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Sample records for understandable format consult

  1. Understanding the consultation processes

    International Nuclear Information System (INIS)

    Laing, A.C.

    1998-01-01

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

  2. Understanding Alliance Formation Patterns

    Science.gov (United States)

    2015-12-01

    military, transportation, and communications technologies, which caused every place in the world to be politically significant. Second, “divisions of power...test a similar claim about the association between distance and dyadic alliance formation. In their first model, in which they use the complete data...1885 to 1990] are positively related to dyadic trade levels, and that their non- defense-pact counterparts are not significantly related to trade in

  3. Consultation system for image diagnosis: Report formation support system

    International Nuclear Information System (INIS)

    Ikeda, M.; Sakuma, S.; Ishigaki, T.; Suzuki, K.; Oikawa, K.

    1987-01-01

    The authors developed a consultation system for image diagnosis, involving artificial intelligence ideas. In this system, the authors proposed a new report formation support system and implemented it in lymphangiography. This support system starts with the input of image interpretation. The input process is made mainly by selecting items. This system encodes the input findings into the semantic network, which is represented as a directed graph, and it reserves them into the knowledge database in the above structure. Finally, the output (report) is made in the near natural language, which corresponds to the input findings

  4. Consultations

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

    IDRC CRDI

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

  5. 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

  6. The Formation of the Model of Diagnosing the Results Implementation of of Consulting Projects for Enterprises

    Directory of Open Access Journals (Sweden)

    Kuzmin Oleh Ye.

    2017-11-01

    Full Text Available In the article the graphic-analytical model of diagnostics of results of implementation of consulting projects is formed, which allows to: take into consideration interests of participants to the project on choice of methods and methodologies of diagnosing; allocate alternative sets of business indicators for each object of impact in terms of consulting project; establish economic and non-economic criteria for evaluating the effectiveness of consulting, as well as monitoring of indicators and automated processing of diagnostic results to control deviations from the optimal values of the diagnosed project results. A structural-logical model of formation of alternative sets of indicators and choice of indicators for diagnostics of results of consulting projects has been developed. The elements of the enterprise management system have been codified to harmonize the corresponding indicators with their subsequent combination within the proposed sets. The control system objects and their elements have been allocated. The groups of indicators according to the technology of Balanced Score Card (BSC have been presented. The prospect of further research is the economic assessment of implementation of the diagnosed consulting projects, which will reveal the links between the parameters of production-economic activity and the assessment of projects, and allows choose the most significant ones.

  7. Virtualized healthcare delivery: understanding users and their usage patterns of online medical consultations.

    Science.gov (United States)

    Jung, Changmi; Padman, Rema

    2014-12-01

    Virtualization of healthcare delivery via patient portals has facilitated the increasing interest in online medical consultations due to its benefits such as improved convenience and flexibility, lower cost, and time savings. Despite this growing interest, adoption by both consumers and providers has been slow, and little is known about users and their usage and adoption patterns. To learn characteristics of online healthcare consumers and understand their patterns of adoption and usage of online clinical consultation services (or eVisits delivered via the portal) such as adoption time for portal users, whether adoption hazard changes over time, and what factors influence patients to become early/late adopters. Using online medical consultation records between April 1, 2009 and May 31, 2010 from four ambulatory practices affiliated with a major healthcare provider, we conduct simple descriptive analysis to understand the users of online clinical consults and their usage patterns. Multilevel Logit regression is employed to measure the effect of patient and primary care provider characteristics on the likelihood of eVisit adoption by the patient, and survival analysis and Ordered Logit regression are applied to study eVisit adoption patterns that delineate elements describing early or late adopters. On average, eVisit adopters are younger and predominantly female. Their primary care providers participate in the eVisit service, highlighting the importance of physician's role in encouraging patients to utilize the service. Patients who are familiar with the patient portal are more likely to use the service, as are patients with more complex health issues. Younger and female patients have higher adoption hazard, but gender does not affect the decision of adopting early vs. late. These adopters also access the patient portal more frequently before adoption, indicating that they are potentially more involved in managing their health. The majority of eVisits are submitted

  8. Understanding reasons for asthma outpatient (non)-attendance and exploring the role of telephone and e-consulting in facilitating access to care: exploratory qualitative study.

    NARCIS (Netherlands)

    Baar, J.D. van; Joosten, H.; Car, J.; Freeman, G.; Partridge, M.R.; Weel, C. van; Sheikh, A.

    2006-01-01

    OBJECTIVE: To understand factors influencing patients' decisions to attend for outpatient follow up consultations for asthma and to explore patients' attitudes to telephone and email consultations in facilitating access to asthma care. DESIGN: Exploratory qualitative study using in depth interviews.

  9. What do our patients understand about their trial participation? Assessing patients' understanding of their informed consent consultation about randomised clinical trials.

    Science.gov (United States)

    Behrendt, C; Gölz, T; Roesler, C; Bertz, H; Wünsch, A

    2011-02-01

    Ethically, informed consent regarding randomised controlled trials (RCTs) should be understandable to patients. The patients can then give free consent or decline to participate in a RCT. Little is known about what patients really understand in consultations about RCTs. Cancer patients who were asked to participate in a randomised trial were surveyed using a semi-standardised interview developed by the authors. The interview addresses understanding, satisfaction and needs of the patients. The sample included eight patients who participated in a trial and two who declined. The data were analysed on the basis of Mayring's qualitative analysis. Patients' understanding of informed consent was less developed than anticipated, especially concerning key elements such as randomisation, content and procedure of RCTs. Analysing the result about satisfaction of the patients, most of the patients described their consultations as hectic and without advance notice. Health limitations due to cancer played a decisive role. However, most of the patients perceived their physician to be sympathetic. Analysing the needs of patients, they ask for a clear informed consent consultation with enough time and adequate advance notice. This study fills an important empirical research gap of what is ethically demanded in an RCT consultation and what is really understood by patients. The qualitative approach enabled us to obtain new results about cancer patients' understanding of informed consent, to clarify patients' needs and to develop new ideas to optimise the informed consent.

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

    DEFF Research Database (Denmark)

    Wolderslund, Maiken

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

  11. Understanding coupling between bone resorption and formation

    DEFF Research Database (Denmark)

    Andersen, Thomas Levin; Abdelgawad, Mohamed Essameldim; Kristensen, Helene Bjørg

    2013-01-01

    these lacunae for bone formation. These cells, called herein reversal cells, cover >80% of the eroded surfaces, but their nature is not identified, and it is not known whether malfunction of these cells may contribute to bone loss in diseases such as postmenopausal osteoporosis. Herein, we combined...... histomorphometry and IHC on human iliac biopsy specimens, and showed that reversal cells are immunoreactive for factors typically expressed by osteoblasts, but not for monocytic markers. Furthermore, a subpopulation of reversal cells showed several distinctive characteristics suggestive of an arrested...

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

    Directory of Open Access Journals (Sweden)

    Karlheinz Kautz

    2015-09-01

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

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

    Science.gov (United States)

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

    2018-01-01

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

  14. Memorandum of Understanding on cooperation and consultation on nuclear installations near borders

    International Nuclear Information System (INIS)

    1977-01-01

    This Agreement signed on 27 September 1977 lays down that the Contracting Parties will inform each other about all nuclear installations constructed along the common border. Nuclear installations within the meaning of the Agreement are installations for the production, processing, reprocessing, manufacture or fission of nuclear fuels and radioactive waste storage. The information to be communicated includes plans and decisions on siting, construction and operation of such installations and relevant documents. The Agreement provides for consultation between the Parties on safety aspects and lays down in detail all the conditions for communication of information. (NEA) [fr

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

    NARCIS (Netherlands)

    Huygens, M.W.J.; Swinkels, I.C.S.; Verheij, R.A.; Friele, R.; Schayck, O.C.P. van; Witte, L.P. de

    2018-01-01

    Objectives It is unclear why the use of email consultation is not more widespread in Dutch general practice, particularly because, since 2006, its costs can be reimbursed. To encourage further implementation, it is needed to understand the current use of email consultations. This study aims to

  16. Understanding Combustion and Soot Formation in Diesel Engines

    Science.gov (United States)

    2016-09-09

    distributions of PLII signals help understand the soot distributions within diesel/ biodiesel flames. In addition, planar laser-induced Figure 1. Transported ...Prescribed by ANSI Std. Z39.18 Page 1 of 1FORM SF 298 9/14/2016https://livelink.ebs.afrl.af.mil/livelink/llisapi.dll This project investigated biodiesel ...emissions testing. 1 FINAL REPORT Project title: Understanding combustion and soot formation in biodiesel fuelled diesel engines Lead Institute and

  17. Understanding the star formation modes in the distant universe

    International Nuclear Information System (INIS)

    Salmi, Fadia

    2012-01-01

    The goal of my PhD study consists at attempt to understand what are the main processes at the origin of the star formation in the galaxies over the last 10 billion years. While it was proposed in the past that merging of galaxies has a dominant role to explain the triggering of the star formation in the distant galaxies having high star formation rates, in the opposite, more recent studies revealed scaling laws linking the star formation rate in the galaxies to their stellar mass or their gas mass. The small dispersion of these laws seems to be in contradiction with the idea of powerful stochastic events due to interactions, but rather in agreement with the new vision of galaxy history where the latter are continuously fed by intergalactic gas. We were especially interested in one of this scaling law, the relation between the star formation (SFR) and the stellar mass (M*) of galaxies, commonly called the main sequence of star forming galaxies. We studied this main sequence, SFR-M"*, in function of the morphology and other physical parameters like the radius, the colour, the clumpiness. The goal was to understand the origin of the sequence's dispersion related to the physical processes underlying this sequence in order to identify the main mode of star formation controlling this sequence. This work needed a multi-wavelength approach as well as the use of galaxies profile simulation to distinguish between the different galaxy morphological types implied in the main sequence. (author) [fr

  18. What Do They Understand? Using Technology to Facilitate Formative Assessment

    Science.gov (United States)

    Mitten, Carolyn; Jacobbe, Tim; Jacobbe, Elizabeth

    2017-01-01

    Formative assessment is so important to inform teachers' planning. A discussion of the benefits of using technology to facilitate formative assessment explains how four primary school teachers adopted three different apps to make their formative assessment more meaningful and useful.

  19. Understanding reasons for asthma outpatient (non)‐attendance and exploring the role of telephone and e‐consulting in facilitating access to care: exploratory qualitative study

    Science.gov (United States)

    van Baar, J D; Joosten, H; Car, J; Freeman, G K; Partridge, M R; van Weel, C; Sheikh, A

    2006-01-01

    Objective To understand factors influencing patients' decisions to attend for outpatient follow up consultations for asthma and to explore patients' attitudes to telephone and email consultations in facilitating access to asthma care. Design Exploratory qualitative study using in depth interviews. Setting Hospital outpatient clinic in West London. Participants Nineteen patients with moderate to severe asthma (12 “attenders” and 7 “non‐attenders”). Results Patients' main reasons for attending were the wish to improve control over asthma symptoms and a concern not to jeopardise the valued relationship with their doctor. Memory lapses, poor health, and disillusionment with the structure of outpatient care were important factors implicated in non‐attendance. The patients were generally sceptical about the suggestion that greater opportunity for telephone consulting might improve access to care. They expressed concerns about the difficulties in effectively communicating through non‐face to face media and were worried that clinicians would not be in a position to perform an adequate physical examination over the telephone. Email and text messaging were viewed as potentially useful for sending appointment reminders and sharing clinical information but were not considered to be acceptable alternatives to the face to face clinic encounter. Conclusions Memory lapses, impaired mobility due to poor health, and frustration with outpatient clinic organisation resulting in long waiting times and discontinuity of care are factors that deter patients from attending for hospital asthma assessments. The idea of telephone review assessments was viewed with scepticism by most study subjects. Particular attention should be given to explaining to patients the benefits of telephone consultations, and to seeking their views as to whether they would like to try them out before replacing face to face consultations with them. Email and text messaging may have a role in issuing

  20. The Contemporary Consultant

    DEFF Research Database (Denmark)

    Olson, Thomas; Poulfelt, Flemming; Greiner, Larry

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

  1. Understanding The Impact of Formative Assessment Strategies on First Year University Students’ Conceptual Understanding of Chemical Concepts

    OpenAIRE

    Mehmet Aydeniz; Aybuke Pabuccu

    2011-01-01

    This study investigated the effects of formative assessment strategies on students’ conceptual understanding in a freshmen college chemistry course in Turkey. Our sample consists of 96 students; 27 males, 69 females. The formative assessment strategies such as reflection on exams, and collective problem solving sessions were used throughout the course. Data were collected through pre and post-test methodology. The findings reveal that the formative assessment strategies used in this study led...

  2. Formative Feedback in a Business School: Understanding the Student Perspective

    Science.gov (United States)

    Poppitt, Nicola J.; Iqbal, Yasser

    2009-01-01

    Inspired by a desire to improve the student experience, this paper reviews primary research carried out into the use of formative feedback within a Business School at a "new" university in the UK. The research adopted a qualitative approach with key objectives to gain staff and student perspectives on the role and practice of feedback…

  3. Satisfaction Formation Processes in Library Users: Understanding Multisource Effects

    Science.gov (United States)

    Shi, Xi; Holahan, Patricia J.; Jurkat, M. Peter

    2004-01-01

    This study explores whether disconfirmation theory can explain satisfaction formation processes in library users. Both library users' needs and expectations are investigated as disconfirmation standards. Overall library user satisfaction is predicted to be a function of two independent sources--satisfaction with the information product received…

  4. Contribution of natural tracers for understanding transfers through argillaceous formations

    International Nuclear Information System (INIS)

    Bensenouci, F.

    2010-01-01

    This study is part of a research programme conducted by IRSN on the safety of deep geological disposal of high level and intermediate long-lived radioactive wastes. It more especially concerns the geological medium considered as a full component of the multi-barrier concept proposed by Andra for a deep repository. Indeed, the Callovo-Oxfordian argillite of the Paris Basin, in the east of France, is being investigated by Andra as a potential host rock for this repository. Performance assessment of this natural barrier is based on the knowledge of its confinement properties and therefore on phenomena possibly involved in the mass transport of radionuclides. In this context, this work aimed at studying the distribution of tracers naturally present in pore waters obtained from boreholes having crossed Mesozoic sedimentary series involving impervious and compacted clay rocks in the East (Andra borehole, EST433) and south of France (IRSN boreholes). Radial diffusion and vapour exchange methods were used to calculate the concentrations and diffusion parameters of the studied tracers. In Tournemire formations, the different profiles describe a curved shapes attributed to a diffusive exchange between the argillite pore water and the surrounding aquifers. Concerning the Mesozoic formations crossed by EST433, the study of the different profiles confirms the diffusion as the dominant transport mechanism in the Callovo-Oxfordian formation, and permits identifying the transport processes in the whole studied column from the Oxfordian formations down to the Liassic one. This study also helps to identify the Liassic formations as a major source of salinity of the Dogger aquifer

  5. Accompanied consultations in occupational health.

    Science.gov (United States)

    Hobson, J; Hobson, H; Sharp, R

    2016-04-01

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

  6. The Effect of Computer Models as Formative Assessment on Student Understanding of the Nature of Models

    Science.gov (United States)

    Park, Mihwa; Liu, Xiufeng; Smith, Erica; Waight, Noemi

    2017-01-01

    This study reports the effect of computer models as formative assessment on high school students' understanding of the nature of models. Nine high school teachers integrated computer models and associated formative assessments into their yearlong high school chemistry course. A pre-test and post-test of students' understanding of the nature of…

  7. Understanding carbon nanotube channel formation in the lipid membrane

    Science.gov (United States)

    Choi, Moon-ki; Kim, Hyunki; Lee, Byung Ho; Kim, Teayeop; Rho, Junsuk; Kim, Moon Ki; Kim, Kyunghoon

    2018-03-01

    Carbon nanotubes (CNTs) have been considered a prominent nano-channel in cell membranes because of their prominent ion-conductance and ion-selectivity, offering agents for a biomimetic channel platform. Using a coarse-grained molecular dynamics simulation, we clarify a construction mechanism of vertical CNT nano-channels in a lipid membrane for a long period, which has been difficult to observe in previous CNT-lipid interaction simulations. The result shows that both the lipid coating density and length of CNT affect the suitable fabrication condition for a vertical and stable CNT channel. Also, simulation elucidated that a lipid coating on the surface of the CNT prevents the CNT from burrowing into the lipid membrane and the vertical channel is stabilized by the repulsion force between the lipids in the coating and membrane. Our study provides an essential understanding of how CNTs can form stable and vertical channels in the membrane, which is important for designing new types of artificial channels as biosensors for bio-fluidic studies.

  8. The autophagosome: current understanding of formation and maturation

    Directory of Open Access Journals (Sweden)

    Mannack LVJC

    2015-02-01

    Full Text Available Lilith VJC Mannack, Jon D Lane Cell Biology Laboratories, School of Biochemistry, University of Bristol, Bristol, UK Abstract: Autophagy is an important and highly conserved catabolic process with roles in development, homeostasis, and cellular stress responses. It describes various distinct pathways for the delivery of cytoplasmic materials (including misfolded protein aggregates and some organelles to the lysosome for degradation and component recycling. The best understood form of autophagy (macroautophagy describes the de novo assembly, maturation, and trafficking of a unique double membrane-bound organelle – the autophagosomes – that sequesters cytoplasmic materials and ultimately merges with the lysosomal compartment to form a degradative autolysosome. To rapidly assemble such a structure in response to stimuli, cells express a family of dedicated autophagy-related (ATG gene products that act sequentially to control membrane events leading first to the nucleation of an isolation membrane or phagophore, followed by phagophore expansion, and sealing to form an autophagosome that traffics to – and ultimately fuses with – the lysosome. These molecules are activated in response to upstream signaling pathways (notably, the mechanistic target of rapamycin [mTOR] pathway, and comprise protein and lipid kinases, putative membrane coats, and unique ubiquitin-like conjugation systems. In concert, a barrage of accessory proteins involved in various membrane trafficking pathways focused on the endosomal compartment are co-opted at the assembly site to facilitate autophagosome biogenesis. Understanding the integrated pathways that coordinate autophagosome assembly at the molecular level will be crucial if we are to realize the potential for autophagy manipulation in future disease therapies. Keywords: autophagy, ATG proteins, lysosome, phagophore, omegasome, autolysosome, membrane trafficking, ULK1, mTOR, PI(3 kinase, PI3P, LIR motif

  9. Understanding communication between emergency and consulting physicians: a qualitative study that describes and defines the essential elements of the emergency department consultation-referral process for the junior learner.

    Science.gov (United States)

    Chan, Teresa; Orlich, Donika; Kulasegaram, Kulamakan; Sherbino, Jonathan

    2013-01-01

    To define the important elements of an emergency department (ED) consultation request and to develop a simple model of the process. From March to September 2010, 61 physicians (21 emergency medicine [EM], 20 general surgery [GS], 20 internal medicine [IM]; 31 residents, 30 attending staff) were questioned about how junior learners should be taught about ED consultation. Two investigators independently reviewed focus group and interview transcripts using grounded theory to generate an index of themes until saturation was reached. Disagreements were resolved by consensus, yielding an inventory of themes and subthemes. All transcripts were coded using this index of themes; 30% of transcripts were coded in duplicate to determine the agreement. A total of 245 themes and subthemes were identified. The agreement between reviewers was 77%. Important themes in the process were as follows: initial preparation and review of investigations by EM physician (overall endorsement 87% [range 70-100% in different groups]); identification of involved parties (patient and involved physicians) (100%); hypothesis of patient's diagnosis (75% [range 62-83%]) or question for the consulting physician (70% [range 55-95%]); urgency (100%) and stability (74% [range 62-80%]); questions from the consultant (100%); discussion/communication (98% [range 95-100%]); and feedback (98% [range 95-100%]). These components were reorganized into a simple framework (PIQUED). Each clinical specialty significantly contributed to the model (χ2  =  7.9; p value  =  0.019). Each group contributed uniquely to the final list of important elements (percent contributions: EM, 57%; GS, 41%; IM, 64%). We define important elements of an ED consultation with input from emergency and consulting physicians. We propose a model that organizes these elements into a simple framework (PIQUED) that may be valuable for junior learners.

  10. An Investigation of Teachers' Growing Understandings of the Picture Book Format

    Science.gov (United States)

    Martinez, Miriam G.; Harmon, Janis M.

    2015-01-01

    This study investigated the impact of a graduate course that focused on picture books on teachers' understandings of the picture book format and the ways in which these understandings influenced their self-reports of picture book use in the classroom. Findings of this qualitative investigation revealed that immersion in and analysis of the picture…

  11. Effect of Sulfur Concentration and PH Conditions on Akaganeite Formation: Understanding Akaganeite Formation Conditions in Yellowknife Bay, Gale Crater, Mars

    Science.gov (United States)

    Fox, A.; Peretyazhko, T.; Sutter, B.; Niles, P.; Ming, D. W.; Morris, R. V.

    2015-01-01

    The Chemistry and Mineralogy Instrument (CHEMIN) on board the Mars Science Laboratory (MSL) Curiosity Rover identified minor amounts of akaganeite (beta-FeOOH) at Yellowknife Bay, Mars. There is also evidence for akaganeite at other localities on Mars from the Compact Reconnaissance Imaging Spectrometer for Mars (CRISM). Akaganeite is an iron(III) hydroxide with a hollandite- like structure and Cl in its tunnels. Terrestrial akaganeite usually forms in Cl-rich environments under acidic, oxidizing conditions. Previous studies of akaganeite have revealed that akaganeite formation is affected by the presence of sulfate (hereafter denoted as S. The prediction of circumneutral pH coupled with the detection of S at Yellowknife Bay dictate that work is needed to determine how S and pH together affect akaganeite formation. The goal of this work is to study how changes in both S concentration and pH influence akaganeite precipitation. Akaganeite formation was investigated at S/Cl molar ratios of 0, 0.017, 0.083, 0.17 and 0.33 at pH 1.5, 2, and 4. Results are anticipated to provide combined S concentration and pH constraints on akaganeite formation in Yellowknife Bay and elsewhere on Mars. Knowledge of solution pH and S concentrations can be utilized in understanding microbial habitability potential on the Martian surface.

  12. Understanding the Sun-Earth Libration Point Orbit Formation Flying Challenges For WFIRST and Starshade

    Science.gov (United States)

    Webster, Cassandra M.; Folta, David C.

    2017-01-01

    In order to fly an occulter in formation with a telescope at the Sun-Earth L2 (SEL2) Libration Point, one must have a detailed understanding of the dy-namics that govern the restricted three body system. For initial purposes, a linear approximation is satisfactory, but operations will require a high-fidelity modeling tool along with strategic targeting methods in order to be successful. This paper focuses on the challenging dynamics of the transfer trajectories to achieve the relative positioning of two spacecraft to fly in formation at SEL2, in our case, the Wide-Field Infrared Survey Telescope (WFIRST) and a proposed Starshade. By modeling the formation transfers using a high fidelity tool, an accurate V approximation can be made to as-sist with the development of the subsystem design required for a WFIRST and Starshade formation flight mission.

  13. Understanding the geographic distribution of tropical cyclone formation for applications in climate models

    Science.gov (United States)

    Tory, Kevin J.; Ye, H.; Dare, R. A.

    2018-04-01

    Projections of Tropical cyclone (TC) formation under future climate scenarios are dependent on climate model simulations. However, many models produce unrealistic geographical distributions of TC formation, especially in the north and south Atlantic and eastern south Pacific TC basins. In order to improve confidence in projections it is important to understand the reasons behind these model errors. However, considerable effort is required to analyse the many models used in projection studies. To address this problem, a novel diagnostic is developed that provides compelling insight into why TCs form where they do, using a few summary diagrams. The diagnostic is developed after identifying a relationship between seasonal climatologies of atmospheric variables in 34 years of ECMWF reanalysis data, and TC detection distributions in the same data. Geographic boundaries of TC formation are constructed from four threshold quantities. TCs form where Emanuel's Maximum Potential Intensity, V_{{PI}}, exceeds 40 {ms}^{{ - 1}}, 700 hPa relative humidity, RH_{{700}}, exceeds 40%, and the magnitude of the difference in vector winds between 850 and 200 hPa, V_{{sh}}, is less than 20 {ms}^{{ - 1}}. The equatorial boundary is best defined by a composite quantity containing the ratio of absolute vorticity (η ) to the meridional gradient of absolute vorticity (β ^{*}), rather than η alone. {β ^*} is also identified as a potentially important ingredient for TC genesis indices. A comparison of detected Tropical Depression (TD) and Tropical Storm (TS) climatologies revealed TDs more readily intensify further to TS where {V_{PI}} is elevated and {V_{sh}} is relatively weak. The distributions of each threshold quantity identify the factors that favour and suppress TC formation throughout the tropics in the real world. This information can be used to understand why TC formation is poorly represented in some climate models, and shows potential for understanding anomalous TC formation

  14. Modelling dewatering behaviour through an understanding of solids formation processes. Part II--solids separation considerations.

    Science.gov (United States)

    Dustan, A C; Cohen, B; Petrie, J G

    2005-05-30

    An understanding of the mechanisms which control solids formation can provide information on the characteristics of the solids which are formed. The nature of the solids formed in turn impacts on dewatering behaviour. The 'upstream' solids formation determines a set of suspension characteristics: solids concentration, particle size distribution, solution ionic strength and electrostatic surface potential. These characteristics together define the suspension's rheological properties. However, the complicated interdependence of these has precluded the prediction of suspension rheology from such a fundamental description of suspension characteristics. Recent shear yield stress models, applied in this study to compressive yield, significantly reduce the empiricism required for the description of compressive rheology. Suspension compressibility and permeability uniquely define the dewatering behaviour, described in terms of settling, filtration and mechanical expression. These modes of dewatering may be described in terms of the same fundamental suspension mechanics model. In this way, it is possible to link dynamically the processes of solids formation and dewatering of the resultant suspension. This, ultimately, opens the door to improved operability of these processes. In part I of this paper we introduced an integrated system model for solids formation and dewatering. This model was demonstrated for the upstream processes using experimental data. In this current paper models of colloidal interactions and dewatering are presented and compared to experimental results from batch filtration tests. A novel approach to predicting suspension compressibility and permeability using a single test configuration is presented and tested.

  15. Towards an understanding of the role of clay minerals in crude oil formation, migration and accumulation

    Science.gov (United States)

    Wu, Lin Mei; Zhou, Chun Hui; Keeling, John; Tong, Dong Shen; Yu, Wei Hua

    2012-12-01

    This article reviews progress in the understanding of the role of clay minerals in crude oil formation, migration and accumulation. Clay minerals are involved in the formation of kerogen, catalytic cracking of kerogen into petroleum hydrocarbon, the migration of crude oil, and the continued change to hydrocarbon composition in underground petroleum reservoirs. In kerogen formation, clay minerals act as catalysts and sorbents to immobilize organic matter through ligand exchange, hydrophobic interactions and cation bridges by the mechanisms of Maillard reactions, polyphenol theory, selective preservation and sorptive protection. Clay minerals also serve as catalysts in acid-catalyzed cracking of kerogen into petroleum hydrocarbon through Lewis and Brønsted acid sites on the clay surface. The amount and type of clay mineral affect the composition of the petroleum. Brønsted acidity of clay minerals is affected by the presence and state of interlayer water, and displacement of this water is a probable driver in crude oil migration from source rocks. During crude oil migration and accumulation in reservoirs, the composition of petroleum is continually modified by interaction with clay minerals. The clays continue to function as sorbents and catalysts even while they are being transformed by diagenetic processes. The detail of chemical interactions and reaction mechanisms between clay minerals and crude oil formation remains to be fully explained but promises to provide insights with broader application, including catalytic conversion of biomass as a source of sustainable energy into the future.

  16. 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...

  17. Skills for Effective Consultation.

    Science.gov (United States)

    Dustin, Dick; Ehly, Stewart

    1984-01-01

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

  18. Understanding the process of social network evolution: Online-offline integrated analysis of social tie formation.

    Science.gov (United States)

    Kwak, Doyeon; Kim, Wonjoon

    2017-01-01

    It is important to consider the interweaving nature of online and offline social networks when we examine social network evolution. However, it is difficult to find any research that examines the process of social tie formation from an integrated perspective. In our study, we quantitatively measure offline interactions and examine the corresponding evolution of online social network in order to understand the significance of interrelationship between online and offline social factors in generating social ties. We analyze the radio signal strength indicator sensor data from a series of social events to understand offline interactions among the participants and measure the structural attributes of their existing online Facebook social networks. By monitoring the changes in their online social networks before and after offline interactions in a series of social events, we verify that the ability to develop an offline interaction into an online friendship is tied to the number of social connections that participants previously had, while the presence of shared mutual friends between a pair of participants disrupts potential new connections within the pre-designed offline social events. Thus, while our integrative approach enables us to confirm the theory of preferential attachment in the process of network formation, the common neighbor theory is not supported. Our dual-dimensional network analysis allows us to observe the actual process of social network evolution rather than to make predictions based on the assumption of self-organizing networks.

  19. Understanding the process of social network evolution: Online-offline integrated analysis of social tie formation.

    Directory of Open Access Journals (Sweden)

    Doyeon Kwak

    Full Text Available It is important to consider the interweaving nature of online and offline social networks when we examine social network evolution. However, it is difficult to find any research that examines the process of social tie formation from an integrated perspective. In our study, we quantitatively measure offline interactions and examine the corresponding evolution of online social network in order to understand the significance of interrelationship between online and offline social factors in generating social ties. We analyze the radio signal strength indicator sensor data from a series of social events to understand offline interactions among the participants and measure the structural attributes of their existing online Facebook social networks. By monitoring the changes in their online social networks before and after offline interactions in a series of social events, we verify that the ability to develop an offline interaction into an online friendship is tied to the number of social connections that participants previously had, while the presence of shared mutual friends between a pair of participants disrupts potential new connections within the pre-designed offline social events. Thus, while our integrative approach enables us to confirm the theory of preferential attachment in the process of network formation, the common neighbor theory is not supported. Our dual-dimensional network analysis allows us to observe the actual process of social network evolution rather than to make predictions based on the assumption of self-organizing networks.

  20. Learning to consult with computers.

    Science.gov (United States)

    Liaw, S T; Marty, J J

    2001-07-01

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

  1. Understanding adult neurogenesis beyond its role in learning and memory formation

    Directory of Open Access Journals (Sweden)

    Ab Latif Wani

    2017-04-01

    Full Text Available There has been a shift in the understanding of brain, neurons, and their functional role over the last two decades. Earlier it was believed that the brain was a static organ and was not subject to any change throughout life. An understanding was developed later that brain reorganizes its structure by a specific property called neuroplasticity. Recent research shows that the brain generates new neurons even in the adult stage, and this process is called adult neurogenesis. Although researchers still not have all the answers about the newborn neurons, and why and how they are generated, and what is their role, some have highlighted the importance of these in learning and memory formation, and even in memories of fear and spatial navigation. A wide range of environmental experience influences the generation of newborn neurons and their functional variability. There are questions about how different environmental experiences cause the differences in the generation of new neurons. Recently the field of optogenetics attempted to answer the questions on adult neurogenesis. However there are still questions about adult neurogenesis which needs a more naturalistic approach, for their better understanding.

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

    OpenAIRE

    Hartley, Jeanette

    2017-01-01

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

  3. Understanding molecular motor walking along a microtubule: a themosensitive asymmetric Brownian motor driven by bubble formation.

    Science.gov (United States)

    Arai, Noriyoshi; Yasuoka, Kenji; Koishi, Takahiro; Ebisuzaki, Toshikazu; Zeng, Xiao Cheng

    2013-06-12

    The "asymmetric Brownian ratchet model", a variation of Feynman's ratchet and pawl system, is invoked to understand the kinesin walking behavior along a microtubule. The model system, consisting of a motor and a rail, can exhibit two distinct binding states, namely, the random Brownian state and the asymmetric potential state. When the system is transformed back and forth between the two states, the motor can be driven to "walk" in one direction. Previously, we suggested a fundamental mechanism, that is, bubble formation in a nanosized channel surrounded by hydrophobic atoms, to explain the transition between the two states. In this study, we propose a more realistic and viable switching method in our computer simulation of molecular motor walking. Specifically, we propose a thermosensitive polymer model with which the transition between the two states can be controlled by temperature pulses. Based on this new motor system, the stepping size and stepping time of the motor can be recorded. Remarkably, the "walking" behavior observed in the newly proposed model resembles that of the realistic motor protein. The bubble formation based motor not only can be highly efficient but also offers new insights into the physical mechanism of realistic biomolecule motors.

  4. 76 FR 55678 - Tribal Consultation Policy

    Science.gov (United States)

    2011-09-08

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

  5. Tribal Consultation Tracking System

    Data.gov (United States)

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

  6. 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.…

  7. 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.

  8. 3 CFR - Tribal Consultation

    Science.gov (United States)

    2010-01-01

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

  9. Understanding the formation and composition of hazes in planetary atmospheres that contain carbon monoxide

    Science.gov (United States)

    Hörst, S. M.; Yoon, Y. H.; Hicks, R. K.; Tolbert, M. A.

    2012-09-01

    Measurements from the Cassini Plasma Spectrometer (CAPS) have revealed the presence of molecules in Titan's ionosphere with masses in excess of hundreds of amu. Negative ions with mass/charge (m/z) up to 10,000 amu/q [1] and positive ions with m/z up to 400 amu/q [2] have been detected. CAPS has also observed O+ flowing into Titan's upper atmosphere [3], which appears to originate from Enceladus and is likely the source of oxygen bearing molecules in Titan's atmosphere [4]. The observed O+ is deposited in the region now known to contain large organic molecules. A recent Titan atmosphere simulation experiment has shown that incorporation of oxygen into Titan aerosol analogues results in the formation of all five nucleotide bases and the two smallest amino acids, glycine and alanine [5]. Similar chemical processes may have occurred in the atmosphere of the early Earth, or in the atmospheres of extrasolar planets; atmospheric aerosols may be an important source of the building blocks of life. Atmospheric aerosols play an important role in determining the radiation budget of an atmosphere and can also provide a wealth of organic material to the surface. The presence of atmospheric aerosols has been invoked to explain the relatively featureless spectrum of HD 189773b, including the lack of predicted atmospheric Na and K spectral lines [9]. The majority of the O+ precipitating into Titan's atmosphere forms CO (O(3P)+CH3 -> CO+H2+H) [4]. CO has also been detected in the atmospheres of a number of exoplanets including HD 189733b, HD 209458b, and WASP-12b [6-8]. It is therefore important to understand the role CO plays in the formation and composition of hazes in planetary atmospheres. Using a High-Resolution Time-of-Flight Aerosol Mass Spectrometer (HR-ToF-AMS) (see e.g. [10]) we have obtained in situ composition measurements of aerosol particles (so-called "tholins") produced in N2/CH4/CO gas mixtures subjected to either FUV radiation (deuterium lamp, 115-400 nm) or a

  10. Understanding the role of contextual cues in supporting the formation of medication-taking habits

    Directory of Open Access Journals (Sweden)

    Katarzyna Stawarz

    2015-10-01

    in the presence of stable cues, with time they start to guide the behaviour and provide triggers to action (Lally & Gardner, 2011. However, adherence technologies tend to disregard contextual cues and the habitual nature of many medication regimens, and instead alert users when it is time to take the pill (Stawarz et al., 2014. Similarly, behaviour change technologies designed specifically to support habit formation also neglect contextual cues and instead focus on behaviour tracking and reminders (Stawarz et al, 2015. By supporting the identification and reinforcement of contextual cues, technology could aid both prospective memory and habit formation: it could help patients remember the new regimen and turn it into a reliable medication habit. Aims: Previous research by Stawarz et al. (2015 suggests that contextual cues support habit formation, but because habits take time to develop, people can still forget; conversely, reminders support remembering, but they can inhibit habit development. However, their study measured the development of an artificial habit (texting the researchers, lasted only for 4 weeks, and did not account for the role of location as a contextual cue. Therefore, the aim of this study was to explore the impact of contextual cues and reminders on the development of automaticity of behaviour (representing habit strength and frequency of repetition (representing adherence to the regimen over a longer period and with behaviours participants wanted to turn into habit. The understanding of how these factors influence the process of habit formation would enable us to design more effective adherence technologies that assist patients when they start a new regimen (prospective memory support as well as over the long term (habit support. Method: 209 participants were recruited on social networks, and among students and university staff. They were 18-58 years old (mean age = 27, SD = 7.6 years; 68% were women, 74% were students. They were asked to repeat a

  11. Toward an understanding of surface layer formation, growth, and transformation at the glass-fluid interface

    Science.gov (United States)

    Hopf, J.; Eskelsen, J. R.; Chiu, M.; Ievlev, A. V.; Ovchinnikova, O. S.; Leonard, D.; Pierce, E. M.

    2018-05-01

    Silicate glass is a metastable and durable solid that has application to a number of energy and environmental challenges (e.g., microelectronics, fiber optics, and nuclear waste storage). If allowed to react with water over time silicate glass develops an altered layer at the solid-fluid interface. In this study, we used borosilicate glass (LAWB45) as a model material to develop a robust understanding of altered layer formation (i.e., amorphous hydrated surface layer and crystalline reaction products). Experiments were conducted at high surface area-to-volume ratio (∼200,000 m-1) and 90 °C in the pressurized unsaturated flow (PUF) apparatus for 1.5-years to facilitate the formation of thick altered layers and allow for the effluent solution chemistry to be monitored continuously. A variety of microscopy techniques were used to characterize reacted grains and suggest the average altered layer thickness is 13.2 ± 8.3 μm with the hydrated and clay layer representing 74.8% and 25.2% of the total altered layer, respectively. The estimate of hydrated layer thickness is within the experimental error of the value estimated from the B release rate data (∼10 ± 1 μm/yr) over the 1.5-year duration. PeakForce® quantitative nanomechanical mapping results suggest the hydrated layer has a modulus that ranges between ∼20 and 40 GPa, which is in the range of porous silica that contains from ∼20 to ∼50% porosity, yet significantly lower than dense silica (∼70-80 GPa). Scanning transmission electron microscopy (STEM) images confirm the presence of pores and an analysis of a higher resolution image provides a qualitative estimate of ≥22% porosity in the hydrated layer with variations in void volume with increasing distance from the unaltered glass. Chemical composition analyses, based on a combination of time-of-flight secondary-ion mass spectrometry (ToF-SIMS), scanning electron microscopy with X-ray energy dispersive spectroscopy (EDS), and STEM-EDS, clearly show

  12. A force sensor using nanowire arrays to understand biofilm formation (Conference Presentation)

    Science.gov (United States)

    Sahoo, Prasana K.; Cavalli, Alessandro; Pelegati, Vitor B.; Murillo, Duber M.; Souza, Alessandra A.; Cesar, Carlos L.; Bakkers, Erik P. A. M.; Cotta, Monica A.

