychiatric presentation in the community, that of physical/psychiatric co-morbidity, and for outcome studies based on such a taxonomy. Consultation-liaison psychiatrists need to educate their colleagues about the changes in concepts and terminology.

  4. Video consultation use by Australian general practitioners: video vignette study.

    Science.gov (United States)

    Jiwa, Moyez; Meng, Xingqiong

    2013-06-19

    There is unequal access to health care in Australia, particularly for the one-third of the population living in remote and rural areas. Video consultations delivered via the Internet present an opportunity to provide medical services to those who are underserviced, but this is not currently routine practice in Australia. There are advantages and shortcomings to using video consultations for diagnosis, and general practitioners (GPs) have varying opinions regarding their efficacy. The aim of this Internet-based study was to explore the attitudes of Australian GPs toward video consultation by using a range of patient scenarios presenting different clinical problems. Overall, 102 GPs were invited to view 6 video vignettes featuring patients presenting with acute and chronic illnesses. For each vignette, they were asked to offer a differential diagnosis and to complete a survey based on the theory of planned behavior documenting their views on the value of a video consultation. A total of 47 GPs participated in the study. The participants were younger than Australian GPs based on national data, and more likely to be working in a larger practice. Most participants (72%-100%) agreed on the differential diagnosis in all video scenarios. Approximately one-third of the study participants were positive about video consultations, one-third were ambivalent, and one-third were against them. In all, 91% opposed conducting a video consultation for the patient with symptoms of an acute myocardial infarction. Inability to examine the patient was most frequently cited as the reason for not conducting a video consultation. Australian GPs who were favorably inclined toward video consultations were more likely to work in larger practices, and were more established GPs, especially in rural areas. The survey results also suggest that the deployment of video technology will need to focus on follow-up consultations. Patients with minor self-limiting illnesses and those with medical

  5. Acute surgical unit: The consultant experience

    Directory of Open Access Journals (Sweden)

    Patrick J Stokes

    2016-07-01

    Full Text Available Background Establishment of the Acute Surgical Unit (ASU has redefined the approach to emergency surgery in Australia with quantitative data showing improvement in patient outcomes. However, as qualitative data regarding the ASU remains scarce, we sought to determine the impact of the ASU on overall surgeon job satisfaction. Aims The aim of this paper was to specifically address the impact of the ASU on consultant surgeons overall job satisfaction. Methods We designed a 34 – item questionnaire with consultant general surgeons addressing important aspects of the ASU. Themes included on – call rostering and workload, academic pursuits, surgical training, work – life balance and overall job satisfaction. Results We received responses from 88 surgeons currently working on ASU units, responding correctly and in full to the survey. Overall, our surveyed cohort reported better on – call rostering, improved surgical training and higher levels of job satisfaction and overall work – life balance with ASU implementation. Conclusion Preliminary qualitative results indicate that the ASU may improve on – call rostering, work – life balance and overall job satisfaction.

  6. Outcome of challenging HIV case consultations provided via teleconference by the Clinician Consultation Center to the Federal Bureau of Prisons.

    Science.gov (United States)

    Dong, Betty J; Williams, Michelle R; Bingham, J Tyler; Tokumoto, Jason; Allen, Jeffery D

    To describe the collaboration and prospective outcome of challenging human immunodeficiency virus (HIV) cases presented by Board of Prisons (BOP) pharmacists in consultation with Clinician Consultation Center (CCC) clinical pharmacists and physicians to improve correctional patient care. Federal correctional facilities. Pharmacists improve care of incarcerated persons infected with HIV. Pharmacists evaluate, implement, and provide successful oversight of HIV/hepatitis C virus (HCV) care. Retrospective review of the clinical outcomes of HIV and HCV coinfected cases implemented by BOP pharmacists following CCC clinical consultations from 2010 through 2012. Most cases focused on selecting optimal antiretroviral therapy (ART) regimens in patients experiencing treatment failure by interpreting resistance tests, limiting ART toxicity, identifying adherence strategies, and managing HIV/HCV coinfection. In 32 of the 34 cases presented, 87.5% (28/32) of CCC recommendations were implemented, resulting in 89% of those patients (25/28) achieving optimal virologic or clinical outcome. Complete virologic suppression occurred in 64% (18/28), and significant viral load reductions in 25% (7/28) of the cases. No changes occurred in 2 patients, and data were not available in 2 others lost to follow-up. BOP participation has increased since its inception from 6 to 12-15 pharmacists per call. Discussions also included updates in antiretroviral guidelines, screening and management of patients coinfected with HIV and HCV, and implications for BOP guidelines. BOP clinical consultant pharmacists can successfully implement CCC recommendations to achieve desired clinical outcomes. Consultations and educational efforts from CCC experts assist BOP pharmacists in ensuring excellence in management of complex HIV/HCV issues and medication regimens to achieve desired outcomes. CCC collaboration and BOP pharmacist involvement have improved patient care. Using a team approach to include BOP

  7. Semi-quantitative assessment of disease risks at the human, livestock, wildlife interface for the Republic of Korea using a nationwide survey of experts: A model for other countries

    Science.gov (United States)

    Hwang, Jusun; Lee, Kyunglee; Walsh, Daniel P.; Kim, SangWha; Sleeman, Jonathan M.; Lee, Hang

    2018-01-01

    Wildlife-associated diseases and pathogens have increased in importance; however, management of a large number of diseases and diversity of hosts is prohibitively expensive. Thus, the determination of priority wildlife pathogens and risk factors for disease emergence is warranted. We used an online questionnaire survey to assess release and exposure risks, and consequences of wildlife-associated diseases and pathogens in the Republic of Korea (ROK). We also surveyed opinions on pathways for disease exposure, and risk factors for disease emergence and spread. For the assessment of risk, we employed a two-tiered, statistical K-means clustering algorithm to group diseases into three levels (high, medium and low) of perceived risk based on release and exposure risks, societal consequences and the level of uncertainty of the experts’ opinions. To examine the experts’ perceived risk of routes of introduction of pathogens and disease amplification and spread, we used a Bayesian, multivariate normal order-statistics model. Six diseases or pathogens, including four livestock and two wildlife diseases, were identified as having high risk with low uncertainty. Similarly, 13 diseases were characterized as having high risk with medium uncertainty with three of these attributed to livestock, six associated with human disease, and the remainder having the potential to affect human, livestock and wildlife (i.e., One Health). Lastly, four diseases were described as high risk with high certainty, and were associated solely with fish diseases. Experts identified migration of wildlife, international human movement and illegal importation of wildlife as the three routes posing the greatest risk of pathogen introduction into ROK. Proximity of humans, livestock and wildlife was the most significant risk factor for promoting the spread of wildlife-associated diseases and pathogens, followed by high density of livestock populations, habitat loss and environmental degradation, and

  8. Opportunities and barriers for OHS consultants in a technological change process at a client enterprise

    DEFF Research Database (Denmark)

    Broberg, Ole; Hermund, Ingelise

    2003-01-01

    In a case study of the design of inside finish and equipment of a new factory building the opportunities and barriers for OHS consultants in integrating work environment aspects are discussed. The work prac-tice of OHS consultants is studied in terms of theories from the sociology of technology....... Taking initially the role as experts the consultants in a reflective process change their strategy towards establishing a net-work in the client enterprise, going beyond the joint safety organization and more directly to the designers of new buildings and equipment. This indicates that the conditions...... for the work of OHS consultants can be challenged and changed if the consultants are able to take the role of a political reflective navigator....

  9. Curricula for Media Literacy Education According to International Experts

    Science.gov (United States)

    Fedorov, Alexander; Levitskaya, Anastasia; Camarero, Emma

    2016-01-01

    The article analyzes the results of the international experts' survey regarding the curriculum of media literacy education, which was administrated by the authors in September-October 2015. The expert panel includes specialists actively involved in the real process of media literacy education in schools, universities and other educational…

  10. The role of the consultant radiographer - Experience of appointees

    Energy Technology Data Exchange (ETDEWEB)

    Ford, Peter, E-mail: peter.ford@wsht.nhs.u [Western Sussex Hospitals NHS Trust, St Richards Hospital, Chichester, West Sussex, PO19 6SE (United Kingdom)

    2010-08-15

    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.

  11. Teaching statistics to nursing students: an expert panel consensus.

    Science.gov (United States)

    Hayat, Matthew J; Eckardt, Patricia; Higgins, Melinda; Kim, MyoungJin; Schmiege, Sarah J

    2013-06-01

    Statistics education is a necessary element of nursing education, and its inclusion is recommended in the American Association of Colleges of Nursing guidelines for nurse training at all levels. This article presents a cohesive summary of an expert panel discussion, "Teaching Statistics to Nursing Students," held at the 2012 Joint Statistical Meetings. All panelists were statistics experts, had extensive teaching and consulting experience, and held faculty appointments in a U.S.-based nursing college or school. The panel discussed degree-specific curriculum requirements, course content, how to ensure nursing students understand the relevance of statistics, approaches to integrating statistics consulting knowledge, experience with classroom instruction, use of knowledge from the statistics education research field to make improvements in statistics education for nursing students, and classroom pedagogy and instruction on the use of statistical software. Panelists also discussed the need for evidence to make data-informed decisions about statistics education and training for nurses. Copyright 2013, SLACK Incorporated.

  12. Toward a General Theory of Consultation

    Science.gov (United States)

    Blake, Robert R.; Mouton, Jane Srygley

    1978-01-01

    Consultation needs a sound basis for an integration of its parts in order to become a scientific discipline. Help givers have concentrated on specializing to the detriment of solidarity of consultation. Studying and evaluating consultation behavior results in a coherent and systematic basis for a consultation theory. (Author/MFD)

  13. Expert Script Generator

    Science.gov (United States)

    Sliwa, Nancy E.; Cooper, Eric G.

    1991-01-01

    Program provides additional level of interface to facilitate use of telerobotic system. ESG (Expert Script Generator) is software package automatically generating high-level task objective commands from complex menu-driven language of the NASA Intelligent Systems Research Laboratory (ISRL). Makes telerobotics laboratory accessible to researchers not familiar with comprehensive language developed by ISRL for interacting with various systems of ISRL test bed. Incorporates expert-system technology to capture typical rules of operation that skilled operator uses. Result: operator interfact optimizing ability of system to perform task remotely in hazardous environment, in timely manner, and without undue stress to operator, while minimizing change for operator erros that damage equipment. Written in CLIPS.

  14. Bioethics for Technical Experts

    Science.gov (United States)

    Asano, Shigetaka

    Along with rapidly expanding applications of life science and technology, technical experts have been implicated more and more often with ethical, social, and legal problems than before. It should be noted that in this background there are scientific and social uncertainty elements which are inevitable during the progress of life science in addition to the historically-established social unreliability to scientists and engineers. In order to solve these problems, therefore, we should establish the social governance with ‘relief’ and ‘reliance’ which enables for both citizens and engineers to share the awareness of the issues, to design social orders and criterions based on hypothetical sense of values for bioethics, to carry out practical use management of each subject carefully, and to improve the sense of values from hypothetical to universal. Concerning these measures, the technical experts can learn many things from the present performance in the medical field.

  15. Expert PLSQL Practices

    CERN Document Server

    Beresniewicz, John

    2011-01-01

    Expert PL/SQL Practices is a book of collected wisdom on PL/SQL programming from some of the best and the brightest in the field. Each chapter is a deep-dive into a specific problem, technology, or feature set that you'll face as a PL/SQL programmer. Each author has chosen their topic out of the strong belief that what they share can make a positive difference in the quality and scalability of code that you write. The path to mastery begins with syntax and the mechanics of writing statements to make things happen. If you've reached that point with PL/SQL, then let the authors of Expert PL/SQL

  16. Evolution of expert systems

    Energy Technology Data Exchange (ETDEWEB)

    Biancoli, L.

    1984-03-01

    A brief exposition of the nature and functions of expert systems (knowledge based systems) and some remarks upon the way in which they resemble, but fall far short of, the very largely intuitive action of the human brain are given. The remainder of the article consists of summaries of the work being done in this field by organisations in Italy, namely: ISPRA; Delphi Electronic Design Systems, VIAREGGIO; SPL Italia SPA, (VA), Milan; Italservice Srl, Milan; and Artificial Intelligence Software, Rovigo.

  17. ALICE Expert System

    CERN Document Server

    Ionita, C

    2014-01-01

    The ALICE experiment at CERN employs a number of human operators (shifters), who have to make sure that the experiment is always in a state compatible with taking Physics data. Given the complexity of the system and the myriad of errors that can arise, this is not always a trivial task. The aim of this paper is to describe an expert system that is capable of assisting human shifters in the ALICE control room. The system diagnoses potential issues and attempts to make smart recommendations for troubleshooting. At its core, a Prolog engine infers whether a Physics or a technical run can be started based on the current state of the underlying sub-systems. A separate C++ component queries certain SMI objects and stores their state as facts in a Prolog knowledge base. By mining the data stored in dierent system logs, the expert system can also diagnose errors arising during a run. Currently the system is used by the on-call experts for faster response times, but we expect it to be adopted as a standard tool by reg...

  18. SURVEY

    DEFF Research Database (Denmark)

    SURVEY er en udbredt metode og benyttes inden for bl.a. samfundsvidenskab, humaniora, psykologi og sundhedsforskning. Også uden for forskningsverdenen er der mange organisationer som f.eks. konsulentfirmaer og offentlige institutioner samt marketingsafdelinger i private virksomheder, der arbejder...

  19. Assessment on nursing serviceat hospital external consulting rooms

    Directory of Open Access Journals (Sweden)

    Mª Dolores Poyatos Ruiz

    2013-05-01

    Full Text Available The social needs and requests change constantly, so that health care is evolving to a more focused on the users, in order to meet users´ needs and expectations of those who are going to get our assistance. Aim: We have developed a research to evaluate the quality of the assistance received by the patientst in their first encounter in the hospital external consulting rooms of traumathology at Santa Bárbara Hospital, letting us know about the patient´s satisfaction after the consulting has finished. Material and method: A transverse descriptive study on the traumathology consulting room of Santa Bárbara Hospital in Puertollano was developed for two months. The research is formed by the patients who attend this consulting room for their first time. A self made multiple choice questionnaire, which was designe by experts, and patients were asked to answer it once their first consulting at traumathology service had finished. Results: 95.6% of the patients considered as good or very good the nursing kindness (confidence/reliabitity when seeing them; 93.5% of them considered as good or very good the information given to them and 90.6% of them considered as good or very good the medical explanations they got. We also noticed a significant statistical difference among nursing kindness (confidence/reliabitity, enough consultation time and explanations received, with regard to the variant high resolution. Conclusions: The study reveals that more than 90% of the interviewed people considered as good or very good the clinical assistance and service given. The research has allowed us to know the areas that we can work on and improve.

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

    Directory of Open Access Journals (Sweden)

    Leonid Davidovich Gitelman

    2017-03-01

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

  1. Efficacy of Collaborative Consultation Coursework in Personnel Preparation of Special Education Teachers.

    Science.gov (United States)

    Andringa, Jane Wilkin; Kasik, Maribeth Montgomery

    Governors State University (University Park, Illinois) includes a three-credit course in collaborative consultation in its Master's degree program in multicategorical special education. A survey of 72 program graduates sought to evaluate the effectiveness of the consultation coursework. Responses from 39 of the graduates indicated that the role of…

  2. Consultancy on Strategic Information Planning.

    Science.gov (United States)

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

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

  3. Consultant appraisals. Appraise where due.

    Science.gov (United States)

    Ledgard, Anna; Thomas, Beverly; McClelland, Siobhan; Robbé, Iain

    2002-11-21

    A study of consultant appraisal in Welsh trusts revealed concerns about lack of protected time and uncertainty about how issues raised should be handled. The research showed it is important to ensure that issues raised are addressed by the organisation. Resources must be made available to trusts to offer protected time for the process, and adequate training.

  4. Faculty Consulting: Responsibility or Promiscuity?

    Science.gov (United States)

    Boyer, Carol M; Lewis, Darrell R.

    1984-01-01

    The potential benefits--to the individual, the institution, and society--and the potential costs of faculty consulting are examined. A review of the relevant literature and data precedes a presentation of new findings and a taxonomy for developing institutional guidelines. (Author/MLW)

  5. Consultative Instructor Supervision and Evaluation

    Science.gov (United States)

    Lee, William W.

    2010-01-01

    Organizations vary greatly in how they monitor training instructors. The methods used in monitoring vary greatly. This article presents a systematic process for improving instructor skills that result in better teaching and better learning, which results in better-prepared employees for the workforce. The consultative supervision and evaluation…

  6. Gamification in a Consulting Company

    NARCIS (Netherlands)

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

    2014-01-01

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

  7. Narrative and Structure in Consultation

    Science.gov (United States)

    Hadley, David

    2012-01-01

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

  8. Bipolar Neutrosophic Soft Expert Sets

    OpenAIRE

    Şahin, Mehmet; Deli, İrfan; Uluçay, Vakkas

    2016-01-01

    In this paper, we introduce concept of bipolar neutrosophic soft expert set and its some operations. Also, we propose score, certainty and accuracy functions to compare the bipolar neutrosophic soft expert sets. We give examples for these concepts. 

  9. Establishing a minimum dataset for prospective registration of systematic reviews: an international consultation.

    Directory of Open Access Journals (Sweden)

    Alison Booth

    Full Text Available In response to growing recognition of the value of prospective registration of systematic review protocols, we planned to develop a web-based open access international register. In order for the register to fulfil its aims of reducing unplanned duplication, reducing publication bias, and providing greater transparency, it was important to ensure the appropriate data were collected. We therefore undertook a consultation process with experts in the field to identify a minimum dataset for registration.A two-round electronic modified Delphi survey design was used. The international panel surveyed included experts from areas relevant to systematic review including commissioners, clinical and academic researchers, methodologists, statisticians, information specialists, journal editors and users of systematic reviews. Direct invitations to participate were sent out to 315 people in the first round and 322 in the second round. Responses to an open invitation to participate were collected separately. There were 194 (143 invited and 51 open respondents with a 100% completion rate in the first round and 209 (169 invited and 40 open respondents with a 91% completion rate in the second round. In the second round, 113 (54% of the participants reported having previously taken part in the first round. Participants were asked to indicate whether a series of potential items should be designated as optional or required registration items, or should not be included in the register. After the second round, a 70% or greater agreement was reached on the designation of 30 of 36 items.The results of the Delphi exercise have established a dataset of 22 required items for the prospective registration of systematic reviews, and 18 optional items. The dataset captures the key attributes of review design as well as the administrative details necessary for registration.

  10. Limitations of Expert Evidence

    OpenAIRE

    Serpil Salaçin

    1997-01-01

    Limitations of Expert Evidence Edited by Stephen Leadbeatter MB ChB MCRPath ISBN 1 86016 029 8 Printed in Great Britain by Cathedral Print Services Ltd, Salisbury, 1996 Kitap 25 Ekim 1994 te The Royal College of Physicians ve The Royal College of Pathologists tarafından düzenlenen konferanstan sonra hekimlere ve avukatlara konuyu tartışmaya açmak için basılmış. Bilirkişi görüşünün temel filozofisinin, bu görevi yapanlar ve bu hizmeti alanların yapabileceklerin...

  11. Expert Oracle Exadata

    CERN Document Server

    Johnson, Randy

    2011-01-01

    Throughout history, advances in technology have come in spurts. A single great idea can often spur rapid change as the idea takes hold and is propagated, often in totally unexpected directions. Exadata embodies such a change in how we think about and manage relational databases. The key change lies in the concept of offloading SQL processing to the storage layer. That concept is a huge win, and its implementation in the form of Exadata is truly a game changer. Expert Oracle Exadata will give you a look under the covers at how the combination of hardware and software that comprise Exadata actua

  12. Age of distrust: industry counters with an army of PR specialists, consultation consultants and 'brand' marketers

    Energy Technology Data Exchange (ETDEWEB)

    Georg, A.

    2002-03-04

    The part that public relations and community consultation plays in the oil and natural gas industry is discussed. Contemporary practices date back to 1974 when Justice Berger began his inquiry into the feasibility of building a pipeline in northern Canada. He discovered two vehemently opposing viewpoints. Whereas the Territorial Council, favoring the pipeline, claimed to speak for all northerners, aboriginal organizations opposed the pipeline without a settlement of land claims first. Because of these conflicting claims Justice Berger decided that northern residents should be able to speak for themselves. He held hearings in 35 communities from Sachs Harbour to Fort Smith in addition to hearing submissions from 300 experts on northern conditions and environments. Thereafter, the process of public consultation was entrenched, until today no major development or construction project can be undertaken without a serious public relations component being part of the process. A case history of Alliance Pipeline Ltd's exhaustive public consultation campaign during the planning stages of the pipeline project is described to illustrate the extent and complexities of the process. In the event, the project succeeded because the company spared no effort to consult and to gain the approval of 99.5 per cent of the 6,000 landowners who were affected by the route.

  13. [Consultation. Considerations on the practice of medical consultation].

    Science.gov (United States)

    Leiss, O

    2007-01-01

    On the theme of Linus Geisler's nine steps for a successful consultation between doctor and patient, the ability for self-criticism, the ability to be able to listen to oneself and the value of the doctor-patient relationship in the context of medical practice will be discussed. Subsequently, the framework of the consultation, the consulting room atmosphere and the complete setting of the consultation will be dealt with. The importance of active listening and the recognition of all messages, both verbal and from body language, will be particularly emphasized. The capability for empathy is presented as the necessary bridge to recognition of the feelings and inner world of the patient. Because one only sees what one is looking for and only recognizes what one knows, the recognition of typical complaints presented by patients in a consultation represents the "something" which must be specifically elucidated. The problems and symptoms which the patient brings to the doctor are surrounded by a ring of fears and apprehensions. For this reason it is decisive to uncover the accompanying cloud of fears and apprehensions with appropriate questions, to correctly assign the unsettling symptoms of the patient and to be able to correctly interpret them. As illustrated by the language of nature - the translation of deoxyribonucleic acid (DNA) triplets into amino acids - the translation of biological, psychological and social aspects of the complaints symptomatic into the level of diagnosis and the translation of the referential, social and affective meaning of the expressions used by the patient, into the level of the significance will be discussed. The role of the doctor here is that of a producer of context and a skilled translator. In the management of functional disorders and chronic diseases the construction of a shared reality is important. The therapeutic function of consultations is due to an introduction of metaphors as bridges - bridges to an improved understanding of

  14. Expert Systems - A Natural History

    OpenAIRE

    Shadbolt, N. R.

    1989-01-01

    This paper examines the origins, current state and future prospects for expert systems. The origins are traced from the schism with classic Artificial Intelligence. The characteristics of early expert systems are described and contrasted with more recent developments. A number of influential forces operating on present day systems are reviewed. The future trends in the evolution of expert systems are discussed.

  15. Justification of CT for Individual Health Assessment of Asymptomatic Persons: A World Health Organization Consultation

    NARCIS (Netherlands)

    Malone, J.; Perez, M. Marza; Friberg, E.G.; Prokop, M.; Jung, S.E.; Griebel, J.; Ebdon-Jackson, S.

    2016-01-01

    An international expert consultation was convened by the World Health Organization (WHO). The purpose of the meeting was to review the use of CT in examining asymptomatic people. This is often referred to as individual health assessment (IHA). IHA was identified as a global phenomenon

  16. Factors determining a successful socioeconomic introduction of horticulture in foreign countries - Academic Consultancy Training Report

    NARCIS (Netherlands)

    Busscher, N.; Dobma, B.J.; Gonbour, M.; González Ximénez de Embún, M.; Heddes, M.; Visser, de J.; Lans, van der C.J.M.

    2010-01-01

    Course: Academic Consultancy Training (YMC 60809) Project: Sustainable development of greenhouse horticulture in developing countries (756) Commissioner: Wageningen UR Greenhouse Horticulture Contact person: Ir. C.J.M. van der Lans Coach: Dr. Ir. J.W. Hofstee Expert: Prof. Dr. O. van Kooten A lot of

  17. Spanning Boundaries: The Case of an Intercultural E-Consulting Experience

    Science.gov (United States)

    Correia, Ana-Paula; Baran, Evrim; Cagiltay, Kursat

    2009-01-01

    The purpose of this case study is to understand ways to plan, organize and facilitate experiences in which experts who are geographically dispersed act as effective consultants. Graduate students enrolled in an advanced course in instructional technology at a large university in the Midwestern United States interacted with colleagues studying at a…

  18. Consultation Barriers between Teachers and External Consultants: A Grounded Theory of Change Resistance in School Consultation

    Science.gov (United States)

    Thornberg, Robert

    2014-01-01

    The aim of this study, conducted in Sweden, was to investigate the cultural barriers between school personnel (teachers and principals) and nonschool personnel (a resource team), who were external to the school system, regarding consultation about challenging or difficult-to-teach students. Focus groups with teachers, principals, and the resource…

  19. Consultation expectations among patients with respiratory tract infection symptoms

    DEFF Research Database (Denmark)

    Bruun Lauridsen, Gitte; Sejr Sørensen, Mette; Hansen, Malene Plejdrup

    2017-01-01

    Introduction: Antibiotic resistance is a growing threat to public health, and antibiotic prescribing increases. About 90% of antibiotics are prescribed in general practice, mostly for acute respiratory tract infections. It is well known that patient expectations and general practitioners’ misinter......­pretation of patients’ expectations are associated with antibiotic overuse. The aim of this study was to explore Danish patients’ expectations when consulting a general prac­titioner with symptoms of acute respiratory tract infection, and to determine predictors for these expectations. Methods: A questionnaire survey...... was conducted in Danish primary care during 2014. Patients aged ≥ 18 years were asked about their expectations to the consultation when consulting with symptoms of acute respiratory tract infections. Associations between socio-demographic characteristics, self-reported antibiotic prescription and patients...

  20. Consultation expectations among patients with respiratory tract infection symptoms

    DEFF Research Database (Denmark)

    Lauridsen, Gitte Bruun; Sørensen, Mette Sejr; Hansen, Malene Plejdrup

    2017-01-01

    INTRODUCTION: Antibiotic resistance is a growing threat to public health, and antibiotic prescribing increases. About 90% of antibiotics are prescribed in general practice, mostly for acute respiratory tract infections. It is well known that patient expectations and general practitioners......' misinterpretation of patients' expectations are associated with antibiotic overuse. The aim of this study was to explore Danish patients' expectations when consulting a general practitioner with symptoms of acute respiratory tract infection, and to determine predictors for these expectations. METHODS......: A questionnaire survey was conducted in Danish primary care during 2014. Patients aged ≥ 18 years were asked about their expectations to the consultation when consulting with symptoms of acute respiratory tract infections. Associations between socio-demographic characteristics, self-reported antibiotic...

  1. Animal Welfare: Data from an Online Consultation.

    Science.gov (United States)

    Sechi, Paola; Baldinelli, Chiara; Iulietto, Maria F; Goga, Beniamino T Cenci

    2015-11-02

    This paper analyses data obtained from an online survey related to animal welfare and religious slaughter topics. The questionnaire was conducted with the purpose of examining the purchase behaviour of a group of consumers (with different religious orientation) and their views on animal protection and ritual slaughter. The main results of the consultation were two. The first evidenced the respondents' great interest about the question on animal welfare, which is in accordance with the growing interest of European citizens concerning this issue. The second was the demand for a more transparent labelling of animal products, which would also reflect animal welfare and the slaughter method used. These results are in contrast with marketing analysis, which finds that consumers want to only receive positive information. Paradoxically, the more information is transmitted to reassure consumers, the higher is the risk to alarm them.

  2. Animal welfare: data from an online consultation

    Directory of Open Access Journals (Sweden)

    Paola Sechi

    2015-12-01

    Full Text Available This paper analyses data obtained from an online survey related to animal welfare and religious slaughter topics. The questionnaire was conducted with the purpose of examining the purchase behaviour of a group of consumers (with different religious orientation and their views on animal protection and ritual slaughter. The main results of the consultation were two. The first evidenced the respondents’ great interest about the question on animal welfare, which is in accordance with the growing interest of European citizens concerning this issue. The second was the demand for a more transparent labelling of animal products, which would also reflect animal welfare and the slaughter method used. These results are in contrast with marketing analysis, which finds that consumers want to only receive positive information. Paradoxically, the more information is transmitted to reassure consumers, the higher is the risk to alarm them.

  3. 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

  4. 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

  5. Consultancy

    NARCIS (Netherlands)

    Vorm, J.K.J. van der

    2014-01-01

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

  6. Consultations

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

    IDRC CRDI

    information la plus fiable. Cette personne connaît bien les modalités du contrat et est la mieux placée pour répondre à vos questions et préoccupations. Voici les réponses à quelques questions que vous pourriez vous poser. [Sans aucune ...

  7. ICADS: A cooperative decision making model with CLIPS experts

    Science.gov (United States)

    Pohl, Jens; Myers, Leonard

    1991-01-01

    A cooperative decision making model is described which is comprised of six concurrently executing domain experts coordinated by a blackboard control expert. The focus application field is architectural design, and the domain experts represent consultants in the area of daylighting, noise control, structural support, cost estimating, space planning, and climate responsiveness. Both the domain experts and the blackboard were implemented as production systems, using an enhanced version of the basic CLIPS package. Acting in unison as an Expert Design Advisor, the domain and control experts react to the evolving design solution progressively developed by the user in a 2-D CAD drawing environment. A Geometry Interpreter maps each drawing action taken by the user to real world objects, such as spaces, walls, windows, and doors. These objects, endowed with geometric and nongeometric attributes, are stored as frames in a semantic network. Object descriptions are derived partly from the geometry of the drawing environment and partly from knowledge bases containing prototypical, generalized information about the building type and site conditions under consideration.

  8. The role of energy-related consultancy in increasing the energy performance in small and mid-sized enterprises. Feedback analysis of a survey among SMEs and energy consultants in Baden-Wuerttemberg. Final report to the Ministry of environment and transport of Baden-Wuerttemberg; Die Rolle der Energieberatung bei der rationellen Energienutzung in kleinen und mittleren Unternehmen. Auswertung einer Umfrage unter kleinen und mittleren Unternehmen und Energieberatern in Baden-Wuerttemberg. Endbericht an das Ministerium fuer Umwelt und Verkehr Baden-Wuerttemberg

    Energy Technology Data Exchange (ETDEWEB)

    Schmid, C. (comp.); Gruber, E.; Weigert, K.

    2000-10-01

    The small and mid-sized enterprises (SMEs) have to cope with typical shortcomings due to tight technical, financial, or human resources, in attempts to implement energy performance improvement measures in their shops. As a rule, none of the persons employed has the time to qualify for and perform the functions of an energy efficiency specialist. This is why consultancy by external specialists is the adequate solution (when doubts about the cost efficiency and general usefulness of such services have been removed). The document contains the important aspects of a survey carried out in order to gather information about availability of consultancy services for SMEs in the producing sector, and available experience and results. The survey covers about 50 enterprises of the mechanical engineering and printer's shop branches, as well as about 50 consulting firms in Baden-Wuerttemberg. (orig./CB) [German] In kleinen und mittleren Unternehmen existieren eine Reihe von technischen, oekonomischen und einstellungsbedingten Hemmnissen bei der Umsetzung von Massnahmen der rationellen Energienutzung. Aufgrund der geringen Mitarbeiterzahl gibt es in diesen Unternehmen in der Regel niemanden, der fuer Fragen der rationellen Energienutzung zustaendig ist und moegliche Einsparmassnahmen verfolgt. Gerade fuer kleinere Unternehmen ist daher die Inanspruchnahme externer Energiefachleute sinnvoller als der kostenintensive Aufbau von eigenem Know-how. Allerdings werden Energieberatungen u. a. aus Kostengruenden und Zweifel am Nutzen haeufig nicht in Anspruch genomen. In der vorliegenden Studie wurden das Angebot von und Erfahrungen mit Energieberatungen fuer kleine und mittlere Unternehmen des produzierenden Gewerbes untersucht. Dazu wurden auch Fragen zum Umfeld, vor allem zur Wirkung und Ueberwindung von Hemmnissen in den Betrieben und zur Bereitschaft zur Durchfuehrung von Massnahmen rationeller Energienutzung beruecksichtigt. Ziel der Arbeit war es, einen Einblick in den

  9. Let the Experts Decide?

    DEFF Research Database (Denmark)

    Morton, Rebecca; Tyran, Jean-Robert

    in information quality is large, we find that voting groups largely coordinate on the SVC equilibrium which is also Pareto Optimal. However, we find that when the asymmetry in information quality is not large and the Pareto Optimal equilibrium is for all to participate, significant numbers of voters with low...... quality information abstain. Furthermore, we find that information asymmetry induces voters with low quality information to coordinate on a non-equilibrium outcome. This suggests that coordination on "letting the experts" decide is a likely voting norm that sometimes validates SVC equilibrium predictions......We examine abstention when voters in standing committees are asymmetrically informed and there are multiple pure strategy equilibria-swing voter's curse (SVC) equilibria where voters with low quality information abstain and equilibria when all participants vote their information. When the asymmetry...

  10. Ultrasound for the Pulmonary Consultant

    Directory of Open Access Journals (Sweden)

    Astha Chichra

    2016-01-01

    Full Text Available Bedside ultrasonographic assessment of the lung and pleura provides rapid, noninvasive, and essential information in diagnosis and management of various pulmonary conditions. Ultrasonography helps in diagnosing common conditions, including consolidation, interstitial syndrome, pleural effusions and masses, pneumothorax, and diaphragmatic dysfunction. It provides procedural guidance for various pulmonary procedures, including thoracentesis, chest tube insertion, transthoracic aspiration, and biopsies. This article describes major applications of ultrasonography for the pulmonary consultant along with illustrative figures and videos.

  11. Ultrasound for the Pulmonary Consultant.

    Science.gov (United States)

    Chichra, Astha; Makaryus, Mina; Chaudhri, Parag; Narasimhan, Mangala

    2016-01-01

    Bedside ultrasonographic assessment of the lung and pleura provides rapid, noninvasive, and essential information in diagnosis and management of various pulmonary conditions. Ultrasonography helps in diagnosing common conditions, including consolidation, interstitial syndrome, pleural effusions and masses, pneumothorax, and diaphragmatic dysfunction. It provides procedural guidance for various pulmonary procedures, including thoracentesis, chest tube insertion, transthoracic aspiration, and biopsies. This article describes major applications of ultrasonography for the pulmonary consultant along with illustrative figures and videos.

  12. Healthy eating at school: consensus among experts

    Directory of Open Access Journals (Sweden)

    Rafaella Guimarães Moraes CAMARGO

    Full Text Available ABSTRACT Objective: To identify attributes that promote healthy eating in order to support a study for the Quality Index for School Meal Menus content validity. Methods: This study used the Delphi technique to consult school nutrition experts in Brazil. These experts were selected among the authors of articles published between 2010 and 2015 that were identified by searching the Web of Science database, using the keywords 'school feeding', 'school nutrition program', and 'school food program', as well as the authors of official documents on this topic. The Likert method was used to record respondent perceptions in two analytical dimensions: foods that are part of a healthy menu for school feeding, and composition of an indicator of nutritional quality for school feeding menus. Results: Most respondents (n=27 were affiliated with public institutions (92.59% and had over six years of experience in the area (70.36%. Assertions resulted in consensus according to the analysis criteria. A consensus was established for fresh food, fruits and vegetables, dairy products, beans, meat and eggs, and a schedule compatible with the meal as promoters of healthy eating, and processed foods, sweets, and fat excess as risk attributes. Conclusion: Since a consensus was not reached in the first round, there is a need to broaden the debate on issues related to foods rich in sugar, replacement of meals by sweets, and foods rich in fat.

  13. Profiles of self-care management versus consulting behaviors in adults with heart failure.

    Science.gov (United States)

    Lee, Christopher S; Gelow, Jill M; Mudd, James O; Green, Jennifer K; Hiatt, Shirin O; Chien, Christopher; Riegel, Barbara

    2015-02-01

    Patients with heart failure (HF) vary in their ability to respond to symptoms when they occur. The goal of this study was to classify common patterns of symptom response behaviors among adults with HF and identify biobehavioral determinants thereof. Consulting behaviors (i.e. contacting a provider for guidance) were measured using the European Heart Failure Self-care Behavior Scale consulting behaviors subscale, and self-care management (i.e. recognizing and engaging in self-initiated treatment of symptoms) was measured with the Self-Care of HF Index self-care management scale in a prospective cohort study. Latent class mixture modeling was used to identify distinct profiles of consulting and of self-care management behaviors. The mean age (n=146) was 57±13 years, 30% were female, and 59% had class III/IV HF. Two distinct profiles of consulting behaviors (novice and expert) and three distinct profiles of self-care management (novice, inconsistent and expert) were identified. There was a weak association between profiles of consulting behaviors and self-care management (Kendall's tau-b=0.211). Higher levels of anxiety were associated with worse consulting behaviors (β=1.67±0.60) and worse self-care management (β= -5.82±3.12) and lower odds of exhibiting expert level consulting behaviors (odds ratio (OR)=0.50; 95% confidence interval (CI)=0.26-0.95) and self-care management (OR=0.47; 95% CI=0.24-0.92) (all pconsulting behaviors does not necessarily confer expertise in symptom self-care management and vice versa. Physical and psychological symptoms are strong determinants of symptom response behaviors. © The European Society of Cardiology 2013.

  14. Endangered Species Consultation Request : Muskrat & raccoon trapping

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This is the Endangered Species Consultation Request report for bald eagles and peregrine falcons on Muscatatuck NWR. This consultation was in response to the...