    2016-03-01

    Understanding the cellular signaling and function at the nano-bio interface can pave the way towards developing next-generation smart diagnostic tools. From this perspective, limited reports detail so far the cellular and subcellular forces exerted by bacterial cells during the interaction with abiotic materials. Nanowire arrays with high aspect ratio have been used to detect such small forces. In this regard, live force measurements were performed ex-vivo during the interaction of Xylella fastidiosa bacterial cells with InP nanowire arrays. The influence of nanowire array topography and surface chemistry on the response and motion of bacterial cells was studied in detail. The nanowire arrays were also functionalized with different cell adhesive promoters, such as amines and XadA1, an afimbrial protein of X.fastidiosa. By employing the well-defined InP nanowire arrays platform, and single cell confocal imaging system, we were able to trace the bacterial growth pattern, and show that their initial attachment locations are strongly influenced by the surface chemistry and nanoscale surface topography. In addition, we measure the cellular forces down to few nanonewton range using these nanowire arrays. In case of nanowire functionalized with XadA1, the force exerted by vertically and horizontally attached single bacteria on the nanowire is in average 14% and 26% higher than for the pristine array, respectively. These results provide an excellent basis for live-cell force measurements as well as unravel the range of forces involved during the early stages of bacterial adhesion and biofilm formation.

  13. Students' Understanding of Cloud and Rainbow Formation and Teachers' Awareness of Students' Performance

    Science.gov (United States)

    Malleus, Elina; Kikas, Eve; Kruus, Sigrid

    2016-01-01

    This study describes primary school students' knowledge about rainfall, clouds and rainbow formation together with teachers' predictions about students' performance. In our study, primary school students' (N = 177) knowledge about rainfall and rainbow formation was examined using structured interviews with open-ended questions. Primary school…

  14. Understanding Educational Policy Formation: The Case of School Violence Policies in Israel

    Science.gov (United States)

    Fast, Idit

    2016-01-01

    This study explores mechanisms underlying processes of educational policy formation. Previous studies have given much attention to processes of diffusion when accounting for educational policy formation. Less account has been given to the day-to-day institutional dynamics through which educational policies develop and change. Building on extensive…

  15. Growing Pebbles and Conceptual Prisms - Understanding the Source of Student Misconceptions about Rock Formation.

    Science.gov (United States)

    Kusnick, Judi

    2002-01-01

    Analyzes narrative essays--stories of rock formation--written by pre-service elementary school teachers. Reports startling misconceptions among preservice teachers on pebbles that grow, human involvement in rock formation, and sedimentary rocks forming as puddles as dry up, even though these students had completed a college level course on Earth…

  16. Toward Understanding Pore Formation and Mobility during Controlled Directional Solidification in a Microgravity Environment Investigation (PFMI)

    Science.gov (United States)

    Grugel, Richard N.; Anilkumar, A. V.; Luz, Paul; Jeter, Linda; Volz, Martin P.; Spivey, Reggie; Smith, G.

    2003-01-01

    The generation and inclusion of detrimental porosity, e.g., pipes and rattails can occur during controlled directional solidification processing. The origin of these defects is generally attributed to gas evolution and entrapment during solidification of the melt. On Earth, owing to buoyancy, an initiated bubble can rapidly rise through the liquid melt and pop at the surface; this is obviously not ensured in a low gravity or microgravity environment. Clearly, porosity generation and inclusion is detrimental to conducting any meaningful solidification-science studies in microgravity. Thus it is essential that model experiments be conducted in microgravity, to understand the details of the generation and mobility of porosity, so that methods can be found to eliminate it. In hindsight, this is particularly relevant given the results of the previous directional solidification experiments conducted in Space. The current International Space Station (ISS) Microgravity Science Glovebox (MSG) investigation addresses the central issue of porosity formation and mobility during controlled directional solidification processing in microgravity. The study will be done using a transparent metal-analogue material, succinonitrile (SCN) and succinonitrile-water 'alloys', so that direct observation and recording of pore generation and mobility can be made during the experiments. Succinonitrile is particularly well suited for the proposed investigation because it is transparent, it solidifies in a manner analogous to most metals, it has a convenient melting point, its material properties are well characterized and, it has been successfully used in previous microgravity experiments. The PFMI experiment will be launched on the UF-2, STS-111 flight. Highlighting the porosity development problem in metal alloys during microgravity processing, the poster will describe: (i) the intent of the proposed experiments, (ii) the theoretical rationale behind using SCN as the study material for

  17. The art of consultation

    Directory of Open Access Journals (Sweden)

    Kulwant S Bhangoo

    2014-01-01

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

  18. The art of consultation.

    Science.gov (United States)

    Bhangoo, Kulwant S

    2014-05-01

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

  19. Ethics in Management Consulting

    OpenAIRE

    Carlo Vallini

    2007-01-01

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

  20. Understanding triplet formation pathways in bulk heterojunction polymer : fullerene photovoltaic devices

    NARCIS (Netherlands)

    Tedla, B.; Zhu, F.; Cox, M.; Drijkoningen, J.; Manca, J.V.; Koopmans, B.; Goovaerts, E.

    2015-01-01

    Triplet exciton (TE) formation pathways are systematically investigated in prototype bulk heterojunction (BHJ) "super yellow" poly(p-phenylene vinylene) (SY-PPV) solar cell devices with varying fullerene compositions using complementary optoelectrical and electrically detected magnetic resonance

  1. 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.

  2. Consultation Models Revisited

    International Nuclear Information System (INIS)

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

    2006-01-01

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

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

    Science.gov (United States)

    Schein, Edgar H.

    1978-01-01

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

  4. Understanding the operational parameters affecting NDMA formation at Advanced Water Treatment Plants.

    Science.gov (United States)

    Farré, Maria José; Döderer, Katrin; Hearn, Laurence; Poussade, Yvan; Keller, Jurg; Gernjak, Wolfgang

    2011-01-30

    N-nitrosodimethylamine (NDMA) can be formed when secondary effluents are disinfected by chloramines. By means of bench scale experiments this paper investigates operational parameters than can help Advanced Water Treatment Plants (AWTPs) to reduce the formation of NDMA during the production of high quality recycled water. The formation of NDMA was monitored during a contact time of 24h using dimethylamine as NDMA model precursor and secondary effluent from wastewater treatment plants. The three chloramine disinfection strategies tested were pre-formed and in-line formed monochloramine, and pre-formed dichloramine. Although the latter is not employed on purpose in full-scale applications, it has been suggested as the main contributing chemical generating NDMA during chloramination. After 24h, the NDMA formation decreased in both matrices tested in the order: pre-formed dichloramine>in-line formed monochloramine≫pre-formed monochloramine. The most important parameter to consider for the inhibition of NDMA formation was the length of contact time between disinfectant and wastewater. Formation of NDMA was initially inhibited for up to 6h with concentrations consistently NDMA concentrations were reduced by a factor of 20 by optimizing the disinfection strategy. Copyright © 2010 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

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

    2018-01-01

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

  6. Making consultations run smoothly

    DEFF Research Database (Denmark)

    Jespersen, Astrid Pernille; Elgaard Jensen, Torben

    2012-01-01

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

  7. 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...

  8. N-body simulations of planet formation: understanding exoplanet system architectures

    Science.gov (United States)

    Coleman, Gavin; Nelson, Richard

    2015-12-01

    Observations have demonstrated the existence of a significant population of compact systems comprised of super-Earths and Neptune-mass planets, and a population of gas giants that appear to occur primarily in either short-period (100 days) orbits. The broad diversity of system architectures raises the question of whether or not the same formation processes operating in standard disc models can explain these planets, or if different scenarios are required instead to explain the widely differing architectures. To explore this issue, we present the results from a comprehensive suite of N-body simulations of planetary system formation that include the following physical processes: gravitational interactions and collisions between planetary embryos and planetesimals; type I and II migration; gas accretion onto planetary cores; self-consistent viscous disc evolution and disc removal through photo-evaporation. Our results indicate that the formation and survival of compact systems of super-Earths and Neptune-mass planets occur commonly in disc models where a simple prescription for the disc viscosity is assumed, but such models never lead to the formation and survival of gas giant planets due to migration into the star. Inspired in part by the ALMA observations of HL Tau, and by MHD simulations that display the formation of long-lived zonal flows, we have explored the consequences of assuming that the disc viscosity varies in both time and space. We find that the radial structuring of the disc leads to conditions in which systems of giant planets are able to form and survive. Furthermore, these giants generally occupy those regions of the mass-period diagram that are densely populated by the observed gas giants, suggesting that the planet traps generated by radial structuring of protoplanetary discs may be a necessary ingredient for forming giant planets.

  9. Molecular understanding of atmospheric particle formation from sulfuric acid and large oxidized organic molecules

    CERN Document Server

    Schobesberger, Siegfried; Bianchi, Federico; Lönn, Gustaf; Ehn, Mikael; Lehtipalo, Katrianne; Dommen, Josef; Ehrhart, Sebastian; Ortega, Ismael K; Franchin, Alessandro; Nieminen, Tuomo; Riccobono, Francesco; Hutterli, Manuel; Duplissy, Jonathan; Almeida, João; Amorim, Antonio; Breitenlechner, Martin; Downard, Andrew J; Dunne, Eimear M; Flagan, Richard C; Kajos, Maija; Keskinen, Helmi; Kirkby, Jasper; Kupc, Agnieszka; Kürten, Andreas; Kurtén, Theo; Laaksonen, Ari; Mathot, Serge; Onnela, Antti; Praplan, Arnaud P; Rondo, Linda; Santos, Filipe D; Schallhart, Simon; Schnitzhofer, Ralf; Sipilä, Mikko; Tomé, António; Tsagkogeorgas, Georgios; Vehkamäki, Hanna; Wimmer, Daniela; Baltensperger, Urs; Carslaw, Kenneth S; Curtius, Joachim; Hansel, Armin; Petäjä, Tuukka; Kulmala, Markku; Donahue, Neil M; Worsnop, Douglas R

    2013-01-01

    Atmospheric aerosols formed by nucleation of vapors affect radiative forcing and therefore climate. However, the underlying mechanisms of nucleation remain unclear, particularly the involvement of organic compounds. Here, we present high-resolution mass spectra of ion clusters observed during new particle formation experiments performed at the Cosmics Leaving Outdoor Droplets chamber at the European Organization for Nuclear Research. The experiments involved sulfuric acid vapor and different stabilizing species, including ammonia and dimethylamine, as well as oxidation products of pinanediol, a surrogate for organic vapors formed from monoterpenes. A striking resemblance is revealed between the mass spectra from the chamber experiments with oxidized organics and ambient data obtained during new particle formation events at the Hyytiälä boreal forest research station. We observe that large oxidized organic compounds, arising from the oxidation of monoterpenes, cluster directly with single sulfuric acid molec...

  10. Control analysis as a tool to understand the formation of the las operon in Lactococcus lactis

    DEFF Research Database (Denmark)

    Købmann, Brian Jensen; Solem, Christian; Jensen, Peter Ruhdal

    2005-01-01

    control on glycolysis and growth rate but high negative control on formate production. We find that PFK and PK have zero control on glycolysis and growth rate at the wildtype enzyme level but both enzymes exert strong positive control on the glycolytic flux at reduced activities. PK has high positive...... coefficient increased towards 3. Increased las expression resulted in a slight decrease in the glycolytic flux. At the wildtype level the control was close to zero on both glycolysis and the pyruvate branches. The sum of control coefficients for the three enzymes individually was comparable to the control...... coefficient found for the entire operon; the strong positive control by PK almost cancels out the negative control by LDH on formate production. The analysis suggests that co-regulation of PFK and PK provides a very efficient way to regulate glycolysis, and co-regulating PK and LDH allows the cells...

  11. Population I Cepheids and understanding star formation history of the Small Magellanic Cloud

    International Nuclear Information System (INIS)

    Joshi, Yogesh Chandra; Joshi, Santosh; Mohanty, Auro Prasad

    2016-01-01

    In this paper, we study the age and spatial distributions of Cepheids in the Small Magellanic Cloud (SMC) as a function of their ages using data from the OGLE III photometric catalogue. A period - age relation derived for Classical Cepheids in the Large Magellanic Cloud (LMC) has been used to find the ages of Cepheids. The age distribution of the SMC Classical Cepheids is found to have a peak at log(Age) = 8.40 ± 0.10 which suggests that a major star formation event might have occurred in the SMC about 250 ± 50 Myr ago. It is believed that this star forming burst had been triggered by close interactions of the SMC with the LMC and/or the Milky Way. A comparison of the observed spatial distributions of the Cepheids and open star clusters has also been carried out to study the star formation scenario in the SMC. (paper)

  12. UNDERSTANDING COMPACT OBJECT FORMATION AND NATAL KICKS. II. THE CASE OF XTE J1118 + 480

    International Nuclear Information System (INIS)

    Fragos, T.; Willems, B.; Kalogera, V.; Ivanova, N.; Rockefeller, G.; Fryer, C. L.; Young, P. A.

    2009-01-01

    In recent years, an increasing number of proper motions have been measured for Galactic X-ray binaries. When supplemented with accurate determinations of the component masses, orbital period, and donor effective temperature, these kinematical constraints harbor a wealth of information on the system's past evolution. Here, we consider all this available information to reconstruct the full evolutionary history of the black hole X-ray binary XTE J1118 + 480, assuming that the system originated in the Galactic disk and the donor has solar metallicity. This analysis accounts for four evolutionary phases: mass transfer through the ongoing X-ray phase, tidal evolution before the onset of Roche lobe overflow, motion through the Galactic potential after the formation of the black hole, and binary orbital dynamics due to explosive mass loss and possibly a black hole natal kick at the time of core collapse. We find that right after black hole formation, the system consists of a ≅6.0-10.0 M sun black hole and a ≅1.0-1.6 M sun main-sequence star. We also find that that an asymmetric natal kick is not only plausible but required for the formation of this system, and derive a lower and upper limit on the black hole natal kick velocity magnitude of 80 km s -1 and 310 km s -1 , respectively.

  13. Understanding perovskite formation through the intramolecular exchange method in ambient conditions

    Science.gov (United States)

    Szostak, Rodrigo; Castro, Jhon A. P.; Marques, Adriano S.; Nogueira, Ana F.

    2017-04-01

    Among the methods to prepare hybrid organic-inorganic perovskite films, the intramolecular exchange method was the first one that made possible to prepare perovskite solar cells with efficiencies higher than 20%. However, perovskite formation by this method is not completely understood, especially in ambient conditions. In this work, perovskite films were prepared by the intramolecular exchange method in ambient conditions. The spin coating speed and the frequency of the MAI solution dripping onto PbI2(DMSO) were varied during the deposition steps. With the combination of these two parameters, a rigid control of the solvent drying was possible. Thus, depending on the chosen conditions, the intermediate MAPb3I8·2DMSO was formed with residual PbI2. Otherwise, direct formation of perovskite film was attained. A mechanism for the direct formation of bulk perovskite was proposed. We also investigated how the posterior thermal annealing affects the crystallinity and defects in perovskite films. With prolonged thermal annealing, the excess of MAI can be avoided, increasing the efficiency and decreasing the hysteresis of the solar cells. The best perovskite solar cell achieved a stabilized power output of 12.9%. The findings of this work pave the way for realizing the fabrication of efficient perovskite solar cells in ambient atmosphere, a very desirable condition for cost-efficient large scale manufacturing of this technology.

  14. How relevant are assembled equilibrium samples in understanding structure formation during lipid digestion?

    Science.gov (United States)

    Phan, Stephanie; Salentinig, Stefan; Hawley, Adrian; Boyd, Ben J

    2015-10-01

    Lipid-based formulations are gaining interest for use as drug delivery systems for poorly water-soluble drug compounds. During digestion, the lipolysis products self-assemble with endogenous surfactants in the gastrointestinal tract to form colloidal structures, enabling enhanced drug solubilisation. Although earlier studies in the literature focus on assembled equilibrium systems, little is known about structure formation under dynamic lipolysis conditions. The purpose of this study was to investigate the likely colloidal structure formation in the small intestine after the ingestion of lipids, under equilibrium and dynamic conditions. The structural aspects were studied using small angle X-ray scattering and dynamic light scattering, and were found to depend on lipid composition, lipid chain length, prandial state and emulsification. Incorporation of phospholipids and lipolysis products into bile salt micelles resulted in swelling of the structure. At insufficient bile salt concentrations, a co-existing lamellar phase was observed, due to a reduction in the solubilisation capacity for lipolysis products. Emulsification accelerated the rate of lipolysis and structure formation. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. Understanding the formation process of exceptionally long fullerene-based nanowires

    DEFF Research Database (Denmark)

    Solov'yov, Ilia; Geng, Junfeng; Solov'yov, Andrey V.

    2009-01-01

    solution of C$_60$. We have performed a thorough theoretical analysis, aiming at gaining an in-depth understanding of the exceptionally large aspect ratio of C$_60$-based nanowires. By accounting for different interactions in the system we have calculated the structures of the unit cell and determined...... the role of the fullerene and of the solvent molecules in the crystallization process of the nanowires. We have calculated the adhesion energy of C$_60$ molecules to the nanowire surface, and on the basis of this explained the growth anisotropy of the crystal. To get a more profound understanding...

  16. Higher-level processes in the formation and application of associations during action understanding

    NARCIS (Netherlands)

    Heil, L.; Pelt, S. van; Kwisthout, J.H.P.; Rooij, I.J.E.I. van; Bekkering, H.

    2014-01-01

    The associative account described in the target article provides a viable explanation for the origin of mirror neurons. We argue here that if mirror neurons develop purely by associative learning, then they cannot by themselves explain intentional action understanding. Higher-level processes seem to

  17. Understanding hydride formation in Zr-1Nb alloy through microstructural characterization

    International Nuclear Information System (INIS)

    Neogy, S.; Srivastava, D.; Tewari, R.; Singh, R.N.; Dey, G.K.; De, P.K.; Banerjee, S.

    2003-07-01

    In this study the experimental results of hydride formation and their microstructure evolution in Zr-1Nb alloy is presented. This Zr-1Nb binary alloy and other Zr-1 Nb based ternary and quaternary alloys are being used as fuel tube materials and have the potential for meeting the requirement of high burn up fuel. Hydriding of Zr-1Nb alloy having a microstructure comprising equiaxed α grains and a uniform distribution of spherical particles of the β phase has been carried out in this study. The specimens have been hydrided by gaseous charging method to different hydrogen levels. The microstructures of hydrided samples were examined as a function of hydrogen content. The formation of δ hydride in slow cooled specimens and formation of γ hydride in rapidly cooled specimens has been studied with their morphology, habit plane and orientation relationship with the α matrix in view. The habit planes of either type of hydride phase has been determined and compared with those observed in other Zr-Nb alloys. The orientation relationship between the α matrix and the δ hydride was found to be the following: (0001) α // (111) δ and [1120] α // [110] δ . The orientation relationship between the α matrix and the γ hydride was of the following type: (0001) α // (111) γ and [1120] α // [110] γ . The internal structure of both types of hydride has been examined. The effect of the presence of the spherical β phase particles in the a matrix on the growth of the hydride plates has been investigated. (author)

  18. Using Laboratory Methods to Better Understand Refractory Cloud Formation in Exoplanet Atmospheres

    Science.gov (United States)

    Kohler, E.; Ferguson, F.

    2017-12-01

    The high number of extrasolar planets found in recent years has brought a new importance to planetary atmospheres. These recently discovered planets show a large diversity in their masses, temperatures, orbital periods, and other properties. With such a diverse mix of planetary parameters, it is safe to assume that the atmospheric properties are just as varied. Recent literature suggests silicates and metals as possible condensates in extrasolar planetary atmospheres as well as the atmospheres of brown dwarfs. While theoretical studies have laid the foundation of cloud formation analysis, their findings still need to be validated via experiments. A verification of the condensation and vaporization predictions of refractory materials needs to be found in order to assist global circulation models in being as accurate as possible. The stability of minerals identified in the literature as potential candidates, will be tested in a thermogravimetric balance. The minerals will be pumped under vacuum for twenty-four hours under room temperature and then heated to a predetermined high temperature, dependent on the expected vaporization temperature of that sample. If there is apparent mass loss, then the temperature will be lowered at preset durations and mass measurements will be taken in similar measured increments. The data will be processed by a computer program in order to calculate the mass loss as a function of temperature. The current cloud formation and global circulation models are very important to the field of planetary science but their accuracy is hindered by the lack of experimental data. The aim of this work is to investigate the mineral stability of potential condensates in an effort to explain the formation of refractory clouds in the atmospheres of extrasolar planets and brown dwarfs.

  19. Observational Corollaries of Proto-AGN: Understanding Formation of Supermassive Black Hole Seeds

    Science.gov (United States)

    Shlosman, Isaac

    2016-10-01

    Formation of supermassive black holes (SMBHs) is still an enigma. Recent detections of high-z quasars which harbor massive SMBHs provide a challenge to models of structure buildup in the universe. Main alternatives for the formation of SMBH seeds are (1) remnants of Population III stars, and (2) a direct baryonic collapse within dark matter (DM) halos of 10^8 Mo -- first halos whose virial temperature exceeds 10^4 K, and which can lead to the formation of proto-AGN -- luminous pre-SMBH objects. Potentially, this can involve both high-z objects as well as low-z dwarf galaxies in voids. We focus on the direct collapse in 10^8 Mo halos which circumvents the pitfalls of Pop III remnants. The collapse can proceed via a radiation pressure-supported quasistar -- with a modified blackbody continuum. Such a configuration requires a very efficient angular momentum transfer. Or, it can form a thick, differentially rotating, self-gravitating disk, which is associated with an X-ray-infrared continuum and Seyfert-level luminosity, anisotropic emission, massive bi-conical outflows, and will be a powerful source of the Ly-alpha emission. We propose to perform radiative transfer in the continuum and hydrogen lines (e.g., Lyman and Balmer), using our models of proto-AGN, and do it on-the-fly -- concurrently with the collapse. We shall test the path to quasistellar and disky proto-AGN, produce first synthetic spectra of proto-AGN, and address the issue of feasibility of their detection by the JWST. Finally, we shall develop the strategy of searching for these objects at high- and low-z, based on the specific features in the spectra and associated variability.

  20. Simulated consultations: a sociolinguistic perspective.

    Science.gov (United States)

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

    2016-01-15

    consultation both expect and reward a particular interactional style. Whilst simulation undoubtedly has a place in formative learning for professional communication, the simulated consultation may distort assessment of professional communication These sociolinguistic findings contribute to the on-going critique of simulations in high-stakes assessments and indicate that further research, which steps outside psychometric approaches, is necessary.

  1. 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.

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

    International Nuclear Information System (INIS)

    Harris, R.; Paterson, A.

    2016-01-01

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

  3. The contribution of tracers in understanding transportation processes in indurated argillaceous formations

    International Nuclear Information System (INIS)

    Savoye, Sebastien

    2008-01-01

    In a first part, the author recalls briefly the properties of the two argillaceous formations studied in this HDR report: the Toarcian/Domerian argillite and the Opalinus clay of Mont Terri. At first, have been described the two undamaged argillite materials and then the damaged Tournemire argillite. The second part gives the results obtained from the researches on the undamaged rock with natural tracers and with approaches using artificial tracers. The third part deals with the study of the damaged rock in separating natural perturbations of those of anthropogenic origin. At last, the conclusion gives the guiding thema of this research work and the main long-term future prospects that may result. (O.M.)

  4. Towards an understanding of the propensity for crystalline hydrate formation by molecular compounds

    Directory of Open Access Journals (Sweden)

    Alankriti Bajpai

    2016-11-01

    Full Text Available Hydrates are technologically important and ubiquitous yet they remain a poorly understood and understudied class of molecular crystals. In this work, we attempt to rationalize propensity towards hydrate formation through crystallization studies of molecules that lack strong hydrogen-bond donor groups. A Cambridge Structural Database (CSD survey indicates that the statistical occurrence of hydrates in 124 molecules that contain five- and six-membered N-heterocyclic aromatic moieties is 18.5%. However, hydrate screening experiments on a library of 11 N-heterocyclic aromatic compounds with at least two acceptor moieties and no competing hydrogen-bond donors or acceptors reveals that over 70% of this group form hydrates, suggesting that extrapolation from CSD statistics might, at least in some cases, be deceiving. Slurrying in water and exposure to humidity were found to be the most effective discovery methods. Electrostatic potential maps and/or analysis of the crystal packing in anhydrate structures was used to rationalize why certain molecules did not readily form hydrates.

  5. Formation, function, and exhaustion of notochordal cytoplasmic vacuoles within intervertebral disc: current understanding and speculation

    Science.gov (United States)

    Sinkemani, Arjun; Xie, Zhi-Yang; Shi, Rui; Wei, Ji-Nan; Wu, Xiao-Tao

    2017-01-01

    Notochord nucleus pulposus cells are characteristic of containing abundant and giant cytoplasmic vacuoles. This review explores the embryonic formation, biological function, and postnatal exhaustion of notochord vacuoles, aiming to characterize the signal network transforming the vacuolated nucleus pulposus cells into the vacuole-less chondrocytic cells. Embryonically, the cytoplasmic vacuoles within vertebrate notochord originate from an evolutionarily conserved vacuolation process during neurulation, which may continue to provide mechanical and signal support in constructing a mammalian intervertebral disc. For full vacuolation, a vacuolating specification from dorsal organizer cells, synchronized convergent extension, well-structured notochord sheath, and sufficient post-Golgi trafficking in notochord cells are required. Postnatally, age-related and species-specific exhaustion of vacuolated nucleus pulposus cells could be potentiated by Fas- and Fas ligand-induced apoptosis, intolerance to mechanical stress and nutrient deficiency, vacuole-mediated proliferation check, and gradual de-vacuolation within the avascular and compression-loaded intervertebral disc. These results suggest that the notochord vacuoles are active and versatile organelles for both embryonic notochord and postnatal nucleus pulposus, and may provide novel information on intervertebral disc degeneration to guide cell-based regeneration. PMID:28915712

  6. A contribution to the understanding of the high burn-up structure formation in nuclear fuels

    International Nuclear Information System (INIS)

    Jonnet, J.

    2007-01-01

    An increase of the discharge burn-up of UO 2 nuclear fuels in the light water reactors results in the appearance of a change of microscopic structure, called HBS. Although well characterised experimentally, important points on the mechanisms of its formation remain to be cleared up. In order to answer these questions, a study of the contribution of the dislocation-type defects was conducted. In a first part, a calculation method of the stress field associated with periodic configurations of dislocations was developed. The method was applied to the cases of edge dislocation pile-up and wall, for which an explicit expression of the internal stress potential was obtained. Through the study of other examples of dislocation configurations, it was highlighted that this method also allows the calculation of any periodic dislocation configuration. In a second part, the evolution of interstitial-type dislocation loops was studied in UO 2 fuel samples doped with 10% in mass of alpha emitters. The experimental loop size distributions were obtained for these samples stored during 4 and 7 years at room temperature. Kinetic equations are proposed in order to study the influence of the resolution process of interstitials from a loop back to the matrix due to an impact with the recoil atom 234 U, as well as the coalescence of two interstitial loops that can diffuse by a volume mechanism. The application of the model shows that the two processes must be considered in the study of the evolution of radiation damage. (author)

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

    Science.gov (United States)

    Stager, Sue; Green, Kathy

    1988-01-01

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

  8. Making comparative performance information more comprehensible: an experimental evaluation of the impact of formats on consumer understanding.

    Science.gov (United States)

    Damman, Olga C; De Jong, Anco; Hibbard, Judith H; Timmermans, Danielle R M

    2016-11-01

    We aimed to investigate how different presentation formats influence comprehension and use of comparative performance information (CPI) among consumers. An experimental between-subjects and within-subjects design with manipulations of CPI presentation formats. We enrolled both consumers with lower socioeconomic status (SES)/cognitive skills and consumers with higher SES/cognitive skills, recruited through an online access panel. Respondents received fictitious CPI and completed questions about interpretation and information use. Between subjects, we tested (1) displaying an overall performance score (yes/no); (2) displaying a small number of quality indicators (5 vs 9); and (3) displaying different types of evaluative symbols (star ratings, coloured dots and word icons vs numbers and bar graphs). Within subjects, we tested the effect of a reduced number of healthcare providers (5 vs 20). Data were analysed using descriptive analysis, analyses of variance and paired-sampled t tests. A total of 902 (43%) respondents participated. Displaying an overall performance score and the use of coloured dots and word icons particularly enhanced consumer understanding. Importantly, respondents provided with coloured dots most often correctly selected the top three healthcare providers (84.3%), compared with word icons (76.6% correct), star ratings (70.6% correct), numbers (62.0%) and bars (54.2%) when viewing performance scores of 20 providers. Furthermore, a reduced number of healthcare providers appeared to support consumers, for example, when provided with 20 providers, 69.5% correctly selected the top three, compared with 80.2% with five providers. Particular presentation formats enhanced consumer understanding of CPI, most importantly the use of overall performance scores, word icons and coloured dots, and a reduced number of providers displayed. Public report efforts should use these formats to maximise impact on consumers. Published by the BMJ Publishing Group Limited

  9. The impact of Einstein observations on our understanding of low mass star formation

    International Nuclear Information System (INIS)

    Walter, F.M.

    1990-01-01

    Prior to 1980, the world of pre-main sequence stars, if not well understood, was at least well defined. The Herbig and Rao (1972) catalog listed 69 pre-main sequence stars in Tau-Aur, with the vast majority clearly being T Tauri stars. The characteristics of the classical T Tauri stars include strong Hα emission, with W λ (Hα)>5-10A; forbidden line emission; continuum ultraviolet and IR excesses; veiling of the absorption line spectrum; significant stellar variability; Li I λ6707A absorption; and association with dark clouds and/or emission nebulosities. Star forming regions were observed extensively with the Einstein Observatory, and showed the abundance of stellar X-ray sources in the Orion Nebula. About 1/3 of the known T Tauri stars were detected as X-ray sources, yet the vast majority of the X-ray sources detected were coincident with anonymous stars not suspected to be pre-main sequence stars. In the grand tradition of X-ray astronomy, X-ray astronomers trooped to telescopes to identify the optical counterparts. It was shown that 5 of the counterparts were K7-M0 stars, above the main sequence, with strong Li I absorption and that these stars were kinematic members of the Tau-Aur star formation complex. Since then, additional members of this class of naked T Tauri Stars (NTTS) have been studied, and charts provided for X-ray selected pre-main sequence star candidates in the general vicinity of Tau-Aur. Thirty five X-ray sources have been selected and optically confirmed as NTTS in Tau-Aur

  10. 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.

  11. 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.

  12. The role of mathematical models in understanding pattern formation in developmental biology.

    Science.gov (United States)

    Umulis, David M; Othmer, Hans G

    2015-05-01

    In a Wall Street Journal article published on April 5, 2013, E. O. Wilson attempted to make the case that biologists do not really need to learn any mathematics-whenever they run into difficulty with numerical issues, they can find a technician (aka mathematician) to help them out of their difficulty. He formalizes this in Wilsons Principle No. 1: "It is far easier for scientists to acquire needed collaboration from mathematicians and statisticians than it is for mathematicians and statisticians to find scientists able to make use of their equations." This reflects a complete misunderstanding of the role of mathematics in all sciences throughout history. To Wilson, mathematics is mere number crunching, but as Galileo said long ago, "The laws of Nature are written in the language of mathematics[Formula: see text] the symbols are triangles, circles and other geometrical figures, without whose help it is impossible to comprehend a single word." Mathematics has moved beyond the geometry-based model of Galileo's time, and in a rebuttal to Wilson, E. Frenkel has pointed out the role of mathematics in synthesizing the general principles in science (Both point and counter-point are available in Wilson and Frenkel in Notices Am Math Soc 60(7):837-838, 2013). We will take this a step further and show how mathematics has been used to make new and experimentally verified discoveries in developmental biology and how mathematics is essential for understanding a problem that has puzzled experimentalists for decades-that of how organisms can scale in size. Mathematical analysis alone cannot "solve" these problems since the validation lies at the molecular level, but conversely, a growing number of questions in biology cannot be solved without mathematical analysis and modeling. Herein, we discuss a few examples of the productive intercourse between mathematics and biology.

  13. Entropic effects in formation of chromosome territories: towards understanding of radiation-induced gene translocation frequency

    Science.gov (United States)

    Gudowska-Nowak, Ewa; Ritter, Sylvia; Durante, Marco; Deperas-Standylo, Joanna; Ciesla, Michal

    2012-07-01

    A detailed understanding of structural organization of biological target, such as geometry of an inter-phase chromosome, is an essential prerequisite for gaining deeper insight into relationship between radiation track structure and radiation-induced biological damage [1]. In particular, coupling of biophysical models aimed to describe architecture of chromosomes and their positioning in a cell nucleus [2-4] with models of local distribution of ionizations caused by passing projectiles, are expected to result in more accurate estimates of aberration induction caused by radiation. There is abundant experimental evidence indicating that arrangements of chromosomes in eukaryotic cell nucleus is non-random and has been evolutionary conserved in specific cell types. Moreover, the radial position of a given chromosome territory (CT) within the cell nucleus has been shown to correlate with its size and gene density. Usually it is assumed that chromosomal geometry and positioning result from the action of specific forces acting locally, such as hydrogen bonds, electrostatic, Van der Waals or hydrophobic interactions operating between nucleosomes and within their interiors. However, it is both desirable and instructive to learn to what extend organization of inter-phase chromosomes is affected by nonspecific entropic forces. In this study we report results of a coarse-grained analysis of a chromatin structure modeled by two distinct approaches. In the first method, we adhere to purely statistical analysis of chromatin packing within a chromosome territory. On the basis of the polymer theory, the chromatin fiber of diameter 30nm is approximated by a chain of spheres, each corresponding to about 30 kbp. Random positioning of the center of the domain is repeated for 1000 spherical nuclei. Configuration of the domain is determined by a random packing of a polymer (a string of identical beads) in estimated fraction of space occupied by a chromosome of a given length and mass

  14. Nuclear planetology: understanding planetary mantle and crust formation in the light of nuclear and particle physics

    Science.gov (United States)

    Roller, Goetz

    2017-04-01

    The Hertzsprung-Russell (HR) diagram is one of the most important diagrams in astronomy. In a HR diagram, the luminosity of stars and/or stellar remnants (white dwarf stars, WD's), relative to the luminosity of the sun, is plotted versus their surface temperatures (Teff). The Earth shows a striking similarity in size (radius ≈ 6.371 km) and Teff of its outer core surface (Teff ≈ 3800 K at the core-mantle-boundary) with old WD's (radius ≈ 6.300 km) like WD0346+246 (Teff ≈ 3820 K after ≈ 12.7 Ga [1]), which plot in the HR diagram close to the low-mass extension of the stellar population or main sequence. In the light of nuclear planetology [2], Earth-like planets are regarded as old, down-cooled and differentiated black dwarfs (Fe-C BLD's) after massive decompression, the most important nuclear reactions involved being 56Fe(γ,α)52Cr (etc.), possibly responsible for extreme terrestrial glaciations events ("snowball" Earth), together with (γ,n), (γ,p) and fusion reactions like 12C(α,γ)16O. The latter reaction might have caused oxidation of the planet from inside out. Nuclear planetology is a new research field, tightly constrained by a coupled 187Re-232Th-238U systematics [3-5]. By means of nuclear/quantum physics and taking the theory of relativity into account, it aims at understanding the thermal and chemical evolution of Fe-C BLD's after gravitational contraction (e.g. Mercury) or Fermi-pressure controlled collapse (e.g. Earth) events after massive decompression, leading possibly to an r-process event, towards the end of their cooling period [2]. So far and based upon 187Re-232Th-238U nuclear geochronometry, the Fe-C BLD hypothesis can successfully explain the global terrestrial MORB 232Th/238U signature [5]. Thus, it may help to elucidate the DM (depleted mantle), EMI (enriched mantle 1), EMII (enriched mantle 2) or HIMU (high U/Pb) reservoirs [6], and the 187Os/188Os isotopic dichotomy in Archean magmatic rocks and sediments [7]. Here I present a

  15. A randomized comparison of patients' understanding of number needed to treat and other common risk reduction formats.

    Science.gov (United States)

    Sheridan, Stacey L; Pignone, Michael P; Lewis, Carmen L

    2003-11-01

    Commentators have suggested that patients may understand quantitative information about treatment benefits better when they are presented as numbers needed to treat (NNT) rather than as absolute or relative risk reductions. To determine whether NNT helps patients interpret treatment benefits better than absolute risk reduction (ARR), relative risk reduction (RRR), or a combination of all three of these risk reduction presentations (COMBO). Randomized cross-sectional survey. University internal medicine clinic. Three hundred fifty-seven men and women, ages 50 to 80, who presented for health care. Subjects were given written information about the baseline risk of a hypothetical "disease Y" and were asked (1) to compare the benefits of two drug treatments for disease Y, stating which provided more benefit; and (2) to calculate the effect of one of those drug treatments on a given baseline risk of disease. Risk information was presented to each subject in one of four randomly allocated risk formats: NNT, ARR, RRR, or COMBO. When asked to state which of two treatments provided more benefit, subjects who received the RRR format responded correctly most often (60% correct vs 43% for COMBO, 42% for ARR, and 30% for NNT, P =.001). Most subjects were unable to calculate the effect of drug treatment on the given baseline risk of disease, although subjects receiving the RRR and ARR formats responded correctly more often (21% and 17% compared to 7% for COMBO and 6% for NNT, P =.004). Patients are best able to interpret the benefits of treatment when they are presented in an RRR format with a given baseline risk of disease. ARR also is easily interpreted. NNT is often misinterpreted by patients and should not be used alone to communicate risk to patients.

  16. Nice to know you: Positive emotions, self-other overlap, and complex understanding in the formation of a new relationship.

    Science.gov (United States)

    Waugh, Christian E; Fredrickson, Barbara L

    2006-04-01

    Based on Fredrickson's ((1998). What good are positive emotions? Review of General Psychology, 2, 300-319.; (2001). The role of positive emotions in positive psychology: The broaden-and-build theory of positive emotions. American Psychologist, 56, 218-226) broaden-and-build theory and Aron and Aron's ((1986). Love as expansion of the self: Understanding attraction and satisfaction. New York: Hemisphere) self-expansion theory, it was hypothesized that positive emotions broaden people's feelings of self-other overlap in the beginning of a new relationship. In a prospective study of first-year college students, we found that, after 1 week in college, positive emotions predicted increased self-other overlap with new roommates, which in turn predicted a more complex understanding of the roommate. In addition, participants who experienced a high ratio of positive to negative emotions throughout the first month of college reported a greater increase in self-other overlap and complex understanding than participants with a low positivity ratio. Implications for the role of positive emotions in the formation of new relationships are discussed.