  15. Nurse Education Consultancy: A New Role.

    Science.gov (United States)

    Jenkins, David A.

    1996-01-01

    A nurse education consultant can help a college enhance the educational process and market effectively and ethically. Nurses considering consultancy should examine their personal qualities, skill and knowledge base, and personal values and beliefs about education and nursing. (SK)

  16. Quality requirements for veterinary hematology analyzers in small animals-a survey about veterinary experts' requirements and objective evaluation of analyzer performance based on a meta-analysis of method validation studies: bench top hematology analyzer.

    Science.gov (United States)

    Cook, Andrea M; Moritz, Andreas; Freeman, Kathleen P; Bauer, Natali

    2016-09-01

    Scarce information exists about quality requirements and objective evaluation of performance of large veterinary bench top hematology analyzers. The study was aimed at comparing the observed total error (TEobs ) derived from meta-analysis of published method validation data to the total allowable error (TEa ) for veterinary hematology variables in small animals based on experts' opinions. Ideally, TEobs should be veterinary experts in clinical pathology and small animal internal medicine for providing the maximal allowable deviation from a given result for each variable. Percent of TEa = (allowable median deviation/clinical threshold) * 100%. Second, TEobs for 3 laser-based bench top hematology analyzers (ADVIA 2120; Sysmex XT2000iV, and CellDyn 3500) was calculated based on method validation studies published between 2005 and 2013 (n = 4). The percent TEobs = 2 * CV (%) + bias (%). The CV was derived from published studies except for the ADVIA 2120 (internal data), and bias was estimated from the regression equation. A total of 41 veterinary experts (19 diplomates, 8 residents, 10 postgraduate students, 4 anonymous specialists) responded. The proposed range of TEa was wide, but generally ≤ 20%. The TEobs was veterinary bench top analyzers fulfilled experts' requirements except for HGB due to method-related bias, and platelet counts due to known preanalytic/analytic issues. © 2016 American Society for Veterinary Clinical Pathology.

  17. Comparison of UK paediatric consultants' participation in child health research between 2011 and 2015.

    Science.gov (United States)

    Winch, Rachel; McColgan, Martin; Modi, Neena; Greenough, Anne

    2017-08-01

    To identify whether there have been changes over time in the capacity of paediatric consultants to undertake research and if the activity differs between men and women. Comparison of data from two surveys of UK paediatric consultants. UK consultant members of the Royal College of Paediatrics and Child Health. Surveys carried out in 2011 and 2015. The proportion of consultants with allocated time in job plans for research, academic appointments, postgraduate qualifications, publications, grant funding and supervision of PhD students. The 2015 survey demonstrated 20% of consultants had one or more programmed activities (PAs) for research, but the average paid PA for research was 0.39 PA. Between the surveys, the proportion of consultants with honorary contracts had declined, and the proportion with a PhD or MDRes was 32% in 2011 compared with 26% in 2015 (pstudent, and 88% had never supervised a PhD student. In 2015, 25% of men and 12% of women had PAs for research (pacademic contract, have authored a publication or supervised a PhD student (all p<0.001). Research activity among paediatric consultants remains low, particularly among women. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  18. 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.

  19. 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

  20. Implementing an International Consultation on Earth System Research Priorities Using Web 2.0 Tools

    Science.gov (United States)

    Goldfarb, L.; Yang, A.

    2009-12-01

    Leah Goldfarb, Paul Cutler, Andrew Yang*, Mustapha Mokrane, Jacinta Legg and Deliang Chen The scientific community has been engaged in developing an international strategy on Earth system research. The initial consultation in this “visioning” process focused on gathering suggestions for Earth system research priorities that are interdisciplinary and address the most pressing societal issues. It was implemented this through a website that utilized Web 2.0 capabilities. The website (http://www.icsu-visioning.org/) collected input from 15 July to 1 September 2009. This consultation was the first in which the international scientific community was asked to help shape the future of a research theme. The site attracted over 7000 visitors from 133 countries, more than 1000 of whom registered and took advantage of the site’s functionality to contribute research questions (~300 questions), comment on posts, and/or vote on questions. To facilitate analysis of results, the site captured a small set of voluntary information about each contributor and their contribution. A group of ~50 international experts were invited to analyze the inputs at a “Visioning Earth System Research” meeting held in September 2009. The outcome of this meeting—a prioritized list of research questions to be investigated over the next decade—was then posted on the visioning website for additional comment from the community through an online survey tool. In general, many lessons were learned in the development and implementation of this website, both in terms of the opportunities offered by Web 2.0 capabilities and the application of these capabilities. It is hoped that this process may serve as a model for other scientific communities. The International Council for Science (ICSU) in cooperation with the International Social Science Council (ISSC) is responsible for organizing this Earth system visioning process.

  1. Contribution of Adlerian Psychology to School Consulting

    Science.gov (United States)

    Dinkmeyer, Don; Dinkmeyer, Don, Jr.

    1976-01-01

    The failure to consult effectively with teachers is often due to a lack of understanding the purpose of behavior. Specific propositions basic to understanding behavior are presented. A transcript which clearly illustrates and critiques Adlerian consultation is included. Specific steps in the consultant process are included. (Author)

  2. The Efficacy of School-Based Consultation.

    Science.gov (United States)

    Sandoval, Jonathan

    This presentation reviews the concept of school-based consultation (Lambert, 1974) and contrasts it with other consultation models. The validity of this model for the professional talking relationships of school psychologists (school-based consultation) is assessed first by examining: (1) the likelihood that interprofessional interchange will take…

  3. Observed Consultation: Confidence and Accuracy of Assessors

    Science.gov (United States)

    Tweed, Mike; Ingham, Christopher

    2010-01-01

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

  4. Core Competencies for Training Effective School Consultants

    Science.gov (United States)

    Burkhouse, Katie Lynn Sutton

    2012-01-01

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

  5. Entry-Level Activities in System Consultation

    Science.gov (United States)

    Hylander, Ingrid

    2014-01-01

    System-level consultation or organizational development in schools is an area in great need of theoretical models and definitions. The three articles in this special issue provide a unique learning opportunity not only for consultation across borders but also for consultation within the same nation. In my commentary, I limit my remarks to a few…

  6. Considerations in development of expert systems for real-time space applications

    Science.gov (United States)

    Murugesan, S.

    1988-01-01

    Over the years, demand on space systems has increased tremendously and this trend will continue for the near future. Enhanced capabilities of space systems, however, can only be met with increased complexity and sophistication of onboard and ground systems. Artificial Intelligence and expert system techniques have great potential in space applications. Expert systems could facilitate autonomous decision making, improve in-orbit fault diagnosis and repair, enhance performance and reduce reliance on ground support. However, real-time expert systems, unlike conventional off-line consultative systems, have to satisfy certain special stringent requirements before they could be used for onboard space applications. Challenging and interesting new environments are faced while developing expert system space applications. This paper discusses the special characteristics, requirements and typical life cycle issues for onboard expert systems. Further, it also describes considerations in design, development, and implementation which are particularly important to real-time expert systems for space applications.

  7. ESG - EXPERT SCRIPT GENERATOR

    Science.gov (United States)

    Cooper, E. G.

    1994-01-01

    The Automation Technology Branch of NASA's Langley Research Center is employing increasingly complex degrees of operator/robot cooperation (telerobotics). A good relationship between the operator and computer is essential for smooth performance by a telerobotic system. ESG (Expert Script Generator) is a software package that automatically generates high-level task objective commands from the NASA Intelligent Systems Research Lab's (ISRL's) complex menu-driven language. ESG reduces errors and makes the telerobotics lab accessible to researchers who are not familiar with the comprehensive language developed by ISRL for interacting with the various systems of the ISRL testbed. ESG incorporates expert system technology to capture the typical rules of operation that a skilled operator would use. The result is an operator interface which optimizes the system's capability to perform a task remotely in a hazardous environment, in a timely manner, and without undue stress to the operator, while minimizing the chance for operator errors that may damage equipment. The intricate menu-driven command interface which provides for various control modes of both manipulators and their associated sensors in the TeleRobotic System Simulation (TRSS) has a syntax which is both irregular and verbose. ESG eliminates the following two problems with this command "language": 1) knowing the correct command sequence to accomplish a task, and 2) inputting a known command sequence without typos and other errors. ESG serves as an additional layer of interface, working in conjunction with the menu command processor, not supplanting it. By specifying task-level commands, such as GRASP, CONNECT, etc., ESG will generate the appropriate menu elements to accomplish the task. These elements will be collected in a script file which can then be executed by the ISRL menu command processor. In addition, the operator can extend the list of task-level commands to include customized tasks composed of sub

  8. A nationwide telepathology consultation and quality control program in China: implementation and result analysis.

    Science.gov (United States)

    Chen, Je; Jiao, Yahui; Lu, Chaohui; Zhou, Jun; Zhang, Zongjiu; Zhou, Chen

    2014-01-01

    Telepathology may play an important role in pathology consultation and quality control for cancer diagnosis in China, as the country has the largest population of cancer patients worldwide. In 2011, the Pathology Quality Control Center of China and Ministry of Health developed and implemented a nationwide telepathology consultation and quality control program for cancer diagnosis in China. We here report the results of the two-year implementation and experiences. the program built an Internet based telepathology platform to connect participating hospitals and expert consultants. The hardware and software used for the platform were validated in previous validation studies in China. The program had three regional centers consisting of Peking Union Medical College, Huasi Medical College of Sichuan and 2nd affiliated hospital of Zhejiang University. It also had 20 provincial consultation centers based in the provincial referral hospitals. 80 provincial or national pathologists served as expert consultants for the program, providing telepathology consultation for cancer diagnosis for more than 60 participating hospitals. from 2011 to July 2013, 16,247 pathology cases were submitted to the platform for consultation. Among them, 84% were due to diagnostic difficulty and 16% were due to request by patients. The preliminary diagnosis provided by submitting pathologists were in agreement with expert opinion in 59.8% of cases but was in disagreement with expert opinion in 24.2% of cases. 16.0% of cases were not provided with preliminary diagnosis. The distribution of pathology cases by system or organ were: digestive system, 17.3%; gynecologic system, 16.7%; head and neck, 15.7%; bone and soft tissue, 10.4%; lung and mediastinum, 8.6%; breast, 7.6%; urinary system, 7.5%; hematopathology, 6.4%; skin, 5.2%; neuropathology, 2.5% and cytopathology, 1.3%. Expert consultants also provided assessment of quality of slide preparation and staining, online lectures and guidance for

  9. Expert systems for satellite stationkeeping

    Science.gov (United States)

    Mekaru, M. M.; Wright, M. A.

    The feasibility of implementing artificial intelligence on satellites is evaluated, with the aim of using an onboard expert system to perform effective stationkeeping functions without assistance from the ground. The Defense Satellite Communication System (DSCS III) is used as an example. The cost for implementing a satellite stationkeeping expert system is analyzed. A ground-based expert system could reduce the current number of support personnel for the stationkeeping task. Results of analyzing a possible flight system are quite promising. An expert system for satellite stationkeeping seems feasible, appears cost-effective, and offers increased satellite endurance through autonomous operations.

  10. Report on CTSA consortium use of the community engagement consulting service.

    Science.gov (United States)

    Carter-Edwards, Lori; Cook, Jennifer L; McDonald, Mary Anne; Weaver, Sarah M; Chukwuka, Kemi; Eder, Milton Mickey

    2013-02-01

    The CTSA Community Engagement Consultative Service (CECS) is a national partnership designed to improve community engaged research (CEnR) through expert consultation. This report assesses the feasibility of CECS and presents findings from 2008 to 2009. A coordinating center and five regional coordinating sites managed the service. CTSAs identified a primary previsit CE best practice for consultants to address and completed self-assessments, postvisit evaluations, and action plans. Feasibility was assessed as the percent of CTSAs participating and completing evaluations. Frequencies were calculated for evaluation responses. Of the 38 CTSAs, 36 (95%) completed a self-assessment. Of these 36 sites, 83%, 53%, and 44% completed a consultant visit, evaluation, and action plan, respectively, and 56% of the consultants completed an evaluation. The most common best practice identified previsit was improvement in CEnR (addressing outcomes that matter); however, relationship building with communities was most commonly addressed during consulting visits. Although 90% of the consultants were very confident sites could develop an action plan, only 35% were very confident in the CTSAs' abilities to implement one. Academic medical centers interested in collaborating with communities and translating research to improve health need to further develop their capacity for CE and CEnR within their institutions. © 2012 Wiley Periodicals, Inc.

  11. Minerals safeguarding areas and mineral consultation areas for West Sussex

    OpenAIRE

    Hannis, S.D.; Steadman, E. J.; Linley, K.A.; Newsham, R.

    2007-01-01

    This report describes work carried out by the British Geological Survey on behalf of West Sussex County Council to delineate its Minerals Safeguarding Areas and Mineral Consultation Areas. This is in accordance with the methodology outlined in “A guide to mineral safeguarding in England” (McEvoy et al., 2007), which is in line with the Communities and Local Government document, Mineral Policy Statement 1: Planning and Minerals. This was released in November 2006 and it introduc...

  12. Are forensic experts biased by the side that retained them?

    Science.gov (United States)

    Murrie, Daniel C; Boccaccini, Marcus T; Guarnera, Lucy A; Rufino, Katrina A

    2013-10-01

    How objective are forensic experts when they are retained by one of the opposing sides in an adversarial legal proceeding? Despite long-standing concerns from within the legal system, little is known about whether experts can provide opinions unbiased by the side that retained them. In this experiment, we paid 108 forensic psychologists and psychiatrists to review the same offender case files, but deceived some to believe that they were consulting for the defense and some to believe that they were consulting for the prosecution. Participants scored each offender on two commonly used, well-researched risk-assessment instruments. Those who believed they were working for the prosecution tended to assign higher risk scores to offenders, whereas those who believed they were working for the defense tended to assign lower risk scores to the same offenders; the effect sizes (d) ranged up to 0.85. The results provide strong evidence of an allegiance effect among some forensic experts in adversarial legal proceedings.

  13. History Making: The Historian as Consultant

    Directory of Open Access Journals (Sweden)

    Jorma Kalela

    2013-11-01

    Full Text Available History is not just a genre of knowledge but also a basic feature of human life. Accounting for the past, or creating histories, to quote David Thelen, is ‘as natural a part of life as eating or breathing’. Casual references to what has taken place make up the vast majority of these accounts. But there are also a great number of deliberately created expositions of the past. They are produced in every field of society and by a wide variety of actors, from private persons to, for example, politicians and various media. The totality of them can be called everyday history. These accounts of the past serve present purposes – histories have innumerable functions and are of countless types. Divergent accounts also influence each other, and my suggestion is that their interaction be called the never-ending social process of history-making. History making, in other words, is not the preserve of academically-trained historians. They are experts but not outside observers. Scholarly historians are inescapably involved in the social process of history making. Their work goes beyond prevailing histories: they seek interpretations that make better sense of the past than the existing ones. Embedded in this effort is another constructivist function: they demonstrate ways to think about the past and how to use it. When demonstrating ‘that’s not how it was’, historians at the same display ‘how the presentation should have been constructed’. Even if they don’t think of themselves as consultants on history making they act in this capacity.

  14. Engineering monitoring expert system's developer

    Science.gov (United States)

    Lo, Ching F.

    1991-01-01

    This research project is designed to apply artificial intelligence technology including expert systems, dynamic interface of neural networks, and hypertext to construct an expert system developer. The developer environment is specifically suited to building expert systems which monitor the performance of ground support equipment for propulsion systems and testing facilities. The expert system developer, through the use of a graphics interface and a rule network, will be transparent to the user during rule constructing and data scanning of the knowledge base. The project will result in a software system that allows its user to build specific monitoring type expert systems which monitor various equipments used for propulsion systems or ground testing facilities and accrues system performance information in a dynamic knowledge base.

  15. Social training consultation effectiveness analysis in the light of the implementation of the Kujawy and Pomorze Regional Operational Programme (KPROP)

    OpenAIRE

    Małgorzata Zajdel; Małgorzata Michalcewicz-Kaniowska

    2011-01-01

    Social consultation is a simultaneous process of providing and getting information from the society in key decision-making, e.g. crucial laws, investment planning and essential enterprises. The aim of the present study was to collect opinions of the respondents on the social consultations essential for the launch of KPROP. One of the key points was finding factors affecting the social consultations process in the Kujawy and Pomorze region. The survey covered 300 respondents, including entrepr...

  16. Reporting Guidelines for the Use of Expert Judgement in Model-Based Economic Evaluations.

    Science.gov (United States)

    Iglesias, Cynthia P; Thompson, Alexander; Rogowski, Wolf H; Payne, Katherine

    2016-11-01

    Expert judgement has a role in model-based economic evaluations (EEs) of healthcare interventions. This study aimed to produce reporting criteria for two types of study design to use expert judgement in model-based EE: (i) an expert elicitation (quantitative) study; and (ii) a Delphi study to collate (qualitative) expert opinion. A two-round online Delphi process identified the degree of consensus for four core definitions (expert; expert parameter values; expert elicitation study; expert opinion) and two sets of reporting criteria in a purposive sample of experts. The initial set of reporting criteria comprised 17 statements for reporting a study to elicit parameter values and/or distributions and 11 statements for reporting a Delphi survey to obtain expert opinion. Fifty experts were invited to become members of the Delphi process panel by e-mail. Data analysis summarised the extent of agreement (using a pre-defined 75 % 'consensus' threshold) on the definitions and suggested reporting criteria. Free-text comments were analysed using thematic analysis. The final panel comprised 12 experts. Consensus was achieved for the definitions of expert (88 %); expert parameter values (83 %); and expert elicitation study (83 %). The panel recommended criteria to use when reporting an expert elicitation study (16 criteria) and a Delphi study to collate expert opinion (11 criteria). This study has produced guidelines for reporting two types of study design to use expert judgement in model-based EE: (i) an expert elicitation study requiring 16 reporting criteria; and (ii) a Delphi study to collate expert opinion requiring 11 reporting criteria.

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

    Science.gov (United States)

    Noroña, Carmen Rosa; Acker, Michelle L

    2016-11-01

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

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

    Science.gov (United States)

    Parsons, Vickie s.

    2009-01-01

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

  19. Towards a consensus definition of maternal sepsis : results of a systematic review and expert consultation

    NARCIS (Netherlands)

    Bonet, Mercedes; Nogueira Pileggi, Vicky; Rijken, Marcus J.|info:eu-repo/dai/nl/343154757; Coomarasamy, Arri; Lissauer, David; Souza, João Paulo; Gülmezoglu, Ahmet Metin

    2017-01-01

    Background: There is a need for a clear and actionable definition of maternal sepsis, in order to better assess the burden of this condition, trigger timely and effective treatment and allow comparisons across facilities and countries. The objective of this study was to review maternal sepsis

  20. Generating Scholarship from Public Service: Media Outreach, Nonprofit Foundation Service, and Legal Expert Consulting

    Science.gov (United States)

    Smith, Daniel A.

    2011-01-01

    Most colleges and universities stipulate that public service is a requirement for tenure and promotion. Yet many political science faculty and their respective administrators pay only lip service to this "third leg" of a scholarly career, relying on teaching and research to shape most career decisions. This reality is particularly surprising in…

  1. DRAFT AGENDA Expert Consultation on the Effects of Climate Change on Children’s Health

    Science.gov (United States)

    Topics for discussion include an interagency special report, thermal extremes, disasters and mental health/stress, air quality impacts, water quality and waterborne disease, food safety issues, vectorborne and zoonotic disease, and next steps.

  2. Report on surveys in fiscal 1998 on the project to invite petroleum substituting energy related experts in Japan and EU; Nichi EU sekiyu daitai energy kanren senmonka shohei jigyo 1998 nendo chosa hokokusho

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-03-01

    In relation with coping with global environmental problems in recent years, needs are increasing more than ever for enhancing fossil energy utilization rates, developing and expanding utilization of petroleum substituting energies that can substitute fossil energies. Since Japan is particularly a large energy consuming country, and cannot escape from depending on import for the majority of its energy resources, it is an urgent issue to enhance the energy utilization efficiency and further promote development and utilization of new energies. To do this, it is indispensable to exchange such item of information as identification of actual status in other countries of handling the petroleum substituting energies. Taking up geothermal energy, fiscal 1998 invited four experts from EU countries. Visits were made for about two weeks on Japanese research institutes and business enterprises related to geothermal energy, and opinions and information were exchanged. A seminar was held on the final day, where the EU experts have made presentations on the current status and future prospects on geothermal research and development in EU. Greatly valuable suggestions were given for the Japan's future geothermal research and development. (NEDO)

  3. Artificial Intelligence and Expert Systems.

    Science.gov (United States)

    Wilson, Harold O.; Burford, Anna Marie

    1990-01-01

    Delineates artificial intelligence/expert systems (AI/ES) concepts; provides an exposition of some business application areas; relates progress; and creates an awareness of the benefits, limitations, and reservations of AI/ES. (Author)

  4. Expert opinion vs. empirical evidence

    Science.gov (United States)

    Herman, Rod A; Raybould, Alan

    2014-01-01

    Expert opinion is often sought by government regulatory agencies when there is insufficient empirical evidence to judge the safety implications of a course of action. However, it can be reckless to continue following expert opinion when a preponderance of evidence is amassed that conflicts with this opinion. Factual evidence should always trump opinion in prioritizing the information that is used to guide regulatory policy. Evidence-based medicine has seen a dramatic upturn in recent years spurred by examples where evidence indicated that certain treatments recommended by expert opinions increased death rates. We suggest that scientific evidence should also take priority over expert opinion in the regulation of genetically modified crops (GM). Examples of regulatory data requirements that are not justified based on the mass of evidence are described, and it is suggested that expertise in risk assessment should guide evidence-based regulation of GM crops. PMID:24637724

  5. A theory of expert leadership

    OpenAIRE

    Goodall, Amanda H.

    2012-01-01

    How much knowledge should leaders have of their organization's core business? This is an important question but not one that has been addressed in the management literature. In a new 'theory of expert leadership' (TEL), this paper blends conceptual work with recent empirical evidence. It suggests that organizations perform more effectively when led by individuals who have a deep understanding of the core business of their organization. Being a capable general manager is not sufficient. Expert...

  6. Expert opinion vs. empirical evidence

    OpenAIRE

    Herman, Rod A.; Raybould, Alan

    2014-01-01

    Expert opinion is often sought by government regulatory agencies when there is insufficient empirical evidence to judge the safety implications of a course of action. However, it can be reckless to continue following expert opinion when a preponderance of evidence is amassed that conflicts with this opinion. Factual evidence should always trump opinion in prioritizing the information that is used to guide regulatory policy. Evidence-based medicine has seen a dramatic upturn in recent years sp...

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

    Directory of Open Access Journals (Sweden)

    M Seyedmajidi

    2013-09-01

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

  8. Spirituality and distress in palliative care consultation.

    Science.gov (United States)

    Hills, Judith; Paice, Judith A; Cameron, Jacqueline R; Shott, Susan

    2005-08-01

    One's spirituality or religious beliefs and practices may have a profound impact on how the individual copes with the suffering that so often accompanies advanced disease. Several previous studies suggest that negative religious coping can significantly affect health outcomes. The primary aim of this study was to explore the relationship between spirituality, religious coping, and symptoms of distress among a group of inpatients referred to the palliative care consult service. Pilot study. The study was conducted in a large academic medical center with a comprehensive Palliative Care and Home Hospice Program. (1) National Comprehensive Cancer Network Distress Management Assessment Tool; (2) Pargament Brief Religious Coping Scale (Brief RCOPE); (3) Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp); (4) Puchalski's FICA; and (5) Profile of Mood States-Short Form (POMS-SF). The 31 subjects surveyed experienced moderate distress (5.8 +/- 2.7), major physical and psychosocial symptom burden, along with reduced function and significant caregiving needs. The majority (87.2%) perceived themselves to be at least somewhat spiritual, with 77.4% admitting to being at least somewhat religious. Negative religious coping (i.e., statements regarding punishment or abandonment by God) was positively associated with distress, confusion, depression, and negatively associated with physical and emotional well-being, as well as quality of life. Palliative care clinicians should be alert to symptoms of spiritual distress and intervene accordingly. Future research is needed to identify optimal techniques to address negative religious coping.

  9. EXADS - EXPERT SYSTEM FOR AUTOMATED DESIGN SYNTHESIS

    Science.gov (United States)

    Rogers, J. L.

    1994-01-01

    The expert system called EXADS was developed to aid users of the Automated Design Synthesis (ADS) general purpose optimization program. Because of the general purpose nature of ADS, it is difficult for a nonexpert to select the best choice of strategy, optimizer, and one-dimensional search options from the one hundred or so combinations that are available. EXADS aids engineers in determining the best combination based on their knowledge of the problem and the expert knowledge previously stored by experts who developed ADS. EXADS is a customized application of the AESOP artificial intelligence program (the general version of AESOP is available separately from COSMIC. The ADS program is also available from COSMIC.) The expert system consists of two main components. The knowledge base contains about 200 rules and is divided into three categories: constrained, unconstrained, and constrained treated as unconstrained. The EXADS inference engine is rule-based and makes decisions about a particular situation using hypotheses (potential solutions), rules, and answers to questions drawn from the rule base. EXADS is backward-chaining, that is, it works from hypothesis to facts. The rule base was compiled from sources such as literature searches, ADS documentation, and engineer surveys. EXADS will accept answers such as yes, no, maybe, likely, and don't know, or a certainty factor ranging from 0 to 10. When any hypothesis reaches a confidence level of 90% or more, it is deemed as the best choice and displayed to the user. If no hypothesis is confirmed, the user can examine explanations of why the hypotheses failed to reach the 90% level. The IBM PC version of EXADS is written in IQ-LISP for execution under DOS 2.0 or higher with a central memory requirement of approximately 512K of 8 bit bytes. This program was developed in 1986.

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

    OpenAIRE

    Keme Carter; Andrew Golden; Shannon Martin; Sarah Donlan; Sara Hock; Christine Babcock; Jeanne Farnan; Vineet Arora

    2015-01-01

    Introduction: An important area of communication in healthcare is the consultation. Existing literature suggests that formal training in consultation communication is lacking. We aimed to conduct a targeted needs assessment of third-year students on their experience calling consultations, and based on these results, develop, pilot, and evaluate the effectiveness of a consultation curriculum for different learner levels that can be implemented as a longitudinal curriculum. Metho...

  11. Hospital consultants and workplace based assessments: how foundation doctors view these educational interactions?

    Science.gov (United States)

    McKavanagh, P; Smyth, A; Carragher, A

    2012-03-01

    To determine how foundation year 2 (F2) doctors view the input of hospital consultants into their workplace based assessments (WPBAs). F2 doctors in Northern Ireland participated in an electronic survey to evaluate their experiences of foundation programme WPBAs. The opportunity to participate was available to all F2 doctors. The survey was performed using questions displayed electronically and the responses were collated using Turning Point technology. Two weeks later a focus group was convened to assess the issues raised by the electronic survey. Consultant input into foundation doctor's WPBAs was an infrequent occurrence. The F2 doctors expressed a clear view that they valued consultant input, when this occurred. The WPBAs gave the foundation doctors an opportunity to have a one to one learning opportunity with their supervising consultants. However, many of the WPBAs were completed by other doctors in training, in the grades immediately above the foundation doctors. It was suggested that friendship could influence these assessments. Completion of foundation doctors' assessments by hospital consultants is viewed as a low priority. These assessments are being completed to a large extent by fellow doctors in training. The learning opportunities are consequently less educationally productive. F2 doctors want more opportunities for valued consultant interaction with timely feedback. Suggestions are proposed to improve WPBA implementation. The present WPBA process lacks integrity and a change in approach is urgently required.

  12. The Consulting Role in a Response-to-Intervention Context: An Exploratory Study of Instructional Consultation

    Science.gov (United States)

    Newman, Daniel S.; Salmon, Diane; Cavanaugh, Kate; Schneider, Mary Frances

    2014-01-01

    Response to intervention (RtI) is an influential system of service delivery in contemporary schools, but the specific role of school consultation in RtI implementation is not clearly defined. Instructional consultation provides a potential meeting point between consultation and RtI practices. Through a mixed-methods approach, this study explored…

  13. Modelling consultation rates in infancy: influence of maternal and infant characteristics, feeding type and consultation history

    OpenAIRE

    McConnachie, Alex; Wilson, Phil; Thomson, Hilary; Ross, Sue; Watson, Richard; Muirhead, Patricia; Munley, Andrew

    2004-01-01

    Background: Severity of illness, sociodemographic factors, and breastfeeding have been identified as predictors of consultation rates in infants, and prescriptions for antibiotics have been found to increase future consultation rates in older children. The Baby Check trial (1996–1998) provided detailed information about consultations for 935 babies during their first 6 months.

  14. Limitations of Expert Evidence

    Directory of Open Access Journals (Sweden)

    Serpil Salaçin

    1997-10-01

    Full Text Available Limitations of Expert Evidence Edited by Stephen Leadbeatter MB ChB MCRPath ISBN 1 86016 029 8 Printed in Great Britain by Cathedral Print Services Ltd, Salisbury, 1996 Kitap 25 Ekim 1994 te The Royal College of Physicians ve The Royal College of Pathologists tarafından düzenlenen konferanstan sonra hekimlere ve avukatlara konuyu tartışmaya açmak için basılmış. Bilirkişi görüşünün temel filozofisinin, bu görevi yapanlar ve bu hizmeti alanların yapabileceklerinin sınırlarının tartışılması amaçlanmış.Seksen altı sayfadan oluşan kitabın fiatı on iki İngiliz Sterlini. Kitap üç bölüm ve bunların altında toplanan on ana başlıktan oluşmakta. Elinize aldığınızda küçük boyutu ve anlaşılır dili ile hemen okunup bitirelecek kitaplardan sanılıyor. En azından ben böyle düşünmüştüm. Ancak daha L A Tuınberg ve A J Bellinham’ın ön yazısında ben çarpıldım. Değerli yazarların kaleme aldığı başlıklar ve gündeme getirdiği tartışmaların tüm Adli Bilimlerle uğraşanların dikkatle okuması gereken cinsten olduğu kanısındayım. Birinci bölüm The Legal Perspective iki anabaşlıktan oluşuyor, The Criminal legal perspective Honour Judje Martin Stephens tarafından yazılmış,bilirkişi olarak görev yapabilmek için belgelenmiş bir eğitim olması gerektiği, mahkemelerde ya da yazılı raporlarda verilebilecek görüşlerin incelikleri tartışılmış. Bu bölümün ikinci anabaşlığı The civil legal perspective avukat Jennifer Cummin tarafından yazılmış. Toplum gözünde bilirkişinin anlamı ve mahkemenin bilirkişi görüşünü değişmez bilimsel doğru gibi algılayarak düştüğü bilimsel yanılgı ve raporlardaki kavram farkı dile getirilmiş. İkinci Bölüm The Medical And Scientific Perspective başlığı altında Roger C Evans MD Clinical evidence başlığında toplumun hasta tedavisi ve bilirkişilik hizmetinden beklentilerinin unrealistik olduğu ve

  15. The Consulting Teacher Program: Ten Years Later.

    Science.gov (United States)

    Perelman, Phyllis F.; And Others

    A program designed to train learning specialists called consulting teachers who, in turn, train classroom teachers to educate handicapped children in the regular classroom setting is described. Consulting teacher trainees are selected on the basis of teaching experience, leadership capability, academic promise, and commitment to special education.…

  16. 24 CFR 92.358 - Consultant activities.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Consultant activities. 92.358 Section 92.358 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development HOME INVESTMENT PARTNERSHIPS PROGRAM Other Federal Requirements § 92.358 Consultant activities. No...

  17. The Counselor as a Mental Health Consultant

    Science.gov (United States)

    Ciaverella, Michael A.

    1970-01-01

    The school counselor is the most logical person in the school to act as a mental health consultant. He has the necessary psychosocial background, is available for consultations, has a wealth of information about the students, and maintains a working relationship with other mental health specialists. He can do much to improve the school environment…

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

    African Journals Online (AJOL)

    This study was undertaken to provide a demographic and clinical profile of all patients consulted by the consultation-liaison psychiatry (CLP) service at the Helen Joseph Hospital (HJH) in Johannesburg, and to describe the clinical management of patients admitted with a diagnosis of a mental disorder associated with a ...

  19. 76 FR 48865 - Tribal Consultation Meetings

    Science.gov (United States)

    2011-08-09

    ... Program Manager Region XI, e-mail [email protected] or phone (202) 401- 5964. Additional...) Tribal Consultations ] for leaders of Tribal Governments operating Head Start and Early Head Start... Natives convention. We are convening the OHS Tribal Consultations in conjunction with other Tribal Leader...

  20. 78 FR 57858 - Tribal Consultation Meeting

    Science.gov (United States)

    2013-09-20

    ... 57701. FOR FURTHER INFORMATION CONTACT: Robert Bialas, Regional Program Manager, Region XI, Office of...) Tribal Consultations for leaders of Tribal Governments operating Head Start and Early Head Start programs... the issues and concerns raised in 2012 OHS Tribal Consultations. Tribal leaders and designated...

  1. 265 Statistical Consulting and the African Universities

    African Journals Online (AJOL)

    User

    2011-07-21

    Jul 21, 2011 ... (RSS, 2005). As a result of the much usefulness of statistics, statisticians are usually saddled with consultancy responsibility in many areas of statistics and related fields. This consultation called has a technique and procedure to be carried out to achieve a success. This know-how is not part of the statistics.

  2. 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.…

  3. Expectation Levels in Dictionary Consultation and Compilation ...

    African Journals Online (AJOL)

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

  4. 77 FR 19020 - Tribal Consultation Meeting

    Science.gov (United States)

    2012-03-29

    ... Program Manager Region XI, email [email protected] or phone (202) 401- 5964. Additional information... Consultations with leaders of Tribal Governments operating Head Start (including Early Head Start) programs for...) programs are located. We are convening the OHS Tribal Consultations in conjunction with other Tribal Leader...

  5. Videoconference as a tool for European interhospital consultations in radiology

    Science.gov (United States)

    Bartsch, Frank-Reinhard; Gerneth, Marlene; Schosser, Rudolf

    1993-10-01

    In the frame of the EC-sponsored TELEMED project, videoconferencing was evaluated as a tool for Remote Expert Consultation (REC) in radiology. The REC environment has been established as a pan-European demonstrator for advanced telecommunication applications in medicine. Five European university hospitals have been interconnected using broadband networks at a speed of 2 Mbit/s and 140 Mbit/s. Videoconference was evaluated in more than 120 sessions. In the experiments, videoconference proved to be a useful tool for teleconsultations, providing a set of requirements identified as indispensable for medical videoconference such as remotely adjustable iris for the document camera are fulfilled. Diagnostic reliability of images recorded with our equipment proved acceptable for digitally acquired images while reliability is limited for conventional images with a high demand of spatial and contrast resolution. Regional spin-off applications that have been established at some participating sites underline the potential of videoconference in health care.

  6. Grounded theory in medical laboratory science expert practice development.

    Science.gov (United States)

    Leibach, Elizabeth Kenimer

    2011-01-01

    Grounded theory and methods related to expert practice development in medical laboratory science were described using data from a large national survey of medical laboratory scientists (MLS) overlaid on findings from analysis of expert practice domains reported in nursing literature. An extensive focus group/expert review iterative process followed by a survey of MLS practitioners produced 25 critical thinking (CT) behaviors important in expert practice. Factor analysis was applied to discern common threads or themes linking the CT behaviors. The 25 important CT behaviors were reduced to a 7-factor structure representing constructs underlying the individual, observable CT behaviors. This 7-factor structure in MLS was compared to the 7 practice domains identified in expert nursing practice. The comparison yielded commonality between MLS and nursing in CT behaviors observed in the 7 expert practice domains of both professions: professional techniques, caring communication, growing professionally, setting priorities, practicing with judgment, anticipating/revising, and creating unique meaning. Emergent grounded theory is that (1) critical thinking is a metaprocess that facilitates learning by interlinking the more basic processes associated with different learning orientations: cognitivist, behaviorist, humanist (affective), and situated/contextual learning, (2) CT behaviors are observable events following from the CT metaprocess, and (3) observations of CT behaviors increase as practice advances from novice to expert. Identification and definition of CT behaviors, i.e., practice competencies, along the continuum of novice to expert can serve as the foundation for MLS curriculum and instructional design as well as measurement and evaluation in both formal and continuing education settings.

  7. Peer-reviewed forensic consultation in practice: multidisciplinary oversight in common expertise.

    Science.gov (United States)

    Welner, Michael; Davey, Emily E; Bernstein, Adam

    2014-09-01

    The fallibility of forensic science consultation is an ongoing and major justice concern. Prospective peer-reviewed forensic consultation has over 10 years of application in American criminal and civil courts, adapting from the traditional oversight of teaching hospitals, rules of evidence and discovery, conventions of testimony of expert witnesses, and attorneys' overall trial strategy. In systematizing heightened oversight, this process ensures greater accountability in forensic science consultation. The integration of peer reviewers' complementary expertise and experience enhances the sophistication and overall quality of assessment. Forensic examination frequently involves the interface of different specialties. Multidisciplinary peer review augments expert proficiency with that of professional peers having different vantage points from relevant scientific disciplines. This approach ensures greater sophistication of a case inquiry, built-in accountability, and streamlined processes when multiple experts are necessitated. Here, the authors present examples of several cases and the primary and secondary benefits of this collaborative, rigorous, cross-disciplinary exercise. © 2014 American Academy of Forensic Sciences.