  17. Nice to know you: Positive emotions, self–other overlap, and complex understanding in the formation of a new relationship

    Science.gov (United States)

    WAUGH, CHRISTIAN E.; FREDRICKSON, BARBARA L.

    2007-01-01

    Based on Fredrickson's ((1998). What good are positive emotions? Review of General Psychology, 2, 300–319.; (2001). The role of positive emotions in positive psychology: The broaden-and-build theory of positive emotions. American Psychologist, 56, 218–226) broaden-and-build theory and Aron and Aron's ((1986). Love as expansion of the self: Understanding attraction and satisfaction. New York: Hemisphere) self-expansion theory, it was hypothesized that positive emotions broaden people's feelings of self–other overlap in the beginning of a new relationship. In a prospective study of first-year college students, we found that, after 1 week in college, positive emotions predicted increased self–other overlap with new roommates, which in turn predicted a more complex understanding of the roommate. In addition, participants who experienced a high ratio of positive to negative emotions throughout the first month of college reported a greater increase in self–other overlap and complex understanding than participants with a low positivity ratio. Implications for the role of positive emotions in the formation of new relationships are discussed. PMID:21691460

  18. A multiscale modelling approach to understand atherosclerosis formation: A patient-specific case study in the aortic bifurcation

    Science.gov (United States)

    Alimohammadi, Mona; Pichardo-Almarza, Cesar; Agu, Obiekezie; Díaz-Zuccarini, Vanessa

    2017-01-01

    Atherogenesis, the formation of plaques in the wall of blood vessels, starts as a result of lipid accumulation (low-density lipoprotein cholesterol) in the vessel wall. Such accumulation is related to the site of endothelial mechanotransduction, the endothelial response to mechanical stimuli and haemodynamics, which determines biochemical processes regulating the vessel wall permeability. This interaction between biomechanical and biochemical phenomena is complex, spanning different biological scales and is patient-specific, requiring tools able to capture such mathematical and biological complexity in a unified framework. Mathematical models offer an elegant and efficient way of doing this, by taking into account multifactorial and multiscale processes and mechanisms, in order to capture the fundamentals of plaque formation in individual patients. In this study, a mathematical model to understand plaque and calcification locations is presented: this model provides a strong interpretability and physical meaning through a multiscale, complex index or metric (the penetration site of low-density lipoprotein cholesterol, expressed as volumetric flux). Computed tomography scans of the aortic bifurcation and iliac arteries are analysed and compared with the results of the multifactorial model. The results indicate that the model shows potential to predict the majority of the plaque locations, also not predicting regions where plaques are absent. The promising results from this case study provide a proof of concept that can be applied to a larger patient population. PMID:28427316

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

    Science.gov (United States)

    2010-09-03

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

  1. Understanding the Formation of Kinetically Stable Compounds and the Development of Thin Film Pair Distribution Function Analysis

    Science.gov (United States)

    Wood, Suzannah Rebecca

    Navigating the synthesis landscape poses many challenges when developing novel solid state materials. Advancements in both synthesis and characterization are necessary to facilitate the targeting of specific materials. This dissertation discusses the formation of chalcogenide heterostructures and their properties in the first part and the development of thin film pair distribution function analysis (tfPDF) in the second part. The heterostructures were formed by the self-assembly of designed precursors deposited by physical vapor deposition in a modulated elemental reactants approach, which provides the control and predictability to synthesis. Specifically, a series of (BiSe)1+delta(TiSe2) n, where n = 2,3,&4, were synthesized to explore the extent of charge transfer from the BiSe to TiSe2 layers. To further explore the role Bi plays in charge donation, a family of structurally similar compounds, (Bix Sn1-xSe)1+deltaTiSe2, where 0≥x≥1, were synthesized and characterized. Electrical measurements show doping efficiency decreases as x increases, correlated with the structural distortion and the formation of periodic antiphase boundaries containing Bi-Bi pairs. The first heterostructures composed of three unique structural types were synthesized and Bi2Se3 layer thickness was used to tune electrical properties and further explore charge transfer. To better understand the potential energy landscape on which these kinetically stable compounds exist, two investigations were undertaken. The first was a study of the formation and subsequent decomposition of [(BiSe)1+delta]n(TiSe2)n compounds, where n= 2&3, the second an investigation of precursor structure for thermodynamically stable FeSb2 and kinetically stable FeSb3. The second section describes the development of thin film pair distribution function analysis, a technique in which total scattering data for pair distribution function (PDF) analysis is obtained from thin films, suitable for local structure analysis

  2. Using quantitative magnetic resonance methods to understand better the gel-layer formation on polymer-matrix tablets.

    Science.gov (United States)

    Mikac, Urša; Kristl, Julijana; Baumgartner, Saša

    2011-05-01

    Magnetic resonance imaging is a powerful, non-invasive technique that can help improve our understanding of the hydrogel layer formed on swellable, polymer-matrix tablets, as well as the layer's properties and its influence on drug release. In this paper, the authors review the NMR and MRI investigations of hydrophilic, swellable polymers published since 1994. The review covers NMR studies on the properties of water and drugs within hydrated polymers. In addition, MRI studies using techniques for determining the different moving-front positions within the swollen tablets, the polymer concentration profiles across them, the influence of the incorporated drug, and so on, are presented. Some complementary methods are also briefly presented and discussed. Using MRI, the formation of a hydrogel along with simultaneous determination of the drug's position within it can be observed non-invasively. However, the MRI parameters can influence the signal's intensity and therefore they need to be considered carefully in order to prevent any misinterpretation of the results. MRI makes possible an in situ investigation of swollen-matrix tablets and provides valuable information that can lead, when combined with other techniques, to a better understanding of polymeric systems and a more effective development of optimal dosage forms.

  3. Understanding Oxygen Vacancy Formation, Interaction, Transport, and Strain in SOFC Components via Combined Thermodynamics and First Principles Calculations

    Science.gov (United States)

    Das, Tridip

    Understanding of the vacancy formation, interaction, increasing its concentration and diffusion, and controlling its chemical strain will advance the design of mixed ionic and electronic conductor (MIEC) materials via element doping and strain engineering. This is especially central to improve the performance of the solid oxide fuel cell (SOFC), an energy conversion device for sustainable future. The oxygen vacancy concentration grows exponentially with the temperature at dilute vacancy concentration but not at higher concentration, or even decreases due to oxygen vacancy interaction and vacancy ordered phase change. This limits the ionic conductivity. Using density functional theory (DFT), we provided fundamental understanding on how oxygen vacancy interaction originates in one of the typical MIEC, La1-xSrxFeO3-delta (LSF). The vacancy interaction is determined by the interplay of the charge state of multi-valence ion (Fe), aliovalent doping (La/Sr ratio), the crystal structure, and the oxygen vacancy concentration and/or nonstoichiometry (delta). It was found excess electrons left due to the formation of a neutral oxygen vacancy get distributed to Fe directly connected to the vacancy or to the second nearest neighboring Fe, based on crystal field splitting of Fe 3d orbital in different Fe-O polyhedral coordination. The progressively larger polaron size and anisotropic shape changes with increasing Sr-content resulted in increasing oxygen vacancy interactions, as indicated by an increase in the oxygen vacancy formation energy above a critical delta threshold. This was consistent with experimental results showing that Sr-rich LSF and highly oxygen deficient compositions are prone to oxygen-vacancy-ordering-induced phase transformations, while Sr-poor and oxygen-rich LSF compositions are not. Since oxygen vacancy induced phase transformations, cause a decrease in the mobile oxygen vacancy site fraction (X), both delta and X were predicted as a function of

  4. Preparation + consultation = better regulation

    International Nuclear Information System (INIS)

    Bines, W.

    2001-01-01

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

  5. Tutoring Mentoring Peer Consulting

    OpenAIRE

    Szczyrba, Birgit; Wildt, Johannes

    2006-01-01

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

  6. "Systematizing" ethics consultation services.

    Science.gov (United States)

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

    2015-03-01

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

  7. Malpractice and the Communication Consultant: A Proactive Approach.

    Science.gov (United States)

    Montgomery, Daniel J.; And Others

    1995-01-01

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

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

    NARCIS (Netherlands)

    Heusinkveld, S.; Visscher, Klaasjan

    2012-01-01

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

  9. Working with boundaries in systems psychodynamic consulting

    Directory of Open Access Journals (Sweden)

    Henk Struwig

    2012-03-01

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

  10. On the Magnitude and Orientation of Stress during Shock Metamorphism: Understanding Peak Ring Formation by Combining Observations and Models.

    Science.gov (United States)

    Rae, A.; Poelchau, M.; Collins, G. S.; Timms, N.; Cavosie, A. J.; Lofi, J.; Salge, T.; Riller, U. P.; Ferrière, L.; Grieve, R. A. F.; Osinski, G.; Morgan, J. V.; Expedition 364 Science Party, I. I.

    2017-12-01

    Shock metamorphism occurs during the earliest moments after impact. The magnitude and orientation of shock leaves recordable signatures in rocks, which spatially vary across an impact structure. Consequently, observations of shock metamorphism can be used to understand deformation and its history within a shock wave, and to examine subsequent deformation during crater modification. IODP-ICDP Expedition 364 recovered nearly 600 m of shocked target rocks from the peak ring of the Chicxulub Crater. Samples from the expedition were used to measure the magnitude and orientation of shock in peak ring materials, and to determine the mechanism of peak-ring emplacement. Here, we present the results of petrographic analyses of the shocked granitic target rocks of the Chicxulub peak ring; using universal-stage optical microscopy, back-scattered electron images, and electron back-scatter diffraction. Deformation microstructures in quartz include planar deformation features (PDFs), feather features (FFs), which are unique to shock conditions, as well as planar fractures and crystal-plastic deformation bands. The assemblage of PDFs in quartz suggest that the peak-ring rocks experienced shock pressures of 15 GPa throughout the recovered drill core, and that the orientation of FFs are consistent with the present-day orientation of the maximum principal stress direction during shock is close to vertical. Numerical impact simulations of the impact event were run to determine the magnitude and orientation of principal stresses during shock and track those orientations throughout crater formation. Our results are remarkably consistent with the geological data, and accurately predict both the shock-pressure magnitudes, and the final near-vertical orientation of the direction of maximum principal stress in the shock wave. Furthermore, analysis of the state of stress throughout the impact event can be used to constrain the timing of fracture and fault orientations observed in the core

  11. 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.

  12. Understanding the Formation of the Self-Assembly of Colloidal Copper Nanoparticles by Surfactant: A Molecular Velcro

    Directory of Open Access Journals (Sweden)

    Raquel Kely Bortoleto-Bugs

    2013-01-01

    Full Text Available Self-assembly procedure is employed to synthesize colloidal copper nanoparticles (ccNPs with cationic surfactant in an environmentally friendly method. Scanning electron microscopy images provide a clear view of the ccNPs formed having an approximate size of 15 nm. The X-ray diffraction reveals that the ccNPs have the two types of copper oxide as well as the metallic copper. The new procedure shows that the cationic surfactant CTAB plays an important role in the understanding and development of self-assembly. There is a strong relationship between the ccNPs formation with the critical micelle concentration of the CTAB which influences both shape and size. The outcomes allowed the development of a molecular model for the ccNPs synthesis showing that the CTAB monomer on the surface has the function of a molecular velcro making the linkage of ccNPs to form an agglomerate with size around 600 nm. Finally, with the emerging new technologies, the synthesis of copper oxide takes a new perspective for their applicability in diverse integrated areas such as the flexible electronics and energy.

  13. A short review of our current understanding of the development of ring faults during collapse caldera formation

    Directory of Open Access Journals (Sweden)

    Adelina eGeyer

    2014-09-01

    Full Text Available The term collapse caldera refers to those volcanic depressions resulting from the sinking of the chamber roof due to the rapid withdrawal of magma during the course of an eruption. During the last three decades, collapse caldera dynamics has been the focus of attention of numerous, theoretical, numerical and experimental studies. Nonetheless, even if there is a tendency to go for a general and comprehensive caldera dynamics model, some key aspects remain unclear, controversial or completely unsolved. This is the case of ring fault nucleation points and propagation and dip direction. Since direct information on calderas’ deeper structure comes mainly from partially eroded calderas or few witnessed collapses, ring faults layout at depth remains still uncertain. This has generated a strong debate over the detailed internal fault and fracture configuration of a caldera collapse and, in more detail, how ring faults initiate and propagate. We offer here a very short description of the main results obtained by those analogue and theoretical/mathematical models applied to the study of collapse caldera formation. We place special attention on those observations related to the nucleation and propagation of the collapse-controlling ring faults. This summary is relevant to understand the current state-of-the-art of this topic and it should be taken under consideration in future works dealing with collapse caldera dynamics.

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

    International Nuclear Information System (INIS)

    Harris, R.; Paterson, A.

    2016-01-01

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

  15. 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

  16. Coupling an aerosol box model with one-dimensional flow: a tool for understanding observations of new particle formation events

    OpenAIRE

    Kivekäs, N.; Carpman, J.; Roldin, P.; Leppä, J.; O'Connor, E. J.; Kristensson, A.; Asmi, E.

    2016-01-01

    Field observations of new particle formation and the subsequent particle growth are typically only possible at a fixed measurement location, and hence do not follow the temporal evolution of an air parcel in a Lagrangian sense. Standard analysis for determining formation and growth rates requires that the time-dependent formation rate and growth rate of the particles are spatially invariant; air parcel advection means that the observed temporal evolution of the particle size distribution at a...

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

    Directory of Open Access Journals (Sweden)

    Dawn E. Pollon

    2013-01-01

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

  18. Mental Health Consultation Among Ontario's Immigrant Populations.

    Science.gov (United States)

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

    2017-11-16

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

  19. 78 FR 48342 - Consultation Agreements: Proposed Changes to Consultation Procedures

    Science.gov (United States)

    2013-08-08

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

  20. Using 238U/235U ratios to understand the formation and oxidation of reduced uranium solids in naturally reduced zones

    Science.gov (United States)

    Jemison, N.; Johnson, T. M.; Druhan, J. L.; Davis, J. A.

    2016-12-01

    Uranium occurs in groundwater primarily as soluble and mobile U(VI), which can be reduced to immobile U(IV), often observed in sediments as uraninite. Numerous U(VI)-contaminated sites, such as the DOE field site in Rifle, CO, contain naturally reduced zones (NRZ's) that have relatively high concentrations of organic matter. Reduction of heavy metals occurs within NRZ's, producing elevated concentrations of iron sulfides and U(IV). Slow, natural oxidation of U(IV) from NRZ's may prolong U(VI) contamination of groundwater. The reduction of U(VI) produces U(IV) with a higher 238U/235U ratio. Samples from two NRZ sediment cores recovered from the Rifle site revealed that the outer fringes of the NRZ contain U(IV) with a high 238U/235U ratio, while lower values are observed in the center . We suggest that as aqueous U(VI) was reduced in the NRZ, it was driven to lower 238U/235U values, such that U(IV) formed in the core of the NRZ reflects a lower 238U/235U. Two oxidation experiments were conducted by injecting groundwater containing between 14.9 and 21.2 mg/L dissolved O2 as an oxidant into the NRZ. The oxidation of U(IV) from this NRZ increased aqueous U(VI) concentrations and caused a shift to higher 238U/235U in groundwater as U(IV) was oxidized primarily on the outer fringes of the NRZ. In total these observations suggest that the stability of solid phase uranium is governed by coupled reaction and transport processes. To better understand various reactive transport scenarios we developed a model for the formation and oxidation of NRZ's utilizing the reactive transport software CrunchTope. These simulations suggest that the development of isotopically heterogeneous U(IV) within NRZ's is largely controlled by permeability of the NRZ and the U(VI) reduction rate. Oxidation of U(IV) from the NRZ's is constrained by the oxidation rate of U(IV) as well as iron sulfides, which can prevent oxidation of U(IV) by scavenging dissolved oxygen.

  1. 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....

  2. Compensation Consultants and CEO Pay

    NARCIS (Netherlands)

    Kabir, Mohammed Rezaul; Minhat, Marizah

    2014-01-01

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

  3. 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.

  4. Quantification of Release of Critical Elements, Formation of Fly Ash and Aerosols: Status on Current Understanding and Research Needs

    DEFF Research Database (Denmark)

    Jappe Frandsen, Flemming

    2017-01-01

    Deposit formation in utility boilers occurs via a number of consecutive steps; 1) release of critical elements like K, Na, Pb, Zn, S and Cl, 2) formation of gaseous species, fly ash and aerosols, 3) transport and adhesion of ash species, 4) deposit build-up and consolidation, and, finally, 5...... formation (slagging and fouling) on superheater tubes, leading to a potential reduction in heat transfer efficiency to the water/steam cycle, or, to chemical attack (corrosion) or physical wear (erosion) of superheater tubes. These problems may give rise to irregular operation, or even costly shutdowns...... of combustion units.Through several years, high quality research has been conducted on characterization of fuels, ashes and deposit formation in utility boilers fired with coal, biomass and waste fractions. Huge amounts of experimental data have been reported, from such work, but the fact...

  5. The effectiveness of formative assessment with understanding by design (UbD) stages in forming habits of mind in prospective teachers

    Science.gov (United States)

    Gloria, R. Y.; Sudarmin, S.; Wiyanto; Indriyanti, D. R.

    2018-03-01

    Habits of mind are intelligent thinking dispositions that every individual needs to have, and it needs an effort to form them as expected. A behavior can be formed by continuous practice; therefore the student's habits of mind can also be formed and trained. One effort that can be used to encourage the formation of habits of mind is a formative assessment strategy with the stages of UbD (Understanding by Design), and a study needs to be done to prove it. This study aims to determine the contribution of formative assessment to the value of habits of mind owned by prospective teachers. The method used is a quantitative method with a quasi-experimental design. To determine the effectiveness of formative assessment with Ubd stages on the formation of habits of mind, correlation test and regression analysis were conducted in the formative assessment questionnaire consisting of three components, i.e. feed back, peer assessment and self assessment, and habits of mind. The result of the research shows that from the three components of Formative Assessment, only Feedback component does not show correlation to students’ habits of mind (r = 0.323). While peer assessment component (r = 0. 732) and self assessment component (r = 0.625), both indicate correlation. From the regression test the overall component of the formative assessment contributed to the habits of mind at 57.1%. From the result of the research, it can be concluded that the formative assessment with Ubd stages is effective and contributes in forming the student's habits of mind; the formative assessment components that contributed the most are the peer assessment and self assessment. The greatest contribution goes to the Thinking interdependently category.

  6. Industrial Buying Behavior Related to Human Resource Consulting Services

    DEFF Research Database (Denmark)

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

    2013-01-01

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

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

    DEFF Research Database (Denmark)

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

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

  8. Starting a nursing consultation practice.

    Science.gov (United States)

    Schulmeister, L

    1999-03-01

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

  9. Characterization of iodine species in the marine aerosol:to understand their roles in particle formation processes

    Institute of Scientific and Technical Information of China (English)

    Hongwei Chen; Rolf Brandt; Rolf Bandur; Thorsten Hoffmann

    2006-01-01

    In this contribution,iodine chemistry in the Marine Boundary Layer(MBL)is introduced.A series of methodologies for the measurements of iodine species in the gas and particle phases of the coastal atmosphere has been developed.Iodine species in the gas phase in real air samples has been determined in two field campaigns at the west coast of Ireland,indicating that gaseous iodo-hydrocarbons and elemental iodine are the precursors of new particle formation.Particulate iodine speciation from the same measurement campaigns show that the non-water-soluble iodine compounds are the main iodine species during the marine particle formation.A seaweed-chamber experiment was performed,indicating that gaseous I2 is one of the important precursors that lead to new particle formation in the presence of solar light in the ambient air at the coastal tidal area.

  10. HOBYS and W43-HERO: Two more steps toward a Galaxy-wide understanding of high-mass star formation

    Science.gov (United States)

    Motte, Frédérique; Bontemps, Sylvain; Tigé, Jérémy

    The Herschel/HOBYS key program allows to statistically study the formation of 10-20 M ⊙ stars. The IRAM/W43-HERO large program is itself dedicated to the much more extreme W43 molecular complex, which forms stars up to 50 M ⊙. Both reveal high-density cloud filaments of several pc3, which are forming clusters of OB-type stars. Given their activity, these so-called mini-starburst cloud ridges could be seen as ``miniature and instant models'' of starburst galaxies. Both surveys also strongly suggest that high-mass prestellar cores do not exist, in agreement with the dynamical formation of cloud ridges. The HOBYS and W43 surveys are necessary steps towards Galaxy-wide studies of high-mass star formation.

  11. Understanding the formation process of the liquid slug in a hilly-terrain wet natural gas pipeline

    DEFF Research Database (Denmark)

    Yang, Yan; Li, Jingbo; Wang, Shuli

    2017-01-01

    condition on the liquid slug formation is discussed including pipe diameter, inclination angle, gas superficial velocity and liquid holdup. The results show that the pipe is blocked by the liquid slug at the moment of slug formed. The pipe pressure suddenly increases, and then decreases gradually...... in the process of liquid slug formation and motion. The pipe pressure drop and liquid holdup decrease along with the increasing inclination angle of ascending pipe. On the contrary, they rise with the increase of the inclination angle of descending pipe. Higher gas superficial velocity and liquid holdup result...

  12. Nuclear consultant: a new profession

    Energy Technology Data Exchange (ETDEWEB)

    Hardung von Hardung, H

    1976-02-01

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

  13. Nuclear consultant - a new profession

    International Nuclear Information System (INIS)

    Hardung von Hardung, H.

    1976-01-01

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

  14. How do family physicians communicate about cardiovascular risk? Frequencies and determinants of different communication formats.

    Science.gov (United States)

    Neuner-Jehle, Stefan; Senn, Oliver; Wegwarth, Odette; Rosemann, Thomas; Steurer, Johann

    2011-04-05

    Patients understand information about risk better if it is communicated in numerical or visual formats (e.g. graphs) compared to verbal qualifiers only. How frequently different communication formats are used in clinical primary care settings is unknown. We collected socioeconomic and patient understanding data using questionnaires and audio-recorded consultations about cardiovascular disease risk. The frequencies of the communication formats were calculated and multivariate regression analysis of associations between communication formats, patient and general practitioner characteristics, and patient subjective understanding was performed. In 73% of 70 consultations, verbal qualifiers were used exclusively to communicate cardiovascular risk, compared to numerical (11%) and visual (16%) formats. Female GPs and female patient's gender were significantly associated with a higher use of verbal formats compared to visual formats (p=0.001 and p=0.039, respectively). Patient subjective understanding was significantly higher in visual counseling compared to verbal counseling (p=0.001). Verbal qualifiers are the most often used communication format, though recommendations favor numerical and visual formats, with visual formats resulting in better understanding than others. Also, gender is associated with the choice of communication format. Barriers against numerical and visual communication formats among GPs and patients should be studied, including gender aspects. Adequate risk communication should be integrated into physicians' education.

  15. How do family physicians communicate about cardiovascular risk? Frequencies and determinants of different communication formats

    Directory of Open Access Journals (Sweden)

    Rosemann Thomas

    2011-04-01

    Full Text Available Abstract Background Patients understand information about risk better if it is communicated in numerical or visual formats (e.g. graphs compared to verbal qualifiers only. How frequently different communication formats are used in clinical primary care settings is unknown. Methods We collected socioeconomic and patient understanding data using questionnaires and audio-recorded consultations about cardiovascular disease risk. The frequencies of the communication formats were calculated and multivariate regression analysis of associations between communication formats, patient and general practitioner characteristics, and patient subjective understanding was performed. Results In 73% of 70 consultations, verbal qualifiers were used exclusively to communicate cardiovascular risk, compared to numerical (11% and visual (16% formats. Female GPs and female patient's gender were significantly associated with a higher use of verbal formats compared to visual formats (p = 0.001 and p = 0.039, respectively. Patient subjective understanding was significantly higher in visual counseling compared to verbal counseling (p = 0.001. Conclusions Verbal qualifiers are the most often used communication format, though recommendations favor numerical and visual formats, with visual formats resulting in better understanding than others. Also, gender is associated with the choice of communication format. Barriers against numerical and visual communication formats among GPs and patients should be studied, including gender aspects. Adequate risk communication should be integrated into physicians' education.

  16. Opinion Formation on Environmental Protection: Understanding the Origins of Attitudes toward Resource Enhancement and Protection in Iowa.

    Science.gov (United States)

    Rodriguez, Lulu; Farnall, Olan; Geske, Joel; Peterson, Jane W.

    1998-01-01

    A study of 483 Iowa citizens and state legislators found that self-interest had the strongest effect on formation of opinions toward environmental protection; sociotropic and symbolic politics models were also effective. Results indicate that campaign messages must stress the benefits of environmental protection to the individual. (JOW)

  17. Critical Incidents as Formative Influences on the Work of Educational Researchers: Understanding an Insider Perspective through Narrative Enquiry

    Science.gov (United States)

    Holligan, Chris; Wilson, Michael

    2015-01-01

    Drawing on insights from phenomenological sociology and various strands of socio-cultural theory, this paper reports the findings of a qualitative investigation into critical incidents as formative influences in the research orientation and research cultivation of 22 academics working in research-intensive university education departments. The…

  18. Impact of Diabetes E-Consults on Outpatient Clinic Workflow.

    Science.gov (United States)

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

    2015-08-01

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

  19. Consultation document Energy Market Concentrations

    International Nuclear Information System (INIS)

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

    2006-06-01

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

  20. A multidisciplinary environmental integrated approach to better understand the Tegnue Reefs formation, offshore Chioggia, Northern Adriatic Sea.

    Science.gov (United States)

    Bergamasco, Andrea; Donnici, Sandra; Tosi, Luigi; Tagliapietra, Davide; Zaggia, Luca; Bonaldo, Davide; Braga, Federica; Da Lio, Cristina; Keppel, Erica; Lorenzetti, Giuliano; Manfè, Giorgia; Franceschini, Gianluca; Giovanardi, Otello; Carol, Eleonora; Fornaro, Elena; Grant, Carley

    2014-05-01

    Several hard substrata cover the northwestern Adriatic shelf around 20 m depth as patchy reefs called 'Tegnue'. These submerged reefs form many discrete sets from offshore Grado south to the Po river delta with a large field located off Chioggia. Even if the outer part of the reef is constituted by a thick biogenic formation the underlying structure, mainly buried, is made by cemented sand and this seems to be correlated with its origin not yet fully understood. Different genetic interpretations have been proposed thus far, contemplating among other cementation due to beach-rock like processes (e.g., Stefanon, 1969, Bonardi and Tosi, 2002, Bonardi et al., 2006) or the action of ascending fluids enriched in hydrocarbons (e.g., Gabbianelli et al., 1997, Casellato and Stefanon, 2008). An on-going project, mainly a multidisciplinary integrated approach, combining physical, biological, geological, geomorphological, hydrogeological and geochemical data, supported by a detailed bathymetric mapping, an overall general circulation modeling at high resolution, a robust geophysical evidence, and detailed underwater surveys performed by a team of scuba-diver scientists, aims to better understand the genetic processes backing the distribution, early genesis and evolution of such relevant habitats. Actually, using all the new available data, our plan is to verify which previous interpretations on the origin of the Tegnue core better match with the diagenetic processes that led to the cementation of the sand layers lying at the base of the organic reefs. Preliminary results suggest that the Tegnue reefs formed along paleochannels features related to the former alluvial plain and submerged by the Holocene transgression. Whatever their genesis, once exposed such rocky substrata are then quickly colonized by living organisms, which contribute to the growth and expansion of the reef. Calcareous algae and in general the organic concretion could have a role during the reef accretion

  1. Hands in medicine: understanding the impact of competency-based education on the formation of medical students' identities in the United States.

    Science.gov (United States)

    Gonsalves, Catherine; Zaidi, Zareen

    2016-01-01

    There have been critiques that competency training, which defines the roles of a physician by simple, discrete tasks or measurable competencies, can cause students to compartmentalize and focus mainly on being assessed without understanding how the interconnected competencies help shape their role as future physicians. Losing the meaning and interaction of competencies can result in a focus on 'doing the work of a physician' rather than identity formation and 'being a physician.' This study aims to understand how competency-based education impacts the development of a medical student's identity. Three ceramic models representing three core competencies 'medical knowledge,' 'patient care,' and 'professionalism' were used as sensitizing objects, while medical students reflected on the impact of competency-based education on identity formation. Qualitative analysis was used to identify common themes. Students across all four years of medical school related to the 'professionalism' competency domain (50%). They reflected that 'being an empathetic physician' was the most important competency. Overall, students agreed that competency-based education played a significant role in the formation of their identity. Some students reflected on having difficulty in visualizing the interconnectedness between competencies, while others did not. Students reported that the assessment structure deemphasized 'professionalism' as a competency. Students perceive 'professionalism' as a competency that impacts their identity formation in the social role of 'being a doctor,' albeit a competency they are less likely to be assessed on. High-stakes exams, including the United States Medical Licensing Exam clinical skills exam, promote this perception.

  2. Windpower opposition : notify, consult, engage or partnership?

    Energy Technology Data Exchange (ETDEWEB)

    Prier, P.G. [Stantec Consulting, Guelph, ON (Canada)

    2010-07-01

    This PowerPoint presentation discussed some of the methods that can be used to understand and defuse opposition to wind power projects. The presentation discussed the actual empowerment of communities and citizens as opposed to the token gestures often used by large organizations to placate and manipulate stakeholders. Stakeholders were defined as regulatory authorities, directly and indirectly affected landowners, non-government organizations, First Nations groups, and anyone in or outside the study area with an interest in the prospective development. The consultation scope should reflect the significance of potential effects and be conducted early in the decision-making process. The design of the project and its implementation should be transparent, and operators should be responsive to all concerns and questions. A range of consultation techniques should be used to reflect the nature of different stakeholders. Community engagement should support mutual respect of values in order to create an authentic decision-making partnership. Communities should be notified when routine operational or maintenance activities are being conducted. Consultations are required for increases in nameplate capacity of less than 25 percent. Community engagement is required for the development of greenfield wind farms greater than 20 MW. tabs., figs.

  3. Formation of colloids from introduced materials in the post-emplacement environment: A report on the state of understanding

    International Nuclear Information System (INIS)

    Meike, A.; Wittwer, C.

    1993-09-01

    This literature review examines potential sources of colloids and enhanced adsorption that may stem from materials introduced into a repository setting, with a view towards prioritizing future studies. Three major sources of colloids are reviewed: metals, cements, and organics. Know chemical influences on colloid formation and mechanisms by which introduced materials may become involved are considered with respect to gradients, chemical species, pH, time, temperature, radiolysis, redox state, and microbial activity. Areas that have not been addressed but may have significant consequences in a repository setting are identified

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

    Science.gov (United States)

    Ali, Nasreen; Atkin, Karl; Neal, Richard

    2006-11-01

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

  5. The effect of different cardiovascular risk presentation formats on intentions, understanding and emotional affect: a randomised controlled trial using a web-based risk formatter (protocol

    Directory of Open Access Journals (Sweden)

    Newcombe Robert

    2010-07-01

    Full Text Available Abstract Background The future risk of heart disease can be predicted with increasing precision. However, more research is needed into how this risk is conveyed and presented. The aim of this study is to compare the effects of presenting cardiovascular risk in different formats on individuals' intention to change behaviour to reduce risk, understanding of risk information and emotional affect. Methods/design A randomised controlled trial comprising four arms, with a between subjects design will be performed. There will be two intervention groups and two control groups. The first control comprises a pre-intervention questionnaire and presents risk in a bar graph format. The second control presents risk in a bar graph format without pre-intervention questionnaire. These two control groups are to account for the potential Hawthorne effect of thinking about cardiovascular risk before viewing actual risk. The two intervention groups comprise presenting risk in either a pictogram or metonym format (image depicting seriousness of having a myocardial infarction. 800 individuals' aged between 45 and 64 years, who have not been previously diagnosed with heart disease and have access to a computer with internet, will be given a link to a website comprising a risk calculator and electronic questionnaires. 10-year risk of having a coronary heart disease event will be assessed and presented in one of the three formats. A post-intervention questionnaire will be completed after viewing the risk format. Main outcome measures are (i intention to change behaviour, (ii understanding of risk information, (iii emotional affect and (iv worry about future heart disease. Secondary outcomes are the sub-components of the theory of planned behaviour: attitudes, perceived behavioural control and subjective norms. Discussion Having reviewed the literature, we are not aware of any other studies which have used the assessment of actual risk, in a trial to compare different

  6. A proteomic and metabolomic approach for understanding the role of the flor yeast mitochondria in the velum formation.

    Science.gov (United States)

    Moreno-García, Jaime; García-Martínez, Teresa; Moreno, Juan; Millán, M Carmen; Mauricio, Juan Carlos

    2014-02-17

    Saccharomyces cerevisiae "flor" yeast shows a strong tolerance to high ethanol concentrations and develops a velum (biofilm) on the wine surface after the alcoholic fermentation of grape must. This velum remains along several years during the so called "biological aging" process in the elaboration of some special wines carried out in specific regions around the world and it contributes to the typical organoleptic characteristics of these wines. In order to grow in this condition, flor yeast has to elaborate a response where the mitochondrial function is essential. The objective of this study is to elucidate the role of the mitochondria in the response of a flor yeast, S. cerevisiae G1, growing in a controlled velum formation condition. For this purpose, proteome and metabolome were characterized by comparing data with those from an initial fermentative condition used as reference. The obtained proteomic profiles show more mitochondrial proteins related with the ethanol resistance (13), cell respiration (18), mitochondrial genome maintenance (13), and apoptosis (2) detected under the velum formation condition. Also, the finger-printing obtained by means of the exo-metabolites directly related with the quality of fermented beverages and quantified in the velum condition shows important differences from those obtained in the reference condition. Copyright © 2013 Elsevier B.V. All rights reserved.

  7. Nice to know you: Positive emotions, self–other overlap, and complex understanding in the formation of a new relationship

    OpenAIRE

    WAUGH, CHRISTIAN E.; FREDRICKSON, BARBARA L.

    2006-01-01

    Based on Fredrickson's ((1998). What good are positive emotions? Review of General Psychology, 2, 300–319.; (2001). The role of positive emotions in positive psychology: The broaden-and-build theory of positive emotions. American Psychologist, 56, 218–226) broaden-and-build theory and Aron and Aron's ((1986). Love as expansion of the self: Understanding attraction and satisfaction. New York: Hemisphere) self-expansion theory, it was hypothesized that positive emotions broaden people's feeling...

  8. Understanding the wetting properties of nanostructured selenium coatings: the role of nanostructured surface roughness and air-pocket formation

    Directory of Open Access Journals (Sweden)

    Tran PA

    2013-05-01

    Full Text Available Phong A Tran,1,2 Thomas J Webster31Department of Chemical and Biomolecular Engineering, University of Melbourne, Melbourne, VIC, Australia; 2The Particulate Fluid Processing Centre, University of Melbourne, Melbourne, VIC, Australia; 3Department of Chemical Engineering and Program in Bioengineering, Northeastern University, Boston, MA, USAAbstract: Wetting properties of biomaterials, in particular nanomaterials, play an important role, as these influence interactions with biological elements, such as proteins, bacteria, and cells. In this study, the wetting phenomenon of titanium substrates coated with selenium nanoparticles was studied using experimental and mathematical modeling tools. Importantly, these selenium-coated titanium substrates were previously reported to increase select protein adsorption (such as vitronectin and fibronectin, to decrease bacteria growth, and increase bone cell growth. Increased selenium nanoparticle coating density resulted in higher contact angles but remained within the hydrophilic regime. This trend was found in disagreement with the Wenzel model, which is widely used to understand the wetting properties of rough surfaces. The trend also did not fit well with the Cassie–Baxter model, which was developed to understand the wetting properties of composite surfaces. A modified wetting model was thus proposed in this study, to understand the contributing factors of material properties to the hydrophilicity/hydrophobicity of these nanostructured selenium-coated surfaces. The analysis and model created in this study can be useful in designing and/or understanding the wetting behavior of numerous biomedical materials and in turn, biological events (such as protein adsorption as well as bacteria and mammalian cell functions.Keywords: hydrophilicity, hydrophobicity, Wenzel model, Cassie–Baxter model, free energy, implant material, proteins, cells, bacteria

  9. Information giving and receiving in hematological malignancy consultations.

    Science.gov (United States)

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

    2012-03-01

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

  10. Understanding the acquisition and regulation mechanisms of the water chemistry in a clay formation: the CEC/ANDRA Archimede-argile project

    International Nuclear Information System (INIS)

    Merceron, T.; Mossmann, J.R.; Neerdael, B.; Canniere, P. de; Beaucaire, C.; Toulhoat, P.; Daumas, S.; Bianchi, A.; Christen, R.

    1993-01-01

    Clay formations are candidate host environments to high level radioactive waste repository. The radioelements could be partially released from the waste into the host geological formation after a very long time. Understanding behaviour of the natural chemical species is considered as a fundamental prerequisite before the disturbed system will be studied. Additional laboratory studies are also essential in order to forecast, by analogy, the behaviour of radioelements released from the radioactive waste repository. The ARCHIMEDE-ARGILE project has two main goals. The first is to gain an understanding of the mechanisms of acquisition and regulation of the water chemistry in a clay environment. This step is essential to predict both the behaviour and the migration in solution of artificial elements which are initially absent in the clay formation. The second is to test and validate in clay the measured physico chemical parameters which are the basis for the geochemical modelling of the behaviour of the natural and artificial radioelements. The paper presents the main results previously obtained on granitic waters and the research strategy established for the ARCHIMEDE project. (authors). 2 figs., 2 refs

  11. Patient assessment: effective consultation and history taking.

    Science.gov (United States)

    Kaufman, Gerri

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

  12. Academic Development for Careers in Management Consulting

    Science.gov (United States)

    Adams, Susan M.; Zanzi, Alberto

    2004-01-01

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

  13. BNFL Sellafield further public consultation

    International Nuclear Information System (INIS)

    1994-01-01

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

  14. 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

  15. Cationic amino acids specific biomimetic silicification in ionic liquid: a quest to understand the formation of 3-D structures in diatoms.

    Directory of Open Access Journals (Sweden)

    Rajesh Ramanathan

    Full Text Available The intricate, hierarchical, highly reproducible, and exquisite biosilica structures formed by diatoms have generated great interest to understand biosilicification processes in nature. This curiosity is driven by the quest of researchers to understand nature's complexity, which might enable reproducing these elegant natural diatomaceous structures in our laboratories via biomimetics, which is currently beyond the capabilities of material scientists. To this end, significant understanding of the biomolecules involved in biosilicification has been gained, wherein cationic peptides and proteins are found to play a key role in the formation of these exquisite structures. Although biochemical factors responsible for silica formation in diatoms have been studied for decades, the challenge to mimic biosilica structures similar to those synthesized by diatoms in their natural habitats has not hitherto been successful. This has led to an increasingly interesting debate that physico-chemical environment surrounding diatoms might play an additional critical role towards the control of diatom morphologies. The current study demonstrates this proof of concept by using cationic amino acids as catalyst/template/scaffold towards attaining diatom-like silica morphologies under biomimetic conditions in ionic liquids.