  8. Use of articulators in the United Kingdom by consultant orthodontists in planning orthognathic surgery.

    Science.gov (United States)

    O'Malley, A M; Milosevic, A

    1999-01-01

    This questionnaire survey aimed to investigate articulator use in orthognathic surgical planning by consultant specialists in the United Kingdom (UK). A total of 205 questionnaires was sent to all consultant orthodontists in the UK. One hundred thirty questionnaires were completed, representing a 63.4% response rate. Consultants had been in their post for a median of 10.5 years (range 0 to 30 years) with a mean of 11.3 (SD 8.4) surgical cases per year. When asked which cases had been planned on a semiadjustable articulator, two thirds of consultants (67.7%) planned maxillary single-jaw procedures, 45.4% planned mandibular single-jaw procedures, and 77.7% planned bimaxillary procedures. While 98.5% of consultants reported access to at least one type of articulator, 14.6% of maxillary single-jaw and 5.4% of bimaxillary surgery was not planned on any articulator. Twice as many consultants who had been in their post fewer than 11 years had been trained on a semiadjustable articulator, compared to those who had more than 11 years of experience. Semiadjustable articulators were the most popular for planning orthognathic surgery. Consultants with less than 11 years of experience completed more surgical cases each year and were more likely to have been trained on a semiadjustable articulator than consultants with more than 11 years of experience. However, no link exists between the age of the consultant and the type of articulator selected for planning; this suggests that more mature consultants have received further training on contemporary articulator systems since receiving their accreditation.

  9. Expert system application education project

    Science.gov (United States)

    Gonzelez, Avelino J.; Ragusa, James M.

    1988-01-01

    Artificial intelligence (AI) technology, and in particular expert systems, has shown potential applicability in many areas of operation at the Kennedy Space Center (KSC). In an era of limited resources, the early identification of good expert system applications, and their segregation from inappropriate ones can result in a more efficient use of available NASA resources. On the other hand, the education of students in a highly technical area such as AI requires an extensive hands-on effort. The nature of expert systems is such that proper sample applications for the educational process are difficult to find. A pilot project between NASA-KSC and the University of Central Florida which was designed to simultaneously address the needs of both institutions at a minimum cost. This project, referred to as Expert Systems Prototype Training Project (ESPTP), provided NASA with relatively inexpensive development of initial prototype versions of certain applications. University students likewise benefit by having expertise on a non-trivial problem accessible to them at no cost. Such expertise is indispensible in a hands-on training approach to developing expert systems.

  10. 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.

  11. Fiscal 2000 survey report on overseas geological structure, etc. Project for exchanging experts - Quality control (China); 2000 nendo kaigai chishitsu kozo to chosa hokokusho. Gijutsusha koryu jigyo - Hinshitsu kanri bunya (Chugoku)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-03-01

    For the stabilization of coal supply/demand in the APEC (Asia-Pacific Economic Cooperation Conference) region and for the stable supply of coal to Japan, Japanese engineers and experts were dispatched to China for training Chinese specialists there, and Chinese specialists were invited to Japan for training here. Japanese instructors on dispatch gave lectures and training to technicians belonging to a coal cleaning plant in Henan Province, during the period of August 20 through September 1, 2000, concerning quality control at the site of production, quality control at the coal cleaning plant, quality control as demanded by coal users, and so forth. The trainees invited to Japan received lectures on coal quality control as viewed from the coal users' standpoint, quality control at power plants, and so forth, during the period September 5-27, 2000, at JCOAL (Japan Coal Energy Center), Idemitsu Kosan Co., Ltd., and Electric Power Development Co. Training was provided on technologies of coal mining, coal washing, quality control, mine pollution prevention, hydraulic filling, management and control, and so forth, at Pacific Colliery and Matsushima Coal Mining Co., Ltd. (NEDO)

  12. 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.

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

    Science.gov (United States)

    Dave, Anish

    2009-01-01

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

  14. Expert Opinions on Nutrition Issues in Clinical Dentistry.

    Science.gov (United States)

    Palmer, Carole A.; And Others

    1990-01-01

    A survey of 79 experts in dental nutrition sought consensus on the appropriate scope of nutrition in clinical dentistry. Results support the need for greater attention to nutrition issues in dental schools and better models for nutrition interventions in dental practice. (Author/MSE)

  15. Expert Consensus on Characteristics of Wisdom: A Delphi Method Study

    Science.gov (United States)

    Jeste, Dilip V.; Ardelt, Monika; Blazer, Dan; Kraemer, Helena C.; Vaillant, George; Meeks, Thomas W.

    2010-01-01

    Purpose: Wisdom has received increasing attention in empirical research in recent years, especially in gerontology and psychology, but consistent definitions of wisdom remain elusive. We sought to better characterize this concept via an expert consensus panel using a 2-phase Delphi method. Design and Methods: A survey questionnaire comprised 53…

  16. Comparing Powerpoint Experts' and University Students' Opinions about Powerpoint Presentations

    Science.gov (United States)

    Mackiewicz, Jo

    2008-01-01

    Technical communication instructors want to help students, as well as professionals, design effective PowerPoint presentations. Toward this end, I compare the advice of academic and industry experts about effective PowerPoint presentation design to survey responses from university students about slide text, visual elements, animations, and other…

  17. A Phenomenology of Expert Musicianship

    DEFF Research Database (Denmark)

    Høffding, Simon

    This dissertation develops a phenomenology of expert musicianship through an interdisciplinary approach that integrates qualitative interviews with the Danish String Quartet with philosophical analyses drawing on ideas and theses found in phenomenology, philosophy of mind, cognitive science...... and psychology of music. The dissertation is structured through the asking, analyzing and answering of three primary questions, namely: 1) What is it like to be an expert? 2) What is the general phenomenology of expert musicianship? 3) What happens to the self in deep musical absorption? The first question...... targets a central debate in philosophy and psychology on whether reflection is conducive for, or detrimental to, skillful performance. My analyses show that the concepts assumed in the literature on this question are poorly defined and gloss over more important features of expertise. The second question...

  18. Database and Expert Systems Applications

    DEFF Research Database (Denmark)

    Viborg Andersen, Kim; Debenham, John; Wagner, Roland

    This book constitutes the refereed proceedings of the 16th International Conference on Database and Expert Systems Applications, DEXA 2005, held in Copenhagen, Denmark, in August 2005.The 92 revised full papers presented together with 2 invited papers were carefully reviewed and selected from 390......, reasoning and learning, network management and mobile systems, expert systems and decision support, and information modelling.......This book constitutes the refereed proceedings of the 16th International Conference on Database and Expert Systems Applications, DEXA 2005, held in Copenhagen, Denmark, in August 2005.The 92 revised full papers presented together with 2 invited papers were carefully reviewed and selected from 390...... submissions. The papers are organized in topical sections on workflow automation, database queries, data classification and recommendation systems, information retrieval in multimedia databases, Web applications, implementational aspects of databases, multimedia databases, XML processing, security, XML...

  19. The role of the system developer/knowledge engineer in the development of materials performance expert systems

    Energy Technology Data Exchange (ETDEWEB)

    Lichti, K.A. [Industrial Research Ltd., Lower Hutt (New Zealand)

    1994-12-31

    The system developer typically co-ordinates expert system development teams and ensures goals and objectives are met in a timely fashion. A spiral model of expert system software development procedures incorporating Quality Assurance principles for determining documentation requirements is advocated to aid the system developer in his co-ordination role. Efficient use of documentation and inter-team consultation can ensure Quality Control and Quality Assurance by exposing each stage of the development to reasoned criticism.

  20. Database and Expert Systems Applications

    DEFF Research Database (Denmark)

    Viborg Andersen, Kim; Debenham, John; Wagner, Roland

    This book constitutes the refereed proceedings of the 16th International Conference on Database and Expert Systems Applications, DEXA 2005, held in Copenhagen, Denmark, in August 2005.The 92 revised full papers presented together with 2 invited papers were carefully reviewed and selected from 390...... submissions. The papers are organized in topical sections on workflow automation, database queries, data classification and recommendation systems, information retrieval in multimedia databases, Web applications, implementational aspects of databases, multimedia databases, XML processing, security, XML......, reasoning and learning, network management and mobile systems, expert systems and decision support, and information modelling....

  1. A Phenomenology of Expert Musicianship

    DEFF Research Database (Denmark)

    Høffding, Simon

    targets a central debate in philosophy and psychology on whether reflection is conducive for, or detrimental to, skillful performance. My analyses show that the concepts assumed in the literature on this question are poorly defined and gloss over more important features of expertise. The second question...... and psychology of music. The dissertation is structured through the asking, analyzing and answering of three primary questions, namely: 1) What is it like to be an expert? 2) What is the general phenomenology of expert musicianship? 3) What happens to the self in deep musical absorption? The first question...

  2. Expert and novice facilitated modelling

    DEFF Research Database (Denmark)

    Tavella, Elena; Papadopoulos, Thanos

    2015-01-01

    This paper provides an empirical study based on action research in which expert and novice facilitators in facilitated modelling workshops are compared. There is limited empirical research analysing the differences between expert and novice facilitators. Aiming to address this gap we study......, and empirically supports the claim that facilitation skills can be taught to participants to enable them to self-facilitate workshops. Differences were also found, which led to the introduction of a new dimension—‘internal versus external’ facilitation. The implications of our findings for effective training...

  3. A Phenomenology of Expert Musicianship

    DEFF Research Database (Denmark)

    Høffding, Simon

    and psychology of music. The dissertation is structured through the asking, analyzing and answering of three primary questions, namely: 1) What is it like to be an expert? 2) What is the general phenomenology of expert musicianship? 3) What happens to the self in deep musical absorption? The first question...... targets a central debate in philosophy and psychology on whether reflection is conducive for, or detrimental to, skillful performance. My analyses show that the concepts assumed in the literature on this question are poorly defined and gloss over more important features of expertise. The second question...

  4. Consultation etiquette: a proposed set of guidelines.

    Science.gov (United States)

    Rogers, Arvey I

    2010-07-01

    Too often, actions and decisions affecting patient care are determined by expediency, cost-effectiveness, and time constraints. At risk of sacrifice are ethics and professionalism, pillars essential to the very structure of medical practice. In particular, there appears to be an erosion of consultation etiquette-exchanges between physicians and patients as well as among physicians. While methods to maximize efficiency are essential to medical practice, they should not come at the expense of etiquette. To improve patient care and strengthen relationships between patients and physicians, as well as relationships between referring and consulting physicians, a set of guidelines for improving consultation etiquette is proposed.

  5. 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.

  6. Consultation-liaison psychiatry in a general hospital

    Directory of Open Access Journals (Sweden)

    M Maroufi

    2006-07-01

    Full Text Available BACKGROUND: At least one half of all patients who admitted to general hospitals, suffer from psychiatric comorbidities. Management of mental disorders in these patients, significantly, improves the course and outcome of medical diseases. The aim of this survey was to answer the following questions: 1 what is the rate of diagnosable psychiatric symptoms among medical and surgical inpatients? and 2 what proportion of them undergo psychiatric consultation? METHODS: Three hundred and ninety two patients admitted to medical and surgical wards of Alzahra hospital (Isfahan from January 2005 until March 2005 were evaluated by the revised form of psychiatric symptoms checklist (SCL-90-R. The total referral records were also maintained and compared with the data of morbidity. RESULTS: One hundred and fifty six (42.7% of the evaluated subjects had psychiatric co-morbidities. The most prevalent psychiatric symptoms determined in this group were depression, somatization and anxiety. Only 84 (3% of these patients had undergone psychiatric consultation. CONCLUSIONS: This study demonstrates that many of the patients, who are admitted to general hospitals, may have psychiatric co-morbidities but only a very small percentage of them receive appropriate mental cares. KEY WORDS: Consultation-liaison psychiatry, general hospital, mental disorder.

  7. Canadian National Consultation on Access to Scientific Research Data

    Directory of Open Access Journals (Sweden)

    Michel Sabourin

    2007-06-01

    Full Text Available In June 2004, an expert Task Force, appointed by the National Research Council Canada and chaired by Dr. David Strong, came together in Ottawa to plan a National Forum as the focus of the National Consultation on Access to Scientific Research Data. The Forum, which was held in November 2004, brought together more than seventy Canadian leaders in scientific research, data management, research administration, intellectual property and other pertinent areas. This article presents a comprehensive review of the issues, and the opportunities and the challenges identified during the Forum. Complex and rich arrays of scientific databases are changing how research is conducted, speeding the discovery and creation of new concepts. Increased access will accelerate such changes even more, creating other new opportunities. With the combination of databases within and among disciplines and countries, fundamental leaps in knowledge will occur that will transform our understanding of life, the world and the universe. The Canadian research community is concerned by the need to take swift action to adapt to the substantial changes required by the scientific enterprise. Because no national data preservation organization exists, may experts believe that a national strategy on data access or policies needs to be developed, and that a "Data Task Force" be created to prepare a full national implementation strategy. Once such a national strategy is broadly supported, it is proposed that a dedicated national infrastructure, tentatively called "Data Canada", be established, to assume overall leadership in the development and execution of a strategic plan.

  8. Consultation length in general practice: cross sectional study.

    NARCIS (Netherlands)

    Deveugele, M.; Derese, A.; Brink-Muinen, A. van den; Bensing, J.; Maeseneer, J. de

    2002-01-01

    Objectives: To compare determinants of consultation length discussed in the literature with those found in consultations with general practitioners from different European countries; to explore the determinants of consultation length, particularly the effect of doctors' and patients' perceptions of

  9. Spiritual issues in palliative care consultations in the Netherlands.

    NARCIS (Netherlands)

    Kuin, A.; Deliens, L.; Zuylen, L. van; Courtens, A.M.; Vernooij-Dassen, M.J.F.J.; Linden, B.; Wal, G. van der

    2006-01-01

    INTRODUCTION: In the Netherlands, healthcare professionals are able to consult Palliative Care Consultation (PCC) teams about individual patients, for information, support and advice. This study aims to understand which spiritual issues are discussed in these consultations and to determine which

  10. The SASPREN primary care survey - who consults the family doctor?

    African Journals Online (AJOL)

    Pickles W. EpidemJoIogy in a Coonuy PriKoce. Bristol: Wright. 1939. 7. Van Casteren V.lnvert/ory of Sentinel HeaJr1IlnfrJnrlcl.Doi1 Systems WIth GPs in ri¥. European CommunItY. Brussels: IllSlrtUte of Hygleoe and epidemiology. 1991. 8. Green lA. Wood M, Becker L er al. The Ambulatory 5efltirlel PractiCe Networ1c.

  11. The SASPREN primary care survey - who consults the family doctor ...

    African Journals Online (AJOL)

    Data were collected by family practitioners in private practice who were affiliated to the South African Sentinel Practitioner Research Network (SASPREN). Participants. ... This study provides essential information on patients seen in family practice. ... There is an urgent need for smoking cessation interventions in the region.

  12. Saturated Zone Flow and Transport Expert Elicitation Project

    Energy Technology Data Exchange (ETDEWEB)

    Coppersmith, Kevin J.; Perman, Roseanne C.

    1998-01-01

    This report presents results of the Saturated Zone Flow and Transport Expert Elicitation (SZEE) project for Yucca Mountain, Nevada. This project was sponsored by the US Department of Energy (DOE) and managed by Geomatrix Consultants, Inc. (Geomatrix), for TRW Environmental Safety Systems, Inc. The DOE's Yucca Mountain Site Characterization Project (referred to as the YMP) is intended to evaluate the suitability of the site for construction of a mined geologic repository for the permanent disposal of spent nuclear fuel and high-level radioactive waste. The SZEE project is one of several that involve the elicitation of experts to characterize the knowledge and uncertainties regarding key inputs to the Yucca Mountain Total System Performance Assessment (TSPA). The objective of the current project was to characterize the uncertainties associated with certain key issues related to the saturated zone system in the Yucca Mountain area and downgradient region. An understanding of saturated zone processes is critical to evaluating the performance of the potential high-level nuclear waste repository at Yucca Mountain. A major goal of the project was to capture the uncertainties involved in assessing the saturated flow processes, including uncertainty in both the models used to represent the physical processes controlling saturated zone flow and transport, and the parameter values used in the models. So that the analysis included a wide range of perspectives, multiple individual judgments were elicited from members of an expert panel. The panel members, who were experts from within and outside the Yucca Mountain project, represented a range of experience and expertise. A deliberate process was followed in facilitating interactions among the experts, in training them to express their uncertainties, and in eliciting their interpretations. The resulting assessments and probability distributions, therefore, provide a reasonable aggregate representation of the knowledge and

  13. The importance of expert feedback during endovascular simulator training.

    Science.gov (United States)

    Boyle, Emily; O'Keeffe, Dara A; Naughton, Peter A; Hill, Arnold D K; McDonnell, Ciaran O; Moneley, Daragh

    2011-07-01

    Complex endovascular skills are difficult to obtain in the clinical environment. Virtual reality (VR) simulator training is a valuable addition to current training curricula, but is there a benefit in the absence of expert trainers? Eighteen endovascular novices performed a renal artery angioplasty/stenting (RAS) on the Vascular Interventional Surgical Trainer simulator. They were randomized into three groups: Group A (n = 6, control), no performance feedback; Group B (n = 6, nonexpert feedback), feedback after every procedure from a nonexpert facilitator; and Group C (n = 6, expert feedback), feedback after every procedure from a consultant vascular surgeon. Each trainee completed RAS six times. Simulator-measured performance metrics included procedural and fluoroscopy time, contrast volume, accuracy of balloon placement, and handling errors. Clinical errors were also measured by blinded video assessment. Data were analyzed using SPSS version 15. A clear learning curve was observed across the six trials. There were no significant differences between the three groups for the general performance metrics, but Group C made fewer errors than Groups A (P = .009) or B (P = .004). Video-based error assessment showed that Groups B and C performed better than Group A (P = .002 and P = .000, respectively). VR simulator training for novices can significantly improve general performance in the absence of expert trainers. Procedure-specific qualitative metrics are improved with expert feedback, but nonexpert facilitators can also enhance the quality of training and may represent a valuable alternative to expert clinical faculty. Copyright © 2011 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

  14. Database and Expert Systems Applications

    DEFF Research Database (Denmark)

    Viborg Andersen, Kim; Debenham, John; Wagner, Roland

    submissions. The papers are organized in topical sections on workflow automation, database queries, data classification and recommendation systems, information retrieval in multimedia databases, Web applications, implementational aspects of databases, multimedia databases, XML processing, security, XML......, reasoning and learning, network management and mobile systems, expert systems and decision support, and information modelling....

  15. QUEST: Quality of Expert Systems

    NARCIS (Netherlands)

    Perre, M.

    1991-01-01

    TNO Physics and Electronics laboratory, in collaboration with the University of Limburg and the Research Institute for Knowledge Systems, worked on a technology project named 'QUEST: Quality of Expert Systems' [FEL90]. QUEST was carried out under commision of the Dutch Ministry of Defence. A strong

  16. Computers that Think Like Experts.

    Science.gov (United States)

    Kinnucan, Paul

    1984-01-01

    Discusses the nature of expert systems, including various techniques they use to represent knowledge (such as production rules, semantic networks, frames, first-order logic, and others), system interactions, and such problem domains as science, medicine, computer configuration, trouble-shooting/repair, and oil/mineral exploration. Also discusses…

  17. Laserjet Printer Troubleshooting Expert System

    African Journals Online (AJOL)

    SOFTLINKS DIGITAL

    This paper model an expert system called LAPTEX for troubleshooting LaserJet printers' faults. Today, with the innumerable advances in information technologies, computerizing printer's fault troubleshooting and identifying faults is far becoming so vital. Also, printers' fault detection is a complicated process that requires a ...

  18. The Naive Expert and the Gifted Child.

    Science.gov (United States)

    Timpson, William M.; Jones, Christine

    1989-01-01

    Mentorship programs are described which involve gifted students and subject experts with no prior knowledge about students' personalities or preconceptions about their abilities, known as "naive experts." The students are challenged by the experts' high expectations and respond to the experts' enthusiasm for sharing their knowledge and…

  19. Mental health consultation in a nursing home.

    Science.gov (United States)

    Kennedy, B; Covington, K; Evans, T; Williams, C A

    2000-11-01

    As the world's population ages, increasing numbers of people can anticipate spending their latter years in long-term care settings. Many of these nursing home residents will also present psychiatric illnesses as primary or secondary diagnoses. The resulting behavioral problems may present challenges to nursing staff that they are ill-prepared to meet. This article illustrates the application of the Blake and Mouton consultation model to a Veterans Administration (VA) nursing home situation by a team of psychiatric mental health nurse specialists. The consultation is described and interpreted in terms of the Blake and Mouton model. The focal conflicts addressed in the consultation included issues of morale/cohesion, power/authority, and norms/standards. Interventions used were acceptant, prescriptive, confrontation, and theories/principles. The model provided a useful structure for conceptualizing and organizing assessment and intervention in the consultation situation.

  20. 76 FR 20674 - Tribal Consultation Meetings

    Science.gov (United States)

    2011-04-13

    ... Services, Administration for Children and Families, Office of Head Start leadership and the leadership of... Consultation Session will be summarized in the report without attribution, along with topics of concern and...

  1. 77 FR 5027 - Tribal Consultation Meetings

    Science.gov (United States)

    2012-02-01

    ... Services, Administration for Children and Families, Office of Head Start leadership and the leadership of... Consultation Session will be summarized in the report without attribution, along with topics of concern and...

  2. Consulting Informs Best Practice in Academia

    Directory of Open Access Journals (Sweden)

    Risa Blair

    2015-10-01

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

  3. Bladder Pain Syndrome International Consultation on Incontinence

    DEFF Research Database (Denmark)

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

    2010-01-01

    cytology and cystoscopy are recommended if clinically indicated. Treatment progresses from conservative management through various oral and intravesical therapies, with most surgical therapies reserved for unresponsive cases. Pain management is critical throughout the treatment process. The consultation......Aims of Study: The Bladder Pain Syndrome Committee of the International Consultation on Incontinence was assigned the task by the consultation of reviewing the syndrome, formerly known as interstitial cystitis, in a comprehensive fashion. This included the topics of definition, nomenclature...... possible, existing evidence was assessed and a level of recommendation was developed according to the Oxford system of classification. Results: The consultation decided to refer to the condition as "bladder pain syndrome" (BPS) because the designation is more descriptive of the clinical condition...

  4. IT Consultants in Acquisition IT Integration

    DEFF Research Database (Denmark)

    Henningsson, Stefan; Øhrgaard, Christian

    2016-01-01

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

  5. Wait times for gastroenterology consultation in Canada: The patients’ perspective

    Science.gov (United States)

    Paterson, WG; Barkun, AN; Hopman, WM; Leddin, DJ; Paré, P; Petrunia, DM; Sewitch, MJ; Switzer, C; van Zanten, S Veldhuyzen

    2010-01-01

    Long wait times for health care have become a significant issue in Canada. As part of the Canadian Association of Gastroenterology’s Human Resource initiative, a questionnaire was developed to survey patients regarding wait times for initial gastroenterology consultation and its impact. A total of 916 patients in six cities from across Canada completed the questionnaire at the time of initial consultation. Self-reported wait times varied widely, with 26.8% of respondents reporting waiting less than two weeks, 52.4% less than one month, 77.1% less than three months, 12.5% reported waiting longer than six months and 3.6% longer than one year. One-third of patients believed their wait time was too long, with 9% rating their wait time as ‘far too long’; 96.4% believed that maximal wait time should be less than three months, 78.9% believed it should be less than one month and 40.3% believed it should be less than two weeks. Of those working or attending school, 22.6% reported missing at least one day of work or school because of their symptoms in the month before their appointment, and 9.0% reported missing five or more days in the preceding month. A total of 20.2% of respondents reported being very worried about having a serious disease (ie, scored 6 or higher on 7-point Likert scale), and 17.6% and 14.8%, respectively, reported that their symptoms caused major impairment of social functioning and with the activities of daily living. These data suggest that a significant proportion of Canadians with digestive problems are not satisfied with their wait time for gastroenterology consultation. Furthermore, while awaiting consultation, many patients experience an impaired quality of life because of their gastrointestinal symptoms. PMID:20186353

  6. Postpartum contraception: An exploratory study of lactation consultants' knowledge and practices.

    Science.gov (United States)

    Dunn, Kathleen; Bayer, Lisa L; Mody, Sheila K

    2016-07-01

    Lactation consultants interact with women during the postpartum period; however, they may not have comprehensive education on postpartum contraception and the impact on breastfeeding. The aims of this study were to assess lactation consultants' knowledge and practices about postpartum contraception and assess whether lactation consultants are interested in more education on postpartum contraception. We distributed a 30-question survey to self-identified lactation consultants and recruited participants via email, social media and at the 2015 California Breastfeeding Summit. We surveyed a total of 194 lactation consultants. Seventy-seven percent (137/177) stated they offer advice about postpartum contraception and its impact on breastfeeding. The majority of lactation consultants felt the theoretical or proven risks outweighed the benefits or there was an unacceptable health risk for the progestin-only pill 76.3% (100/131), progestin injection 90.1% (118/131) and progestin implant 93.1% (122/131) if used within 21days of delivery. Although 68.7% (92/134) reported prior education on postpartum contraception, 82.1% (110/134) reported wanting more education on this topic, specifically in the form of a webinar 61.9% (83/134). Only 29.9% (40/134) reported knowledge of the United States Centers for Disease Control and Prevention 2011 Medical Eligibility Criteria for Contraceptive Use (USMEC) guidance for postpartum contraception. There is a disconnect between the USMEC guidance and lactation consultants' knowledge regarding the safety of immediate postpartum contraception. This study explores lactation consultants' knowledge and practices about postpartum contraception, demonstrating that more evidence-based education is needed on this topic. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. [The pain resource nurse consultation guidelines].

    Science.gov (United States)

    Morey, Muriel Perriot

    2017-05-01

    The cross-disciplinary activities of pain resource nurses were provided with guidelines in 2007. Due to the development of their role in care structures and the ongoing organisation of the nursing activity, guidelines relating to their consultation activities were drawn up in 2016. These describe the circumstances in which a pain resource nurse may intervene and the types of consultation she carries out. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  8. Adaptation and Validation of the Brief Sexual Opinion Survey (SOS) in a Colombian Sample and Factorial Equivalence with the Spanish Version.

    Science.gov (United States)

    Vallejo-Medina, Pablo; Marchal-Bertrand, Laurent; Gómez-Lugo, Mayra; Espada, José Pedro; Sierra, Juan Carlos; Soler, Franklin; Morales, Alexandra

    2016-01-01

    Attitudes toward sexuality are a key variable for sexual health. It is really important for psychology and education to have adapted and validated questionnaires to evaluate these attitudes. Therefore, the objective of this research was to adapt, validate and calculate the equivalence of the Colombia Sexual Opinion Survey as compared to the same survey from Spain. To this end, a total of eight experts were consulted and 1,167 subjects from Colombia and Spain answered the Sexual Opinion Survey, the Sexual Assertiveness Scale, the Massachusetts General Hospital-Sexual Functioning Questionnaire, and the Sexuality Scale. The evaluation was conducted by online and the results show adequate qualitative and quantitative properties of the items, with adequate reliability and external validity and compliance with the strong invariance between the two countries. Consequently, the Colombia Sexual Opinion Survey is a valid and reliable scale and its scores can be compared with the ones from the Spain survey, with minimum bias.

  9. Adaptation and Validation of the Brief Sexual Opinion Survey (SOS) in a Colombian Sample and Factorial Equivalence with the Spanish Version

    Science.gov (United States)

    Sierra, Juan Carlos; Soler, Franklin

    2016-01-01

    Attitudes toward sexuality are a key variable for sexual health. It is really important for psychology and education to have adapted and validated questionnaires to evaluate these attitudes. Therefore, the objective of this research was to adapt, validate and calculate the equivalence of the Colombia Sexual Opinion Survey as compared to the same survey from Spain. To this end, a total of eight experts were consulted and 1,167 subjects from Colombia and Spain answered the Sexual Opinion Survey, the Sexual Assertiveness Scale, the Massachusetts General Hospital-Sexual Functioning Questionnaire, and the Sexuality Scale. The evaluation was conducted by online and the results show adequate qualitative and quantitative properties of the items, with adequate reliability and external validity and compliance with the strong invariance between the two countries. Consequently, the Colombia Sexual Opinion Survey is a valid and reliable scale and its scores can be compared with the ones from the Spain survey, with minimum bias. PMID:27627114

  10. An exploration of partnership through interactions between young 'expert' patients with cystic fibrosis and healthcare professionals.

    Science.gov (United States)

    MacDonald, Kath; Irvine, Lindesay; Smith, Margaret Coulter

    2015-12-01

    To explore how young 'expert patients' living with Cystic Fibrosis and the healthcare professionals with whom they interact perceive partnership and negotiate care. Modern healthcare policy encourages partnership, engagement and self-management of long-term conditions. This philosophy is congruent with the model adopted in the care of those with Cystic Fibrosis, where self-management, trust and mutual respect are perceived to be integral to the development of the ongoing patient/professional relationship. Self-management is associated with the term; 'expert patient'; an individual with a long-term condition whose knowledge and skills are valued and used in partnership with healthcare professionals. However, the term 'expert patient' is debated in the literature as are the motivation for its use and the assumptions implicit in the term. A qualitative exploratory design informed by Interpretivism and Symbolic Interactionism was conducted. Thirty-four consultations were observed and 23 semi-structured interviews conducted between 10 patients, 2 carers and 12 healthcare professionals. Data were analysed thematically using the five stages of 'Framework' a matrix-based qualitative data analysis approach and were subject to peer review and respondent validation. The study received full ethical approval. Three main themes emerged; experiences of partnership, attributes of the expert patient and constructions of illness. Sub-themes of the 'ceremonial order of the clinic', negotiation and trust in relationships and perceptions of the expert patient are presented. The model of consultation may be a barrier to person-centred care. Healthcare professionals show leniency in negotiations, but do not always trust patients' accounts. The term 'expert patient' is unpopular and remains contested. Gaining insight into structures and processes that enable or inhibit partnership can lead to a collaborative approach to service redesign and a revision of the consultation model. © 2015

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

    Science.gov (United States)

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

    2010-12-08

    In primary care between 10% and 35% of all visits concern patients with medically unexplained physical symptoms (MUPS). MUPS are associated with high medical consumption, significant disabilities and psychiatric morbidity. To assess the effectiveness of consultation letters (CLs) to assist primary care physicians or occupational health physicians in the treatment of patients with MUPS and diagnostic subgroups. We searched for randomized controlled trials (RCTs) on the Cochrane Collaboration Depression, Anxiety and Neurosis Group Controlled Trials Registers, the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 2, 2009), MEDLINE  (1966-2009), MEDLINE In Process (2009-08-17), EMBASE (1974-2009), PSYCINFO (1980-2009) and CINAHL (1982-2009). We screened the references lists of selected studies and consulted experts in the field to identify any additional, eligible RCTs. RCTs of CLs for patients with MUPS being treated in primary care settings. Two authors independently screened the abstracts of the studies identified through the searches and independently assessed the risk of bias of the included studies. We resolved any disagreement by discussion with a third review author. We assessed heterogeneity and, where a number of studies reported the same outcomes, pooled results in a meta-analysis. We included six RCTs, with a total of 449 patients. In four studies (267 patients) the CL intervention resulted in reduced medical costs (in two studies the outcomes could be pooled: MD -352.55 US Dollars (95% CI -522.32 to -182.78)) and improved physical functioning (three studies, MD 5.71 (95% CI 4.11 to 7.31)). In two studies (182 patients) the intervention was a joint consultation with a psychiatrist in presence of the physician, and resulted in reduced severity of somatization symptoms, reduced medical consumption and improved social functioning. There is limited evidence that a CL is effective in terms of medical costs and improvement of physical functioning

  12. Making a team of experts into an expert team.

    Science.gov (United States)

    Charney, Carol

    2011-10-01

    Health care has traditionally been delivered primarily by experts working individually in a decentralized system lacking cohesive organization among professional disciplines. Only recently have the advantages of teamwork training been acknowledged in health care. This article explores the history, benefits, and recommendations for team training in neonatal care. TeamSTEPPS (Rockville, MD) and the revised Neonatal Resuscitation Program are cited as promising models for improved neonatal outcomes through professional teamwork.

  13. [Speech audiometry in expert assessment of hearing impairment].

    Science.gov (United States)

    Batsoulis, C; Lesinski-Schiedat, A

    2017-03-01

    In the assessment process of hearing impairment the medical expert has to verify its causality and to quantify its severity as hearing loss in percentage. Based on the determined hearing loss in percentage, the degree of impairment/disability or, in the case of work-related noise-induced hearing loss, the reduction in earning capacity is estimated. In Germany the guideline for the expert assessment of work-related noise-induced hearing loss is the Königstein Guideline. Currently, the 5th edition from 2012 is used. Here, the hearing loss quantification depends mainly on the results of speech audiometry. Based on the Freiburg speech test, the hearing loss in percentage is determined using approved tables. For patients with a mild hearing loss, typically characterized by a high-frequency hearing loss, tone audiometry results are consulted additionally. Speech-in-noise tests are available and are frequently used to measure the benefit of hearing systems. They allow for the detection of these patients' hearing impairment, which generally occurs in noisy environments. The first suggestions for a table to determine hearing loss in noise in percent are available. In experimental studies it was shown that tests in quiet, other than the Freiburg speech test, can be used and the same tables can be applied. In this article the current use of speech audiometry for expert assessment is presented, and options of using further developed speech test material are discussed.

  14. Expert Panel Recommendations for Hanford Double-Shell Tank Life Extension

    Energy Technology Data Exchange (ETDEWEB)

    Stewart, Charles W; Bush, Spencer H; Berman, Herbert Stanton; Czajkowski, Carl J; Divine, James R; Posakony, Gerald J; Johnson, A B; Elmore, Monte R; Reynolds, D A; Anantatmula, Ramamohan P; Sindelar, Robert L; Zapp, Philip E

    2001-06-29

    Expert workshops were held in Richland in May 2001 to review the Hanford Double-Shell Tank Integrity Project and make recommendations to extend the life of Hanford's double-shell waste tanks. The workshop scope was limited to corrosion of the primary tank liner, and the main areas for review were waste chemistry control, tank inspection, and corrosion monitoring. Participants were corrosion experts from Hanford, Savannah River Site, Brookhaven National Lab., Pacific Northwest National Lab., and several consultants. This report describes the current state of the three areas of the program, the final recommendations of the workshop, and the rationale for their selection.

  15. Bridging Troubled Waters: Historians, Natural Resource Litigation, and the Expert Witness Phenomenon.

    Science.gov (United States)

    Brescia, Michael M

    2015-02-01

    This special issue of The Public Historian examines the nature and scope of the historian's role as a consultant and expert witness in natural resource litigation. The introductory essay identifies the major issues and challenges that historians face when they bring their knowledge, skills, and professional best standards into law offices and courtrooms, while also positing a conceptual framework for public history practitioners to better understand and appreciate the larger stakes in conducting research for environmental litigation. The author delineates his own experience as an expert in certain water rights cases in the American Southwest where knowledge of the Spanish and Mexican civil law of property is essential.