  16. Applying a new understanding of supergene REE deposit formation to global exploration initiatives for environmentally sustainable resources

    Science.gov (United States)

    Hardy, Liam; Smith, Martin; Hood, Leo; Heller, Shaun; Faltyn, Rowan; Blum, Astrid; Bamberger, Axel

    2017-04-01

    Two new models have recently been proposed for the formation of REE ion-adsorption deposits and it is likely that they are both active in their related study profiles described in the Ambohimirahavavy Complex in Madagascar (Marquis et al, 2016) and the Serra de Monchique (SDM) complex in Portugal (Hardy et al, 2016). These are two separate environments presenting two different soil systems in terms of flora, protolith and structure. In the latosol profiles of SDM the natural sweating cycle of eucalyptus trees is proposed as the main geochemical cycling control for some 40% of Fe and 30% of Y, which have been observed migrating up and down profile seasonally between upper horizons and the rooting depths of these intensively farmed trees. If, through their natural cycle, eucalyptus trees in SDM are capable of concentrating depleted protolithic Y contents of 4-10ppm to some 140-160ppm in their enriched 150-200cm deep E horizons in only the 40 years since they were introduced to the region (Jenkins, 1979), then what potential deposits and concentrations may lay underneath older plantations across Brazil, Chile, China and most importantly, Australia, where these trees naturally cover some 16% of the entire continent. Eucalyptus is mostly farmed as pulp for paper mills and has lost its market value with the demand for paper decreasing, as the demand for REEs increases, ironically driven by the demand for the accessible technology to replace paper (EPA, 2012). Not only might there be great resources below these forests, but the removal of the aggressive intrusive species would be welcomed across Southern Europe and South America where they have limited market value and have destroyed local ecosystems and water supplies (Brito, 1999), where local people are actively seeking an alternative use of their lands. References: Brito, J. G. (1999). Management strategies for conservation of the lizard Lacerta schreiberi in Portugal. Biological conservation, 311-319. EPA. (2012

  17. Energy saving consulting in Hamburg

    Energy Technology Data Exchange (ETDEWEB)

    1982-10-01

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

  18. Nanoparticle Surface Specific Adsorption of Zein and Its Self-assembled Behavior of Nanocubes Formation in Relation to On-Off SERS: Understanding Morphology Control of Protein Aggregates.

    Science.gov (United States)

    Navdeep; Banipal, Tarlok Singh; Kaur, Gurinder; Bakshi, Mandeep Singh

    2016-01-27

    Zein, an industrially important protein, is characterized in terms of its food and pharmaceutical coating applications by using surface enhanced Raman spectroscopy (SERS) on Au, Ag, and PbS nanoparticles (NPs). Its specific surface adsorption behavior on Ag NPs produced self-assembled zein nanocubes which demonstrated on and off SERS activity. Both SERS characterization as well as nanocube formation of zein helped us to understand the complex protein aggregation behavior in shape controlled morphologies, a process with significant ramifications in protein crystallization to achieve ordered morphologies. Interestingly, nanocube formation was promoted in the presence of Ag rather than Au or PbS NPs under in situ synthesis and discussed in terms of specific adsorption. Zein fingerprinting was much more clear and enhanced on Au surface in comparison to Ag while PbS did not demonstrate SERS due to its semiconducting nature.

  19. Understanding the spatial formation and accumulation of fats, oils and grease deposits in the sewer collection system.

    Science.gov (United States)

    Dominic, Christopher Cyril Sandeep; Szakasits, Megan; Dean, Lisa O; Ducoste, Joel J

    2013-01-01

    Sanitary sewer overflows are caused by the accumulation of insoluble calcium salts of fatty acids, which are formed by the reaction between fats, oils and grease (FOG) and calcium found in wastewaters. Different sewer structural configurations (i.e., manholes, pipes, wet wells), which vary spatially, along with other obstructions (roots intrusion) and pipe deformations (pipe sags), may influence the detrimental buildup of FOG deposits. The purpose of this study was to quantify the spatial variation in FOG deposit formation and accumulation in a pilot-scale sewer collection system. The pilot system contained straight pipes, manholes, roots intrusion, and a pipe sag. Calcium and oil were injected into the system and operated at alkaline (pH = 10) and neutral (pH = 7) pH conditions. Results showed that solid accumulations were slightly higher at neutral pH. Fourier transform infrared (FTIR) analysis on the solids samples confirmed that the solids were indeed calcium-based fatty acid salts. However, the fatty acid profiles of the solids deviated from the profile found from FOG deposits in sewer systems, which were primarily saturated fatty acids. These results confirm the work done previously by researchers and suggest an alternative fate of unsaturated fatty acids that does not lead to their incorporation in FOG deposits in full-scale sewer systems.

  20. Hands in medicine: understanding the impact of competency-based education on the formation of medical students’ identities in the United States

    Science.gov (United States)

    2016-01-01

    Purpose There have been critiques that competency training, which defines the roles of a physician by simple, discrete tasks or measurable competencies, can cause students to compartmentalize and focus mainly on being assessed without understanding how the interconnected competencies help shape their role as future physicians. Losing the meaning and interaction of competencies can result in a focus on ‘doing the work of a physician’ rather than identity formation and ‘being a physician.’ This study aims to understand how competency-based education impacts the development of a medical student’s identity. Methods Three ceramic models representing three core competencies ‘medical knowledge,’ ‘patient care,’ and ‘professionalism’ were used as sensitizing objects, while medical students reflected on the impact of competency-based education on identity formation. Qualitative analysis was used to identify common themes. Results Students across all four years of medical school related to the ‘professionalism’ competency domain (50%). They reflected that ‘being an empathetic physician’ was the most important competency. Overall, students agreed that competency-based education played a significant role in the formation of their identity. Some students reflected on having difficulty in visualizing the interconnectedness between competencies, while others did not. Students reported that the assessment structure deemphasized ‘professionalism’ as a competency. Conclusion Students perceive ‘professionalism’ as a competency that impacts their identity formation in the social role of ‘being a doctor,’ albeit a competency they are less likely to be assessed on. High-stakes exams, including the United States Medical Licensing Exam clinical skills exam, promote this perception. PMID:27572244

  1. Hands in medicine: understanding the impact of competency-based education on the formation of medical students’ identities in the United States

    Directory of Open Access Journals (Sweden)

    Catherine Gonsalves

    2016-08-01

    Full Text Available Purpose There have been critiques that competency training, which defines the roles of a physician by simple, discrete tasks or measurable competencies, can cause students to compartmentalize and focus mainly on being assessed without understanding how the interconnected competencies help shape their role as future physicians. Losing the meaning and interaction of competencies can result in a focus on ‘doing the work of a physician’ rather than identity formation and ‘being a physician.’ This study aims to understand how competency-based education impacts the development of a medical student’s identity. Methods Three ceramic models representing three core competencies ‘medical knowledge,’ ‘patient care,’ and ‘professionalism’ were used as sensitizing objects, while medical students reflected on the impact of competency-based education on identity formation. Qualitative analysis was used to identify common themes. Results Students across all four years of medical school related to the ‘professionalism’ competency domain (50%. They reflected that ‘being an empathetic physician’ was the most important competency. Overall, students agreed that competency-based education played a significant role in the formation of their identity. Some students reflected on having difficulty in visualizing the interconnectedness between competencies, while others did not. Students reported that the assessment structure deemphasized ‘professionalism’ as a competency. Conclusion Students perceive ‘professionalism’ as a competency that impacts their identity formation in the social role of ‘being a doctor,’ albeit a competency they are less likely to be assessed on. High-stakes exams, including the United States Medical Licensing Exam clinical skills exam, promote this perception.

  2. The understanding of the formation of valleys and its implication on site characterization: Moredalen and Pukedalen, south-eastern Sweden

    International Nuclear Information System (INIS)

    Tiren, Sven A.; Waenstedt, Stefan; Straeng, Thomas

    2010-11-01

    In south-eastern Sweden, there are a number of over-deepened narrow valleys, more than 20 m deep, formed in Precambrian bedrock located above the highest post-glacial shoreline. Canyon-like valleys, called 'kursu' or kursu valleys, are generally interpreted to be formed by glaciofluvial erosion. An example of such a valley is Moredalen, a canyon in the Fennoscandian Shield, which has an implication on site selection for radioactive waste disposal. There are also more open over-deepened valleys along which sub-glacial flow has occurred, e.g. Pukedalen. The main part of this paper discusses a combined geological and geophysical investigation of Moredalen, with the aim to investigate possible reasons for the formation of such an unusual feature formed in acid vulcanite and foliated tonalitic to granodioritic rocks. Moredalen is a marked, approximately 7 km long, E-W striking valley that cuts through a plateau (c. 140 m a.s.l.), and an elevated block of the sub-Cambrian peneplain. Glaciofluvial sediments can be found up-streams where the canyon widens to the west. Just east of the valley is a larger delta deposited at the highest post-glacial shoreline (c. 105 m a.s.l). Further east of, and in line with the Moredalen valley there is an esker. Rock debris in the valley is angular. Pukedalen is a northwest-southeast trending valley incised in massive granite. The valley is in its northern parts relatively open and becomes narrow in its south-eastern part having partly a vertical south-western wall. Rock surfaces are smooth along the valley and rock debris in the valley consists generally of rounded blocks. In line with Pukedalen, on both sides at great distances though, there are eskers. Geomorphological features of this kind indicate certain characteristics of the bedrock that need to be considered during safety analysis of repositories for nuclear waste. The distinct weakness zones along which the kursu-valleys are formed create prominent transport paths for

  3. The understanding of the formation of valleys and its implication on site characterization: Moredalen and Pukedalen, south-eastern Sweden

    Energy Technology Data Exchange (ETDEWEB)

    Tiren, Sven A.; Waenstedt, Stefan; Straeng, Thomas (GEOSIGMA AB (Sweden))

    2010-11-15

    In south-eastern Sweden, there are a number of over-deepened narrow valleys, more than 20 m deep, formed in Precambrian bedrock located above the highest post-glacial shoreline. Canyon-like valleys, called 'kursu' or kursu valleys, are generally interpreted to be formed by glaciofluvial erosion. An example of such a valley is Moredalen, a canyon in the Fennoscandian Shield, which has an implication on site selection for radioactive waste disposal. There are also more open over-deepened valleys along which sub-glacial flow has occurred, e.g. Pukedalen. The main part of this paper discusses a combined geological and geophysical investigation of Moredalen, with the aim to investigate possible reasons for the formation of such an unusual feature formed in acid vulcanite and foliated tonalitic to granodioritic rocks. Moredalen is a marked, approximately 7 km long, E-W striking valley that cuts through a plateau (c. 140 m a.s.l.), and an elevated block of the sub-Cambrian peneplain. Glaciofluvial sediments can be found up-streams where the canyon widens to the west. Just east of the valley is a larger delta deposited at the highest post-glacial shoreline (c. 105 m a.s.l). Further east of, and in line with the Moredalen valley there is an esker. Rock debris in the valley is angular. Pukedalen is a northwest-southeast trending valley incised in massive granite. The valley is in its northern parts relatively open and becomes narrow in its south-eastern part having partly a vertical south-western wall. Rock surfaces are smooth along the valley and rock debris in the valley consists generally of rounded blocks. In line with Pukedalen, on both sides at great distances though, there are eskers. Geomorphological features of this kind indicate certain characteristics of the bedrock that need to be considered during safety analysis of repositories for nuclear waste. The distinct weakness zones along which the kursu-valleys are formed create prominent transport paths for

  4. Theoretical understanding on the v(1)-SO4(2-) band perturbed by the formation of magnesium sulfate ion pairs.

    Science.gov (United States)

    Zhang, Hao; Zhang, Yun-Hong; Wang, Feng

    2009-02-01

    The factors determining the spectroscopic characteristics of the v(1)-SO4(2-) band of the MgSO4 ion pairs are discussed via ab initio calculation, including coupling effect, hydrogen bonding effect, and direct contact effect of Mg2+ with SO4(2-). With the calculation of the heavy water hydrated contact ion pairs (CIP), the overlap between the librations of water and the v(1)-SO4(2-) band can be separated, and thus the coupling effect is abstracted, and this coupling effect leads to a blue shift for the v(1)-SO4(2-) band of 5.6 cm(-1) in the monodentate CIP and 3.6 cm(-1) in the bidentate CIP. The hydrogen bonding between each water molecule without relation to Mg2+ and the sulfate ion makes the v(1)-SO4(2-) band blue shift of 3.7 cm(-1). When the outer-sphere water around Mg2+ are hydrogen bonded between SO4(2-) and Mg2+, it will make the largest disturbance to the v(1)-SO4(2-) band. Moreover, the inner-sphere water can affect the v(1)-SO4(2-) band conjunct with the direct contact of Mg2+ with SO4(2-), showing a blue shift of 14.4 cm(-1) in the solvent-shared ion pair, 22.6 cm(-1) in the monodentate CIP, 4.3 cm(-1) in the bidentate CIP, and 21.4 cm(-1) in the tridentate CIP. At last, the Raman spectral evolution in the efflorescence production process is tried to be rationalized. The shoulder at 995 cm(-1) is attributed to the monodentate CIP with 2-3 outer-sphere water molecules, whereas the new peak at 1021 cm(-1) at high concentration is assigned to the formation of aqueous triple ion.

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

    Science.gov (United States)

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

    2009-08-01

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

  6. Development of a Remote Consultation System Using Avatar Technology

    Science.gov (United States)

    Ohnishi, Tatsuya; Yajima, Hiroshi; Sawamoto, Jun

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

  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. 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:…

  9. 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…

  10. The Organizational Communication Consulting Spectrum.

    Science.gov (United States)

    Tubbs, Stewart L.

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

  11. Improving Indonesian Construction Consulting Services

    Directory of Open Access Journals (Sweden)

    Rizal Z. Tamin

    2015-05-01

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

  12. 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

  13. Formation of complexes between hematite nanoparticles and a non-conventional galactomannan gum. Toward a better understanding on interaction processes.

    Science.gov (United States)

    Busch, Verónica M; Loosli, Fréderic; Santagapita, Patricio R; Buera, M Pilar; Stoll, Serge

    2015-11-01

    The physicochemical characteristics of hematite nanoparticles related to their size, surface area and reactivity make them useful for many applications, as well as suitable models to study aggregation kinetics. For several applications (such as remediation of contaminated groundwater) it is crucial to maintain the stability of hematite nanoparticle suspensions in order to assure their arrival to the target place. The use of biopolymers has been proposed as a suitable environmentally friendly option to avoid nanoparticle aggregation and assure their stability. The aim of the present work was to investigate the formation of complexes between hematite nanoparticles and a non-conventional galactomannan (vinal gum--VG) obtained from Prosopis ruscifolia in order to promote hematite nanoparticle coating with a green biopolymer. Zeta potential and size of hematite nanoparticles, VG dispersions and the stability of their mixtures were investigated, as well as the influence of the biopolymer concentration and preparation method. DLS and nanoparticle tracking analysis techniques were used for determining the size and the zeta-potential of the suspensions. VG showed a polydispersed size distribution (300-475 nm Z-average diameter, 0.65 Pdi) and a negative zeta potential (between -1 and -12 mV for pH2 and 12, respectively). The aggregation of hematite nanoparticles (3.3 mg/L) was induced by the addition of VG at lower concentrations than 2mg/L (pH5.5). On the other hand, hematite nanoparticles were stabilized at concentrations of VG higher than 2 mg/L. Several phenomena between hematite nanoparticles and VG were involved: steric effects, electrostatic interactions, charge neutralization, charge inversion and polymer bridging. The process of complexation between hematite nanoparticles and the biopolymer was strongly influenced by the preparation protocols. It was concluded that the aggregation, dispersion, and stability of hematite nanoparticles depended on biopolymer

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

    OpenAIRE

    von Wietersheim, Julia

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    van Dulmen Sandra

    2010-11-01

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

  16. 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…

  17. Why Do Patients Choose to Consult Homeopaths? | McIntosh ...

    African Journals Online (AJOL)

    Background: Patients are using homeopathy in increasing numbers and not telling their doctors about it. It is important as family physicians that we understand the reasons why patients choose to consult homeopaths. It is important to know what our patients are looking for that they do not find in Western medicine.

  18. 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

  19. Medical consultations and the sharing of medical images involving spinal injury over mobile phone networks.

    Science.gov (United States)

    Filip, Michal; Linzer, Petr; Šámal, Filip; Tesař, Jiří; Herzig, Roman; Školoudík, David

    2012-07-01

    The transmission of medical images and other data over mobile phone networks may facilitate remote medical consultations between neurosurgeons and regional hospitals treating spinal injury patients. The aim of this study was to compare the efficacy of mobile phone consultations with standard hospital workstation consultations in spinal injury patients. The images were exported over the Internet from surrounding local hospitals through the Picture Archiving and Communication System, in DICOM III format, to the central hospital server. The xVision browser was used to view the acquired images on a standard workstation. The data were also exported to the secured hospital Web server IIS60 and converted to JPEG format to enable remote physician access and consultation. The remote consulting physician connected to this server by mobile phone using the phone's Internet browser. A second physician, blind to the mobile phone results, evaluated the same images at a workstation in the hospital. The results of the mobile phone consultations were compared with the results from standard workstation consultations. There was no difference in the quality of spinal computed tomographic/magnetic resonance images viewed on the phone screen compared with on the workstation. More importantly, the final diagnoses made by mobile phone did not differ from those made by workstation consultations. A transfer to the department of neurosurgery was required after consultation in 11 patients. Mobile phone consultations for patients with spinal injuries was as effective as workstation consultations. Mobile phone consultations can increase the expertise available to regional hospitals, which are often the first responders to medical emergencies. Copyright © 2012 Elsevier Inc. All rights reserved.

  20. Uruguay; 2011 Article IV Consultation

    OpenAIRE

    International Monetary Fund

    2011-01-01

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

  1. Austria; 2013 Article IV Consultation

    OpenAIRE

    International Monetary Fund

    2013-01-01

    This paper presents details of Austria’s 2013 Article IV Consultation. Austria has been growing economically but is facing challenges in the financial sector. Full implementation of medium-term fiscal adjustment plans require specifying several measures and plans that need gradual strengthening to take expected further bank restructuring cost into account. It suggests that strong early bank intervention and resolution tools, a better designed deposit insurance system, and a bank-financed reso...

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

    NARCIS (Netherlands)

    Noordman, J.; Verhaak, P.; Dulmen, S. van

    2010-01-01

    Background: The increasing prevalence of chronic diseases and the growing understanding that lifestyle behaviour plays an essential role in improving overall health suggest a need for increased attention to lifestyle choices in the consulting room. This study aims to examine whether or not healthy

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

    African Journals Online (AJOL)

    Mandefrot Belay

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

  4. Consultation for Parents of Young Gifted Children.

    Science.gov (United States)

    Wolf, Joan S.

    1989-01-01

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

  5. Lay Consultations in Heart Failure Symptom Evaluation.

    Science.gov (United States)

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

    2017-01-01

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

  6. The Role of Agricultural Consultants in New Zealand in Environmental Extension

    Science.gov (United States)

    Botha, Neels; Coutts, Jeff; Roth, Hein

    2008-01-01

    The aim of this study was to understand the role that agricultural consultants in New Zealand were undertaking in the Research, Development and Extension (RD&E) system--and in particular in relation to environmental extension. New Zealand does not have a public extension service and hence there is a strong reliance on consultants and regional…

  7. 34 CFR 75.191 - Consultation costs.

    Science.gov (United States)

    2010-07-01

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

  8. 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…

  9. 15 CFR 923.57 - Continuing consultation.

    Science.gov (United States)

    2010-01-01

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

  10. Edgar Schein's Process versus Content Consultation Models.

    Science.gov (United States)

    Rockwood, Gary F.

    1993-01-01

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

  11. From the teachers' eyes: An ethnographic-case study on developing models of Informal Formative Assessments (IFA) and understanding the challenges to effective implementation in science classrooms

    Science.gov (United States)

    Sezen, Asli

    The emphasis on socio-cultural theories of learning has required the understanding of multi-dimensional, dynamic and social nature of acquiring the scientific knowledge and practices. Recent policy documents suggest a focus on formative and dynamic assessment practices that will help understand and improve the complex nature of scientific learning in classrooms. This study focuses on teachers' use of "Informal Formative Assessments (IFA)" aimed at improving students' learning and teachers' frequent recognition of students' learning process. The study was designed as an ethnographic case study of four middle school teachers and their students at a local charter school. The data of the study included (a) teachers' responses to history of teaching questionnaire (b) video and audio records of teachers' assessment practices during two different scientific projects (c) video and audio records of ethnographic interviews with teachers during their reflections on their practices, and (d) field notes taken by the researcher to understand the assessment culture of the school. The analytical tools from sociolinguistics (e.g., transcripts and event maps) were prepared and discourse analysis based in an ethnographic perspective was used to analyze the data. Moreover, Cultural-Historical Activity Theory (CHAT) was also introduced as an alternative data analysis framework for understanding the role of division of labor among the elements of the community on the challenges and the outcomes of IFA practices. The findings from the analysis of the classroom discourse showed three different types of IFA cycles: connected, non-connected, and repeating. The analysis of the teachers' reflections showed that the effectiveness of these cycles did not only depend on whether the cycles were connected, but also on other variables such as the phase of the lessons and student's identities and abilities. Teachers' reflections during researcher-teacher meetings on the concept and the aims of IFA

  12. ENDF/B Format

    International Nuclear Information System (INIS)

    Khalil, M.A.

    1975-01-01

    This document is a brief user's description of the format of ENDF/B, the evaluated neutron nuclear data library of the US National Nuclear Data Center. This summary is an aid to customers of the IAEA Nuclear Data Section when receiving data retrievals in ENDF/B format. For more detailed information the report BNL-50274 (ENDF-102) should be consulted. (author)

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

    Science.gov (United States)

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

    2011-09-01

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

  14. Systematic review: frequency and reasons for consultation for gastro-oesophageal reflux disease and dyspepsia.

    Science.gov (United States)

    Hungin, A P S; Hill, C; Raghunath, A

    2009-08-15

    Upper gastrointestinal symptoms impose a substantial illness burden and management costs. Understanding perceptions and reasons for seeking healthcare is a prerequisite for meeting patients' needs effectively. To review systematically findings on consultation frequencies for gastro-oesophageal reflux disease (GERD) and dyspepsia and patients' reasons for consultation. Systematic literature searches. Reported consultation rates ranged from 5.4% to 56% for GERD and from 26% to 70% for dyspepsia. Consultation for GERD was associated with increased symptom severity and frequency, interference with social activities, sleep disturbance, lack of timetabled work, higher levels of comorbidity, depression, anxiety, phobia, somatization and obsessionality. Some consulted because of fears that their symptoms represented serious disease; others avoided consultation because of this. Inconsistent associations were seen with medication use. Patients were less likely to consult if they felt that their doctor would trivialize their symptoms. Few factors were consistently associated with dyspepsia consultation. However, lower socio-economic status and Helicobacter pylori infection were associated with increased consultation. Patients' perceptions of their condition, comorbid factors and external reasons such as work and social factors are related to consultation rates for GERD. Awareness of these factors can guide the clinician towards a more effective strategy than one based on drug therapy alone.

  15. Focusing on relationships, not information, respects autonomy during antenatal consultations.

    Science.gov (United States)

    Gaucher, Nathalie; Payot, Antoine

    2017-01-01

    Policy statements regarding antenatal consultations for preterm labour are guided by physicians' concerns for upholding the legal doctrine of informed consent, through the provision of standardised homogeneous medical information. This approach, led by classical in-control conceptions of patient autonomy, conceives moral agents as rational, independent, self-sufficient decision-makers. Recent studies on these antenatal consultations have explored patients' perspectives, and these differ from guidelines' suggestions. Relational autonomy - which understands moral agents as rational, emotional, creative and interdependent - resonates impressively with these new data. A model for antenatal consultations is proposed. This approach encourages clinicians to explore individual patients' lived experiences and engage in trusting empowering relationships. Moreover, it calls on physicians to enhance patients' relational autonomy by becoming advocates for their patients within healthcare institutions and professional organisations, while calling for broadscale policy changes to encourage further funding and support in investigations of the patient's voice. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  16. Can Process Understanding Help Elucidate The Structure Of The Critical Zone? Comparing Process-Based Soil Formation Models With Digital Soil Mapping.

    Science.gov (United States)

    Vanwalleghem, T.; Román, A.; Peña, A.; Laguna, A.; Giráldez, J. V.

    2017-12-01

    There is a need for better understanding the processes influencing soil formation and the resulting distribution of soil properties in the critical zone. Soil properties can exhibit strong spatial variation, even at the small catchment scale. Especially soil carbon pools in semi-arid, mountainous areas are highly uncertain because bulk density and stoniness are very heterogeneous and rarely measured explicitly. In this study, we explore the spatial variability in key soil properties (soil carbon stocks, stoniness, bulk density and soil depth) as a function of processes shaping the critical zone (weathering, erosion, soil water fluxes and vegetation patterns). We also compare the potential of traditional digital soil mapping versus a mechanistic soil formation model (MILESD) for predicting these key soil properties. Soil core samples were collected from 67 locations at 6 depths. Total soil organic carbon stocks were 4.38 kg m-2. Solar radiation proved to be the key variable controlling soil carbon distribution. Stone content was mostly controlled by slope, indicating the importance of erosion. Spatial distribution of bulk density was found to be highly random. Finally, total carbon stocks were predicted using a random forest model whose main covariates were solar radiation and NDVI. The model predicts carbon stocks that are double as high on north versus south-facing slopes. However, validation showed that these covariates only explained 25% of the variation in the dataset. Apparently, present-day landscape and vegetation properties are not sufficient to fully explain variability in the soil carbon stocks in this complex terrain under natural vegetation. This is attributed to a high spatial variability in bulk density and stoniness, key variables controlling carbon stocks. Similar results were obtained with the mechanistic soil formation model MILESD, suggesting that more complex models might be needed to further explore this high spatial variability.

  17. Understanding the role of the cytoskeleton in wood formation in angiosperm trees: hybrid aspen (Populus tremula x P. tremuloides) as a model species

    Energy Technology Data Exchange (ETDEWEB)

    Chaffey, N.; Barlow, P. [Bristol Univ., Dept. of Agricultural Sciences, Long Ashton, (United Kingdom); Sundberg, B. [Swedish Univ. of Agricultural Sciences, Dept. of Forest Genetics and Plant Physiology, Umea (Sweden)

    2002-03-01

    The involvement of microfilaments (MFs) and microtubules (MTs) in the development of the radial and axial components of secondary wood in hybrid aspen (Populus tremula X P. tremuloides) was studied by indirect immunofluorescent localization techniques in order to elucidate a consensus view of the roles of the cytoskeleton during wood formation in angiosperm trees. Early and late vessel elements, axial parenchyma, normal-wood fibres and contact and isolation cells were included in addition to cambial cells. Microfilaments were found to be rare in cambial cells, but were abundant and axially arranged in their derivatives once cell elongation begun. Microtubules were randomly oriented in ray and fusiform cells of the cambial zone. Ellipses of microfilaments were associated with pit development in fiber cells and isolation ray cells. Rings of localized microtubules and microfilaments were associated with developing inter-vessel bordered pits and vessel-contact ray cell contact pits. Although only microtubules were seen in the periphery of the perforation plate of vessel elements, a prominent meshwork of microfilaments overlaid the perforation plate itself. These observations indicate that there are corresponding subcellular control points whose manipulation could lead to the development of 'designer wood'. However, such development would require a better understanding of the physiological basis for the behaviour of microtubule and microfibre cytoskeletons during wood formation. 44 refs., 6 figs.

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

    DEFF Research Database (Denmark)

    Jensen, Matilde Nisbeth; Fage-Butler, Antoinette Mary

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

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

    Science.gov (United States)

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

    2017-09-15

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

  20. Strangers at the Benchside: Research Ethics Consultation

    Science.gov (United States)

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

    2008-01-01

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

  1. Biophysical and biochemical strategies to understand membrane binding and pore formation by sticholysins, pore-forming proteins from a sea anemone.

    Science.gov (United States)

    Alvarez, Carlos; Ros, Uris; Valle, Aisel; Pedrera, Lohans; Soto, Carmen; Hervis, Yadira P; Cabezas, Sheila; Valiente, Pedro A; Pazos, Fabiola; Lanio, Maria E

    2017-10-01

    Actinoporins constitute a unique class of pore-forming toxins found in sea anemones that are able to bind and oligomerize in membranes, leading to cell swelling, impairment of ionic gradients and, eventually, to cell death. In this review we summarize the knowledge generated from the combination of biochemical and biophysical approaches to the study of sticholysins I and II (Sts, StI/II), two actinoporins largely characterized by the Center of Protein Studies at the University of Havana during the last 20 years. These approaches include strategies for understanding the toxin structure-function relationship, the protein-membrane association process leading to pore formation and the interaction of toxin with cells. The rational combination of experimental and theoretical tools have allowed unraveling, at least partially, of the complex mechanisms involved in toxin-membrane interaction and of the molecular pathways triggered upon this interaction. The study of actinoporins is important not only to gain an understanding of their biological roles in anemone venom but also to investigate basic molecular mechanisms of protein insertion into membranes, protein-lipid interactions and the modulation of protein conformation by lipid binding. A deeper knowledge of the basic molecular mechanisms involved in Sts-cell interaction, as described in this review, will support the current investigations conducted by our group which focus on the design of immunotoxins against tumor cells and antigen-releasing systems to cell cytosol as Sts-based vaccine platforms.

  2. Understanding Litter Input Controls on Soil Organic Matter Turnover and Formation are Essential for Improving Carbon-Climate Feedback Predictions for Arctic, Tundra Ecosystems

    Energy Technology Data Exchange (ETDEWEB)

    Wallenstein, Matthew [Colorado State Univ., Fort Collins, CO (United States)

    2017-12-05

    The Arctic region stored vast amounts of carbon (C) in soils over thousands of years because decomposition has been limited by cold, wet conditions. Arctic soils now contain roughly as much C that is contained in all other soils across the globe combined. However, climate warming could unlock this oil C as decomposition accelerates and permafrost thaws. In addition to temperature-driven acceleration of decomposition, several additional processes could either counteract or augment warming-induced SOM losses. For example, increased plant growth under a warmer climate will increase organic matter inputs to soils, which could fuel further soil decomposition by microbes, but will also increase the production of new SOM. Whether Arctic ecosystems store or release carbon in the future depends in part on the balance between these two counteracting processes. By differentiating SOM decomposition and formation and understanding the drivers of these processes, we will better understand how these systems function. We did not find evidence of priming under current conditions, defined as an increase in the decomposition of native SOM stocks. This suggests that decomposition is unlikely to be further accelerated through this mechanism. We did find that decomposition of native SOM did occur when nitrogen was added to these soils, suggesting that nitrogen limits decomposition in these systems. Our results highlight the resilience and extraordinary C storage capacity of these soils, and suggest shrub expansion may partially mitigate C losses from decomposition of old SOM as Arctic soils warm.

  3. 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.

  4. Consultant breast radiographers: Where are we now?

    International Nuclear Information System (INIS)

    Rees, Zebby

    2014-01-01

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

  5. Modern limnology, sediment accumulation and varve formation processes in Lake Żabińskie, northeastern Poland: comprehensive process studies as a key to understand the sediment record

    Directory of Open Access Journals (Sweden)

    Alicja Bonk

    2014-12-01

    Full Text Available Reconstructions of paleoclimatic and paleoenvironmental data from sediment records require a thorough knowledge of the physical, chemical and biological factors that influence sediment-formation processes and signal preservation in lake sediments. Lake Żabińskie, an eutrophic hardwater lake located in northeastern Poland (Masurian Lake District, provides an unique environment for the investigation of processes that lead to the varve formation. During a two-year long observation period we investigated limnological and hydrochemical conditions within the water column, recent sediment fluxes and laminations preserved in the sediments of this lake to understand the relationship between the lake water properties and the sediment formation processes. We demonstrate that different mixing patterns may occur in Lake Żabińskie, from dimictic to meromictic depending on the meteorological conditions. Regardless of the water mixing pattern, the lake was stratified during much of the year which led to significant differences between surface and near-bottom water environments. The hypolimnion was characterized by higher conductivity and anoxic conditions with only short periods of better oxygenation, which created conditions ideal for the formation and preservation of biogenic varves. The material collected from the sediment trap revealed notable changes in sediment fluxes with characteristic spring maxima and, optionally, a second late fall maxima. Considerable variability was also observed for the fluxes of total organic carbon, biogenic silica and calcite. Microscopic investigation of the topmost sediments revealed a complex structure of the varves showing a distinct spring calcite lamina followed by several fine calcite laminae interbedded with diatom-rich laminae and, finally, by an organic-rich lamina with minerogenic admixtures deposited during winter. This seasonal variability was also reflected in the chemical composition inferred from high

  6. Job share a consultant post.

    OpenAIRE

    Thornicroft, G.; Strathdee, G.

    1992-01-01

    Job sharing offers advantages to both employer and employee but it is still uncommon in medicine. Based on the experiences of two psychiatrists sharing a consultant post this article describes some of the problems in obtaining a job share. The most difficult part can be getting an interview, and once a post has been obtained the terms and conditions of service may have to be modified to suit job sharing. Getting on well with your job sharing partner and good communication will not only help o...

  7. [Teenagers' drawings in transcultural consultations].

    Science.gov (United States)

    Simon, Amalini; Titia Rizzi, Alice

    The place of teenagers' drawings has been studied as part of a transcultural consultation, based on the creativity of the children of migrants. When speaking is difficult, drawings enable teenagers to show another dimension of their internal world. Aravin, a young Tamil boy, who lacked the necessary words, was able to express all the complexity of his thoughts through his drawings, finally being able to formulate in the group the difficult situations which he was drawing. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

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

    OpenAIRE

    Joseph Lampel; Ajay Bhalla; Kaivalya Vishnu

    2010-01-01

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

  9. Development and face validation of strategies for improving consultation skills

    OpenAIRE

    Lefroy, J; Thomas, A; Harrison, C; Williams, S; O'Mahony, F; Gay, S; Kinston, R; McKinley, RK

    2014-01-01

    While formative workplace based assessment can improve learners' skills, it often does not because the procedures used do not facilitate feedback which is sufficiently specific to scaffold improvement. Provision of pre-formulated strategies to address predicted learning needs has potential to improve the quality and automate the provision of written feedback. To systematically develop, validate and maximise the utility of a comprehensive list of strategies for improvement of consultation skil...

  10. Revenue Potential for Inpatient IR Consultation Services: A Financial Model.

    Science.gov (United States)

    Misono, Alexander S; Mueller, Peter R; Hirsch, Joshua A; Sheridan, Robert M; Siddiqi, Assad U; Liu, Raymond W

    2016-05-01

    Interventional radiology (IR) has historically failed to fully capture the value of evaluation and management services in the inpatient setting. Understanding financial benefits of a formally incorporated billing discipline may yield meaningful insights for interventional practices. A revenue modeling tool was created deploying standard financial modeling techniques, including sensitivity and scenario analyses. Sensitivity analysis calculates revenue fluctuation related to dynamic adjustment of discrete variables. In scenario analysis, possible future scenarios as well as revenue potential of different-size clinical practices are modeled. Assuming a hypothetical inpatient IR consultation service with a daily patient census of 35 patients and two new consults per day, the model estimates annual charges of $2.3 million and collected revenue of $390,000. Revenues are most sensitive to provider billing documentation rates and patient volume. A range of realistic scenarios-from cautious to optimistic-results in a range of annual charges of $1.8 million to $2.7 million and a collected revenue range of $241,000 to $601,000. Even a small practice with a daily patient census of 5 and 0.20 new consults per day may expect annual charges of $320,000 and collected revenue of $55,000. A financial revenue modeling tool is a powerful adjunct in understanding economics of an inpatient IR consultation service. Sensitivity and scenario analyses demonstrate a wide range of revenue potential and uncover levers for financial optimization. Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    Kaufman, Roger

    1996-01-01

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

  12. Energy futures project : backgrounder for consultation sessions

    International Nuclear Information System (INIS)

    Bhargava, A.

    2006-05-01

    The National Energy Board periodically publishes a long-term energy and demand report as part of an ongoing monitoring program. The next report is planned for release in 2007. This background document provided background information to ensure that consultation participants have a common understanding of key issues to be addressed during the cross-country consultations that have been planned before the release of the final version of the report. An outline of the proposed analytical approach was presented, as well as details of major assumptions and scenario storylines. Scenario themes included: economic, energy and environmental sustainability; a security-focused world shaped by war and civil strife; and strong global economic growth fueled by the rapid growth of the Chinese and Indian economies. A methodology overview was provided as well as a reference case. Issues related to energy supply included oil; natural gas liquids; natural gas; and electricity. Issues related to energy demand included the residential sector; the commercial sector; the industrial sector; and the transportation sector. Historical trends and forecasts were outlined using the macroeconomic variable of interest. Supply, demand, and supporting infrastructure across all energy forms within a North American and global context were considered. The impact of environmental management strategies were reviewed, as well as the role of the government in shaping policies. It was concluded that the purpose of the final report is to serve as a standard of references for parties interested in Canadian energy issues and trends as well as to inform decision makers of key risks and uncertainties facing the energy future.9 tabs., 1 fig

  13. The assessment of usefulness of the qualification card and ultrasonographic consultation

    Directory of Open Access Journals (Sweden)

    Zbigniew Pilecki

    2012-09-01

    Full Text Available The result of therapeutic success is always the effect of medical professionals coopera‑ tion. The creation of adequate mechanisms of cooperation of these teams demands time and appropriate examples. In the understanding of differentiated behaviors in the line patient – diagnostician – surgeon, particularly the mechanism of the cascade of errors formation, giving simple examples may help – their awareness will facilitate the forma‑ tion of an adequate pattern of diagnostic‑therapeutic chain. The therapeutic team formed in this way provides optimal forms of cooperation and positive result. One of the elements of the cooperation is the surgical procedure qualification card which is an example of the communication between surgeon and diagnostician. The propagation of proven examples seems to be justified by practical reasons. The introduction of the surgical procedure qual‑ ification card enabled maintaining of the preoperative and postoperative diagnoses in the range from 88.4% to 89.29%, the barrier of 90% however is still not achieved. The diag‑ noses discrepancy is still the most often occurring patient safety incident and our results should head towards its mineralization. In particularly complicated cases we come back to a well‑known form of medical consultation, that is the form of examination and treat‑ ment establishment basing on simultaneous physical and ultrasound examination – hence the colloquial name of ultrasound consultation. The universality of medical consultation makes out of it an excellent tool, particularly in cases of significant discrepancy between physical and ultrasound examination. This is excellent form of the experience exchange and learning about mutual possibilities. We believe that the mechanisms presented will influence the improvement of patient security.

  14. Consultative exercise on dose assessments.

    Science.gov (United States)

    Bridges, B A; Parker, T; Simmonds, J R; Sumner, D

    2001-06-01

    A summary is given of a meeting held at Sussex University, UK, in October 2000, which allowed the exchange of ideas on methods of assessment of dose to the public arising from potential authorised radioactive discharges from nuclear sites in the UK. Representatives of groups with an interest in dose assessments were invited, and hence the meeting was called the Consultative Exercise on Dose Assessments (CEDA). Although initiated and funded by the Food Standards Agency, its organisation, and the writing of the report, were overseen by an independent Chairman and Steering Group. The report contains recommendations for improvement in co-ordination between different agencies involved in assessments, on method development and on the presentation of data on assessments. These have been prepared by the Steering Group, and will be taken forward by the Food Standards Agency and other agencies in the UK. The recommendations are included in this memorandum.

  15. The effects of infographics and several quantitative versus qualitative formats for cardiovascular disease risk, including heart age, on people's risk understanding.

    Science.gov (United States)

    Damman, Olga C; Vonk, Suzanne I; van den Haak, Maaike J; van Hooijdonk, Charlotte M J; Timmermans, Danielle R M

    2018-03-11

    To study how comprehension of cardiovascular disease (CVD) risk is influenced by: (1) infographics about qualitative risk information, with/without risk numbers; (2) which qualitative risk dimension is emphasized; (3) heart age vs. traditional risk format. For aim 1, a 2 (infographics versus text) x 2 (risk number versus no risk number) between-subjects design was used. For aim 2, three pieces of information were tested within-subjects. Aim 3 used a simple comparison group. Participants (45-65 yrs old) were recruited through an online access panel; low educated people were oversampled. They received hypothetical risk information (20%/61yrs). Primary outcomes: recall, risk appraisals, subjective/objective risk comprehension. behavioral intentions, information evaluations. Infographics of qualitative risk dimensions negatively affected recall, subjective risk comprehension and information evaluations. No effect of type of risk dimension was found on risk perception. Heart age influenced recall, comprehension, evaluations and affective risk appraisals. Infographics of hypothetical CVD risk information had detrimental effects on measures related to risk perception/comprehension, but effects were mainly seen in undereducated participants. Heart age influenced perceptions/comprehension of hypothetical risk in a way that seemed to support understanding. Heart age seems a fruitful risk communication approach in disease risk calculators. Copyright © 2018 Elsevier B.V. All rights reserved.

  16. The negotiation of writer identity in engineering faculty - writing consultant collaborations

    Directory of Open Access Journals (Sweden)

    Sarah Read

    2011-12-01

    Full Text Available Negotiating faculty-writing consultant collaborations in engineering contexts can be challenging when the writing consultant originates in the humanities. The author found that one of the sites of negotiation in the formation of working relationships is that of writer identity, and disciplinary writer identity in particular. In order to confirm her experiential knowledge, the author interviewed her faculty collaborators to further investigate their attitudes and experiences about writing. Analysis of two excerpts of these interviews makes visible "clashes" between the faculty engineers' and the writing consultant's autobiographical and disciplinary writer identities. Implications of the role of writer identity in faculty-writing consultant collaborations include considering the value of extending this negotiation explicitly to students and the question of how writing curriculum can explicitly engage students in the formation of positive disciplinary writer identities

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

    Science.gov (United States)

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

    2007-01-01

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

  18. Galaxy formation

    International Nuclear Information System (INIS)

    Silk, J.; Di Cintio, A.; Dvorkin, I.

    2014-01-01

    Galaxy formation is at the forefront of observation and theory in cosmology. An improved understanding is essential for improving our knowledge both of the cosmological parameters, of the contents of the universe, and of our origins. In these lectures intended for graduate students, galaxy formation theory is reviewed and confronted with recent observational issues. In lecture 1, the following topics are presented: star formation considerations, including IMF, star formation efficiency and star formation rate, the origin of the galaxy luminosity function, and feedback in dwarf galaxies. In lecture 2, we describe formation of disks and massive spheroids, including the growth of supermassive black holes, negative feedback in spheroids, the AGN-star formation connection, star formation rates at high redshift and the baryon fraction in galaxies.

  19. Understanding Electrically Active Interface Formation on Wide Bandgap Semiconductors through Molecular Beam Epitaxy Using Fe3O 4 for Spintronics as a Base Case

    Science.gov (United States)

    Hamedani Golshan, Negar

    Nanoelectronics, complex heterostructures, and engineered 3D matrix materials are quickly advancing from research possibilities to manufacturing challenges for applications ranging from high-power devices to solar cells to any number of novel multifunctional sensors and controllers. Formation of an abrupt and effective interface is one of the basic requirements for integration of functional materials on different types of semiconductors (from silicon to the wide bandgaps) which can significantly impact the functionality of nanoscale electronic devices. To realize the potential of next-generation electronics, the understanding and control of those initial stages of film layer formation must be understood and translated to a process that can control the initial stages of film deposition. Thin film Fe3O4 has attracted much attention as a material for exploring the potential of spintronics in next-generation information technologies. Synthesis of highly spin-polarized material as spin sources, in combination with wide bandgap semiconductors which have a long spin relaxation time in addition to functionality in high-temperature, high-power, and high-frequency environments, would enhance the performance of today's spintronic devices. Spinel ferrite Fe3O4 has a high Curie temperature of 858 K and it is predicted to possess half-metallic properties, i.e. 100% spin polarization at the Fermi level, which can lead to ultrahigh tunneling magnetoresistance at room temperature. However, these properties have been very difficult to realize in thin film form, and device design strategies require high-quality thin films of Fe3O4. The most common reason reported in literature for the failure of the films to achieve theoretical performance is that the growth techniques used today produce films with antiphase boundaries (APB). These APBs have a strong antiferromagnetic coupling that negatively impact the magnetic and transport properties of epitaxial Fe 3O4 films. Therefore, greater

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

    Science.gov (United States)

    La Via, Jennifer; Schiedermayer, David

    2012-01-01

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

  1. The Concept of Body Language in the Medical Consultation.

    Science.gov (United States)

    Lindsley, Isabella; Woodhead, Sophie; Micallef, Claranne; Agius, Mark

    2015-09-01

    In this paper we wish to argue that the human body is an instrument of communication that can be used by the individual. This can be shown by the use of phenomenology, as described by Husserl, and that indeed empathy, as described by phenomenology, can be seen as a link enabling two human bodies/persons to communicate. We then wish to show from neuroscience that empathy can itself be seen as a bodily function. We then will describe how the doctor-patient relationship in the consultation is an extremely important type of communication between two persons, and how teaching of consultation skills has developed. We will show that, once consultation skills teaching was established, then study of body language became an essential part of this teaching, as soon as the technology was developed, and finally we will demonstrate that it is now possible to confirm by observational and controlled trials that appropriate use of body language does indeed enhance the effectiveness of the consultation, including, we would suggest, by appropriate communication of empathy and understanding.

  2. Expertise, Ethics Expertise, and Clinical Ethics Consultation: Achieving Terminological Clarity

    Science.gov (United States)

    Iltis, Ana S.; Sheehan, Mark

    2016-01-01

    The language of ethics expertise has become particularly important in bioethics in light of efforts to establish the value of the clinical ethics consultation (CEC), to specify who is qualified to function as a clinical ethics consultant, and to characterize how one should evaluate whether or not a person is so qualified. Supporters and skeptics about the possibility of ethics expertise use the language of ethics expertise in ways that reflect competing views about what ethics expertise entails. We argue for clarity in understanding the nature of expertise and ethics expertise. To be an ethics expert, we argue, is to be an expert in knowing what ought to be done. Any attempt to articulate expertise with respect to knowing what ought to be done must include an account of ethics that specifies the nature of moral truth and the means by which we access this truth or a theoretical account of ethics such that expertise in another domain is linked to knowing or being better at judging what ought to be done and the standards by which this “knowing” or “being better at judging” is determined. We conclude with a discussion of the implications of our analysis for the literature on ethics expertise in CEC. We do think that there are clear domains in which a clinical ethics consultant might be expert but we are skeptical about the possibility that this includes ethics expertise. Clinical ethics consultants should not be referred to as ethics experts. PMID:27256848

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

    Science.gov (United States)

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

    2016-11-01

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

  4. "What We Have Here is a Failure to Communicate": Association of Preferred Language With the Rate of Psychiatric Consultation.

    Science.gov (United States)

    Cheung, Stephanie G; Mishkin, Adrienne D; Shapiro, Peter A

    In the United States, people with limited English proficiency (LEP) receive poorer medical care than those proficient in English. Few studies demonstrate how linguistic barriers complicate psychiatric care; in consultation-liaison (C-L) psychiatry, there are no published data about care disparities for patients with LEP or for whom English is not the preferred language (PL). We sought to determine if PL affects the psychiatric consultation rate. Among adult patients admitted during 1 year to a large urban academic medical center, we compared psychiatric consultation rates in English PL patients with non-English PL patients. PL was ascertained from demographics during the medical record. The occurrence of psychiatric consultation was ascertained from C-L service logs. There were 54,534 admissions: the no-consultation group (N = 53,196) and the consultation group (N = 1,398). English as PL was more common in the consult group (72.0% of consult group, 62.0% of no-consult group, χ 2 = 92.98, p < 0.0001). Spanish speakers were underrepresented in the consult group (14.2% of consult, 25.8% of no-consult, χ 2 = 98.78, p < 0.0001). Primary teams requested more consultations for patients whose PL was English than for patients with other PLs, suggesting that psychiatric needs of patients with non-English PL may be unaddressed. This is the first study to demonstrate a disproportionately low rate of general hospital psychiatric consultations in this population. Further study is necessary to confirm and understand this disparity. We recommend routine use of professional interpreters and low threshold for consultation in patients with non-English PL. Copyright © 2017 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

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

    OpenAIRE

    Kreutzer, Markus; Menz, Markus

    2012-01-01

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

  6. The Effect of the Strictness of Consultation Requirements on Fraud Consultation

    NARCIS (Netherlands)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2018-01-18

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

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

    Directory of Open Access Journals (Sweden)

    Zoe Belshaw

    2018-01-01

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

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

    Science.gov (United States)

    Robinson, Natalie J.; Dean, Rachel S.

    2018-01-01

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

  10. Energy consultancy in the year 2000

    International Nuclear Information System (INIS)

    Loeve, M.J.

    1998-01-01

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

  11. The International Consultant: Substance and Culture.

    Science.gov (United States)

    Fest, Thorrel B.

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

  12. Multiple Compensation Consultants and CEO Pay

    NARCIS (Netherlands)

    Kabir, Mohammed Rezaul; Minhat, Marizah

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

  13. Ubiquitous consultation tool for decentral knowledge workers

    OpenAIRE

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

    2003-01-01

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

  14. Lessons Learned from a Consultation Process Overseas

    Science.gov (United States)

    Merino-Soto, César

    2014-01-01

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

  15. 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 ...

  16. Why do people consult the doctor?

    Science.gov (United States)

    Campbell, S M; Roland, M O

    1996-02-01

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

  17. Capturing the competence of management consulting work

    NARCIS (Netherlands)

    Visscher, Klaasjan

    2006-01-01

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

  18. ARL/OMS Consultant Training Program.

    Science.gov (United States)

    Euster, Joanne R.

    1982-01-01

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

  19. Consultants' Corner: System Performance. A Forum.

    Science.gov (United States)

    Drabenstott, John, Ed.

    1986-01-01

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

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

    Science.gov (United States)

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

    2018-01-01

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

  1. Consultant radiographer leadership - A discussion

    International Nuclear Information System (INIS)

    Hogg, Peter; Hogg, Dianne; Henwood, Suzanne

    2008-01-01

    Effective leadership can be defined in many ways and is an essential element of successful organisations; poor leadership can result in problems such as low staff morale, high staff turnover and reduced productivity. Effective leadership behaviours are well documented in the literature and various leadership models have been proposed that illustrate these behaviours. This discussion paper does not focus on any particular model. Instead it considers the 'Leadership Qualities Framework' which was developed specifically for use within the UK National Health Service. This framework draws upon a range of leadership models and as such it gives a broad indication of leadership behaviours. The framework comprises three components - 'personal qualities', 'setting direction' and 'delivering the service'. This paper commences with an argument as to why effective leadership is important in organisations generally, and specifically within healthcare organisations. Various examples of leadership are illustrated from within and outside the NHS in order to demonstrate effective leadership behaviours. The Leadership Qualities Framework is then examined, along with scenarios to illustrate effective leadership behaviours in context (i.e. within a healthcare organisation). Subsequent reflections on the scenarios aim to identify leadership behaviours that are explained within the framework. The final element of this paper draws on [limited] published evidence of where consultant radiographers have demonstrated effective leadership behaviours. In this section the published evidence is examined and reflected upon. At the end of the article we indicate additional reading for those who wish to further develop their theoretical and practical leadership skills

  2. Managing outpatient consultations: from referral to discharge.

    Science.gov (United States)

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

    2017-08-01

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

  3. Consultant radiographers: Profile of the first generation

    International Nuclear Information System (INIS)

    Forsyth, Lesley J.; Maehle, Valerie

    2010-01-01

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

  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. 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.

  6. Consultant radiographer leadership - A discussion

    Energy Technology Data Exchange (ETDEWEB)

    Hogg, Peter [Directorate of Radiography, University of Salford, Allerton Building, Frederick Road, Salford, Greater Manchester M6 6PU (United Kingdom)], E-mail: p.hogg@salford.ac.uk; Hogg, Dianne [Henwood Associates (South East) Ltd, Company Number: 513796, Registered Office: 2 Lakeview Stables, Lower St Clere, Kemsing, Kent, TN15 6NL (United Kingdom); Henwood, Suzanne [East Lancashire Primary Care Trust, Linden Business Centre, Linden Road, Colne. BB8 9BA (United Kingdom)

    2008-12-15

    Effective leadership can be defined in many ways and is an essential element of successful organisations; poor leadership can result in problems such as low staff morale, high staff turnover and reduced productivity. Effective leadership behaviours are well documented in the literature and various leadership models have been proposed that illustrate these behaviours. This discussion paper does not focus on any particular model. Instead it considers the 'Leadership Qualities Framework' which was developed specifically for use within the UK National Health Service. This framework draws upon a range of leadership models and as such it gives a broad indication of leadership behaviours. The framework comprises three components - 'personal qualities', 'setting direction' and 'delivering the service'. This paper commences with an argument as to why effective leadership is important in organisations generally, and specifically within healthcare organisations. Various examples of leadership are illustrated from within and outside the NHS in order to demonstrate effective leadership behaviours. The Leadership Qualities Framework is then examined, along with scenarios to illustrate effective leadership behaviours in context (i.e. within a healthcare organisation). Subsequent reflections on the scenarios aim to identify leadership behaviours that are explained within the framework. The final element of this paper draws on [limited] published evidence of where consultant radiographers have demonstrated effective leadership behaviours. In this section the published evidence is examined and reflected upon. At the end of the article we indicate additional reading for those who wish to further develop their theoretical and practical leadership skills.

  7. The Center for Intercultural Formation, Cuernavaca, Mexico, its reports (1962-1967 and Illich’s critical understanding of mission in Latin America

    Directory of Open Access Journals (Sweden)

    Bruno-Jofré, Rosa

    2014-12-01

    Full Text Available This paper examines the Reports of the Center for Intercultural Formation (CIF, which were produced in Cuernavaca, Mexico, between 1962-1967 by the Centro de Investigaciones Culturales (Center for Cultural Research (CIC, and supported since 1963 by the Centro Intercultural de Documentación (Center for Intercultural Documentation (CIDOC (an offshoot of CIC. The network is placed within the historical conjuncture of the early 1960s and the alignment of the Vatican with the Alliance for Progress and its anti-communist developmentalist community projects. The core of the paper centers in the ‘illocutionary force’ (Quentin Skinner behind Illich’s responses to John XXIII’s call to congregations and lay Catholics for a renewed mission in Latin America. It addresses Illich’s resignification of the understanding of mission and missioner rooted in the Gospel, the notion of incarnation in the culture rather than missioners being agents of their culture, and missionary “poverty” as a virtue of the community worker. Illich’s radicalization of his critical discourse led to a confrontation with the Vatican in 1967 and 1968 after he published “The Seamy Side of Charity” and “The Vanishing Clergyman” in the last year, 1967, of the CIF Report. The conflict with the Vatican signaled Illich’s turn to educational, health and other issues moving away from a critique of the institutionalized Catholic Church.Este artículo examina los Reports del Center of Intercultural Formation (CIF que fueron elaborados en Cuernavaca, México, entre 1962 y 1967 por el Centro de Investigaciones Culturales (CIC, y producidos desde 1963 por el Centro Intercultural de Documentación constituido dentro del CIC. Esta red de centros es situada dentro de la coyuntura histórica del principio de los años sesenta y de la convergencia entre el Vaticano y la Alianza para el Progreso y sus proyectos comunitarios desarrollistas. El artículo se centra en la

  8. 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…

  9. "How long does it take?" A mixed methods evaluation of computer-related work in GP consultations.

    Science.gov (United States)

    Hayward, James; Buckingham, Susan; Thomson, Fionagh; Milne, Heather; Sheikh, Aziz; Fernando, Bernard; Cresswell, Kathrin; Williams, Robin; Pinnock, Hilary

    2015-12-24

    Systematic reviews have suggested that time spent on computer-related tasks increases consultation length. However, these reviews pre-date the current ubiquitous use of computers in U.K. general practice. As part of a U.K. national study of the influence of information technology (IT) on the interaction between patients and healthcare professionals during consultations, we explored how IT functions affected time allocation and styles of computer use during general practitioner (GP) consultations. We drew on multichannel video recording of consultations and measured consultation phases and the duration of computer-related tasks. We related measures of actual time to GP's interpretation of computer use elicited in qualitative interviews. Our sample included recordings of 112 consultations from 6 GPs in three practices. The computer was used for about one-third of the greater consultation. However, its use was concentrated pre- and post- the patient consultation. The workflow of consultation was exemplified through six computer use cases. Most functionality was accepted and accommodated within the consultation, though disruptive and time-consuming tasks were generally delegated to administrative staff. Recognised styles of computer use (minimal, block and conversational) were apparent, but applied very flexibly by GPs according to the nature of the consultation. In contrast to earlier reports, contemporary computer use does not appear to have lengthened consultations. GPs adopted different styles of computer use in different consultations, challenging classifications that seek to stereotype GP computer use. Designing systems that support this versatility require an understanding of the fluid application of computer use within consultation structure.

  10. An assessment of the Atomic Energy Control Board consultation process

    International Nuclear Information System (INIS)

    1984-03-01

    This report analyzes the consultation process followed by the AECB in discharging its responsibility for regulation development. It shows how the process could be improved by better targeting of the consultation towards groups that can be expected to provide valuable input. It also addresses the question of how best to convey to members of those groups the information they need before making comments on proposed regulatory changes. The study also looks at how effective the process is and at possible procedural improvements that might facilitate the preparation of comments by outside groups and improve the understanding among the public of the role played by the AECB and of the issues surrounding nuclear facilities and the use and handling of prescribed substances

  11. ENDF/B format

    International Nuclear Information System (INIS)

    Khalil, M.A.; Lemmel, H.D.

    1986-09-01

    This document is a brief user's description of the format of ENDF/B. This format, originally designed for the US Evaluated Nuclear Data File, is recommended for international use. This summary is an aid to customers of the IAEA Nuclear Data Section when receiving data retrievals in ENDF/B format. For more detailed information the report BNL-NCS-50496 (ENDF 102) should be consulted. An Appendix to the present document gives a summary of the format differences between ENDF/B-4 and ENDF/B-5. (author)

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

    OpenAIRE

    Scott, Gustav; Gyllenstedt, Felix

    2008-01-01

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

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

    Science.gov (United States)

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

    2018-02-01

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

  14. Teaching Teaching & Understanding Understanding

    DEFF Research Database (Denmark)

    2006-01-01

    "Teaching Teaching & Understanding Understanding" is a 19-minute award-winning short-film about teaching at university and higher-level educational institutions. It is based on the "Constructive Alignment" theory developed by Prof. John Biggs. The film delivers a foundation for understanding what...

  15. 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.

  16. Eliciting Patients’ Health Concerns in Consulting Rooms and Wards in Vietnamese Public Hospitals

    Directory of Open Access Journals (Sweden)

    Huong Thi Linh Nguyen

    2018-03-01

    Full Text Available This article examines the doctor’s elicitation of the patient’s presenting health concern in two clinical settings in the Vietnamese public hospital system: the consulting room and the ward. The data were taken from 66 audio-recorded consultations. Our analysis shows that the elicitors used by the doctor in the consulting room often communicate a weak epistemic stance towards the patient’s health issue, while those used in the ward tend to signal a strong epistemic stance. In addition, this contrast between the elicitors employed in the consulting room and the ward is evident in our data regardless of whether the consultation is a first visit or a same follow-up (in which the doctor is the same one that treated the patient on their last visit, though the contrast is less clear for different follow-ups (in which the doctor has not treated the patient before. An additional finding is that the clinical setting has some bearing on the use of inappropriate elicitation formats (in which the doctor opens the visit with an elicitor which is more appropriate for another type of visit. The precise way in which each of the consulting room and the ward operates is, of course, a feature of the Vietnamese public hospital system itself. Hence, the overall contrast between the elicitors and elicitation formats used in these two settings illustrates how, on a more general level, the institutional context can have an impact on doctor-patient communication.

  17. The effects of infographics and several quantitative versus qualitative formats for cardiovascular disease risk, including heart age, on people's risk understanding.

    NARCIS (Netherlands)

    Damman, Olga C; Vonk, Suzanne I; Van den Haak, Maaike J; van Hooijdonk, Charlotte M J; Timmermans, Danielle R M

    2018-01-01

    To study how comprehension of cardiovascular disease (CVD) risk is influenced by: (1) infographics about qualitative risk information, with/without risk numbers; (2) which qualitative risk dimension is emphasized; (3) heart age vs. traditional risk format.

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

    International Nuclear Information System (INIS)

    Henwood, S.; Booth, L.

    2016-01-01

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

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

    NARCIS (Netherlands)

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

    2009-01-01

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

  20. 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...

  1. Bladder Pain Syndrome International Consultation on Incontinence

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  2. Conceptual model of integrated apiarian consultancy

    OpenAIRE

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

    2010-01-01

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

  3. Qualification of contractor/consultant instructors

    International Nuclear Information System (INIS)

    Hanson, H.D.

    1985-01-01

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

  4. Optimal Pricing Strategy in Marketing Research Consulting.

    OpenAIRE

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

    1994-01-01

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

  5. Political consultation and large-scale research

    International Nuclear Information System (INIS)

    Bechmann, G.; Folkers, H.

    1977-01-01

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

  6. 40 CFR 725.17 - Consultation with EPA.

    Science.gov (United States)

    2010-07-01

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

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

    CSIR Research Space (South Africa)

    Cousins, CC

    2000-01-01

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

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

    International Nuclear Information System (INIS)

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

    2016-01-01

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

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

    OpenAIRE

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

    2017-01-01

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

  10. Some observations of a psychiatric consultant to a hospice.

    Science.gov (United States)

    Shanfield, S B

    1983-01-01

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

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

    International Nuclear Information System (INIS)

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

    1997-01-01

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

  12. [Homeostasis and Disorder of Musculoskeletal System.Enthesis formation and repair:Current understanding and perspectives for the future regenerative therapy.

    Science.gov (United States)

    Tokunaga, Takuya; Arimura, Hitoshi; Mizuta, Hiroshi; Hiraki, Yuji; Shukunami, Chisa

    Tendons and ligaments are dense fibrous connective tissues mainly composed of type I collagen, aligned in highly ordered arrays along the axis of the tendon and ligament. The enthesis is defined as the attachment site of a tendon, ligament, joint capsule, or fascia to bone. During morphogenesis, the cell population co-expressing Scleraxis(Scx)and the SRY-box containing gene 9(Sox9)contributes to the formation of fibrocartilaginous entheses. Scx regulates tendon and ligament maturation, while Sox9 is a key regulatory factor for cartilage formation. The considerable mechanical forces transmitted through the enthesis and avascular properties of the tissue make it more prone to injuries and degenerative changes. Thus, integration of tendons or ligaments with bone following surgical repair remains a clinical challenge. In this review, we summarize the current knowledge regarding the formation, maintenance, damage, and repair of fibrocartilaginous entheses, focusing on the rotator cuff tendon-to-bone attachment sites.

  13. Consultation on AIDS and the workplace.

    Science.gov (United States)

    1988-12-01

    The 1988 Consultation on Acquired Immunodeficiency Syndrome (AIDS) and the Workplace, organized by the World Health Organization (WHO), addressed 3 issues: 1) risk factors associated with human immunodeficiency virus (HIV) infection in the workplace, 2) the response of businesses and workers to the AIDS epidemic, and 3) use of the workplace for AIDS education. There is no evidence to suggest that HIV can be transmitted by casual, person-to-person contact in the workplace. The central policy issue for businesses concerns protection of the human rights of workers with HIV infection. Most workers with HIV/AIDS want to continue working as long as they are able to, and they should be enabled to contribute their creativity and productivity in a supportive occupational setting. Consistent policies and procedures should be developed at national and enterprise levels before HIV-related questions arise in the workplace. Such policies should be communicated to all concerned, continually reviewed in the light of scientific and epidemiologic evidence, monitored for their successful implementation, and evaluated for their effectiveness. Pre-employment HIV/AIDS screening, whether for assessment of fitness to work or for insurance purposes, should not be required and raises serious concerns about discrimination. Moreover, there should be no obligation on the worker's part to inform his or her employer if HIV infection develops. Information and educational activities at the workplace are essential to create the climate of collective responsibility and mutual understanding required to protect individuals with HIV or AIDS from stigmatization and discrimination by co-workers, employers or clients, and unions.

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

    OpenAIRE

    Campion, P D; Gabriel, J

    1984-01-01

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

  15. e-EPS News: Consultation on European Research, Innovation & Gender

    CERN Document Server

    e-EPS

    2011-01-01

    e-EPS News is a monthly addition to the CERN Bulletin line-up, showcasing an article by the e-EPS – the European Physical Society newsletter – as part of a new collaboration between the two publications.   EPS members have been invited to take part in a Public Consultation on the Future of Gender and Innovation in Europe. The consultation, which is intended to complement the EC Green Paper ‘From Challenges to Opportunities: Towards a Common Strategic Framework for EU Research and Innovation Funding’, will be published and discussed during the first European Gender Summit in Brussels on 8-9 November this year. It is hoped that the consultation – which is being coordinated by genSET and the organisers of the European Gender Summit – will create a better understanding of how Europe might benefit from a more effective mainstreaming of the gender dimension in research, innovation and scientific systems. Responses from the co...

  16. Using Clumped Isotopes to Understand Early Diagenetic Processes in Carbonate Microbialites of Mid-Cretaceous Codó Formation, NE Brazil

    Science.gov (United States)

    Bahniuk, A. M.; Vasconcelos, C.; McKenzie, J. A.; Franca, A. B.; Matsuda, N.; Eiler, J.

    2010-12-01

    Recent studies of the sedimentological, stratigraphic and geochemical aspects of carbonate microbialites have been carried out to characterize the paleoenvironmental and hydrological conditions of deposition for the Aptian Codó Formation (Parnaíba Basin) and the time-equivalent Santana Formation (Araripe Basin). This environmental interpretation is of interest because these sediments record the early stages of the opening of the Equatorial Atlantic Ocean, as well as being potentially important reservoir rock. Specifically, clumped isotope thermometry has been applied to evaluate the growth temperatures of carbonate components in selected samples from both outcrop and drill core. Preliminary results of clumped isotope measurements provide paleotemperatures derived for dense stromatolitic fabrics drilled from outcrop samples of the Codó Formation which vary between 29 and 33°C. In contrast, the micritic matrix of the drill core samples of the Codó Formation indicates a temperature range from 30 to 48°C. The lower values for the outcrop samples may represent a primary or early diagenetic temperature signal preserved in the rock. Moreover, the micritic matrix from the Santana Formation drill core samples indicates paleotemperatures ranging from 40 to 68°C, which are slightly higher than those for all measured samples of the Codó Formation. We propose that the higher paleotemperatures for all drill core samples denote a diagenetic effect that occurred with sediment lithification processes during burial; that is, isotopic reequilibration at depth is reflected in the higher measured paleotemperatures. Increased paleotemperatures are probably present in some carbonate fabrics of the outcrop samples of the Codo Formation, which also underwent lithification, but this signal was missed by our inability to micro-sample primary or early diagenetic stromatolitic fabrics. Assuming that the outcrop samples of the Codó Formation preserve an original stable isotope signal

  17. Surgical Consultation as Social Process: Implications for Shared Decision Making.

    Science.gov (United States)

    Clapp, Justin T; Arriaga, Alexander F; Murthy, Sushila; Raper, Steven E; Schwartz, J Sanford; Barg, Frances K; Fleisher, Lee A

    2017-12-12

    This qualitative study examines surgical consultation as a social process and assesses its alignment with assumptions of the shared decision-making (SDM) model. SDM stresses the importance of patient preferences and rigorous discussion of therapeutic risks/benefits based on these preferences. However, empirical studies have highlighted discrepancies between SDM and realities of surgical decision making. Qualitative research can inform understanding of the decision-making process and allow for granular assessment of the nature and causes of these discrepancies. We observed consultations between 3 general surgeons and 45 patients considering undergoing 1 of 2 preference-sensitive elective operations: (1) hernia repair, or (2) cholecystectomy. These patients and surgeons also participated in semi-structured interviews. By the time of the consultation, patients and surgeons were predisposed toward certain decisions by preceding events occurring elsewhere. During the visit, surgeons had differential ability to arbitrate surgical intervention and construct the severity of patients' conditions. These upstream dynamics frequently displaced the centrality of the risk/benefit-based consent discussion. The influence of events preceding consultation suggests that decision-making models should account for broader spatiotemporal spans. Given surgeons' authority to define patients' conditions and control service provision, SDM may be premised on an overestimation of patients' power to alter the course of decision making once in a specialist's office. Considering the subordinate role of the risk/benefit discussion in many surgical decisions, it will be important to study if and how the social process of decision making is altered by SDM-oriented decision aids that foreground this discussion.

  18. Supporting clinical leadership through action: The nurse consultant role.

    Science.gov (United States)

    Rosser, Elizabeth; Grey, Rachael; Neal, Deborah; Reeve, Julie; Smith, Caroline; Valentine, Janine

    2017-12-01

    To evaluate the effectiveness of an action learning set to enhance clinical leadership and extend their scope and confidence more strategically. As the most senior clinical role in most healthcare systems, the consultant nurse role is a solitary one. They are required to develop personal resilience, commitment and a belief in their ability to lead, with new consultants needing a strong support network to succeed. Following a 2-year action learning set, four nurse consultants, one therapy consultant, and a university educationalist engaged in a cooperative inquiry approach using four cycles of discussion, reflection, analysis and action over an 18-month period from March 2015-July 2016, to learn how to change and enhance their working practices. Data were analysed thematically. Four themes emerged where the action learning set (i) offered structure and support, (ii) enabled a wider influence and (iii) empowered them to lead. The cooperative inquiry helped them realise how much they had gained from their collective learning and they felt empowered to lead. Their motivation to "make a difference" remains palpable. The outcomes of the cooperative inquiry included an enhanced understanding of the importance of openness and trust and a willingness to share and learn from each other in a respectful and confidential environment with a receptiveness to change. Self-leadership has clearly been accepted and embraced, and their collaboration has improved communication across the organisation, enhanced their strategic leadership capability and given confidence to disseminate externally. The action learning set offered structure to support these clinical leaders to keep them focused across the breadth of their role. Additionally, peer review with external facilitation has enabled these clinical leaders to gain a wider influence and empowered them to lead. © 2017 John Wiley & Sons Ltd.

  19. The effect of different cardiovascular risk presentation formats on intentions, understanding and emotional affect: a randomised controlled trial using a web-based risk formatter (protocol).

    NARCIS (Netherlands)

    Waldron, C.A.; Gallacher, J.; Weijden, G.D.E.M. van der; Newcombe, R.; Elwyn, G.

    2010-01-01

    BACKGROUND: The future risk of heart disease can be predicted with increasing precision. However, more research is needed into how this risk is conveyed and presented. The aim of this study is to compare the effects of presenting cardiovascular risk in different formats on individuals' intention to

  20. An approach of understanding acid volcanics and tuffaceous volcaniclastics from field studies: A case from Tadpatri Formation, Proterozoic Cuddapah basin, Andhra Pradesh, India

    Science.gov (United States)

    Goswami, Sukanta; Upadhyay, P. K.; Bhagat, Sangeeta; Zakaulla, Syed; Bhatt, A. K.; Natarajan, V.; Dey, Sukanta

    2018-03-01

    The lower stratigraphic part of the Cuddapah basin is marked by mafic and felsic volcanism. Tadpatri Formation consists of a greater variety of rock types due to bimodal volcanism in the upper part. Presence of bimodal volcanism is an indication of continental rift setting. Various genetic processes involved in the formation of such volcanic sequence result in original textures which are classified into volcaniclastic and coherent categories. Detailed and systematic field works in Tadpatri-Tonduru transect of SW Cuddapah basin have provided information on the physical processes producing this diversity of rock types. Felsic volcanism is manifested here with features as finger print of past rhyolite-dacite eruptions. Acid volcanics, tuffs and associated shale of Tadpatri Formation are studied and mapped in the field. With supporting subordinate studies on geochemistry, mineralogy and petrogenesis of the volcanics to validate field features accurately, it is understood that volcanism was associated with rifting and shallow marine environmental condition. Four facies (i.e., surge, flow, fall and resedimented volcaniclastic) are demarcated to describe stratigraphic units and volcanic history of the mapped area. The present contribution focuses on the fundamental characterization and categorization of field-based features diagnostic of silica-rich volcanic activities in the Tadpatri Formation.

  1. Formational Turning Points in the Transition to College: Understanding How Communication Events Shape First-Generation Students' Pedagogical and Interpersonal Relationships with Their College Teachers

    Science.gov (United States)

    Wang, Tiffany R.

    2014-01-01

    In the present study, I explored student-teacher interaction, student-teacher relationship formation and development, and the ways in which student-teacher interaction and relationships facilitated support and persistence for first-generation (FG) students during the transition to college. Using transition theory as a sensitizing framework, I took…

  2. Psychiatric Consultation and Substance Use Disorders

    Directory of Open Access Journals (Sweden)

    Sheila Specker

    2009-01-01

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

  3. Psychiatric Consultation and Substance Use Disorders

    Directory of Open Access Journals (Sweden)

    Sheila Specker

    2009-11-01

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

  4. Development and face validation of strategies for improving consultation skills.

    Science.gov (United States)

    Lefroy, Janet; Thomas, Adam; Harrison, Chris; Williams, Stephen; O'Mahony, Fidelma; Gay, Simon; Kinston, Ruth; McKinley, R K

    2014-12-01

    While formative workplace based assessment can improve learners' skills, it often does not because the procedures used do not facilitate feedback which is sufficiently specific to scaffold improvement. Provision of pre-formulated strategies to address predicted learning needs has potential to improve the quality and automate the provision of written feedback. To systematically develop, validate and maximise the utility of a comprehensive list of strategies for improvement of consultation skills through a process involving both medical students and their clinical primary and secondary care tutors. Modified Delphi study with tutors, modified nominal group study with students with moderation of outputs by consensus round table discussion by the authors. 35 hospital and 21 GP tutors participated in the Delphi study and contributed 153 new or modified strategies. After review of these and the 205 original strategies, 265 strategies entered the nominal group study to which 46 year four and five students contributed, resulting in the final list of 249 validated strategies. We have developed a valid and comprehensive set of strategies which are considered useful by medical students. This list can be immediately applied by any school which uses the Calgary Cambridge Framework to inform the content of formative feedback on consultation skills. We consider that the list could also be mapped to alternative skills frameworks and so be utilised by schools which do not use the Calgary Cambridge Framework.

  5. Intermediate Scale Laboratory Testing to Understand Mechanisms of Capillary and Dissolution Trapping during Injection and Post-Injection of CO2 in Heterogeneous Geological Formations

    Energy Technology Data Exchange (ETDEWEB)

    Illangasekare, Tissa [Colorado School of Mines, Golden, CO (United States); Trevisan, Luca [Colorado School of Mines, Golden, CO (United States); Agartan, Elif [Colorado School of Mines, Golden, CO (United States); Mori, Hiroko [Colorado School of Mines, Golden, CO (United States); Vargas-Johnson, Javier [Colorado School of Mines, Golden, CO (United States); Gonzalez-Nicolas, Ana [Colorado School of Mines, Golden, CO (United States); Cihan, Abdullah [Colorado School of Mines, Golden, CO (United States); Birkholzer, Jens [Colorado School of Mines, Golden, CO (United States); Zhou, Quanlin [Colorado School of Mines, Golden, CO (United States)

    2015-03-31

    Carbon Capture and Storage (CCS) represents a technology aimed to reduce atmospheric loading of CO2 from power plants and heavy industries by injecting it into deep geological formations, such as saline aquifers. A number of trapping mechanisms contribute to effective and secure storage of the injected CO2 in supercritical fluid phase (scCO2) in the formation over the long term. The primary trapping mechanisms are structural, residual, dissolution and mineralization. Knowledge gaps exist on how the heterogeneity of the formation manifested at all scales from the pore to the site scales affects trapping and parameterization of contributing mechanisms in models. An experimental and modeling study was conducted to fill these knowledge gaps. Experimental investigation of fundamental processes and mechanisms in field settings is not possible as it is not feasible to fully characterize the geologic heterogeneity at all relevant scales and gathering data on migration, trapping and dissolution of scCO2. Laboratory experiments using scCO2 under ambient conditions are also not feasible as it is technically challenging and cost prohibitive to develop large, two- or three-dimensional test systems with controlled high pressures to keep the scCO2 as a liquid. Hence, an innovative approach that used surrogate fluids in place of scCO2 and formation brine in multi-scale, synthetic aquifers test systems ranging in scales from centimeter to meter scale developed used. New modeling algorithms were developed to capture the processes controlled by the formation heterogeneity, and they were tested using the data from the laboratory test systems. The results and findings are expected to contribute toward better conceptual models, future improvements to DOE numerical codes, more accurate assessment of storage capacities, and optimized placement strategies. This report presents the experimental and modeling methods

  6. The OHS consultant as a facilitator of learning in workplace design processes

    DEFF Research Database (Denmark)

    Broberg, Ole; Hermund, Ingelise

    2007-01-01

    Occupational health service (OHS) consultancy on workplace design proc-esses in client enterprises is expected also to entail some elements of learn-ing. When the OHS consultant has performed the task the enterprise should have learned something on how to integrate health and safety aspects...... into the workplace design process, thereby making it easier for the enterprise to manage such a change in the future. The objective of this explorative study was to survey current practice of OHS consultants and put forward recom-mendations on how to improve the learning aspects of OHS consultancy. Four cases were...... devices between different communities of practice. Certain boundary objects work better than others in promoting learning and collaborative workplace design processes. For both industry and OHS units it is of importance to properly understand learning models and to align their mutual expectations...