  16. Survey on solar dryers for drying of food and wood in Ghana

    Energy Technology Data Exchange (ETDEWEB)

    Oestergaard Jensen, S.; Correll Frank, F. [Danish Technological Inst., Taastrup (Denmark); Floejgaard Kristensen, E. [Danish Inst. of Agricultural Sciences, Tjele (Denmark)

    1999-11-01

    The survey was conducted as a part of the project 'Test and Research Project into the Drying of Food and Wood Products with Solar Heat'. The aim of the survey was to investigate the need for drying of food and wood in Ghana and the already existing experience on solar drying in order to form a basis for the initial decisions within the project concerning the location of three demonstration solar dryers for crops, fish and wood, which species to dry and the type of solar dryers. The project deals with transfer of knowledge in the field of drying of crops and wood and solar air heating systems from Denmark to Ghana. The aim of the survey was, therefore, also to give the Danish experts an impression of the conditions in Ghana in order to facilitate an appropriate design of the solar dryers. Three of the four Danish partners participated in the survey. The fourth Danish partner - the manufacturer of solar heating systems Aidt Miljoe - are already familiar with the conditions in Ghana due to an earlier project in Ghana. The survey was planed by the Energy Commission of Ghana, the Ghanaian partner and consultants: DENG, University of Science and Technology, Kumasi and Econkoad. The time schedules for the survey - one for crops/fish and one for wood - are found in Annex A. The schedules were very well prepared and the sites to visit were well chosen. The visits gave the Danish experts a good overview of the situation in Ghana in the field of post harvesting of crops, handling of fish, drying and manufacturing of wood and existing experience on solar drying. The schedules included a large variety of different information and impressions e.g. ranging from large sawmill to small carpenters and workshops. Despite tight schedules the consultants managed to stick very close to the time schedules shown in Annex A. (au)

  17. What Do Experts Know About Forecasting Journal Quality? A Comparison with ISI Research Impact in Finance?

    NARCIS (Netherlands)

    C-L. Chang (Chia-Lin); M.J. McAleer (Michael)

    2013-01-01

    textabstractExperts possess knowledge and information that are not publicly available. The paper is concerned with forecasting academic journal quality and research impact using a survey of international experts from a national project on ranking academic finance journals in Taiwan. A comparison is

  18. What do Experts Know About Ranking Journal Quality? A Comparison with ISI Research Impact in Finance

    NARCIS (Netherlands)

    C-L. Chang (Chia-Lin); M.J. McAleer (Michael)

    2012-01-01

    textabstractExperts possess knowledge and information that are not publicly available. The paper is concerned with the ranking of academic journal quality and research impact using a survey of experts from a national project on ranking academic finance journals. A comparison is made with publicly

  19. What Do Experts Know About Forecasting Journal Quality? A Comparison with ISI Research Impact in Finance

    NARCIS (Netherlands)

    C-L. Chang (Chia-Lin); M.J. McAleer (Michael)

    2013-01-01

    textabstractExperts possess knowledge and information that are not publicly available. The paper is concerned with forecasting academic journal quality and research impact using a survey of international experts from a national project on ranking academic finance journals in Taiwan. A comparison is

  20. A 16th Suggestions for Educational Curriculum Improvement in Jordan, from the Experts Point of View

    Science.gov (United States)

    Mahasneh, Omar

    2015-01-01

    The present research was conducted to identify the most important suggestions for educational curriculum improvement in Jordan, from the expert's point of view. A descriptive survey through data and information collection tool (questionnaire) was used as an approach. The study sample consisted of (620) educational experts in the field of…

  1. “Psychosomatic consultation in the workplace” – a new model of care at the interface of company-supported mental health care and consultation-liaison psychosomatics: design of a mixed methods implementation study

    Directory of Open Access Journals (Sweden)

    Rothermund Eva

    2012-09-01

    Full Text Available Abstract Background Mental health issues are gaining in importance in society and the economic system. At the same time, the accessibility and stigmatisation of the mental health care system in Germany can obstruct help-seeking behavior and delay early psychotherapeutic interventions. Therefore, new models of care are being established at the interface of company-supported health promotion and conventional health insurance sponsored outpatient care for people developing mental illnesses. Two large industrial companies, in cooperation with two psychosomatic clinics, have recently established a model of “psychosomatic consultation in the workplace“. This new model of care offers the opportunity for a first psychotherapeutic door to door consultation with occupational medicine within the industrial workplace. The main empirical goals of this study are: 1 Describing the differences between patients who use this new diagnostic and therapeutic offer within the industrial workplace vs. patients who visit a conventional regional outpatient clinic, especially in regard to symptom duration and severity, work ability, and demographic characteristics, and 2 A first evaluation of how patients may benefit more from this new model of care compared to those first seen by standard outpatient care. In the qualitative part of the study, occupational physicians, psychosomatic therapists, involved personnel and select employees of the involved companies will be asked to comment on their experiences with this new approach. Methods/Design The implementation study will take place in Ulm and in Stuttgart, with each site looking at one regional conventional psychosomatic outpatient clinic and one psychosomatic consultation offer within the workplace. 70 consecutive patients in each setting will be recruited (overall n = 280. For the cross-sectional study and pre-post comparison we will use established and validated survey instruments (PHQ, SF-12, WAI, MBI, IS as

  2. Medical students’ perceptions of using e-learning to enhance the acquisition of consulting skills

    Directory of Open Access Journals (Sweden)

    Warnecke E

    2011-06-01

    Full Text Available BackgroundThis study aims to evaluate medical students’ perception ofthe usefulness and effectiveness of an e-learning packagedeveloped to enhance the acquisition of consulting skills.MethodA survey with mixed method data analysis was conducted.Participants were 67 medical students completing theirthird year primary care rotation as part of a five-year degreeat the University of Tasmania. Participants completed a 10question anonymous online survey after using the elearningpackageResultsOf the participants, 92% found it enjoyable and 95% foundthe e-learning package useful; 75% perceived it to beeffective in increasing their performance and 91% believedit increased their knowledge in consulting skills. Benefits forparticipants’ confidence, style and structure of consultingskills were found.ConclusionParticipants found the e-learning package to be enjoyableand effective. E-learning should be further utilised in ablended learning environment to support face-to-faceteaching in consulting skills.

  3. Nurse consultants: organizational influences on role achievement.

    Science.gov (United States)

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

    2006-03-01

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

  4. Expert witness and Jungian archetypes.

    Science.gov (United States)

    Lallave, Juan Antonio; Gutheil, Thomas Gordon

    2012-01-01

    Jung's theories of archetype, shadow, and the personal and collective unconscious provide a postmodern framework in which to consider the role of the expert witness in judicial proceedings. Archetypal themes, motifs, and influences help to illuminate the shadow of the judicial system and projections and behaviors among the cast of the court in pursuing justice. This article speaks to archetypal influences and dialectical tensions encountered by the expert witness in this judicial drama. The archetype of Justice is born from the human need for order and relational fairness in a world of chaos. The persona of justice is the promise of truth in the drama. The shadow of justice is untruth, the need to win by any means. The dynamics of the trickster archetype serve and promote injustice. These influences are examined by means of a case example. This approach will deepen understanding of court proceedings and the role of the expert witness in the heroic quest for justice. Copyright © 2012 Elsevier Ltd. All rights reserved.

  5. Expert System for ASIC Imaging

    Science.gov (United States)

    Gupta, Shri N.; Arshak, Khalil I.; McDonnell, Pearse; Boyce, Conor; Duggan, Andrew

    1989-07-01

    With the developments in the techniques of artificial intelligence over the last few years, development of advisory, scheduling and similar class of problems has become very convenient using tools such as PROLOG. In this paper an expert system has been described which helps lithographers and process engineers in several ways. The methodology used is to model each work station according to its input, output and control parameters, combine these work stations in a logical sequence based on past experience and work out process schedule for a job. In addition, all the requirements vis-a-vis a particular job parameters are converted into decision rules. One example is the exposure time, develop time for a wafer with different feature sizes would be different. This expert system has been written in Turbo Prolog. By building up a large number of rules, one can tune the program to any facility and use it for as diverse applications as advisory help, trouble shooting etc. Leitner (1) has described an advisory expert system that is being used at National Semiconductor. This system is quite different from the one being reported in the present paper. The approach is quite different for one. There is stress on job flow and process for another.

  6. Lay and Expert Perceptions of Planetary Protection

    Science.gov (United States)

    Race, Margaret S.; MacGregor, Donald G.; Slovic, Paul

    2000-01-01

    As space scientists and engineers plan new missions to Mars and other planets in our solar system, they will face critical questions about the potential for biological contamination of planetary surfaces. In a society that places ever-increasing importance on the role of public involvement in science and technology policy, questions about risks of biological contamination will be examined and debated in the media, and will lead to the formation of public perceptions of planetary-contamination risks. These perceptions will, over time, form an important input to the development of space policy. Previous research in public and expert perceptions of technological risks and hazards has shown that many of the problems faced by risk-management organizations are the result of differing perceptions of risk (and risk management) between the general public and scientific and technical experts. These differences manifest themselves both as disagreements about the definition (and level) of risk associated with a scientific, technological or industrial enterprise, and as distrust about the ability of risk-management organizations (both public and private) to adequately protect people's health and safety. This report presents the results of a set of survey studies designed to reveal perceptions of planetary exploration and protection from a wide range of respondents, including both members of the general public and experts in the life sciences. The potential value of this research lies in what it reveals about perceptions of risk and benefit that could improve risk-management policies and practices. For example, efforts to communicate with the public about Mars sample return missions could benefit from an understanding of the specific concerns that nonscientists have about such a mission by suggesting areas of potential improvement in public education and information. Assessment of both public and expert perceptions of risk can also be used to provide an advanced signal of

  7. Design of the expert system to analyze disease in Plant Teak using Forward Chaining

    Directory of Open Access Journals (Sweden)

    Poningsih Poningsih

    2017-06-01

    Full Text Available Teak is one kind of plant that is already widely known and developed by the wider community in the form of plantations and community forests. This is because until now Teak wood is a commodity of luxury, high quality, the price is expensive, and high economic value. Expert systems are a part of the method sciences artificial intelligence to make an application program disease diagnosis teak computerized seek to replace and mimic the reasoning process of an expert or experts in solving the problem specification that can be said to be a duplicate from an expert because science knowledge is stored inside a database  Expert System for the diagnosis of disease teak using forward chaining method aims to explore the characteristics shown in the form of questions in order to diagnose the disease teak with web-based software. Device keel expert system can recognize the disease after consulting identity by answering some of the questions presented by the application of expert systems and can infer some kind of disease in plants teak. Data disease known customize rules (rules are made to match the characteristics of teak disease and provide treatment solutions.

  8. Identifying challenges in project consultants engagement practices

    Science.gov (United States)

    Shariffuddin, Nadia Alina Amir; Abidin, Nazirah Zainul

    2017-10-01

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

  9. Working with boundaries in systems psychodynamic consulting

    Directory of Open Access Journals (Sweden)

    Henk Struwig

    2012-01-01

    Full Text Available Orientation: The researcher described the systems psychodynamics of boundary management in organisations. The data showed how effective boundary management leads to good holding environments that, in turn, lead to containing difficult emotions.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.

  10. Acquisition of Expert/Non-Expert Vocabulary from Reformulations.

    Science.gov (United States)

    Antoine, Edwige; Grabar, Natalia

    2017-01-01

    Technical medical terms are complicated to be correctly understood by non-experts. Vocabulary, associating technical terms with layman expressions, can help in increasing the readability of technical texts and their understanding. The purpose of our work is to build this kind of vocabulary. We propose to exploit the notion of reformulation following two methods: extraction of abbreviations and of reformulations with specific markers. The segments associated thanks to these methods are aligned with medical terminologies. Our results allow to cover over 9,000 medical terms and show precision of extractions between 0.24 and 0.98. The results and analyzed and compared with the existing work.

  11. From Expert Elicitations to Integrated Assessment: Future Prospects of Carbon Capture Technologies

    OpenAIRE

    Elena Claire Ricci; Valentina Bosetti; Erin Baker

    2014-01-01

    This paper analyzes the future prospects of carbon capture technologies. The first part of the analysis presents and discusses the results of an expert elicitation survey on a broad range of carbon capture options. The survey collected probabilistic estimates on the future values of energy penalty under three different scenarios of R&D investments and climate policies from twelve leading European experts from both academia and industry. In the second part of the analysis, the elicitation resu...

  12. The Relationship between Gender of Consultant and Social Power Perceptions within School Consultation. Research Brief

    Science.gov (United States)

    Erchul, William P.; Raven, Bertram H.; Wilson, Kristen E.

    2004-01-01

    This study's focus was on school psychologists' perceived effectiveness of 11 social power bases (Raven, 1993) that may be drawn upon when consulting with initially resistant teachers. Specifically, the relationship between consultant gender and perceptions of power base effectiveness was examined. The Interpersonal Power Inventory-Form CT…

  13. Improving Methods of Consulting with Young People: Piloting a New Model of Consultation

    Science.gov (United States)

    Woolfson, Richard C.; Bryce, Donna; Mooney, Lindsay; Harker, Michael; Lowe, Dorothy; Ferguson, Ellen

    2008-01-01

    National and international legislation has increasingly placed a duty on professionals to consult with young people about matters affecting their lives. Consequently, conducting consultation exercises with young people in order to improve the quality of services available is becoming established practice in many areas. Following on from previous…

  14. Diagnostic consultations: a speech-act theoretical reconstruction for the design of consultation systems.

    Science.gov (United States)

    Müller-Kolck, U

    1991-10-01

    In this paper the theory of speech acts is applied for a structural reconstruction of medical diagnostic consultations. The reconstruction provides the conceptual model for a research prototype of a consultation tool which is expected to play a mediating role between the participants in the professional diagnostic discourse. Preliminary results of the design will be outlined.

  15. Influence in-sourcing and outsourcing of consultants on construction project performance in Nigeria

    Directory of Open Access Journals (Sweden)

    Godwin Iroroakpo Idoro

    2011-12-01

    Full Text Available Research studies have discovered that outsourcing has several benefits and the practice is fast replacing in-sourcing especially with regard to construction consultants. In the attempt to examine the benefits of the two approaches on project outcome, this study investigates the influence of the use of in-sourced and outsourced consultants on project performance in Nigeria. The objectives are to determine the use of in-sourcing and outsourcing for selected consultants, compare the use of the two approaches in project delivery and their influence on project performance and compare the performance of projects in which in-sourced and outsourced selected consultants were engaged. To achieve these objectives, a questionnaire design approach was adopted. A field survey involving a sample of 164 projects were selected by stratified random sampling. Data were collected using structured questionnaires and analysed using percentage, mean, Spearman and t-tests. The results of the study reveal that clients engage both in-sourced and outsourced consultants in project development and that the practice has significant influence on project performance. It also discovered that the use of the two approaches has differing benefits on project delivery time and cost. The study concludes that in-sourcing and outsourcing are common practices in project development and that clients are facing a challenge in deciding which approach to adopt. The study also discovers that both approaches has benefits associated with project outcome and suggests that clients should consider these benefits in deciding in-sourced and outsourced consultants.

  16. QUANTITATIVE AND QUALITATIVE DIMENSIONS OF BUSINESS CONSULTING MARKET IN THE REPUBLIC OF MOLDOVA

    Directory of Open Access Journals (Sweden)

    Natalia LOBANOV

    2016-06-01

    Full Text Available Business-consulting services, as well as any other product, are designed to be sold;however, the recipients of such services shouldrecognize the need to invest in harnessing organizational knowledge of the enterprise, which requires a certain level of economic maturity,managerial intelligence and well developed management skills. On the other hand, the domain of business consulting services is determined by the availability of market knowledge, professional experience and technologies that match those organizational and production problems that require intervention to be resolved. These technologies and knowledge have to be systematized, adapted and incorporated into a form that allows its use and transmission by the consultant to the customer during advisory mission. This study has the aim to determine the interdependencies between supply for business consulting services in the Republic of Moldova,and for this purpose, there were investigated the following aspects: the identification of factors of influence and trends that are manifested on the local advisory services; market research performance made by an industrial survey in order to assess the situation on the market of consulting services, its advantages and constraints; formulating estimates of market development forecasts for consulting services in Moldova for the period of 2016-2020.

  17. Language in Consultation: The Effect of Affect and Verb Tense

    Science.gov (United States)

    Newman, Daniel S.; Guiney, Meaghan C.; Barrett, Courtenay A.

    2017-01-01

    This study was an exploration of school consultation interactions between instructional consultants and consultees. Of specific interest was how consultants (n = 18) and consultees (n = 18) used verb tense and emotion words during the problem identification and analysis instructional consultation stage, similarities and differences in…

  18. Expert – Non-expert differences in visual behaviour during alpine slalom skiing

    OpenAIRE

    Decroix, Marjolein; Wazir, Mohd Rozilee Wazir Norjali; Zeuwts, Linus; Deconinck, Frederik; Lenoir, Matthieu; Vansteenkiste, Pieter

    2017-01-01

    The aim of this study was to investigate visual behaviour of expert and non-expert ski athletes during an alpine slalom. Fourteen non-experts and five expert slalom skiers completed an alpine slalom course in an indoor ski slope while wearing a head-mounted eye tracking device. Experts completed the slalom clearly faster than non-experts, but no significant difference was found in timing and position of the turn initiation. Although both groups already looked at future obstacles approximately...

  19. Therapists’ Perspectives on the Effective Elements of Consultation Following Training

    Science.gov (United States)

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

    2013-01-01

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

  20. User Consultation Behaviour in Internet Dictionaries

    DEFF Research Database (Denmark)

    Simonsen, Henrik Køhler

    2011-01-01

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

  1. Fellow As Teacher Curriculum: Improving Rheumatology Fellows' Teaching Skills During Inpatient Consultation.

    Science.gov (United States)

    Miloslavsky, Eli M; Criscione-Schreiber, Lisa G; Jonas, Beth L; O'rourke, Kenneth S; McSparron, Jakob I; Bolster, Marcy B

    2016-06-01

    Enhancing rheumatology fellows' teaching skills in the setting of inpatient consultation may have a broad positive impact. Such efforts may improve fellows' clinical skills and overall patient care. Most importantly, effective resident-fellow teaching interactions may not only increase residents' knowledge of rheumatology but may influence their career choice. However, a number of barriers to the resident-fellow teaching interaction have been identified, including fellows' teaching skills. We developed the Fellow As Clinical Teacher (FACT) curriculum in order to enhance fellows' teaching skills during inpatient consultation. The FACT curriculum was delivered in two 45-minute workshops during the 3-day Winter Symposium of the Carolinas Fellows Collaborative. We evaluated its effect with self-assessment surveys and fellow performance on the objective structured teaching exercise (OSTE) before and after participation in the curriculum. Nineteen fellows from 4 rheumatology training programs participated in the pre- and post-curriculum OSTEs and 18 fellows completed pre- and post-curriculum surveys. OSTE scores improved on 5 of the 8 items assessed, and the total OSTE score improved as well (34.7 versus 29.5; P teaching skills and intent to teach during consultation also increased after participation in the curriculum. The FACT curriculum, focused on teaching during consultation, improved fellows' teaching skills and attitudes toward teaching. Improving and increasing fellow teaching, particularly in the consultation setting, may impact patient care, resident and fellow learning, and teaching skills of future faculty, and could potentially influence residents' career choice. © 2016, American College of Rheumatology.

  2. Expert judgment and uncertainty regarding the protection of imperiled species.

    Science.gov (United States)

    Heeren, Alexander; Karns, Gabriel; Bruskotter, Jeremy; Toman, Eric; Wilson, Robyn; Szarek, Harmony

    2017-06-01

    Decisions concerning the appropriate listing status of species under the U.S. Endangered Species Act (ESA) can be controversial even among conservationists. These decisions may determine whether a species persists in the near term and have long-lasting social and political ramifications. Given the ESA's mandate that such decisions be based on the best available science, it is important to examine what factors contribute to experts' judgments concerning the listing of species. We examined how a variety of factors (such as risk perception, value orientations, and norms) influenced experts' judgments concerning the appropriate listing status of the grizzly bear (Ursus arctos horribilis) population in the Greater Yellowstone Ecosystem. Experts were invited to complete an online survey examining their perceptions of the threats grizzly bears face and their listing recommendation. Although experts' assessments of the threats to this species were strongly correlated with their recommendations for listing status, this relationship did not exist when other cognitive factors were included in the model. Specifically, values related to human use of wildlife and norms (i.e., a respondent's expectation of peers' assessments) were most influential in listing status recommendations. These results suggest that experts' decisions about listing, like all human decisions, are subject to the use of heuristics (i.e., decision shortcuts). An understanding of how heuristics and related biases affect decisions under uncertainty can help inform decision making about threatened and endangered species and may be useful in designing effective processes for protection of imperiled species. © 2016 Society for Conservation Biology.