  7. Experimental formation of Pb, Sn, Ge and Sb sulfides, selenides and chlorides in the presence of sal ammoniac: A contribution to the understanding of the mineral formation processes in coal wastes self-ignition

    Czech Academy of Sciences Publication Activity Database

    Laufek, F.; Veselovský, F.; Drábek, M.; Kříbek, B.; Klementová, Mariana

    176-177, May (2017), s. 1-7 ISSN 0166-5162 Institutional support: RVO:68378271 Keywords : coal wastes * metalloids * mineral formation * self-burning processes Subject RIV: DB - Geology ; Mineralogy OBOR OECD: Geology Impact factor: 4.783, year: 2016

  8. Employer branding through social media platforms in financial consulting companies

    OpenAIRE

    O' Brien, Krista

    2017-01-01

    The purpose of this thesis is to analyse the use of social media and its effects on enhancing Employer Branding, as done by 5 case companies in the financial consulting industry. The five case companies have been chosen based on employee size and industry: J.P. Morgan, Deloitte, EY, KPMG, and PwC. Each case company has been matched with a focus country in Northern Europe to better understand the efforts put into local Employer Branding. The social media platforms used for data collection ...

  9. Public consultation: regulatory requirement or business principle?

    International Nuclear Information System (INIS)

    Seeley, R.

    1999-01-01

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

  10. 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.

  11. Public consultation: regulatory requirement or business principle?

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Silvia Riva

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

  13. Investigating preventive-medicine consultations in first-opinion small-animal practice in the United Kingdom using direct observation.

    Science.gov (United States)

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

    2016-02-01

    acted upon during all types of consultations. Dental and behavioural non-presenting problems were discussed more frequently during preventive-medicine consultations compared with specific health-problem consultations. Preventive-medicine consultations represent an opportunity for veterinary surgeons to discuss other aspects of preventive medicine, and to detect and manage new and ongoing health problems. A greater evidence base is needed to understand whether detecting and managing underlying disease during the preventive-medicine consultation has a positive impact on lifelong patient health and welfare. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

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

    2000-01-01

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

  15. Interaction of amines with native aluminium oxide layers in non-aqueous environment: Application to the understanding of the formation of epoxy-amine/metal interphases

    International Nuclear Information System (INIS)

    Mercier, D.; Rouchaud, J.-C.; Barthes-Labrousse, M.-G.

    2008-01-01

    Interaction of propylamine (PA), 1,2-diaminoethane (DAE) or 3-aminomethyl-3,5,5-trimethylcyclohexylamine (isophorone diamine, IPDA) with native aluminium oxide layers in non-aqueous environment has been studied using time-resolved inductively coupled plasma optical emission spectroscopy (ICP-OES) and X-ray photoelectron spectroscopy (XPS). The formation of several surface complexes has been evidenced. Monodentate and bidentate metal-bond surface complexes (MBSC) result from interactions between the amine terminations of the molecule and aluminium cations by donation of the N lone electron pair to the metal ion (Lewis-like mechanism leading to O-Al...N bonds). Monodentate and bidentate hydrogen-bond surface complexes (HBSC) are due to interaction of the amino group with surface hydroxyl groups by protonation of the amine termination (Bronsted-like mechanism leading to the formation of Al-OH...N bonds) or interaction with carbonaceous contamination (C x O y H z ...N bonds). Diamines can also form mixed complexes with one amino group forming an O-Al...N bond and the other group forming an Al-OH...N or C x O y H z ...N bond. Al-OH...N and C x O y H z ...N bonds are less stable under vacuum than O-Al...N bonds, leading to partial desorption of the DAE molecules in vacuum and modification of the interaction modes. Only DAE and IPDA can lead to partial dissolution of the aluminium native (hydr)oxide films. A detailed mechanism of dissolution has been proposed based on the formation of mononuclear bidentate (chelate) MBSC by ligand exchange between the terminal η 1 -OH and bridged μ 2 -OH surface sites and the amino terminations of the molecule. The detachment of this complex from the surface is likely to be the precursor step to the formation of the interphase in epoxy-amine/metal systems

  16. 75 FR 78709 - Public Comment on the Draft Tribal Consultation Policy

    Science.gov (United States)

    2010-12-16

    ... future. ACF solicited membership for an ACF Tribal/Federal Workgroup to develop the initial draft policy... disparities of American Indians and Alaska Natives (AI/AN) and ensuring that access to critical health and... consult with American Indians and Alaska Natives (AI/ ANs). 3. Background Since the formation of the Union...

  17. Understanding the formation and growth of Ag nanoparticles on silver chromate induced by electron irradiation in electron microscope: A combined experimental and theoretical study

    International Nuclear Information System (INIS)

    Fabbro, Maria T.; Gracia, Lourdes; Silva, Gabriela S.; Santos, Luís P.S.; Andrés, Juan; Cordoncillo, Eloisa; Longo, E.

    2016-01-01

    Ag 2 CrO 4 microcrystals were synthesized using the co-precipitation method. These microcrystals were characterized through X-ray diffraction (XRD) with Rietveld analysis, field-emission scanning electron microscopy (FE-SEM), transmission electron microscopy (TEM) with energy-dispersive spectroscopy (EDS), micro-Raman (MR). XRD patterns and Rietveld refinement data showed that the material exhibits an orthorhombic structure without any deleterious phases. FE-SEM and TEM micrographs revealed the morphology and the growth of Ag nanoparticles on Ag 2 CrO 4 microcrystals during electron beam irradiation. These events were directly monitored in real-time. Their optical properties were investigated using ultraviolet-visible (UV–vis) diffuse reflectance spectroscopy that allowed the calculation of the optical band gap energy. Theoretical analyses based on the density functional theory level indicate that the incorporation of electrons is responsible for structural modifications and formation of defects on the [AgO 6 ] and [AgO 4 ] clusters, generating ideal conditions for the growth of Ag nanoparticles. - Graphical abstract: Theoretical representation of the Ag 2 CrO 4 orthorhombic structure. Display Omitted - Highlights: • The Ag 2 CrO 4 microcrystals indicate an orthorhombic structure. • The formation of Ag 0 promotes Ag-nanoparticle growth on the surface of the Ag 2 CrO 4 . • Electron irradiation of the material induces the formation of Ag vacancies.

  18. Consultation and IBA negotiations in wind projects

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-07-01

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

  19. 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...

  20. Therapists perspectives on the effective elements of consultation following training.

    Science.gov (United States)

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

    2013-11-01

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

  1. 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

  2. Valued Components of a Consultant Letter from Referring Physicians' Perspective: a Systematic Literature Synthesis.

    Science.gov (United States)

    Rash, Arjun H; Sheldon, Robert; Donald, Maoliosa; Eronmwon, Cindy; Kuriachan, Vikas P

    2018-03-05

    Effective communication between the consultants and physicians form an integral foundation of effective and expert patient care. A broad review of the literature has not been undertaken to determine the components of a consultant's letter of most value to the referring physician. We aimed to identify the components of a consultant's letter preferred by referring physicians. We searched Embase and MEDLINE (OVID) Medicine (EBM) Reviews and Cochrane Database of Systematic Reviews for English articles with no restriction on initial date to January 6, 2017. Articles containing letters from specialists to referring physicians regarding outpatient assessments with either an observational or experimental design were included. Studies were excluded if they pertained to communications from referring physicians to consultant specialists, or pertained to allied health professionals, inpatient documents, or opinion articles. We enumerated the frequencies with which three common themes were addressed, and the positive or negative nature of the comments. The three themes were the structure of consultant letters, their contents, and whether referring physicians and consultants shared a common opinion about the items. Eighteen articles were included in our synthesis. In 11 reports, 91% of respondents preferred structured formats. Other preferred structural features were problem lists and brevity (four reports each). The most preferred contents were oriented to insight: diagnosis, prognosis, and management plan (16/21 mentions in the top tertile). Data items such as history, physical examination, and medication lists were less important (1/23 mentions in the top tertile). Reports varied as to whether referring physicians and consultants shared common opinions about letter features. Referring physicians prefer brief, structured letters from consultants that feature diagnostic and prognostic opinions and management plans over unstructured letters that emphasize data elements such as

  3. 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.

  4. Minimizing the legal risk with 'curbside' consultation.

    Science.gov (United States)

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

    2008-01-01

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

  5. 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…

  6. CONCEPTUALIZING SPECIALIZED PSYCHOSOCIAL CONSULTING FOR PERSONS WITH EPILEPSY

    Directory of Open Access Journals (Sweden)

    Polina Šedienė

    2016-09-01

    Full Text Available The goal of the article is to describe and to reason conception of specialized psychosocial consulting, revealing definition of epilepsy as disease in classical sociological and existential theories and from rights of disabled person’s perspectives. Restriction of social life and possibilities for disabled, person’s with epilepsy and social worker’s interactions, which have importance for development of disabled people participation in social life, are analysed in the article. In order to achieve the goal various methods are used: scientific literature review, reflection of social worker who works with persons with epilepsy, interviews with the clients of Psychosocial consulting centre for persons with epilepsy in 2015, groups discussions (2013, 2016, analysis of conception of Psychosocial consulting centre for persons with epilepsy. 139SPECIALIZUOTO PSICHOSOCIALINIO KONSULTAVIMO EPILEPSIJA S ERGANTIEMS ASMENIMS KONCEPCIJOS PAGRINDIMAS Based on classical sociological theories, people with disease and society members attach such meanings to the illness, which support and enforce stigmatized attitude and behaviour toward person with disease, strengthens negative social aspects of epilepsy, which restricts present and new developed social interactions, full engagement into society. Historical cultural context of epilepsy presupposes attitude that epileptic seizure is “an awful” event, encounter with death, which reminds finality of human, event which causes fear, panic, rejection of surrenders and which restrains social life of person with epilepsy, his or her selfperception. Therefore people with epilepsy very often confine themselves in sick person role, isolate themselves from society, and become dependent on others. Positive interaction between social worker and person with epilepsy during epileptic seizure strengthens understanding of possibilities of person with epilepsy. Specialised psychosocial consulting services for people with

  7. Consulting the community: public expectations and attitudes about genetics research

    Science.gov (United States)

    Etchegary, Holly; Green, Jane; Dicks, Elizabeth; Pullman, Daryl; Street, Catherine; Parfrey, Patrick

    2013-01-01

    Genomic discoveries and technologies promise numerous opportunities for improving health. Key to these potential health improvements, however, are health-care consumers' understanding and acceptance of these new developments. We identified community groups and invited them to a public information-consultation session in order to explore public awareness, perception and expectations about genetics and genomics research. One hundred and four members of seven community groups in Newfoundland, Canada took part in the community sessions. Content analysis of participant comments revealed they were largely hopeful about genetics research in its capacity to improve health; however, they did not accept such research uncritically. Complex issues arose during the community consultations, including the place of genetics in primary care, the value of genetics for personal health, and concerns about access to and uses of genetic information. Participants unequivocally endorsed the value of public engagement with these issues. The rapid pace of discoveries in genomics research offers exciting opportunities to improve population health. However, public support will be crucial to realize health improvements. Our findings suggest that regular, transparent dialog between researchers and the public could allow a greater understanding of the research process, as well as assist in the design of efficient and effective genetic health services, informed by the public that will use them. PMID:23591403

  8. Department of Training and Consulting - Overview

    International Nuclear Information System (INIS)

    Dobrzynski, L.

    2008-01-01

    Full text: The Department of Training and Consulting is regularly serving secondary schools' pupils and teachers, university students and the public. As usual, we have been visited by over 5000 visitors, mainly students from secondary schools in Poland. In this contest, it is worth to mention the organization of the two 3-days Workshops '' On the nuclear energy from the very basics '', aimed to offer the teachers of secondary schools general understanding of the problems connected with nuclear energy. The Workshops were organized in collaboration with the International Atomic Energy Agency and Polish Atomic Agency. Also two other one-day courses on the nuclear radiation were organized for teachers from rather remote parts of Poland. In the teachers' opinion all these events were very successful. The Department is constantly developing experiments that can be conducted by students of secondary schools and universities, as well as by professionals. At the moment there are about 20 experiments available for the guests of the Department. They cover the measurements of lifetimes, essential elements of radioprotection, absorption of radiation in various materials, excitation of fluorescence radiation, influence of magnetic field on beta radiation as well as on electrons emitted from a typical electron gun, Compton scattering and elements of gamma spectroscopy, search for radioactive pollutions etc. A new task of preparing some experiments to be driven through the internet was put forward. It is hoped that this project will end within 2008. For the second time the Department has organized (together with the Institute of Physics of the Polish Academy of Sciences, Warsaw) '' The Physical Pathways '' competition for the students of secondary schools. The students could choose one of three possibilities (even all of them): either to submit a scientific paper, or to present demonstration of a physical phenomena, or to write an essay on the connection between physics and the

  9. Department of Training and Consulting - Overview

    International Nuclear Information System (INIS)

    Dobrzynski, L.

    2009-01-01

    Full text: The Department of Training and Consulting regularly serves secondary schools pupils and teachers, university students and the public. Almost 6600 visitors, mainly students from secondary schools in Poland, visited the Department. In addition to regular lectures, demonstrations, visits to the reactor MARIA and two current exhibitions (on nuclear waste and the WWER reactor model), several laboratory experiments have been organized for secondary schools. A one-day summer workshop on '' Basics of nuclear radiation, its properties and use in science, technology and medicine '' offered secondary school teachers a general understanding of the problems connected with radioactivity. The Department is constantly developing experiments that can be conducted by students of secondary schools and universities, as well as by professionals. At the moment, there are about 25 experiments available for the guests of the Department. They cover the measurement of lifetimes, essential elements of radioprotection, absorption of radiation in various materials, excitation of fluorescence radiation, influence of magnetic fields on beta radiation as well as on electrons emitted from a typical electron gun, Compton scattering and elements of gamma spectroscopy, search for radioactive pollutions etc. Three experiments were modernized to enable them to be conducted over the Internet. This project is a bit delayed but should be finished by the end of April 2009. For the third time the Department organized (together with the Institute of Physics of the Polish Academy of Sciences, Warsaw) '' The Physical Pathways '' competition for secondary school students. The students could choose one of three possibilities (even all of them): either to submit a scientific paper, to present a demonstration of a physical phenomenon, or to write an essay on the connection between physics and the development of civilization. They could also submit work prepared by a team of up to three persons. The

  10. Department of Training And Consulting - Overview

    International Nuclear Information System (INIS)

    Dobrzynski, L.

    2005-01-01

    Full text: The Department of Training and Consulting is regularly serving secondary school pupils and teachers, university students and the public. As usual we have been visited by more than 5000 visitors, mainly students from secondary schools. Since January 2003, the Department participated in an European program called NUPEX (from Nuclear Physics Experience) that aimed at creating an internet platform of educational material from nuclear physics and its applications. The platform was finally prepared in eight languages (English, French, German, Italian, Flemish, Greek, Hungarian and Polish) and is dedicated to pupils from secondary schools and to science teachers. The whole material can be found at http://www.nupex.org. The Polish part is displayed additionally at http://ipj.gov.pl/pl/szkolenia/nupex. It is worth mentioning that the Polish group played an important role in the whole project. Seven modules were fully prepared by us; we also were active in helping the other Project's participants to understand technicalities connected with preparation of the material for internet. New educational posters have been designed by the Department. The titles of these posters are: Energy and its transformations; typical electric power plants; Nuclear Power Plants; Nuclear Power Plants in Europe and in the World. The posters are offered to visiting schools. The number of possible experiments at our Laboratory of Atomic Physics is still increasing. Recently a computer simulation of the process of start-up of the nuclear reactor was prepared. Although it can be considered as a game, in fact the animation reflects the reality of the process and can be used for training of nuclear reactor's operators. For the first time one, of the leading secondary schools in Warsaw, the Stefan Batory School, participated in a Summer School of Physics organized at our Department, which lasted 10 days. Most of the educational program was filled with the basics of nuclear physics with emphasis

  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. Rates of star formation

    International Nuclear Information System (INIS)

    Larson, R.B.

    1977-01-01

    It is illustrated that a theoretical understanding of the formation and evolution of galaxies depends on an understanding of star formation, and especially of the factors influencing the rate of star formation. Some of the theoretical problems of star formation in galaxies, some approaches that have been considered in models of galaxy evolution, and some possible observational tests that may help to clarify which processes or models are most relevant are reviewed. The material is presented under the following headings: power-law models for star formation, star formation processes (conditions required, ways of achieving these conditions), observational indications and tests, and measures of star formation rates in galaxies. 49 references

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

    Science.gov (United States)

    Galbraith, Kyle L

    2014-10-01

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

  14. Delving into the 'emotional storms': A thematic analysis of psychoanalysts' initial consultation reports.

    Science.gov (United States)

    Pérez, Alejandra; Crick, Penelope; Lawrence, Susan

    2015-06-01

    Psychoanalysts' written reports on initial consultations are a window into the complexities of a crucial aspect of psychoanalytic work. However, systematic research in this area has largely focused on patients' demographic factors or standardized measures. The present study looked at reports of all the consultations taking place at the London Clinic of Psychoanalysis over one calendar year (N = 100). The aim was to explore psychoanalysts' different explicit styles of working and reporting as well as further understanding implicit processes used in thinking and writing about each particular consultation experience. A thematic analysis revealed a set of themes that related to a style of working and thinking about the consultation process as a dyadic experience, where the interaction, affective reactions and contact made between the two are the focus when thinking of making a recommendation for psychoanalysis. The majority of the reports had an open, exploratory quality. The writing of reports appears to give the analyst an opportunity to process the consultation experience and arrive at a more triangular position. Writing reports is a more valuable part of the consultation process than has formally been recognized and acknowledged. The limitations of this study as well as the relevance of these findings for future research are discussed. Copyright © 2015 Institute of Psychoanalysis.

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Science.gov (United States)

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

    2005-01-01

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

  17. Communication and information-giving in high-risk breast cancer consultations: influence on patient outcomes.

    Science.gov (United States)

    Lobb, E A; Butow, P N; Barratt, A; Meiser, B; Gaff, C; Young, M A; Haan, E; Suthers, G; Gattas, M; Tucker, K

    2004-01-26

    This longitudinal study aimed to document (i) the information-giving and patient-communication styles of clinical geneticists and genetic counsellors (consultants) in familial breast cancer clinics and (ii) assess the effect of these styles on women's knowledge, whether their expectations were met, satisfaction, risk perception and psychological status. A total of 158 women from high-risk breast cancer families completed self-report questionnaires at 2 weeks preconsultation and 4 weeks postconsultation. The consultations were audiotaped, transcribed and coded. Multivariate logistic regressions showed that discussing prophylactic mastectomy (P=0.00) and oophorectomy (P=0.01) led to women having significantly more expectations met; discussing genetic testing significantly decreased anxiety (P=0.03) and facilitating understanding significantly decreased depression (P=0.05). Receiving a summary letter of the consultation significantly lowered anxiety (P=0.01) and significantly increased the accuracy of perceived risk (P=0.02). Women whose consultant used more supportive communications experienced significantly more anxiety about breast cancer at the 4 weeks follow-up (P=0.00). These women were not significantly more anxious before genetic counselling. In conclusion, this study found that consultants vary in the amount of information they give and the way they communicate; and this variation can result in better or worse psychosocial outcomes. Greater use of supportive and counselling communications appeared to increase anxiety about breast cancer. Identifying methods to assist consultants to address emotional issues effectively may be helpful.

  18. What to listen for in the consultation

    DEFF Research Database (Denmark)

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

    2014-01-01

    OBJECTIVE: To analyze whether qualitative themes in breast cancer patients' self-presentations predicted symptoms of psychological distress and depression in order to improve the consultation process. METHODS: Ninety-seven breast cancer patients gave unstructured, 10-min self-presentations at the...

  19. Behavior Analytic Consultation for Academic Referral Concerns

    Science.gov (United States)

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

    2016-01-01

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

  20. 29 CFR 1908.4 - Offsite consultation.

    Science.gov (United States)

    2010-07-01

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

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

    African Journals Online (AJOL)

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

  2. 77 FR 48159 - Tribal Consultation Meeting

    Science.gov (United States)

    2012-08-13

    ... Anchorage Hotel, 500 West Third Avenue, Anchorage, AK 99501. FOR FURTHER INFORMATION CONTACT: Ann Linehan... convention. As much as possible, OHS Tribal Consultations are scheduled in conjunction with other Tribal... delivery of Head Start services in their geographic locations. In addition, OHS will share actions taken...

  3. Service Learning In Physics: The Consultant Model

    Science.gov (United States)

    Guerra, David

    2005-04-01

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

  4. Using Communication Consultants to Rightsize Successfully.

    Science.gov (United States)

    Tudor, Thomas R.; Sleeth, Randall G.

    1997-01-01

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

  5. 77 FR 23283 - Tribal Consultation Policy

    Science.gov (United States)

    2012-04-18

    ... and Waivers VII. Consultation Process Guidelines VIII. Performance and Accountability IX. Designated..., improving working conditions, and assuring work-related benefits and rights of workers and retirees in the... services. The Department's Women's Bureau (WB) has an ongoing relationship with the United Indians of All...

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

    Science.gov (United States)

    Eichman, Caroline

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

  7. 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

  8. 40 CFR 93.105 - Consultation.

    Science.gov (United States)

    2010-07-01

    ... Implementation Plans of Transportation Plans, Programs, and Projects Developed, Funded or Approved Under Title 23... EPA with MPOs, State departments of transportation, and DOT in developing applicable implementation...) through (e) of this section. Public consultation procedures will be developed in accordance with the...

  9. 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.

  10. Arriving at the postmodern medical consultation.

    NARCIS (Netherlands)

    Elwyn, G.

    2004-01-01

    The analysis of the medical consultation is characterised by mainly prescriptive attempts to recommend 'best practice'. As the role of the individual in society has gained prominence, the power relationships in medical practice have had to change to reflect the increasing recognition of autonomy and

  11. Expectation Levels in Dictionary Consultation and Compilation*

    African Journals Online (AJOL)

    Abstract: Dictionary consultation and compilation is a two-way engagement between two par- ties, 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 con- sultation skills, their knowledge of ...

  12. 77 FR 13338 - Tribal Consultation Meetings

    Science.gov (United States)

    2012-03-06

    ..., Public Law 110-134, notice is hereby given of one-day Tribal Consultation Sessions to be held between the... American Indian and Alaska Native children and their families, taking into consideration funding... consideration funding allocations, distribution formulas, and other issues affecting the delivery of Head Start...

  13. 78 FR 11891 - Tribal Consultation Meeting

    Science.gov (United States)

    2013-02-20

    ... Law 110-134, notice is hereby given of two 1-day Tribal Consultation Sessions to be held between the... American Indian and Alaska Native children and their families, taking into consideration funding... families, taking into consideration funding allocations, distribution formulas, and other issues affecting...

  14. 77 FR 5027 - Tribal Consultation Meetings

    Science.gov (United States)

    2012-02-01

    ..., Public Law 110-134, notice is hereby given of a one-day Tribal Consultation Session to be held between... American Indian and Alaska Native children and their families, taking into consideration funding... the needs of American Indian and Alaska Native children and families, taking into consideration...

  15. 76 FR 48865 - Tribal Consultation Meetings

    Science.gov (United States)

    2011-08-09

    ..., Public Law 110-134, notice is hereby given of one-day Tribal Consultation Sessions to be held between the... American Indian and Alaska Native children and their families, taking into consideration funding... meeting the needs of American Indian and Alaska Native children and families, taking into consideration...

  16. 77 FR 19020 - Tribal Consultation Meeting

    Science.gov (United States)

    2012-03-29

    ... Law 110-134, notice is hereby given of a one-day Tribal Consultation Session to be held between the... needs of American Indian and Alaska Native children and their families, taking into consideration... children and families, taking into consideration funding allocations, distribution formulas, and other...

  17. 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.

  18. 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…

  19. Process Consultation: Its Role in Organization Development.

    Science.gov (United States)

    Schein, Edgar H.

    This volume focuses on the process by which the consultant builds readiness for organizational development (OD) programs, actually conducts training, and works with the key individuals of an organization as part of an OD program. Part I describes in some detail the human processes in organizations--communication, functional roles of group members,…

  20. 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…

  1. 78 FR 57858 - Tribal Consultation Meeting

    Science.gov (United States)

    2013-09-20

    ... and posted on the Early Childhood Learning and Knowledge Center Web site at http://eclkc.ohs.acf.hhs... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Tribal Consultation Meeting AGENCY: Administration for Children and Families' Office of Head Start (OHS), HHS. ACTION...

  2. 78 FR 20658 - Tribal Consultation Meeting

    Science.gov (United States)

    2013-04-05

    ... been sent to tribal leaders via email and posted on the Early Childhood Learning and Knowledge Center... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Tribal Consultation Meeting AGENCY: Administration for Children and Families' Office of Head Start (OHS), HHS. ACTION...

  3. Consulting communities: a renewable energy toolkit

    Energy Technology Data Exchange (ETDEWEB)

    Hinshelwood, E.; McCallum, D.

    2001-07-01

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

  4. Consultation as an implementation strategy for evidence-based practices across multiple contexts: unpacking the black box.

    Science.gov (United States)

    Nadeem, Erum; Gleacher, Alissa; Beidas, Rinad S

    2013-11-01

    There is great interest in the dissemination and implementation of evidence-based treatments and practices for children across schools and community mental health settings. A growing body of literature suggests that the use of one-time workshops as a training tool is ineffective in influencing therapist behavior and patient outcomes and that ongoing expert consultation and coaching is critical to actual uptake and quality implementation. Yet, we have very limited understanding of how expert consultation fits into the larger implementation support system, or the most effective consultation strategies. This commentary reviews the literature on consultation in child mental health, and proposes a set of core consultation functions, processes, and outcomes that should be further studied in the implementation of evidence-based practices for children.

  5. International telemedicine consultations for neurodevelopmental disabilities.

    Science.gov (United States)

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

    2014-06-01

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

  6. CURBSIDE CONSULTATION IN KNEE ARTHROPLASTY: 49 CLINICAL QUESTIONS

    Directory of Open Access Journals (Sweden)

    Craig J. Della Vale

    2008-12-01

    chapter there are revision questions including painful total knee arthroplasty, periprosthetic infection, exposure in revision knee arthroplasty, surgical technique, using stem, offset stems, massive bone loss, retaining patellar component, severe patellar bone loss, assessing joint line position, inserts, chronic extensor mechanism deficiency, spacers, knee fusion, positive culture. AUDIENCE Mainly orthopedic surgeons and residents who are interested in knee arthroplasty have been targeted but the current information related to total knee replacement surgery will also be welcomed by experienced clinicians practicing in knee arthroplasty. Also non-physician personnel may benefit the brief knowledge. ASSESSMENT The brief answers including current concepts and opinions of expert arthroplasty surgeons to carefully chosen questions related to the problems faced in the daily practice of knee artroplasty forming the sections are making almost comprehensive source knowledge for total knee replacement surgery. This reference of complicated cases and controversies in knee arthroplasty by Craig J. Della Vale, MD.and his collaborators will be one of the most practical source of current solutions in the management of knee arthroplasty . Providing straightforward, brief and useful advices, in the form of pearls and pitfalls for frequently encountered problems in total knee replacement surgery makes the text a user friendly, essential reference. The casual style of articles resembling the advices in a dialog of colleagues on a curbside consult makes the text easier to read and understand. Various image and diagrams enhances the knowledge in the text

  7. Hospitalist Perspective of Interactions with Medicine Subspecialty Consult Services.

    Science.gov (United States)

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

    2018-05-01

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

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

    Science.gov (United States)

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

    2009-06-01

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

  9. Conflict prevention, conflict mitigation, and manifestations of conflict during emergency department consultations.

    Science.gov (United States)

    Chan, Teresa; Bakewell, Francis; Orlich, Donika; Sherbino, Jonathan

    2014-03-01

    The objective was to determine the causes of and mitigating factors for conflict between emergency physicians and other colleagues during consultations. From March to September 2010, a total of 61 physicians (31 residents and 30 attendings from emergency medicine [EM], internal medicine, and general surgery) were interviewed about how junior learners should be taught about emergency department (ED) consultations. During these interviews, they were asked if and how conflict manifests during the ED consultation process. Two investigators reviewed the transcripts independently to generate themes related to conflict until saturation was reached. Disagreements were resolved by consensus. The trustworthiness of the analysis was ensured by generating an audit trail, which was subsequently audited by an investigator not involved with the initial analysis. This analysis was compared to previously proposed models of trust and conflict from the sociology and business literature. All participants recalled some manifestation of conflict. There were 12 negative conflict-producing themes and 10 protective conflict-mitigating themes. When comparing these themes to a previously developed model of the domains of trust, each theme mapped to domains of the model. Conflict affects the ED consultation process. Areas that lead to conflict are identified that map to previous models of trust and conflict. This work extends the current understanding about intradisciplinary conflict in the clinical realm. These new findings may improve the understanding of the nature of conflicts that occur and form the foundation for interventions that may decrease conflict during ED consultations. © 2014 by the Society for Academic Emergency Medicine.

  10. Public comment sentiment on educational videos: Understanding the effects of presenter gender, video format, threading, and moderation on YouTube TED talk comments.

    Directory of Open Access Journals (Sweden)

    George Veletsianos

    Full Text Available Scholars, educators, and students are increasingly encouraged to participate in online spaces. While the current literature highlights the potential positive outcomes of such participation, little research exists on the sentiment that these individuals may face online and on the factors that may lead some people to face different types of sentiment than others. To investigate these issues, we examined the strength of positive and negative sentiment expressed in response to TEDx and TED-Ed talks posted on YouTube (n = 655, the effect of several variables on comment and reply sentiment (n = 774,939, and the projected effects that sentiment-based moderation would have had on posted content. We found that most comments and replies were neutral in nature and some topics were more likely than others to elicit positive or negative sentiment. Videos of male presenters showed greater neutrality, while videos of female presenters saw significantly greater positive and negative polarity in replies. Animations neutralized both the negativity and positivity of replies at a very high rate. Gender and video format influenced the sentiment of replies and not just the initial comments that were directed toward the video. Finally, we found that using sentiment as a way to moderate offensive content would have a significant effect on non-offensive content. These findings have far-reaching implications for social media platforms and for those who encourage or prepare students and scholars to participate online.

  11. Public comment sentiment on educational videos: Understanding the effects of presenter gender, video format, threading, and moderation on YouTube TED talk comments

    Science.gov (United States)

    Kimmons, Royce; Larsen, Ross; Dousay, Tonia A.; Lowenthal, Patrick R.

    2018-01-01

    Scholars, educators, and students are increasingly encouraged to participate in online spaces. While the current literature highlights the potential positive outcomes of such participation, little research exists on the sentiment that these individuals may face online and on the factors that may lead some people to face different types of sentiment than others. To investigate these issues, we examined the strength of positive and negative sentiment expressed in response to TEDx and TED-Ed talks posted on YouTube (n = 655), the effect of several variables on comment and reply sentiment (n = 774,939), and the projected effects that sentiment-based moderation would have had on posted content. We found that most comments and replies were neutral in nature and some topics were more likely than others to elicit positive or negative sentiment. Videos of male presenters showed greater neutrality, while videos of female presenters saw significantly greater positive and negative polarity in replies. Animations neutralized both the negativity and positivity of replies at a very high rate. Gender and video format influenced the sentiment of replies and not just the initial comments that were directed toward the video. Finally, we found that using sentiment as a way to moderate offensive content would have a significant effect on non-offensive content. These findings have far-reaching implications for social media platforms and for those who encourage or prepare students and scholars to participate online. PMID:29856749

  12. Towards understanding the role of amines in the SO2 hydration and the contribution of the hydrated product to new particle formation in the Earth's atmosphere.

    Science.gov (United States)

    Lv, Guochun; Nadykto, Alexey B; Sun, Xiaomin; Zhang, Chenxi; Xu, Yisheng

    2018-08-01

    By theoretical calculations, the gas-phase SO 2 hydration reaction assisted by methylamine (MA) and dimethylamine (DMA) was investigated, and the potential contribution of the hydrated product to new particle formation (NPF) also was evaluated. The results show that the energy barrier for aliphatic amines (MA and DMA) assisted SO 2 hydration reaction is lower than the corresponding that of water and ammonia assisted SO 2 hydration. In these hydration reactions, nearly barrierless reaction (only a barrier of 0.1 kcal mol -1 ) can be found in the case of SO 2  + 2H 2 O + DMA. These lead us to conclude that the SO 2 hydration reaction assisted by MA and DMA is energetically facile. The temporal evolution for hydrated products (CH 3 NH 3 + -HSO 3 - -H 2 O or (CH 3 ) 2 NH 2 + -HSO 3 - -H 2 O) in molecular dynamics simulations indicates that these complexes can self-aggregate into bigger clusters and can absorb water and amine molecules, which means that these hydrated products formed by the hydration reaction may serve as a condensation nucleus to initiate the NPF. Copyright © 2018 Elsevier Ltd. All rights reserved.

  13. Public comment sentiment on educational videos: Understanding the effects of presenter gender, video format, threading, and moderation on YouTube TED talk comments.

    Science.gov (United States)

    Veletsianos, George; Kimmons, Royce; Larsen, Ross; Dousay, Tonia A; Lowenthal, Patrick R

    2018-01-01

    Scholars, educators, and students are increasingly encouraged to participate in online spaces. While the current literature highlights the potential positive outcomes of such participation, little research exists on the sentiment that these individuals may face online and on the factors that may lead some people to face different types of sentiment than others. To investigate these issues, we examined the strength of positive and negative sentiment expressed in response to TEDx and TED-Ed talks posted on YouTube (n = 655), the effect of several variables on comment and reply sentiment (n = 774,939), and the projected effects that sentiment-based moderation would have had on posted content. We found that most comments and replies were neutral in nature and some topics were more likely than others to elicit positive or negative sentiment. Videos of male presenters showed greater neutrality, while videos of female presenters saw significantly greater positive and negative polarity in replies. Animations neutralized both the negativity and positivity of replies at a very high rate. Gender and video format influenced the sentiment of replies and not just the initial comments that were directed toward the video. Finally, we found that using sentiment as a way to moderate offensive content would have a significant effect on non-offensive content. These findings have far-reaching implications for social media platforms and for those who encourage or prepare students and scholars to participate online.

  14. Solid Phases Precipitating in Artificial Urine in the Absence and Presence of Bacteria Proteus mirabilis—A Contribution to the Understanding of Infectious Urinary Stone Formation

    Directory of Open Access Journals (Sweden)

    Jolanta Prywer

    2018-04-01

    Full Text Available Magnesium ammonium phosphate hexahydrate, called struvite, is the dominant component of infectious urinary stones. In addition to struvite, infectious urinary stones include solid phases with poor crystallinity as well as amorphous matter. This article is devoted to the analysis of these solid phases, because they have not been characterized well until now. The solid phases tested were obtained from artificial urine in the absence and presence of Proteus mirabilis. The solid phases were characterized by different techniques (X-ray Diffraction, Energy Dispersive X-ray, Scanning Electron Microscopy, as well as Raman and Infrared Spectroscopies. According to the results these phases are carbonate apatite (CA, hydroxylapatite (HAP, amorphous calcium carbonate (ACC, amorphous calcium phosphate (ACP and/or amorphous carbonated calcium phosphate (ACCP. Carbonate apatite and hydroxylapatite may occur in non-stoichiometric forms, i.e., various anions can be substituted for CO32−, OH−, and PO43− groups in them. The non-stoichiometry of carbonate apatite and hydroxylapatite also implies a deficiency of calcium ions, i.e., calcium ions may be partially replaced by other cations. Experimental techniques and chemical speciation analysis demonstrate that the presence of magnesium influences the formation of CA and HAP.

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

    Science.gov (United States)

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

    2012-01-01

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

  16. Functional somatic symptoms and consultation patterns in 5- to 7-year-olds

    DEFF Research Database (Denmark)

    Rask, Charlotte Ulrikka; Ørnbøl, Eva; Fink, Per Klausen

    2013-01-01

    at 5 to 7 years (odds ratio 1.03, 95% confidence interval 1.00-1.06; odds ratio interpreted per unit change in number of contacts). CONCLUSIONS: This study adds to our understanding of health care use for FSS in childhood by highlighting the influence of parents' early consultation patterns...

  17. Consultation and referral between physicians in new medical practice environments.

    Science.gov (United States)

    Schaffer, W A; Holloman, F C

    1985-10-01

    The traditional exchange of medical expertise between physicians for patient benefit has been accomplished by referral. Physicians have traditionally decided when and to whom to refer patients. Health care "systems" now dominate medical practice, and their formats can alter spontaneous collegial interaction in referral. Institutional programs now pursue patient referrals as part of a marketing strategy to attract new patients who then become attached to the institution, rather than to a physician. Referral behavior can affect a physician's personal income in prepaid insurance programs where referrals are discouraged. The referring physician may bear legal liability for actions of the consultant. New practice arrangements and affiliations may place physicians in financial conflict-of-interest situations, challenge ethical commitments, and add new moral responsibility.

  18. Understanding the role of the cytoskeleton in wood formation in angiosperm trees: hybrid aspen (Populus tremula x P. tremuloides) as the model species.

    Science.gov (United States)

    Chaffey, Nigel; Barlow, Peter; Sundberg, Björn

    2002-03-01

    The involvement of microfilaments and microtubules in the development of the radial and axial components of secondary xylem (wood) in hybrid aspen (Populus tremula L. x P. tremuloides Michx.) was studied by indirect immunofluorescent localization techniques. In addition to cambial cells, the differentiated cell types considered were early- and late-wood vessel elements, axial parenchyma, normal-wood fibers and gelatinous fibers, and contact and isolation ray cells. Microfilaments were rare in ray cambial cells, but were abundant and axially arranged in their derivatives once cell elongation had begun, and persisted in that orientation in mature ray cells. Microfilaments were axially arranged in fusiform cambial cells and persisted in that orientation in all xylem derivatives of those cells. Microtubules were randomly oriented in ray and fusiform cells of the cambial zone. Dense arrays of parallel-aligned microtubules were oriented near axially in the developing gelatinous fibers, but at a wide range of angles in normal-wood fibers. Ellipses of microfilaments were associated with pit development in fiber cells and isolation ray cells. Rings of co-localized microtubules and microfilaments were associated with developing inter-vessel bordered pits and vessel-contact ray cell contact pits, and, in the case of bordered pits, these rings decreased in diameter as the over-arching pit border increased in size. Although only microtubules were seen at the periphery of the perforation plate of vessel elements, a prominent meshwork of microfilaments overlaid the perforation plate itself. A consensus view of the roles of the cytoskeleton during wood formation in angiosperm trees is presented.

  19. Understanding the formation and evolution of early-type galaxies based on newly developed single-burst stellar population synthesis models in the infrared

    Science.gov (United States)

    Roeck, Benjamin

    2015-12-01

    whole optical and infrared wavelength range between 3500 and 50000Å which are almost completely based on spectra of observed stars (apart from two gaps which were fitted with theoretical stellar spectra) . We analyze the behaviour of the near-infrared (J - K) and the Spitzer ([3.6]-[4.5]) colour calculated from our models. For ages older than 3 Gyr, both colours depend only slightly on age and metallicity. However, for younger ages, both colours become redder which is caused by the asymptotic giant branch stars contributing significantly to the light in the infrared at ages between 0.1 and 3 Gyr. Furthermore, we find a satisfactory agreement between the optical and near-infrared colours measured from our models and the colours observed from various samples of globular clusters and early-type x galaxies. However, our model predictions are only able to reproduce correctly the Spitzer ([3.6]-[4.5]) colours of older, more massive galaxies that resemble a single-burst population. Younger, less massive and more metal-poor galaxies show redder colours than our models. This mismatch can be explained by a more extended star formation history of these galaxies which includes a metal-poor or/and young population. The Spitzer ([3.6]-[4.5]) colours derived from our models also agree very well with those from most other models available in this wavelength range as long as they also correctly take into account a strong CO absorption band situated at 4.5 μm. The model predictions for colours in the near-infrared, such as (J - K), differ more between the different sets of models, depending on the underlying prescriptions for the asymptotic giant branch stellar evolutionary phase. Compared to other authors, we adopt only a moderate contribution of asymptotic giant branch stars to our models. Our stellar population models allow us also to determine mass-to-light ratios in different infrared bands. Consequently, we can confirm that the massto- light ratio determined in the Spitzer [3

  20. Risk communication in consultations about hormone therapy in the menopause: concordance in risk assessment and framing due to the context.

    Science.gov (United States)

    Hoffmann, M; Hammar, M; Kjellgren, K I; Lindh-Astrand, L; Ahlner, J

    2006-10-01

    It is important for the physician and the patient to have a mutual understanding of the possible consequences of different treatment alternatives in order to achieve a partnership in decision-making. The aim of this study was to explore to which degree first-time consultations for discussion of climacteric discomfort achieved shared understanding of the risks and benefits associated with hormone therapy in the menopausal transition. Analysis of structure and content of transcribed consultations (n = 20), and follow-up interviews of the women (n = 19 pairs of consultations and interviews), from first-time visits for discussion of climacteric discomfort and/or HT with five physicians at three different outpatient clinics of gynecology in Sweden. Four distinctively different interpretations of risk, depending on whether or not benefits were discussed in the same context, emerged from the analysis. On average, five advantages (range 0-11) and two (0-3) disadvantages were mentioned during the consultations. In the interviews, the women expressed on average four advantages (0-7) and one disadvantage (0-3). There were major variations between advantages and disadvantages expressed in the consultation and the following interview. Even though the consultations scored high in patient involvement, the information in most consultations was not structured in a way that made it possible to achieve a shared or an informed decision-taking.

  1. Nuclear fuel waste disposal. Canada's consultative approach

    Energy Technology Data Exchange (ETDEWEB)

    Hillier, J A.R.; Dixon, R S [AECL (Canada)

    1993-07-01

    Over the past two decades, society has increasingly demanded more public participation and public input into decision-making by governments. Development of the Canadian concept for deep geological disposal of used nuclear fuel has proceeded in a manner that has taken account of the requirements for social acceptability as well as technical excellence. As the agency responsible for development of the disposal concept, Atomic Energy of Canada Limited (AECL) has devoted considerable effort to consultation with the various publics that have an interest in the concept. This evolutionary interactive and consultative process, which has been underway for some 14 years, has attempted to keep the public informed of the technical development of the concept and to invite feedback. This paper describes the major elements of this evolutionary process, which will continue throughout the concept assessment and review process currently in progress. (author)

  2. Nuclear fuel waste disposal. Canada's consultative approach

    International Nuclear Information System (INIS)

    Hillier, J.A.R.; Dixon, R.S.

    1993-01-01

    Over the past two decades, society has increasingly demanded more public participation and public input into decision-making by governments. Development of the Canadian concept for deep geological disposal of used nuclear fuel has proceeded in a manner that has taken account of the requirements for social acceptability as well as technical excellence. As the agency responsible for development of the disposal concept, Atomic Energy of Canada Limited (AECL) has devoted considerable effort to consultation with the various publics that have an interest in the concept. This evolutionary interactive and consultative process, which has been underway for some 14 years, has attempted to keep the public informed of the technical development of the concept and to invite feedback. This paper describes the major elements of this evolutionary process, which will continue throughout the concept assessment and review process currently in progress. (author)

  3. “How long does it take?” A mixed methods evaluation of computer-related work in GP consultations

    Directory of Open Access Journals (Sweden)

    James Hayward

    2015-12-01

    Full Text Available Background Systematic reviews have suggested that time spent on computerrelated tasks increases consultation length. However, these reviews pre-date the current ubiquitous use of computers in U.K. general practice.Objective As part of a U.K. national study of the influence of information technology (IT on the interaction between patients and healthcare professionals during consultations, we explored how IT functions affected time allocation and styles of computer use during general practitioner (GP consultations.Methods We drew on multichannel video recording of consultations and measured consultation phases and the duration of computer-related tasks. We related measures of actual time to GP’s interpretation of computer use elicited in qualitative interviews.Results Our sample included recordings of 112 consultations from 6 GPs in three practices. The computer was used for about one-third of the greater consultation. However, its use was concentrated pre- and post- the patient consultation. The workflow of consultation was exemplified through six computer use cases. Most functionality was accepted and accommodated within the consultation, though disruptive and time-consuming tasks were generally delegated to administrative staff. Recognised styles of computer use (minimal, block and conversational were apparent, but applied very flexibly by GPs according to the nature of the consultation.Conclusions In contrast to earlier reports, contemporary computer use does not appear to have lengthened consultations. GPs adopted different styles of computer use in different consultations, challenging classifications that seek to stereotype GP computer use. Designing systems that support this versatility require an understanding of the fluid application of computer use within consultation structure.

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

    Science.gov (United States)

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

    2017-08-04

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

  5. Consultant tells how to reduce nuclear risk

    International Nuclear Information System (INIS)

    Smock, R.

    1983-01-01

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

  6. United Arab Emirates; 2013 Article IV Consultation

    OpenAIRE

    International Monetary Fund

    2013-01-01

    This staff report on United Arab Emirates 2013 Article IV Consultation highlights economic policies and development. Against a backdrop of political stability, confidence has further increased, tourism has been firm, demand from expatriates from the broader region has increased, and capital inflows have strengthened amid high global liquidity. The real estate sector, which had been impaired since the 2009 crisis, has stabilized in Abu Dhabi and has started to recover in Dubai. Dubai aims to b...

  7. Users enlist consultants to calculate costs, savings

    Energy Technology Data Exchange (ETDEWEB)

    1982-05-24

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

  8. Clinical ethics consultation's dilemma, and a solution.

    Science.gov (United States)

    Rasmussen, Lisa M

    2011-01-01

    Clinical ethics consultation is on the horns of a dilemma. One horn skewers the field for its lack of standards, while the other horn skewers it for proposing arbitrary or deeply contested foundations. I articulate the dilemma by discussing several critiques of the field and the challenge of formulating standards and suggest that the solution lies, at least until a robust consensus emerges, with establishing a list of proscriptive standards to guide the field.

  9. A report on the green plan consultations

    International Nuclear Information System (INIS)

    1990-08-01

    This document is a summary of what Canadians who participated in the consultations had to say about environmental issues and concerns; the solutions, roles and responsibilities, and priorities for action. It is based on detailed reports from 41 information sessions and 17 consultation workshops held across Canada. It is based on some 3,000 pages of comments and suggestions, an analysis of 4,500 question response forms, and written submissions from more than 1,000 individuals and organizations. The report is organized into two sections: improving decision making; and, action on environmental issues. The first section deals with science, education, enforcement, decision-making processes and partnerships. The second section deals with specific environmental issues identified in the consultation document, such as global warming and toxic substances, and other publicly identified issues, including energy and land use. Suggestions for further consideration represent possible policy, program and legislative elements of 'The Green Plan'. They are intended as a basis for a more focused debate which will help in the establishment of priorities

  10. Virtual slides: application in pulmonary pathology consultations.

    Directory of Open Access Journals (Sweden)

    Michał Wojciechowski

    2008-02-01

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

  11. Knowledge Sharing in IT Consultant and SME Interactions

    Directory of Open Access Journals (Sweden)

    Adrian Bradshaw

    2015-10-01

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

  12. Services of strategic consulting: special features and types

    Directory of Open Access Journals (Sweden)

    Klenin Oleh Volodymyrovych

    2016-09-01

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

  13. The Next Frontier in Family Business: Career Consulting.

    Science.gov (United States)

    Haid, Richard L.

    1995-01-01

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

  14. Business Communication Consulting and Research in Multinational Companies.

    Science.gov (United States)

    Hildebrandt, Herbert W.

    1978-01-01

    Describes three issues involved in communication research and consulting for multinational companies, particularly those in Germany: qualifications for doing international consulting and research, problems of American scholar-researchers in those firms, and suggestions for dealing with those issues. (JMF)

  15. Teaching and assessing consultation skills: an evaluation of a South ...

    African Journals Online (AJOL)

    Teaching and assessing consultation skills: an evaluation of a South African workshop ... of this work is unsupervised consultations with patients suffering from new or ... Their attitudes to the LAP and the forms of teaching that its use promotes ...

  16. Department of Training and Consulting: Overview

    International Nuclear Information System (INIS)

    Dobrzynski, L.

    2003-01-01

    Full text: The Department of Training and Consulting is a training centre for high-school students and their teachers, for students of physics and natural sciences in general, last but not least for society broadly understood, including professionals dealing with nuclear radiation. In 2002 the Department was visited by about 5000 high-school students who could listen to the lectures, and take part in experimental demonstrations on ionising radiation, its role in everyday life, technical and medical applications. In addition, the Department led the radiation protection course for the accelerators' operators employed by the Institute for Nuclear Studies. One-day courses on physics of radiation were also arranged for teachers. The Laboratory of Atomic and Nuclear Physics for Schools is still developing. The Laboratory permits high-school students to make simple experiments of qualitative and quantitative character. Its main purpose is to teach the elements of experimental work. In addition, university students of physics can conduct quite complicated experiments. Indeed, the Laboratory is also used for this purpose. The actual list of experiments available to students includes: the behaviour of charged particles in electric and magnetic fields, excitation and properties of photoluminescence, production and properties of X-rays, wave-particle duality, properties of alpha, beta and gamma radiation, elements of gamma spectroscopy including identification of elements by means of induced X-ray fluorescence. The first experience gathered recently is positive although there is still some work to do in order to make the Laboratory more educational. In particular, one of the conclusions drawn from our meetings at the instruments is that although high-school students can follow instructions and understand briefly the physical processes, they are not prepared for reporting the results of the observations or experiments. It is clear that we have to help them in overcoming this

  17. Therapists’ Perspectives on the Effective Elements of Consultation Following Training

    OpenAIRE

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

    2013-01-01

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

  18. Calibration of the seismic velocity structure and understanding of the fault formation in the environs of the Orkney M5.5 earthquake, South Africa

    Science.gov (United States)

    Ogasawara, H.; Manzi, M. S.; Durrheim, R. J.; Ogasawara, H.

    2017-12-01

    In August 2014, the largest seismic event (M5.5) to occur in a South African gold mining district took place near Orkney. The M5.5 event and aftershocks were recorded by strainmeters installed at 3 km depth hundreds of meters above the M5.5 fault, 46 in-mine 4.5Hz triaxial geophone stations at depths of 2-3 km within a hypocentral radius of 2-3 km, and 17 surface strong motion stations (South African Seismograph Network; SANSN) within an epicentral radius of 25 km. Aftershocks were distributed on a nearly vertical plane striking NNW-SSE. The upper edge of this fault was hundreds of meters below the deepest level of the mine. ICDP approved a project "Drilling into seismogenic zones of M2.0-5.5 earthquakes in South African gold mines" to elucidate the details of the events (DSeis; Yabe et al. invited talk in S020 in this AGU). On 1 August 2017 drilling was within a few hundreds of meters of intersecting the M5.5 fault zone. To locate the drilling target accurately it is very important to determine the velocity structure between the seismic events and sensors. We do this by using the interval velocities used to migrate 3D-reflection seismic data that was previously acquired by a mining company to image the gold-bearing reef and any fault structures close to the mining horizon. Less attention was given to the velocities below the mining horizon, as accurate imaging of the geological structure was not as important and very little drilling information was available. We used the known depths of prominent reflectors above the mining horizon to derive the interval velocities needed to convert two-way-travel-time to depth. We constrain the velocity below the mining horizon by comparing the DSeis drilling results with the 3D seismic cube. The geometric data is crucial for the kinematic modeling that Ogasawara et al. (S018 in this AGU) advocates. The efforts will result in a better understanding of the main rupture and aftershocks.

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

    International Nuclear Information System (INIS)

    Driftmann, Christian; Josipovic, Neven

    2015-01-01

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

  20. Summary report of the consultants' meeting on nuclear data for production of therapeutic radioisotopes

    International Nuclear Information System (INIS)

    Haight, R.C.; Paviotti-Corcuera, R.

    2002-04-01

    This report summarizes the presentations, recommendations and conclusions of the Consultants' Meeting on Nuclear Data for Production of Therapeutic Radioisotopes. The purpose of this meeting was to discuss scientific and technical matters related to the subject and to advise the IAEA Nuclear Data Section (NDS) on the need and possible formation of a Coordinated Research Programme (CRP). Accurate and complete knowledge of nuclear data are essential for the production of radionuclides for therapy to achieve the specific activity and purity required for efficient and safe clinical application. The Consultants recommended updating and completing the data for production of radionuclides that are recognized to be important in therapy. In addition, the consultants recommend investigating other radionuclides that have a potential interest and for which there exists a medical rationale for therapeutic use. To date no serious effort has been devoted to evaluation of nuclear data for the reactor and accelerator production of therapeutic radionuclides. The IAEA is in the unique and privileged position to address this important public health related problem. Therefore, the consultants highly recommend the formation of a CRP with the title: 'Nuclear Data for Production of Therapeutic Radionuclides.' (author)

  1. Crisis Communication Consultation of the Federal Reserve Bank System

    Science.gov (United States)

    Chandler, Robert C.; Wallace, J. D.

    2008-01-01

    This article, designed for both consulting practitioners and academics, reveals what it is like to do a high-level and high-profile client consultancy. This consultancy was highly informed by and assumes a working knowledge of instructional communication theory, research, and methods as well as drawing upon contemporary communication scholarship…

  2. 20 CFR 404.1616 - Medical or psychological consultants.

    Science.gov (United States)

    2010-04-01

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

  3. 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.

  4. 42 CFR 493.1419 - Standard; Clinical consultant responsibilities.

    Science.gov (United States)

    2010-10-01

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

  5. Group Work in Schools: A Process Consultation Approach

    Science.gov (United States)

    Farouk, Shaalan

    2004-01-01

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

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

    Science.gov (United States)

    Hayes, Marie; Stringer, Phil

    2016-01-01

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

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

    African Journals Online (AJOL)

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

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

    Science.gov (United States)

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

    2018-04-01

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

  9. The Role of Ethics Committees and Ethics Consultation in Allocation Decisions

    Science.gov (United States)

    Strech, Daniel; Hurst, Samia; Danis, Marion

    2013-01-01

    Background Decisions about the allocation and rationing of medical interventions likely occur in all health care systems worldwide. So far very little attention has been given to the question of what role ethics consultation and ethics committees could or should play in questions of allocation at the hospital level. Objectives and Methods This article argues for the need for ethics consultation in rationing decisions using empirical data about the status quo and the inherent nature of bedside rationing. Subsequently, it introduces a 4-stage process for establishing and conducting ethics consultation in rationing questions with systematic reference to core elements of procedural justice. Results Qualitative and quantitative findings show a significant demand for ethics consultation expressed directly by doctors, as well as additional indirect evidence of such a need as indicated by ethically challenging circumstances of inconsistent and structurally disadvantaging rationing decisions. To address this need, we suggest 4 stages for establishing and conducting ethics consultation in rationing questions we recommend: (1) training, (2) identifying actual scarcity-related problems at clinics, (3) supporting decision-making, and (4) evaluation. Conclusion This process of ethics consultation regarding rationing decisions would facilitate the achievement of several practical goals: (i) encouragement of an awareness and understanding of ethical problems in bedside rationing, (ii) encouragement of achieving efficiency along with rationing, (iii) reinforcement of consistency in inter- and intraindvidual decision-making, (iv) encouragement of explicit reflection and justification of the prioritization criteria taken into consideration, (v) improvement in internal (in-house) and external transparency, and (vi) prevention of the misuse of the corresponding consulting structures. PMID:20706163

  10. Experiences of using email for general practice consultations: a qualitative study.

    Science.gov (United States)

    Atherton, Helen; Pappas, Yannis; Heneghan, Carl; Murray, Elizabeth

    2013-11-01

    Reports suggest approximately 21-23% of GPs in the UK have consulted with patients using email, but little is known about the nature of this use and what it means for clinicians and patients in general practice. To understand the use of email consultation in general practice by investigating the experiences of existing users and views of experts. A qualitative study conducted in 2010 using purposive sampling and semi-structured interviews in general practice and community settings in some London boroughs. A maximum variation sample of GPs and patients who had used email for consultation in general practice were recruited, as were policy and/or implementation experts. Interviews continued until saturation was achieved. In total 10 GPs, 14 patients, and six experts were interviewed. Consultation by email was often triggered by logistic or practical issues; motivators for ongoing use were the benefits, such as convenience, for GPs and patients. Both GPs and patients reported concerns about safety and lack of guidance about the 'rules of engagement' in email consultations, with GPs also concerned about workload. In response, both groups attempted to introduce their own rules, although this only went some way to addressing uncertainty. Long term, participants felt there was a need for regulation and guidance. Consultations by email in general practice occur in an unregulated and unstructured way. Current UK policy is to promote consultations by email, making it crucial to consider the responsibility and workload faced by clinicians, and the changes required to ensure safe use; not doing so may risk safety breaches and result in suboptimal care for patients.

  11. Understanding the visual resource

    Science.gov (United States)

    Floyd L. Newby

    1971-01-01

    Understanding our visual resources involves a complex interweaving of motivation and cognitive recesses; but, more important, it requires that we understand and can identify those characteristics of a landscape that influence the image formation process. From research conducted in Florida, three major variables were identified that appear to have significant effect...

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

    Science.gov (United States)

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

    2015-01-01

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

  13. 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.

  14. CURBSIDE CONSULTATION IN FRACTURE MANAGEMENT: 49 CLINICAL QUESTIONS

    Directory of Open Access Journals (Sweden)

    Walter W. Virkus

    2008-12-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Tiziana Volpe

    2013-01-01

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

  17. Interactional difficulties as a resource for patient participation in prenatal screening consultations in Hong Kong.

    Science.gov (United States)

    Kang, M Agnes; Zayts, Olga A

    2013-07-01

    In this paper, we examine the interactional means by which non-native English speaking patients in Hong Kong participate in prenatal screening sessions. Using interactional sociolinguistics as the theoretical framework, we apply the concept of contextualization cues to illustrate that patients indicate their participation in the consultation through verbal and non-verbal modes. We find that non-native English speaking patients participate: (1) by displaying the interactional difficulties they are encountering and (2) by coordinating their displays of interactional difficulties with the activities of the healthcare provider. We conclude that the notion of patient participation must be expanded to take into account non-native speaking contexts; in particular, that collaborative displays of knowledge (or lack thereof) must be included as part of the definition of patient participation. While verbal contributions represent an important mode of participation in consultations, patients also participate by contextualizing their lack of understanding, which then can serve as a resource to healthcare providers in pursuing meaningful consultations. Our analysis illustrates how health care professionals' awareness of the modes of patient participation and what these modes may signal in non-native consultations can help to establish what the patient knows in the consultation. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  18. Characterisation of organisational issues in paediatric clinical ethics consultation: a qualitative study.

    Science.gov (United States)

    Opel, D J; Wilfond, B S; Brownstein, D; Diekema, D S; Pearlman, R A

    2009-08-01

    The traditional approach to resolving ethics concerns may not address underlying organisational issues involved in the evolution of these concerns. This represents a missed opportunity to improve quality of care "upstream". The purpose of this study was to understand better which organisational issues may contribute to ethics concerns. Directed content analysis was used to review ethics consultation notes from an academic children's hospital from 1996 to 2006 (N = 71). The analysis utilised 18 categories of organisational issues derived and modified from published quality improvement protocols. Organisational issues were identified in 68 of the 71 (96%) ethics consult notes across a range of patient settings and reasons for consultation. Thirteen of the 18 categories of organisational issues were identified and there was a median of two organisational issues per consult note. The most frequently identified organisational issues were informal organisational culture (eg, collective practices and approaches to situations with ethical dimensions that are not guided by policy), policies and procedures (eg, staff knows policy and/or procedural guidelines for an ethical concern but do not follow it) and communication (eg, communication about critical information, orders, or hand-offs repeatedly does not occur among services). Organisational issues contribute to ethical concerns that result in clinical ethics consults. Identifying and addressing organisational issues such as informal culture and communication may help decrease the recurrence of future similar ethics concerns.

  19. Web-based depression screening and psychiatric consultation for college students: a feasibility and acceptability study.

    Science.gov (United States)

    Williams, Aya; Larocca, Rachel; Chang, Trina; Trinh, Nhi-Ha; Fava, Maurizio; Kvedar, Joseph; Yeung, Albert

    2014-01-01

    Background. A steady rise in the prevalence of depression among college students has negatively affected student quality of life. This study investigates the feasibility and acceptability of a Web-based model, including Skype, to screen and provide psychiatric consultation to depressed college students. Methods. Students completed the 9-item Patient Health Questionnaire (PHQ-9) online; those who screened positive (PHQ-9 ≥ 10) or endorsed any level of suicidal ideation were offered Web-based psychiatric consultation using Skype. After the consultation, students filled out a 7-item satisfaction questionnaire to report on the acceptability of this Web-based method. Results. A total of 972 students consented to the online depression screening and 285 screened positive. Of those, 69 students consented and 17 students successfully completed the psychiatric consultation via Skype. Thirteen (76.4%) students found the interview useful in helping them understand their depression. Fifteen (88.2%) students thought that psychologists and psychiatrists could successfully see patients via videoconferencing. Conclusions. Current online technologies can provide depression screening and psychiatric consultation to college students; those who participated reported a positive experience. Future studies will need to address the low levels of participation among college students and attract students who are underserved, as well as use a videoconferencing platform that adequately protects data confidentiality.

  20. Web-Based Depression Screening and Psychiatric Consultation for College Students: A Feasibility and Acceptability Study

    Directory of Open Access Journals (Sweden)

    Aya Williams

    2014-01-01

    Full Text Available Background. A steady rise in the prevalence of depression among college students has negatively affected student quality of life. This study investigates the feasibility and acceptability of a Web-based model, including Skype, to screen and provide psychiatric consultation to depressed college students. Methods. Students completed the 9-item Patient Health Questionnaire (PHQ-9 online; those who screened positive (PHQ-9 ≥ 10 or endorsed any level of suicidal ideation were offered Web-based psychiatric consultation using Skype. After the consultation, students filled out a 7-item satisfaction questionnaire to report on the acceptability of this Web-based method. Results. A total of 972 students consented to the online depression screening and 285 screened positive. Of those, 69 students consented and 17 students successfully completed the psychiatric consultation via Skype. Thirteen (76.4% students found the interview useful in helping them understand their depression. Fifteen (88.2% students thought that psychologists and psychiatrists could successfully see patients via videoconferencing. Conclusions. Current online technologies can provide depression screening and psychiatric consultation to college students; those who participated reported a positive experience. Future studies will need to address the low levels of participation among college students and attract students who are underserved, as well as use a videoconferencing platform that adequately protects data confidentiality.

  1. Palliative Care Specialist Consultation Is Associated With Supportive Care Quality in Advanced Cancer.

    Science.gov (United States)

    Walling, Anne M; Tisnado, Diana; Ettner, Susan L; Asch, Steven M; Dy, Sydney M; Pantoja, Philip; Lee, Martin; Ahluwalia, Sangeeta C; Schreibeis-Baum, Hannah; Malin, Jennifer L; Lorenz, Karl A

    2016-10-01

    Although recent randomized controlled trials support early palliative care for patients with advanced cancer, the specific processes of care associated with these findings and whether these improvements can be replicated in the broader health care system are uncertain. The aim of this study was to evaluate the occurrence of palliative care consultation and its association with specific processes of supportive care in a national cohort of Veterans using the Cancer Quality ASSIST (Assessing Symptoms Side Effects and Indicators of Supportive Treatment) measures. We abstracted data from 719 patients' medical records diagnosed with advanced lung, colorectal, or pancreatic cancer in 2008 over a period of three years or until death who received care in the Veterans Affairs Health System to evaluate the association of palliative care specialty consultation with the quality of supportive care overall and by domain using a multivariate regression model. All but 54 of 719 patients died within three years and 293 received at least one palliative care consult. Patients evaluated by a palliative care specialist at diagnosis scored seven percentage points higher overall (P specialist consultation is associated with better quality of supportive care in three advanced cancers, predominantly driven by improvements in information and care planning. This study supports the effectiveness of early palliative care consultation in three common advanced cancers within the Veterans Affairs Health System and provides a greater understanding of what care processes palliative care teams influence. Published by Elsevier Inc.

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

    Science.gov (United States)

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

    2014-05-01

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

  3. Reflections on the role of consultant radiographers in the UK: The perceived impact on practice and factors that support and hinder the role

    International Nuclear Information System (INIS)

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

    2016-01-01

    Study context: This paper is the third paper arising from a two year long, in-depth case study exploring various components of the role of consultant radiographers in the UK. This paper focuses particularly upon the perceived impact of the role and factors that support and hinder the role in practice. Methods: A longitudinal case study method was used to explore the role of consultant radiographers. Interviewing was informed and guided by a phenomenological approach to promote a deeper understanding of consultants' experiences in the role. Eight consultant radiographers participated, with six involved throughout the whole study. Over an 18 month period each of those six consultants was interviewed three times. Two consultants only participated in the first interview; these interviews are also reported here. A total of 20 interviews were conducted. Findings: Interviews explored the impact of the consultant role as perceived by consultants themselves, and encouraged individual reflection on factors which had both supported and hindered success therein. Analysis demonstrated that there was substantial variation in the experiences communicated yet, and without any exception, all consultants reported that the introduction of their role had been beneficial to service delivery and quality of patient care. A number of obstacles were outlined, as well as a range of support mechanisms. Recommendations are thus made as to how the consultant role might be more effectively supported in the future. - Highlights: • The perceived impact of the consultant radiographer role in practice. • Reflections upon what supported the consultants in their role. • Reflections upon what hindered the consultants in their role.

  4. Habit formation.

    Science.gov (United States)

    Smith, Kyle S; Graybiel, Ann M

    2016-03-01

    Habits, both good ones and bad ones, are pervasive in animal behavior. Important frameworks have been developed to understand habits through psychological and neurobiological studies. This work has given us a rich understanding of brain networks that promote habits, and has also helped us to understand what constitutes a habitual behavior as opposed to a behavior that is more flexible and prospective. Mounting evidence from studies using neural recording methods suggests that habit formation is not a simple process. We review this evidence and take the position that habits could be sculpted from multiple dissociable changes in neural activity. These changes occur across multiple brain regions and even within single brain regions. This strategy of classifying components of a habit based on different brain signals provides a potentially useful new way to conceive of disorders that involve overly fixed behaviors as arising from different potential dysfunctions within the brain's habit network.

  5. Habit formation

    Science.gov (United States)

    Smith, Kyle S.; Graybiel, Ann M.

    2016-01-01

    Habits, both good ones and bad ones, are pervasive in animal behavior. Important frameworks have been developed to understand habits through psychological and neurobiological studies. This work has given us a rich understanding of brain networks that promote habits, and has also helped us to understand what constitutes a habitual behavior as opposed to a behavior that is more flexible and prospective. Mounting evidence from studies using neural recording methods suggests that habit formation is not a simple process. We review this evidence and take the position that habits could be sculpted from multiple dissociable changes in neural activity. These changes occur across multiple brain regions and even within single brain regions. This strategy of classifying components of a habit based on different brain signals provides a potentially useful new way to conceive of disorders that involve overly fixed behaviors as arising from different potential dysfunctions within the brain's habit network. PMID:27069378

  6. SOME INDICATORS OF CONSULTATIVE SERVICES DEVELOPMENT IN SERBIA

    Directory of Open Access Journals (Sweden)

    Vesna PARAUSIC

    2012-01-01

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

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

    DEFF Research Database (Denmark)

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

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

  8. Client/consultant model services agreement

    CERN Document Server

    International Federation of Consulting Engineers

    2006-01-01

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

  9. Search and nonsearch protocols for radiographic consultation

    International Nuclear Information System (INIS)

    Swensson, R.G.; Theodore, G.H.

    1989-01-01

    Six radiologists, acting as film reviewers, used two different consultation protocols to differentiate among 292 ambiguous findings on chest films: 120 simulated nodules and 172 normal findings (previous readers' false-positive reports of nodules). The non-search protocol identified each finding (by location), and reviewers rated its likelihood as a nodule. The search protocol, which asked reviewers to report and rate all locations regarded as possible nodules on each film, assigned a default negative rating to any unreported finding (nodule or normal). Receiver operator characteristic analyses demonstrated a significantly higher accuracy for each reviewer's search- protocol discriminations between these nodules and confusing normal findings

  10. New hospital consultant: surviving a difficult period.

    Science.gov (United States)

    Robinson, Geoffrey; Morreau, Johan; Leighton, Marion; Beasley, Richard

    2007-08-10

    The first years of consultant practice are amongst the most stressful in a medical specialist's career. Recognising the likely difficulties is essential if measures are to be put in place to lessen their impact. In this article, recommendations are made on how to balance clinical and non-clinical duties and to obtain the support required for professional development. Self-care of mental and physical health is vital and planning is necessary to ensure that both personal health and a work/life balance are maintained.

  11. A rock characterisation facility consultative document

    International Nuclear Information System (INIS)

    1992-10-01

    This U.K. Nirex Ltd., consultative document describes a proposed underground rock characterisation facility, east of Sellafield, for conducting geophysical surveys as a basis for refining long-term safety analysis of an underground repository for intermediate-level and low-level radioactive wastes. Planning application will be submitted in 1993. The construction of shafts and galleries is described and the site's geologic, topographical, climatic and archaeological features discussed. The effects to the local environment and on local populations and other socio-economic factors are discussed. (UK)

  12. The duty to consult and legal obligations

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-07-01

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

  13. Scientific decision-making and stakeholder consultations: the case of salt recommendations.

    Science.gov (United States)

    Timotijevic, Lada; Barnett, Julie; Brown, Kerry; Raats, Monique M; Shepherd, Richard

    2013-05-01

    Scientific advisory committees (SACs) are seen as "boundary organisations" working at the interface between science, policy and society. Although their narrowly defined remit of risk assessment is anchored in notions of rationality, objectivity, and reason, in reality, their sources for developing recommendations are not limited to scientific evidence. There is a growing expectation to involve non-scientific sources of information in the formation of knowledge, including the expectation of stakeholder consultation in forming recommendations. Such a move towards "democratisation" of scientific processes of decision-making within SACs has been described and often studied as "post-normal science" (PNS) (Funtowicz & Ravetz, 1993). In the current paper we examine the application of PNS in practice through a study of stakeholder consultations within the workings of the UK Scientific Advisory Committee for Nutrition (SACN). We use the theoretical insights from PNS-related studies to structure the analysis and examine the way in which PNS tenets resonate with the practices of SACN. We have selected a particular case of the SACN UK recommendations for salt as it is characterized by scientific controversy, uncertainty, vested interests and value conflict. We apply the tenets of PNS through documentary analysis of the SACN Salt Subgroup (SSG) consultation documents published in 2002/2003: the minutes of the 5 SACN SSG's meetings which included summary of the SACN SSG's stakeholder consultation and the SSG's responses to the consultation. The analysis suggests that the SACN consultation can be construed as a process of managing sources of risk to its organisation. Thus, rather than being an evidence of post-normal scientific practice, engagement became a mechanism for confirming the specific framing of science that is resonant with technocratic models of science holding authority over the facts. The implications for PNS theory are discussed. Copyright © 2013 Elsevier Ltd. All

  14. 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.

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-01-15

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

  17. Comet formation

    Science.gov (United States)

    Blum, J.

    2014-07-01

    There has been vast progress in our understanding of planetesimal formation over the past decades, owing to a number of laboratory experiments as well as to refined models of dust and ice agglomeration in protoplanetary disks. Coagulation rapidly forms cm-sized ''pebbles'' by direct sticking in collisions at low velocities (Güttler et al. 2010; Zsom et al. 2010). For the further growth, two model approaches are currently being discussed: (1) Local concentration of pebbles in nebular instabilities until gravitational instability occurs (Johansen et al. 2007). (2) A competition between fragmentation and mass transfer in collisions among the dusty bodies, in which a few ''lucky winners'' make it to planetesimal sizes (Windmark et al. 2012a,b; Garaud et al. 2013). Predictions of the physical properties of the resulting bodies in both models allow a distinction of the two formation scenarios of planetesimals. In particular, the tensile strength (i.e, the inner cohesion) of the planetesimals differ widely between the two models (Skorov & Blum 2012; Blum et al. 2014). While model (1) predicts tensile strengths on the order of ˜ 1 Pa, model (2) results in rather compactified dusty bodies with tensile strengths in the kPa regime. If comets are km-sized survivors of the planetesimal-formation era, they should in principle hold the secret of their formation process. Water ice is the prime volatile responsible for the activity of comets. Thermophysical models of the heat and mass transport close to the comet-nucleus surface predict water-ice sublimation temperatures that relate to maximum sublimation pressures well below the kPa regime predicted for formation scenario (2). Model (1), however, is in agreement with the observed dust and gas activity of comets. Thus, a formation scenario for cometesimals involving gravitational instability is favored (Blum et al. 2014).

  18. Psychoimmunology Consultation - A Study on Comorbidity

    Directory of Open Access Journals (Sweden)

    Mariana Marinho

    2017-03-01

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

  19. Options for change in the NHS consultant contract.

    Science.gov (United States)

    Clarke, R W; Gray, C

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

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

    Science.gov (United States)

    Fiester, Autumn

    2015-01-01

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

  1. Cap and trade offsets regulation - consultation paper

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-07-01

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

  2. First joint environmental consultancy for China

    International Nuclear Information System (INIS)

    Hendry, S.

    1993-01-01

    China's first joint venture environmental consulting firm, Environomics, formed with $100,000 from Chinese and U.S. investors, will begin doing business next month, says general manager Husayn Anwar. Last December Beijing slated its environmental industry's output to triple to yuan 10 billion ($1.8 billion)/year by the year 2000 - a response to increased strains on the environment caused by China's economic boom. The chemical industry is the foremost source of emissions of toxic substances such as mercury, phenol, and chromium: it also emits one-third of all industrial wastewater in the country, according to a May 1992 Ministry of the Chemical Industry report. Demand for ozone-depleting chlorofluorocarbons, without any change in technology, is set to triple by 2000, the ministry says

  3. 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.

  4. Key Value Considerations for Consultant Pharmacists.

    Science.gov (United States)

    Meyer, Lee; Perry, Ronald G; Rhodus, Susan M; Stearns, Wendy

    2016-07-01

    Managing the efficiency and costs of residents' drug regimens outside the acute-care hospital and through transitions of care requires a toolbox filled with cost-control tools and careful collaboration among the pharmacy provider(s), facility staff, and the consultant/senior care pharmacist. This article will provide the reader with key long-term care business strategies that affect the profitability of the pharmacy provider in various care settings while, at the same time, ensuring optimal therapy for residents as they transition across levels of care. Readers can take away ideas on how to access critical information, what they can do with this information, and how they can improve the overall care process. Four experts in various aspects of pharmacy management share their insights on pharmacy practice issues including formulary management, performance metrics, short-cycle dispensing challenges/solutions, cost-control measures, facility surveys, billing practices, medication reconciliation, prospective medication reviews, and transitions of care.

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

    Science.gov (United States)

    1996-01-01

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

  6. Structural analysis consultation using artificial intelligence

    Science.gov (United States)

    Melosh, R. J.; Marcal, P. V.; Berke, L.

    1978-01-01

    The primary goal of consultation is definition of the best strategy to deal with a structural engineering analysis objective. The knowledge base to meet the need is designed to identify the type of numerical analysis, the needed modeling detail, and specific analysis data required. Decisions are constructed on the basis of the data in the knowledge base - material behavior, relations between geometry and structural behavior, measures of the importance of time and temperature changes - and user supplied specifics characteristics of the spectrum of analysis types, the relation between accuracy and model detail on the structure, its mechanical loadings, and its temperature states. Existing software demonstrated the feasibility of the approach, encompassing the 36 analysis classes spanning nonlinear, temperature affected, incremental analyses which track the behavior of structural systems.

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

    Science.gov (United States)

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

    2015-10-01

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

  8. Economic Evaluation of Pediatric Telemedicine Consultations to Rural Emergency Departments.

    Science.gov (United States)

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

    2015-08-01

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

  9. Services of strategic consulting: special features and types

    OpenAIRE

    Klenin Oleh Volodymyrovych

    2016-01-01

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

  10. SOME REFLECTIONS UPON MANAGEMENT CONSULTING AS PROFESSIONAL SERVICES

    OpenAIRE

    Tomescu Ada; Botezat Elena

    2008-01-01

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

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

    Science.gov (United States)

    Parker, J Clint

    2018-06-01

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

  12. Telephone consultations on exposure to nuclear disaster radiation

    International Nuclear Information System (INIS)

    Yashima, Sachiko; Chida, Koichi

    2014-01-01

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

  13. Inconsistency of residents' communication performance in challenging consultations.

    Science.gov (United States)

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

    2013-12-01

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

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

    DEFF Research Database (Denmark)

    Rasmussen, Anne

    2015-01-01

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

  15. 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.