  3. Wind power projects and Aboriginal consultation

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-07-01

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

  4. Bladder Pain Syndrome International Consultation on Incontinence

    DEFF Research Database (Denmark)

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

    2010-01-01

    Aims of Study: The Bladder Pain Syndrome Committee of the International Consultation on Incontinence was assigned the task by the consultation of reviewing the syndrome, formerly known as interstitial cystitis, in a comprehensive fashion. This included the topics of definition, nomenclature...... to the bladder with at least one urinary symptom, such as frequency not obviously related to high fluid intake, or a persistent urge to void should be evaluated for possible BPS. The initial assessment consists of a frequency/volume chart, focused physical examination, urinalysis, and urine culture. Urine...

  5. 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.

  6. 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…

  7. The impact of the law on consultation practices and purpose: A case study of Aboriginal cultural heritage consultations in NSW

    Directory of Open Access Journals (Sweden)

    Kylie Lingard

    2012-08-01

    Full Text Available Consultation research to date has largely concentrated on how consultation practices generally serve only the purpose of procedural compliance. This article identifies and explores the gap in existing research on the impact of law on consultation practices and purposes. To explore current practices and the potential contribution of law to the nature of consultation practices, the article focuses on the NSW duty to consult Aboriginal people before permitting harm to Aboriginal cultural heritage. Conventional regulatory approaches to consultation assume that Aboriginal interests are accommodated by the same consultation strategies applied to other stakeholders in rural law and policy. This article uses an administrative law doctrinal research approach to identify the specific issues and requirements for Aboriginal consultation relating to cultural heritage. Consideration is given to the effectiveness of the case study consultation requirements, the duty design, and the recent Land and Environment Court judgment of Ashton Coal Operations Pty Limited v Director-General, Department of Environment, Climate Change and Water. The article argues that statutory consultation requirements and purposes can, and should, be taken more seriously. The law reform discussion highlighted in the paper considers how identified consultation requirements can be incorporated into Australian Cultural Heritage legislation, and the possible impact of such incorporation on the purpose of the consultation. More broadly, the law reform discussion indicates that when consultation requirements are tailored to suit the purpose of the consultation and the consultation parties, the law can play a positive role in consultation, engagement and capacity building.

  8. Do consultant obstetricians and gynaecologists comply with motor traffic regulations when recalled to hospital to attend emergencies? A national audit.

    Science.gov (United States)

    Ogah, J; Pring, D W

    2009-10-01

    Consultant obstetricians and gynaecologists are often recalled from home back into hospital to attend emergencies. We audited their driving practices and compliance to motor traffic regulations on recall to these emergencies with the aid of a questionnaire survey. A total of 218 of the 300 UK consultants surveyed responded. Some 65% of those who owned a green warning light beacon (GWL) admitted to speeding on some journeys and 46% ignored red lights; 84% of non-owners of a GWL would speed and 28% would ignore a red light. A total of 37 consultants had been stopped for traffic violations, nine with a GWL and 28 without. Five consultants had been involved in accidents returning to hospital to attend an emergency. Obstetricians and gynaecologists are disregarding motor traffic regulations in order to attend emergencies.

  9. Expert SQL Server 2008 Development

    CERN Document Server

    Machanic, Adam

    2009-01-01

    Expert SQL Server 2008 Development is aimed at SQL Server developers ready to move beyond Books Online. Author and experienced developer Alastair Aitchison shows you how to think about SQL Server development as if it were any other type of development. You'll learn to manage testing in SQL Server and to properly deal with errors and exceptions. The book also covers critical, database-centric topics such as managing concurrency and securing your data and code through proper privileges and authorization. Alastair places focus on sound development and architectural practices that will help you be

  10. Expert Oracle RAC 12c

    CERN Document Server

    Shamsudeen, Riyaj; Yu, Kai; Farooq, Tariq

    2013-01-01

    Expert Oracle RAC 12c is a hands-on book helping you understand and implement Oracle Real Application Clusters (RAC), and to reduce the total-cost-of-ownership (TCO) of a RAC database. As a seasoned professional, you are probably aware of the importance of understanding the technical details behind the RAC stack. This book provides deep understanding of RAC concepts and implementation details that you can apply toward your day-to-day operational practices. You'll be guided in troubleshooting and avoiding trouble in your installation. Successful RAC operation hinges upon a fast-performing netwo

  11. An Exploration of the Superintendent Hiring Process in Texas Used by School Boards That Utilized Search Consultants

    Science.gov (United States)

    Beagle, Steven W.

    2012-01-01

    This study explored the superintendent hiring process in Texas. Participating school board presidents were part of a target population who used search consultants and hired a superintendent during 2011. Using survey research methods, data were collected from 17 school board presidents. The Superintendent Profile survey was used to measure how…

  12. Expert Systems for auditing management information systems

    Directory of Open Access Journals (Sweden)

    Gheroghe Popescu

    2007-05-01

    Full Text Available Expert systems are built with the help of: specialised programming languages or expert system generators (shell. But this structure was reached after tens of years of work and research, because expert systems are nothing but pragmatic capitalisation of the results of research carried out in artificial intelligence and theory of knowledge.

  13. Enhancing the Learning Process with Expert Systems.

    Science.gov (United States)

    Karake, Zeinab A.

    1990-01-01

    Discusses the use of artificial intelligence and expert system shells to enhance the learning process of graduate or undergraduate statistics students. A student exercise is described using STAT-EXPERT, an expert system designed to help students select the appropriate statistical analysis technique. (25 references) (LRW)

  14. Differentiating Experts' Anticipatory Skills in Beach Volleyball

    Science.gov (United States)

    Canal-Bruland, Rouwen; Mooren, Merel; Savelsbergh, Geert J. P.

    2011-01-01

    In this study, we examined how perceptual-motor expertise and watching experience contribute to anticipating the outcome of opponents' attacking actions in beach volleyball. To this end, we invited 8 expert beach volleyball players, 8 expert coaches, 8 expert referees, and 8 control participants with no beach volleyball experience to watch videos…

  15. Fire Effects, Education, and Expert Systems

    Science.gov (United States)

    Robert E. Martin

    1987-01-01

    Predicting the effects of fires in the year 2000 and beyond will be enhanced by the use of expert systems. Although our predictions may have broad confidence limits, expert systems should help us to improve the predictions and to focus on the areas where improved knowledge is most needed. The knowledge of experts can be incorporated into previously existing knowledge...

  16. Evaluating Econometric Models and Expert Intuition

    NARCIS (Netherlands)

    R. Legerstee (Rianne)

    2012-01-01

    textabstractThis thesis is about forecasting situations which involve econometric models and expert intuition. The first three chapters are about what it is that experts do when they adjust statistical model forecasts and what might improve that adjustment behavior. It is investigated how expert

  17. Contextual Factors for Finding Similar Experts

    DEFF Research Database (Denmark)

    Hofmann, Katja; Balog, Krisztian; Bogers, Toine

    2010-01-01

    -seeking models, are rarely taken into account. In this article, we extend content-based expert-finding approaches with contextual factors that have been found to influence human expert finding. We focus on a task of science communicators in a knowledge-intensive environment, the task of finding similar experts...

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

    Science.gov (United States)

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

    2014-01-01

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

  19. CURBSIDE CONSULTATION OF THE ACL: 49 CLINICAL QUESTIONS

    Directory of Open Access Journals (Sweden)

    Bernard R. Bach

    2008-09-01

    Full Text Available DESCRIPTION A unique reference that offers opinions, preferences and expert advice associated with management of ACL injuries in the questions and answers format which enhanced by images, diagrams and references. PURPOSE "Curbside Consultation of the ACL" aims to provide some knowledge more than the basic information in the evaluation and the management of ACL injuries. This information is based on the opinion or the advice of an expert. Quick access of audience to these pearl and pit-falls and evidence-based expert advice for complicated cases in ACL reconstruction in the form of brief answers including current concepts is targeted by the authors. FEATURES 49 Clinical questions are outlined in 5 sections. In the first section is about preoperative questions including indications, diagnostic measures, combined ligament injuries, graft choice, preparation before surgery, avulsion of the eminence, examination in posterolateral corner injury. In the second section is preoperative questions are subjected including dropping the graft to the floor, posterior wall blowout, knees without hamstring tendon, graft amputation by interference screw, to avoid vertical tunnel in tibia, fixation methods of graft, femoral and tibial tunnel positioning. Third section is about postoperative questions including postoperative management, differences in postoperative rehabilitation protocols in different type of grafts, postoperative man-agement of meniscal repair, management in difficulties in gaining extension, infection, patellar pain, timing of reop-eration in motion problems, criteria returning to sports, outcome measures, outcome in using different grafts, role of bracing. The fourth section is about failed ACL recon-struction including causes, indications for revision, ex-panded tunnels, graft choice in revision surgery, contro-lateral patellar tendon graft for revision, rehab protocol after revision surgery, hardware removal, early degenera-tive joint disease

  20. Expert system validation in prolog

    Science.gov (United States)

    Stock, Todd; Stachowitz, Rolf; Chang, Chin-Liang; Combs, Jacqueline

    1988-01-01

    An overview of the Expert System Validation Assistant (EVA) is being implemented in Prolog at the Lockheed AI Center. Prolog was chosen to facilitate rapid prototyping of the structure and logic checkers and since February 1987, we have implemented code to check for irrelevance, subsumption, duplication, deadends, unreachability, and cycles. The architecture chosen is extremely flexible and expansible, yet concise and complementary with the normal interactive style of Prolog. The foundation of the system is in the connection graph representation. Rules and facts are modeled as nodes in the graph and arcs indicate common patterns between rules. The basic activity of the validation system is then a traversal of the connection graph, searching for various patterns the system recognizes as erroneous. To aid in specifying these patterns, a metalanguage is developed, providing the user with the basic facilities required to reason about the expert system. Using the metalanguage, the user can, for example, give the Prolog inference engine the goal of finding inconsistent conclusions among the rules, and Prolog will search the graph intantiations which can match the definition of inconsistency. Examples of code for some of the checkers are provided and the algorithms explained. Technical highlights include automatic construction of a connection graph, demonstration of the use of metalanguage, the A* algorithm modified to detect all unique cycles, general-purpose stacks in Prolog, and a general-purpose database browser with pattern completion.

  1. SCIENTIFIC-PROJECT CONSULTING AS AN INNOVATIVE FORMAT OF POSTGRADUATE EDUCATION

    Directory of Open Access Journals (Sweden)

    G. A. Ignatieva

    2017-01-01

    Full Text Available Introduction. Today the main social and economic advantage of Russia in global economy (we do not take natural wealth into account is the human capital which development has to become a priority for all levels of an education system. The relevance of the article determined by the need to modernize the educational programs, technology and content of the educational process in the institutional space of postgraduate teacher education. It is one of the key factors in the development of the intellectual capital of a society, providing a transition to continuous, socially oriented, associated with global and domestic fundamental science education for all people and aimed at the formation of the creative socially responsible personality. The new mission of post-degree training «through all life», consisting in the advancing formation of intellectual potential of the country, demands search of new forms and methods of additional professional education.Aim. The aim of the article is to disclosure the essence of scientific-project consulting as an innovative format of teachers and scientific-pedagogical staff.Methods. The institutional approach is the basis of the study. In accordance with this approach, the development strategy and the areas of work of traditional and new institutions of post-degree education – Department of Pedagogy and Andragogy and the Center of Scientific and Design Consulting are designated. As methodological base of this type of consulting, it is offered to use provisions of the genetic-substantial theory of the developing education, in particular the principle of development regulating processes of continuous improvement of professionalism of experts of education and development of new functions by them in post-industrial society.Results. The conceptual model of a reflexive outline of management of process of formation of new professional positions of the teacher is constructed; its components are

  2. Nursing consultation tool for people with human immunodeficiency virus/tuberculosis co-infection

    Directory of Open Access Journals (Sweden)

    Alexsandra Rodrigues Feijão

    2015-11-01

    Full Text Available Objective: to verify the opinion of judges about a nursing consultation tool for people with co-infection by the human immunodeficiency virus and tuberculosis. Methods: methodological study, involving the construction of a tool based on Orem’s self-care theory and its submission for evaluation by judges experts in the area, which gave opinions about organization, clarity and relevance. Results: the instrument gained a positive evaluation for all assessment criteria, with agreement greater than 75% and Content Validity Index greater than 0.80 in most items. Following judges opinion, three items were excluded and two modified. Conclusion: the adequacy of the nursing consultation tool for people with HIV/tuberculosis co-infection was confirmed regarding organization into subdivisions and items. Minimal disagreement among judges in the analysis of the issues was noted. Although most items were evaluated positively, further validation studies will be needed.

  3. Organizational design approaches in management consulting

    NARCIS (Netherlands)

    Visscher, Klaasjan; Visscher-Voerman, Irene

    2010-01-01

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

  4. The Writing Consultation: Developing Academic Writing Practices

    Science.gov (United States)

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

    2008-01-01

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

  5. 21 CFR 211.34 - Consultants.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Consultants. 211.34 Section 211.34 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR FINISHED PHARMACEUTICALS Organization and Personnel § 211.34...

  6. Consulting in Union-Mangement Relations.

    Science.gov (United States)

    Henderson, James W.

    1980-01-01

    Reviews the development of unions in libraries, measures the impact of unionism on library administration, examines the sources of assistance in union-management relations available to library administrators, and cnsiders questions pertaining to the role of library consultants in union matters. (FM)

  7. 265 Statistical Consulting and the African Universities

    African Journals Online (AJOL)

    User

    2011-07-21

    Jul 21, 2011 ... statistical methods to a variety of subject areas, such as economics, biology, ... psychology, marketing, education, and sports. Many economic, social, political, and military decisions cannot be made without statistical techniques. ... The apprenticeship method of learning statistical consulting is really time.

  8. Consulting the Public through Deliberative Polling

    Science.gov (United States)

    Fishkin, James S.

    2003-01-01

    In this article, the author discusses Deliberative Polling as the most credible and practical method of public consultation. As compared with self-selected forums or samples of convenience, it employs scientific random samples. As compared with the snapshots of an inattentive public often offered by conventional polls, it assesses informed public…

  9. Information Skills and Instructional Consulting: A Synergy?

    Science.gov (United States)

    Turner, Philip M.

    1991-01-01

    Argues that the school library media specialist's instructional consultation role can optimize the impact of information skills, and proposes that the choice of the information skills be dictated by (1) the cognitive requirements of the lesson; (2) the teacher's instructional design decisions; and (3) the learning characteristics of the students.…

  10. School Neuropsychology Consultation in Neurodevelopmental Disorders

    Science.gov (United States)

    Decker, Scott L.

    2008-01-01

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

  11. Compliance with the recommendations of medical consultants.

    Science.gov (United States)

    Ballard, W P; Gold, J P; Charlson, M E

    1986-01-01

    Compliance with the consultant's recommendations is one measure of the effectiveness of a consultation. A previous study showed that compliance was better when fewer recommendations were made. In the subsequent year, consultants were encouraged to limit their recommendations to five or fewer. Despite a significant decrease in the number of recommendations, compliance rates remained essentially unchanged (72%). Multivariate analysis demonstrated that the clinical severity of the patient's disease and the number of associated problems, as well as the types of recommendations, were significant predictors of compliance. Compliance was best for recommendations involving medications (84%) and worst for recommendations involving diagnostic tests (62%). Compliance was also evaluated in the context of a surgeon's view of the appropriateness of the recommendations. For recommendations felt to be essential to patient care the compliance rate was 75%, but it was only 44% for recommendations judged nonessential (p less than 0.001). The consulting internist should be aware that the surgeon's view of the relevance of the recommendations to patient care needs may have an important effect on compliance.

  12. 78 FR 20658 - Tribal Consultation Meeting

    Science.gov (United States)

    2013-04-05

    ... CONTACT: Robert Bialas, Regional Program Manager, Region XI, Office of Head Start, email [email protected] leaders of Tribal Governments operating Head Start and Early Head Start programs. As much as possible, the... OHS Tribal Consultations. Tribal leaders and designated representatives interested in submitting...

  13. 78 FR 11891 - Tribal Consultation Meeting

    Science.gov (United States)

    2013-02-20

    ... INFORMATION CONTACT: Robert Bialas, Regional Program Manager, Region XI, Office of Head Start, email Robert... leaders of Tribal Governments operating Head Start and Early Head Start programs. As much as possible, the... OHS Tribal Consultations. Tribal leaders and designated representatives interested in submitting...

  14. 34 CFR 200.63 - Consultation.

    Science.gov (United States)

    2010-07-01

    ... children from low-income families residing in participating public school attendance areas, including... to teachers and families of participating private school children. (c)(1) Consultation by the LEA... before the LEA makes any decision that affects the opportunity of eligible private school children to...

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

    Science.gov (United States)

    Kirby, David A.

    2003-01-01

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

  16. 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.

  17. Consultation: A Model for Helping Professions.

    Science.gov (United States)

    Strickland, Ben; Arnn, John

    This handbook attempts to revise and revitalize the concept of consultation as commonly employed by members of the helping professions, particularly school counselors and student personnel workers in educational settings. The authors believe that neither counseling nor coordination provide the kind of visibility necessary for credibility, and that…

  18. 7 CFR 372.7 - Consultation.

    Science.gov (United States)

    2010-01-01

    ... Endangered Species Act. [60 FR 6002, Feb. 1, 1995; 60 FR 13212, Mar. 10, 1995] ... 7 Agriculture 5 2010-01-01 2010-01-01 false Consultation. 372.7 Section 372.7 Agriculture Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH INSPECTION SERVICE...

  19. The representations of adolescents about gynecological consultation

    Directory of Open Access Journals (Sweden)

    Vera Lúcia de Oliveira Gomes

    2014-06-01

    Full Text Available Objective: To analyze the social representation of adolescents about gynecological consultation and the influence of those in searching for consultations. Method: Qualitative descriptive study based on the Social Representations Theory, conducted with 50 adolescents in their last year of middle school. The data was collected between April and May of 2010 by Evocations and a Focal Group. The software EVOC and contextual analysis were used in the data treatment. Results: The elements fear and constraint, constant in the central nucleus, can justify the low frequency of adolescents in consultations. The term embarrassment in the peripheral system reinforce current sociocultural norms, while prevention, associated with learning about sex and clarifying doubts, allows to envision an educative function. Obtained testimonies in the focal groups exemplify and reinforce those findings. Conclusion: For an effective health education, professionals, including nurses, need to clarify the youth individually and collectively about their rights to privacy, secrecy, in addition to focus the gynecological consultation as a promotion measure to sexual and reproductive health.

  20. 76 FR 55678 - Tribal Consultation Policy

    Science.gov (United States)

    2011-09-08

    ... President Obama's Executive Memorandum be moved to either the Background section or some sort of History... ACF. ACF will continue to utilize TFWGs that incorporate tribal leadership to inform ACF leadership... concepts of Executive Order 13175. ACF would like to refer the commenter to Section 7. Consultation Parties...