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

    Directory of Open Access Journals (Sweden)

    Spreeuwenberg Peter

    2007-01-01

    circumstances can easily be identified and will add to the understanding of the health complaints of the individual patient in the consulting room. Family circumstances related to health risks often cannot be changed but they can illuminate the reasons for a visit, and mould strategies for prevention, treatment or recovery. Health beliefs, on the other hand, may be influenced by providing specific knowledge.

  17. Public consultation in public policy information: a state-of-the-art report

    International Nuclear Information System (INIS)

    Bishop, A.B.; McKee, M.; Hansen, R.D.

    1977-01-01

    The purpose of the National Waste Terminal Storage (NWTS) Program is to site, construct and operate nuclear waste repositories at several locations. Recent experience indicates that the public is aware of the problems of nuclear waste disposal, and correspondingly there is public concern about how and where to dispose of nuclear wastes. The selection of sites involves a wide range of considerations including geological, technical and environmental feasibility. In addition to these, it is important that societal acceptance of repository options also be taken into account in moving foward with the NWTS Program. Such an incorporation of social considerations and preferences correspondingly implies the need for public consultation in the site selection process. In exploring the concept and state-or-the-art of public involvement in public policy decision, a number of important questions are relevant: (1) What are the basic objectives of public participation in policy formation and program decisions. (2) Who are the ''publics'' that should be involved and how can they be identified. (3) What information should be communicated between the agency and the publics. (4) What techniques are available to elicit public participation and involvement and what are their capabilities. At the outset, it should be noted that the purpose of this paper in addressing these questions is not to design public participation procedures for the NWTS program. Rather, the above are questions that provide a broad framework for developing an understanding of citizen participation in public policy decisions, such as nuclear waste disposal. In this sense, the following discussion is to provide a context and guidance for approaching the problem of organizing and structuring involvement in the NWTS program. Annotated bibliography of 95 references is included

  18. Public consultation in public policy information: a state-of-the-art report

    Energy Technology Data Exchange (ETDEWEB)

    Bishop, A.B.; McKee, M.; Hansen, R.D.

    1977-01-01

    The purpose of the National Waste Terminal Storage (NWTS) Program is to site, construct and operate nuclear waste repositories at several locations. Recent experience indicates that the public is aware of the problems of nuclear waste disposal, and correspondingly there is public concern about how and where to dispose of nuclear wastes. The selection of sites involves a wide range of considerations including geological, technical and environmental feasibility. In addition to these, it is important that societal acceptance of repository options also be taken into account in moving foward with the NWTS Program. Such an incorporation of social considerations and preferences correspondingly implies the need for public consultation in the site selection process. In exploring the concept and state-or-the-art of public involvement in public policy decision, a number of important questions are relevant: (1) What are the basic objectives of public participation in policy formation and program decisions. (2) Who are the ''publics'' that should be involved and how can they be identified. (3) What information should be communicated between the agency and the publics. (4) What techniques are available to elicit public participation and involvement and what are their capabilities. At the outset, it should be noted that the purpose of this paper in addressing these questions is not to design public participation procedures for the NWTS program. Rather, the above are questions that provide a broad framework for developing an understanding of citizen participation in public policy decisions, such as nuclear waste disposal. In this sense, the following discussion is to provide a context and guidance for approaching the problem of organizing and structuring involvement in the NWTS program. Annotated bibliography of 95 references is included.

  19. The role of consultant-researchers in the design and implementation process of a programme budget in a local government organization

    NARCIS (Netherlands)

    ter Bogt, H.J.; van Helden, G.J.

    This paper deals with our role as consultant-researchers in the improvement trajectory of a programme budget used in a Dutch province. For the 2009s programme budget the newly designed budget format was used in two pilot programmes. One year later we participated in the implementation of this format

  20. Improving athletes' perspectives of sport psychology consultation: a controlled evaluation of two interview methods.

    Science.gov (United States)

    Donohue, B; Dickens, Y; Lancer, K; Covassin, T; Hash, A; Miller, A; Genet, J

    2004-03-01

    Although investigations have consistently demonstrated the effectiveness of sport psychology interventions, these methods have been underutilized by athletes. In this study, 124 athletes completed the athletes' Attitudes Toward Seeking Sport Psychology Consultation Questionnaire (ATSSPCQ) and were subsequently randomly assigned to receive one of the two semistructured interview formats. One interview focused on discussing the athlete's experiences in sports, and the other focused on delineating sport psychology and its potential benefits to the athlete. Upon being interviewed, athletes were readministered the ATSSPCQ. Discussing sport psychology and its personal benefits was more effective in enhancing athletes' perception of need for sport psychology than discussing sport experiences. However, neither interview format enhanced athletes' perceptions of openness to discuss personal issues with a sport psychology consultant and tolerance of stigma associated with sport psychology consultation. Indeed, participants who received the discussion of sports intervention reported a significant decrease in personal openness to discuss personal issues relevant to sports psychology from pre- to postintervention. Intervention effects were similar for male and female athletes. Study implications and future directions are discussed in light of these results.

  1. Radionuclide migration in clayrock host formations for deep geological disposal of radioactive waste: advances in process understanding and up-scaling methods resulting from the EC integrated project `Funmig

    Science.gov (United States)

    Altmann, S.; Tournassat, C.; Goutelard, F.; Parneix, J. C.; Gimmi, T.; Maes, N.

    2009-04-01

    One of the ‘pillars' supporting Safety Cases for deep geological disposal of radioactive waste in clayrock formations is the knowledge base regarding radionuclide (Rn) retention by sorption and diffusion-driven transport which is why the EC integrated project ‘Funmig' focused a major part of its effort on advancing understanding of these two macroscopic phenomena. This talk presents some of the main results of this four year effort (2005-2008). One of the keys to understanding diffusion-driven transport of anionic and cationic radionuclide species in clayrocks lies in a detailed understanding of the phenomena governing Rn total concentration and speciation (dissolved, adsorbed) in the different types of pore spaces present in highly-compacted masses of permanently charged clay minerals. Work carried out on a specifically synthesized montmorillonite (a model for the clay mineral fraction in clayrocks) led to development, and preliminary experimental validation, of a conceptually coherent set of theoretical models (molecular dynamics, electrostatic double layer, thermodynamic) describing dissolved ion and water solvent behavior in this material. This work, complemented by the existing state of the art, provides a sound theoretical basis for explaining such important phenomena as anion exclusion, cation exchange and the diffusion behavior of anions, weakly sorbing cations and water tracers. Concerning the behavior of strongly sorbing and/or redox-reactive radionuclides in clay systems, project research improved understanding of the nature of sorption reactions and sorbed species structure for key radioelements, or analogues (U, Se, Eu, Sm, Yb, Nd) on the basal surfaces and in the interlayers of synthetic or purified clay minerals. A probable mechanism for Se(IV) retention by reduction to Se° in Fe2+-containing clays was brought to light; this same process was also studied on the Callovo-Oxfordien clayrock targeted by the French radwaste management program. The

  2. Parental knowledge in pediatric otolaryngology surgical consultations: A qualitative content analysis.

    Science.gov (United States)

    Gorodzinsky, Ayala Y; Hong, Paul; Chorney, Jill MacLaren

    2015-07-01

    To understand the source of parents' knowledge prior to and desire for further information following pediatric otolaryngology surgical consultations. Mixed-methods approach using descriptive and qualitative content analysis of interviews with parents following otolaryngology consultations for children under the age of 6 years was performed. The children were being seen for either tonsillitis, obstructive sleep apnea, otitis media, and/or sinusitis/nasal obstruction. Forty-one parents completed a phone interview two weeks following their child's surgical consultation. The majority of parents indicated that their primary care physician referred their child for either: investigation of symptoms (50%), to have a specific discussion about surgery (27.5%), or because other treatment options were no longer working (20%). Many parents (56.5%) indicated that the Internet was their primary source of information prior to the appointment. Most parents (93%) wanted more information; majority of these parents noted that a technology-based mode of delivery of information available prior to the appointment would be most desirable. Desired information was most often regarding the surgical procedure, including risks and benefits, and symptoms of concern prior to surgery. This study provides a description of parental knowledge and information sources prior to their child's surgical consultation and continued desire for information. This information may lead to decreased knowledge barriers and increased communication to facilitate shared decision-making between the provider and parents. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Moving It Along: A study of healthcare professionals' experience with ethics consultations.

    Science.gov (United States)

    Crigger, Nancy; Fox, Maria; Rosell, Tarris; Rojjanasrirat, Wilaiporn

    2017-05-01

    Ethics consultation is the traditional way of resolving challenging ethical questions raised about patient care in the United States. Little research has been published on the resolution process used during ethics consultations and on how this experience affects healthcare professionals who participate in them. The purpose of this qualitative research was to uncover the basic process that occurs in consultation services through study of the perceptions of healthcare professionals. The researchers in this study used a constructivist grounded theory approach that represents how one group of professionals experienced ethics consultations in their hospital in the United States. The results were sufficient to develop an initial theory that has been named after the core concept: Moving It Along. Three process stages emerged from data interpretation: moral questioning, seeing the big picture, and coming together. It is hoped that this initial work stimulates additional research in describing and understanding the complex social process that occurs for healthcare professionals as they address the difficult moral issues that arise in clinical practice.

  4. Oil sands and organizational cultures: strategy and stakeholder dynamics in an environmental public consultation process (Alberta)

    Energy Technology Data Exchange (ETDEWEB)

    Rouse, M.J.

    2000-07-01

    The demand for corporate responsiveness to environmental and social concerns, more specifically the requirement for public participation/consultation with stakeholders is, according to industry insiders, one of the most pressing changes for the oil industry. For this study, data on a public consultation process involving Syncrude Canada Limited, Alberta Environmental Protection, and the Alberta Energy and Utilities Board was collected through a combination of public hearing transcripts, participant observation, interview methodologies and reports. >From the perspective of organizational strategy, stakeholder relations, institutional theory and organizational cultures, the author investigated the public consultation process. Strategic action was the central theme to emerge through the findings. Positioning strategies influenced by stakeholder status from the organization's viewpoint and stakeholder relationships informed by the network of stakeholder relationships are included in stakeholder dynamics. The management of organizational culture and the creation of an institutional field to generate and maintain values across the relational field of focal organizations, and reduce costs and conflicts, are included in strategic outcomes. The elaboration and extension of components of stakeholder and institutional theories are part of further results, as well as an integrated understanding of the dynamic interconnectedness of organizational cultures, strategies and stakeholders in an environmental public consultation process.

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

    Science.gov (United States)

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

    2018-04-01

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

  6. Consultant-Client Relationship and Knowledge Transfer in Small- and Medium-Sized Enterprises Change Processes.

    Science.gov (United States)

    Martinez, Luis F; Ferreira, Aristides I; Can, Amina B

    2016-04-01

    Based on Szulanski's knowledge transfer model, this study examined how the communicational, motivational, and sharing of understanding variables influenced knowledge transfer and change processes in small- and medium-sized enterprises, particularly under projects developed by funded programs. The sample comprised 144 entrepreneurs, mostly male (65.3%) and mostly ages 35 to 45 years (40.3%), who filled an online questionnaire measuring the variables of "sharing of understanding," "motivation," "communication encoding competencies," "source credibility," "knowledge transfer," and "organizational change." Data were collected between 2011 and 2012 and measured the relationship between clients and consultants working in a Portuguese small- and medium-sized enterprise-oriented action learning program. To test the hypotheses, structural equation modeling was conducted to identify the antecedents of sharing of understanding, motivational, and communicational variables, which were positively correlated with the knowledge transfer between consultants and clients. This transfer was also positively correlated with organizational change. Overall, the study provides important considerations for practitioners and academicians and establishes new avenues for future studies concerning the issues of consultant-client relationship and the efficacy of Government-funded programs designed to improve performance of small- and medium-sized enterprises. © The Author(s) 2016.

  7. Prognostic accuracy of antenatal neonatology consultation.

    Science.gov (United States)

    Kukora, S; Gollehon, N; Weiner, G; Laventhal, N

    2017-01-01

    Neonatologists provide antenatal counseling to support shared decision-making for complicated pregnancies. Poor or ambiguous prognostication can lead to inappropriate treatment and parental distress. We sought to evaluate the accuracy of antenatal prognosticaltion. A retrospective cohort was assembled from a prospectively populated database of all outpatient neonatology consultations. On the basis of the written consultation, fetuses were characterized by diagnosis groups (multiple anomalies or genetic disorders, single major anomaly and obstetric complications), assigned to five prognostic categories (I=survivable, IIA=uncertain but likely survivable, II=uncertain, IIB=uncertain but likely non-survivable, III non-survivable) and two final outcome categories (fetal demise/in-hospital neonatal death or survival to hospital discharge). When possible, status at last follow-up was recorded for those discharged from the hospital. Prognostic accuracy was assessed using unweighted, multi-level likelihood ratios (LRs). The final cohort included 143 fetuses/infants distributed nearly evenly among the three diagnosis groups. Over half (64%) were assigned an uncertain prognosis, but most of these could be divided into 'likely survivable' or 'likely non-survivable' subgroups. Overall survival for the entire cohort was 62% (89/143). All but one of the fetuses assigned a non-survivable prognosis suffered fetal demise or died before hospital discharge. The neonatologist's antenatal prognosis accurately predicted the probability of survival by prognosis group (LR I=4.56, LR IIA=10.53, LR II=4.71, LR IIB=0.099, LR III=0.040). The LRs clearly differentiated between fetuses with high and low probability of survival. Eleven fetuses (7.7%) had misalignment between the predicted prognosis and outcome. Five died before discharge despite being given category I or IIA prognoses, whereas six infants with category IIB or III prognoses survived to discharge, though some of these were

  8. Report on AECB consultative document C-70: The use of fault trees in licensing submissions

    International Nuclear Information System (INIS)

    1984-01-01

    The Atomic Energy Control Board (AECB) has issued Consultative Document C-70, 'The Use of Fault Trees in Licensing Submissions', for public comment. The Advisory Committee on Nuclear Safety (ACNS) has examined this document and ACNS members have met with AECB staff and representatives of the nuclear industry to discuss it. The ACNS presents its comments and recommendations in this report. The consultative document defines a fault tree as a hierarchically-structured graphical representation of system failures and their potential causes. The document then states certain basic characteristics or attributes which fault trees should possess, and certain conditions affecting the use of fault trees. It defines fault tree fundamentals, sets criteria for the application of fault trees to systems and defines ground rules for a fault tree format. Finally, in two appendices, it includes specific rules for fault tree symbols and fault tree description files for computer use. The appendices are referred to in the text as 'acceptable' standards or methods

  9. An integrated occupational hygiene consultation model for the catering industry.

    Science.gov (United States)

    Lin, Yi-Kuei; Lee, Lien-Hsiung

    2010-07-01

    Vegetable oil used in food processing, during high-temperature exposure, will generate particulate matter (PM) and polycyclic aromatic hydrocarbons (PAHs), which are carcinogenic chemical compounds, with the potential to cause lung disease for restaurant kitchen staff. This study's design includes a three-stage consultation process with eight major consultation items, in order to build an integrated consultation model for occupational hygiene. This model combines inspection and consultation, targeting Chinese restaurants in the catering industry. Characteristics of the integrated consultation model include cooperation between different government departments and collaboration with nongovernmental, professional consulting organizations. An additional benefit of the model is the building of a good partnership relationship with the Catering Trade Association. The consultation model helps Chinese restaurants attain improvements in their work environments with minimal investment. Postconsultation, results show a 63.35% and 61.98% (P < 0.001) decrease in the mean time-weighted concentration of exposure to PM and PAHs, respectively. The overall regulation compliance rate of Chinese restaurants significantly increased from 34.3% to 89.6%. These results show that the integrated consultation model for occupational hygiene not only helps small and medium enterprises reduce exposure concentrations in the workplace but also has specific potential for successful implementation in Taiwan.

  10. 20 CFR 416.1016 - Medical or psychological consultants.

    Science.gov (United States)

    2010-04-01

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

  11. The preoperative cardiology consultation: Indications and risk modification

    NARCIS (Netherlands)

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

    2017-01-01

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

  12. Consulting-Research Froblems with German and American Multinational Firms.

    Science.gov (United States)

    Hildebrandt, Herbert W.

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

  13. 14 CFR 413.5 - Pre-application consultation.

    Science.gov (United States)

    2010-01-01

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

  14. 76 FR 47089 - Regulatory Review Schedule; Cancellation of Consultation Meetings

    Science.gov (United States)

    2011-08-04

    ... Consultation-- Wild Horse Resort Casino, 1, 2, 3, 4, 5 Southwest. Scottsdale, AZ. September 19-20, 2011 NIGC Regional Training..... Sky Ute Casino Resort 3, 4, 5 Ignacio, CO. September 27-28, 2011 NIGC Consultation-- Turning Stone Casino, NY... 3, 5 Northeast. November 7-12, 2011 USET Annual Meeting........ Mississippi...

  15. Consultation: Creating School-Based Interventions. Second Edition.

    Science.gov (United States)

    Dinkmeyer, Don, Jr.; Carlson, Jon

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

  16. 36 CFR 1270.50 - Consultation with law enforcement agencies.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Consultation with law enforcement agencies. 1270.50 Section 1270.50 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION PRESIDENTIAL RECORDS PRESIDENTIAL RECORDS Presidential Records Compiled for Law Enforcement Purposes § 1270.50 Consultation with...

  17. Intellectual Humility and Morality as Consultee-Centered Consultation Epistemologies

    Science.gov (United States)

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

    2017-01-01

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

  18. 42 CFR 431.105 - Consultation to medical facilities.

    Science.gov (United States)

    2010-10-01

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

  19. 42 CFR 493.1457 - Standard; Clinical consultant responsibilities.

    Science.gov (United States)

    2010-10-01

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

  20. 10 CFR 19.15 - Consultation with workers during inspections.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Consultation with workers during inspections. 19.15...: INSPECTION AND INVESTIGATIONS § 19.15 Consultation with workers during inspections. (a) Commission inspectors... inspectors deem necessary for the conduct of an effective and thorough inspection. (b) During the course of...

  1. A Critical Review of Videoconferencing Software to Support School Consultation

    Science.gov (United States)

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

    2018-01-01

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

  2. 29 CFR 1903.10 - Consultation with employees.

    Science.gov (United States)

    2010-07-01

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

  3. 10 CFR 51.40 - Consultation with NRC staff.

    Science.gov (United States)

    2010-01-01

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

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

    Science.gov (United States)

    Ibrahim, Farah A.

    2015-01-01

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

  5. Addressing Cultural Responsiveness in Consultation: An Empirical Demonstration

    Science.gov (United States)

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

    2017-01-01

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

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

    Science.gov (United States)

    Trohanis, Pascal L.; And Others

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

  7. 76 FR 28446 - Policy on Consultation With Indian Tribes

    Science.gov (United States)

    2011-05-17

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

  8. Federal Consulting: Strategies and Tools for the Career Development Professional.

    Science.gov (United States)

    Kahnweiler, Jennifer B.; Pressman, Sue

    The Federal Government is America's largest employer and is expanding consulting opportunities for career development professionals. Increased Federal mandates for outsourcing have opened wide doors for the entrepreneurial-spirited career counselors and created new challenges for traditional methods of offering career services. As consultants who…

  9. Got Guilt? Consultant Guilt in the Writing Center Community

    Science.gov (United States)

    Nicklay, Jennifer

    2012-01-01

    During class discussions, the author's fellow consultants would often lament consultations that could have gone better if they had only known the "rules" of how to handle the situation. They perceived that there were acceptable and unacceptable ways to approach certain situations, rather than a range of flexible choices. The author began to…

  10. Concertation or Consultation. That is the question.

    CERN Multimedia

    Staff Association

    2018-01-01

    In April 2017 (as reported in Echo No. 268), the Staff Association, when invited to an Enlarged Directorate meeting, stressed that “concertation requires a positive attitude and mutual trust. […] The Staff Association is firmly committed in this respect but does not consider that the concertation process is as effective as we should like”. The continued lack, for the Staff Association, of an effective concertation process led to a revisiting of the situation in June 2017 (Echo No. 271), in an article that stressed the importance of the concertation process at CERN since it was introduced in 1983, the year in which the Standing Concertation Committee (SCC) replaced the Standing Consultation Committee. The importance of concertation was also highlighted by Mr Bernard Dormy, Chair of TREF, in an interview he gave to the Staff Association at the end of January 2018 (Echo No. 284), when he retired from his position as the Chair of the Forum. “To sum it up, I would certainl...

  11. Concertation rather than Consultation or Negotiation!

    CERN Multimedia

    Staff Association

    2017-01-01

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

  12. Gas priority users consultation : government response

    International Nuclear Information System (INIS)

    2007-01-01

    This consultation document presents the results of an updated analysis of gas priority users comments on the UK government's proposals for updating the current priority lists, amending the eligibility criteria for priority user status, and simplifying the administration of the scheme. The extension of Category C priority users to include sites where interruption of gas supplies would lead to damage exceeding fifty million pounds to a plant at another site is discussed. It is acknowledged that there is a preference for a reduction of gas demand as opposed to a cessation in the case of an emergency gas supply deficit and details are given of a Task Group set up to examine options for reducing demand rather than cessation for large industrial gas users. The role of the Network Emergency Co-ordinator, support for a more flexible approach, pre-agreed rota interruption, a long-duration emergency, demand reduction, and the establishment of a Government/Industry Gas/Electricity Task Group are discussed, and the raising of the load shedding threshold of 25,000 therms/yr is considered

  13. 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.

  14. Department of Training and Consulting - Overview

    International Nuclear Information System (INIS)

    Dobrzynski, L.

    2007-01-01

    Department of Training and Consulting is regularly serving secondary schools' pupils and teachers, university students and the public. As usual we have been visited by about 7000 visitors, mainly students from secondary schools in Poland. The Department is constantly developing experiments which can be conducted by students of secondary schools and universities, as well as by professionals. At the moment there are about 20 experiments available for the guests of the Department. They cover measurements of the lifetimes, elements of radioprotection, absorption of radiation in various materials, excitation of fluorescence radiation, influence of magnetic field on beta radiation as well as electrons emitted from typical electron gun, Compton scattering and elements of gamma spectroscopy, search for radioactive pollutions etc. In addition the Department was very active during Science Picnic in May and Science Festival in September, when the Department proposed organisation of a '' Day with Radioactivity ''. '' The Day '' consisted of a number of public lectures and demonstrations. In addition two evenings were dedicated to a public debate on energy sources and energy demands and supply in next 50-100 years. One should also mention organisation and leading of the professional course for accelerators' operators, as well as starting a new university course on '' Nuclear Energy and Its Use '' (Cardinal Stefan Wyszynski University, Warsaw). The web side of the Department contains educational materials (part of it can be found on international platform http://www.nupex.org), quizzes and self-teaching materials. (author)

  15. Stakeholder consultations regarding centralized power procurement processes in Ontario

    International Nuclear Information System (INIS)

    2005-01-01

    In 2004, Ontario held 4 Requests for Proposals (RFPs) to encourage the development of new clean renewable combined heat and power generation and the implementation of conservation and demand management programs. Details of a stakeholder consultation related to the RFP process were presented were in this paper. The aim of the consultation was to synthesize stakeholder comments and to provide appropriate recommendations for future RFPs held by the Ontario Power Authority (OPA). The financial burden of bidding was discussed, as well as communications procedures and contract ambiguities. Issues concerning the criteria used for qualifying potential bidders and evaluating project submissions were reviewed. Recommendations for future processes included prequalification, a simplification in collusion requirements, and a fixed time response. It was also recommended that the process should not emphasize financing as lenders do not make firm commitments to bidders prior to a bid being accepted. It was suggested that the amount of bid security should vary with the project size and phase of development, and that the contracts for differences format should be refined to allow participants to propose parameters. Issues concerning audit procedures and performance deviations were reviewed. It was suggested that contract terms should be compatible with gas markets. It was also suggested that the OPA should adopt a more simplified approach to co-generation proposals, where proponents can specify amounts of energy and required prices. The adoption of the Swiss challenge approach of allowing other vendors an opportunity to match or beat terms on an offer was recommended. It was suggested that renewables should be acquired through a targeted and volume limited standard-offer process to be set yearly. Conservation and demand management recommendations were also presented. It was suggested that the OPA should serve as a facilitator of clean development mechanism (CDM) programs. It was

  16. Does professional-centred training improve consultation outcomes?

    DEFF Research Database (Denmark)

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

    2006-01-01

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

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

    Science.gov (United States)

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

    1998-08-05

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

  18. 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

  19. An empirical study of multidimensional fidelity of COMPASS consultation.

    Science.gov (United States)

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

    2018-06-01

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

  20. What matters most to people in musculoskeletal physiotherapy consultations? A qualitative study.

    Science.gov (United States)

    Stenner, Rob; Palmer, Shea; Hammond, Ralph

    2018-06-01

    Person-centred approaches to care require clinicians to engage in trying to understand the full range of problems and concerns, treatment and investigation requests, and emotional and social issues that people bring to the consultation. If, however, the main issues of importance are not openly declared and discussed they cannot be addressed. This is likely to result in people receiving the care that clinicians think they need, rather than care based on individual needs and preferences. To understand people's abilities to express the issues of importance to them within a consultation and clinicians' abilities to acknowledge and address those issues. A qualitative study using an interpretive phenomenological approach. Fifteen people and their physiotherapists were interviewed and their consultations recorded. The resulting data sets were analysed to identify and report themes within the data. The findings revealed that people present with what are often simple issues, but which are sometimes expressed in an unstructured way in clinical encounters and are often difficult for clinicians to establish. Three linked themes emerged: (1) clear versus unstructured agendas; (2) people need information and understanding; and (3) developing a sense of collaboration. The issues of importance that people bring to a consultation are varied and often vague. This research highlights the importance of communication to elicit, identify and address the issues of importance to people in clinical encounters to ensure a positive experience and outcome for both the individual person and clinician. Achieving desirable health outcomes is more likely when people are supported to think about their priorities and 'what matters to them'. Copyright © 2018 Elsevier Ltd. All rights reserved.

  1. Asymmetrical knowledge claims in general practice consultations with frequently attending patients: limitations and opportunities for patient participation.

    Science.gov (United States)

    Ariss, Steven M

    2009-09-01

    Asymmetry of knowledge does not simply relate to knowing or not knowing. Participants in consultations also display normative entitlements to knowledge which are related to their identities in the interaction. Claims of entitlement to knowledge are oriented to by the other participant as either straightforwardly acceptable or problematic. Thus research has shown that asymmetry in doctor-patient interactions is collaboratively achieved. Whilst the asymmetry of medical consultations has long been recognised, understanding asymmetry in the context of patient participation is becoming an increasingly important priority. This paper is not concerned with potential benefits or the feasibility of increasing patient participation in general practice (GP) consultations. Rather it seeks to describe specific limitations and opportunities for the participation of patients regarding the discussion of their problems, treatments and management of illness. Using Conversation Analysis this paper investigates GP consultations with frequently attending patients in the UK. It describes how the moral dimensions of epistemic authority constrain the different conversational resources available to GPs and patients. Findings suggest that in maintaining asymmetrical claims to knowledge debate is foregone in favour of efficient progression through the phases of the interaction. Thus interactions militate against the discussion of areas where alignment of perspectives might be lacking and participants do not pursue actions which might lead towards claiming a greater understanding of each others' point of view. However, there are aspects of consultations with frequently attending patients which display reduced asymmetry with regard to participants' claims to epistemic authority.

  2. Improving access to urologists through an electronic consultation service

    Science.gov (United States)

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

    2017-01-01

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

  3. Nurse and allied health professional consultants: perceptions and experiences of the role.

    Science.gov (United States)

    Stevenson, Kay; Ryan, Sarah; Masterson, Abigail

    2011-02-01

    To explore the perceptions and experiences of nurse and allied health professional consultants and key stakeholders. Nurse and allied health professional consultants' roles were introduced in the United Kingdom in 1999 with defined role criteria and a remit to improve patient outcomes. Although these roles have now existed for over a decade, there is a lack of research as to whether these roles have achieved their intended impact on clinical care. Through an exploration of the experiences of consultant nurses and allied health professionals and key stakeholders who work with these practitioners, a greater understanding of the consultant role can be achieved. Qualitative. A purposive sample of seven non-medical consultants (five nurses, one physiotherapist and a pharmacist) and eight stakeholders took part in focus group interviews. Each focus group was audio-taped and lasted between 1.5-2 hours. Content analysis was used to interpret the data. Four main themes were identified: (1) Role interpretation--core features include clinical practice, leadership, education and research. Debate surrounded the need to incorporate managerial responsibilities into the role. (2) Role implementation required political skills and emotional intelligence. (3) Role impact especially on clinical practice was a major priority for both groups. (4) Challenges included lack of organisational and administrative support. There was consensus amongst the two groups regarding the value of the role, key role functions and skills and the emerging impact on clinical practice. Both groups were able to identify the clinical impact of the role including helping patients manage chronic pain, reducing the need for follow-up appointments and managing emergency admissions. To capture the clinical diversity of the roles, a variety of evaluation strategies should be implemented. © 2011 Blackwell Publishing Ltd.

  4. 77 FR 31348 - Boott Hydropower, Inc.; Notice of Consulting Parties and Agenda for Section 106 Consultation Meeting

    Science.gov (United States)

    2012-05-25

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

  5. Balancing Acts: Culture as Commodity Among Business Consultants

    Directory of Open Access Journals (Sweden)

    Elias Mellander

    2013-09-01

    Full Text Available In this article the authors intend to analyze how the concept of culture is packaged, sold and delivered as a commodity. It is based on an ethnographic study of a Swedish consultancy in the field of cross-cultural communication and the relationship between the company and its clients. The clients were primarily foreign executives working in Sweden or Swedish expatriates, preparing for life abroad. The significance of culture-as-commodity will be explored from the perspective of the company as well as its clients in order to shed light on how the concept of culture can be communicated and what happens to it in the process. The study shows how the company combines theoretical perspectives from anthropology and intercultural communication with the aim to deliver a complex yet accessible understanding of culture to its clients. The analysis shows that these perspectives both clash and synergize, creating contradictions as well as turning culture into an accessible and useful tool for clients. The authors argue that researchers in the field of applied cultural analysis can learn from the example put forth by the balancing act between these two perspectives on culture performed by the company. The authors conclude that although the commodification process reduces and simplifies the meaning(s of culture, the company still manages to put culture on the agenda, demonstrating to its clients how, why, and in what ways it matters to them.

  6. 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.

  7. Department of Training and Consulting - Overview

    International Nuclear Information System (INIS)

    Dobrzynski, L.

    2010-01-01

    Full text: The Department of Training and Consulting concentrates on the dissemination of knowledge on radiation phenomena: the origins, applications and health effects of ionizing radiation in particular. Its activity is open to the public. However, the main recipients are students of secondary schools and teachers. During about 12 years of such activity the number of visitors has exceeded 60 000 persons, while during last few years the average number of our visitors varies between 6 000 and 7 000 per year, which shows how much this kind of activity is needed. It should be noted that the term 'visitor' is not the most appropriate, because what the 'visitor' actually experiences in the Department is a series of lectures with demonstrations, visits to the MARIA reactor or regular experimenting in a specially designed Laboratory of Atomic and Nuclear Physics for schools, teachers and university students. The Department organized two permanent exhibitions. One is connected with the nuclear waste treatment and storage, another one displays a large model. 4x4x4 m. of a nuclear reactor of the WWER-type which was about to be installed at Zarnowiec about 20 years ago. The Department is equally active during annual Picnics and Festivals of Science in Warsaw and other Polish towns. Our staff is often asked to deliver lectures outside the Institute for Nuclear Studies, and participates in discussions on problems of teaching, in addition, the Department leads, together with the Institute of Physics of the Polish Academy of Sciences, Warsaw, the annual competition, named '' Physical Paths '', for high-school students. The competition is arranged in three categories: research, demonstration of physical phenomena, and essays on physics and its relation to civilization. This competition particularly stimulates small educational centers in Poland. This year, 2010, the competition was organized for the fifth time. The Department of Training and Consulting arranges regular courses

  8. 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.

  9. Understanding the effects of potassium ferricyanide on lead hydride formation in tetrahydroborate system and its application for determination of lead in milk using hydride generation inductively coupled plasma optical emission spectrometry

    International Nuclear Information System (INIS)

    Deng, Biyang; Xu, Xiangshu; Xiao, Yan; Zhu, Pingchuan; Wang, Yingzi

    2015-01-01

    Highlights: • Proposed a novel explanation for plumbane generation. • Expounded the role of K 3 Fe(CN) 6 in plumbane generation. • Clarified the controversial aspects in the mechanism of K 3 Fe(CN) 6 enhancement. • Used X-ray diffractometry to analyze the intermediates. • Developed a method to analyze lead in milk using K 3 Fe(CN) 6 and K 4 Fe(CN) 6 as new additives. - Absract: To understand the formation of plumbane in the Pb II -NaBH 4 -K 3 Fe(CN) 6 system, the intermediate products produced in the reaction of lead(II) and NaBH 4 in the presence of K 3 Fe(CN) 6 were studied. The produced plumbane and elemental lead were measured through continuous flow hydride generation (HG)-inductively coupled plasma optical emission spectrometry (ICP OES) and X-ray diffraction spectrometry techniques, respectively. Based on the experimental results, the explanations can be depicted in the following steps: (1) plumbane and black lead sediment (black Pb) are formed in the reaction of lead(II) and NaBH 4 ; (2) the black Pb is oxidized by K 3 Fe(CN) 6 to form Pb 2 [Fe(CN) 6 ], which further reacts with NaBH 4 to form more plumbane and black Pb; and (3) another round starts in which the produced black Pb from the step 2 is then oxidized continuously by K 3 Fe(CN) 6 to form more Pb 2 [Fe(CN) 6 ] complex, which would produce more plumbane. In short, the black Pb and Pb 2 [Fe(CN) 6 ] complex are the key intermediate products for the formation of plumbane in the Pb II -NaBH 4 -K 3 Fe(CN) 6 system. Based on the enhancement effect of potassium ferricyanide and potassium ferrocyanide, a method was developed to analyze lead in milk with HG-ICP OES technique. The detection limit of the method was observed as 0.081 μg L −1 . The linearity range of lead was found between 0.3 and 50,000 μg L −1 with correlation coefficient of 0.9993. The recovery of lead was determined as 97.6% (n = 5) for adding 10 μg L −1 lead into the milk sample

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

    Science.gov (United States)

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

    2013-10-01

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

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

    Science.gov (United States)

    Mendoza, Danielle W.

    1993-01-01

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

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

    Science.gov (United States)

    Sibarani, Roza Marsaulina

    2014-01-01

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

  13. Joint medico-psychological consultation for patients suffering from tinnitus.

    Science.gov (United States)

    Degive, Colette; Kos, Maria-Izabel

    2006-01-01

    Because no effective treatment against tinnitus is available, all sorts of approaches have been developed. We believe the care of tinnitus patients concerns mainly ENT medical doctors. In order to take care of such patients, we started in 1993 a joint medico-psychological consultation (JMPC) to dispense adequate care for patients and training to the ENT residents. Every patient visiting our clinic for a tinnitus consultation benefits first from a comprehensive audiological examination. Once all objective causes of tinnitus are excluded, those patients who were not able to accept their auditory disorder or who insist on focusing on the annoyance caused by the perception of their tinnitus are invited by the doctor to the JMPC. The intolerance caused by tinnitus is enhanced by psychological and social aspects. These aspects are considered and discussed during the JMPC. The patients talk about their tinnitus bringing additional information on professional, familial and relational issues. In the JMPC, the therapists try to help the patients to void the affective irritation and the internal tension they clearly demonstrate. When the patients notice that the therapists accept their distress, they usually talk more calmly about their hearing irritation and even consider it tolerable. The medical and psychological information given during the JMPC helps the patients to understand the links between tinnitus and the disturbing elements of their current life. During the JMPC, the medical residents have been able to observe how somatic complaints can lead to complaints of another nature, to distress, to aggressive or angered behaviors. They have acknowledged the way the psychologist deals with the attitudes of these patients. This learning process became mandatory to all our residents specializing in ENT. At the end of their training they should have learned how to help the patient accept the tinnitus and the irritation it causes. They should be able to help tinnitus patients

  14. Interventions before consultations for helping patients address their information needs.

    Science.gov (United States)

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

    2007-07-18

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

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

    Science.gov (United States)

    Jones, Mavis; Einsiedel, Edna

    2011-09-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

    Long, Jennifer; Long, Airdrie

    2012-01-01

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

  18. Interpreted consultations as 'business as usual'? An analysis of organisational routines in general practices.

    Science.gov (United States)

    Greenhalgh, Trisha; Voisey, Christopher; Robb, Nadia

    2007-09-01

    UK general practices operate in an environment of high linguistic diversity, because of recent large-scale immigration and of the NHS's commitment to provide a professional interpreter to any patient if needed. Much activity in general practice is co-ordinated and patterned into organisational routines (defined as repeated patterns of interdependent actions, involving multiple actors, bound by rules and customs) that tend to be stable and to persist. If we want to understand how general practices are responding to pressures to develop new routines, such as interpreted consultations, we need to understand how existing organisational routines change. This will then help us to address a second question, which is how the interpreted consultation itself is being enacted and changing as it becomes routinised (or not) in everyday general practice. In seeking answers to these two questions, we undertook a qualitative study of narratives of interpreted primary care consultations in three London boroughs with large minority ethnic populations. In 69 individual interviews and two focus groups, we sought accounts of interpreted consultations from service users, professional interpreters, family member interpreters, general practitioners, practice nurses, receptionists, and practice managers. We asked participants to tell us both positive and negative stories of their experiences. We analysed these data by searching for instances of concepts relating to the organisational routine, the meaning of the interpreted consultation to the practice, and the sociology of medical work. Our findings identified a number of general properties of the interpreted consultation as an organisational routine, including the wide variation in the form of adoption, the stability of the routine, the adaptability of the routine, and the strength of the routine. Our second key finding was that this variation could be partly explained by characteristics of the practice as an organisation, especially

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

    Science.gov (United States)

    Erbas, Dilek

    2010-01-01

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

  20. Understanding Alzheimer's

    Science.gov (United States)

    ... Navigation Bar Home Current Issue Past Issues Understanding Alzheimer's Past Issues / Fall 2007 Table of Contents For ... and brain scans. No treatment so far stops Alzheimer's. However, for some in the disease's early and ...