Sample records for public consultation synthesis

  1. 45 CFR 1302.3 - Consultation with public officials and consumers.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Consultation with public officials and consumers. 1302.3 Section 1302.3 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN... officials and consumers. Responsible HHS officials will consult with Governors, or their representatives...

  2. 45 CFR 1302.3 - Consultation with public officials and consumers.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 4 2011-10-01 2011-10-01 false Consultation with public officials and consumers. 1302.3 Section 1302.3 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN... officials and consumers. Responsible HHS officials will consult with Governors, or their representatives...

  3. Public consultation in ethics: an experiment in representative ethics.

    PubMed

    Burgess, Michael M

    2004-01-01

    Genome Canada has funded a research project to evaluate the usefulness of different forms of ethical analysis for assessing the moral weight of public opinion in the governance of genomics. This paper will describe a role of public consultation for ethical analysis and a contribution of ethical analysis to public consultation and the governance of genomics/biotechnology. Public consultation increases the robustness of ethical analysis with a more diverse set of moral experiences. Consultation must be carefully and respectfully designed to generate sufficiently diverse and rich accounts of moral experiences. Since dominant groups tend to define ethical or policy issues in a manner that excludes some interests or perspectives, it is important to identify the range of interests that diverse publics hold before defining the issue and scope of the discussion and the premature foreclosure of ethical dialogue. Consequently, a significant contribution of ethical dialogue strengthened by social analysis is to consider the context and non-policy use of power to govern genomics and to sustain social debate on enduring ethical issues.

  4. Community Consultation and Public Disclosure: Preliminary Results From A New Model

    PubMed Central

    Ramsey, Cornelia A.; Quearry, Bonnie; Ripley, Elizabeth

    2011-01-01

    Emergency medicine research conducted under the exception from informed consent (EFIC) regulation enables critical scientific advancements. When EFIC is proposed, there is a requirement for broad community consultation and public disclosure regarding the risks and benefits of the study. At the present time, no clear guidelines or standards exist for conducting and evaluating the community consultation and public disclosure. This preliminary study tested the feasibility and acceptability of a new approach to community consultation and public disclosure for a large-scale EFIC trial by engaging community members in designing and conducting the strategies. The authors enrolled key community members (called Community Advocates for Research, or CARs) to use community-based participatory methods to design and implement community consultation and public disclosure. By partnering with community members who represent target populations for the research study, this new approach has demonstrated a feasible community consultation and public disclosure plan with greater community participation and less cost than previous studies. In a community survey, the percentage of community members reporting having heard about the EFIC trial more than doubled after employing the new approach. This article discusses initial implementation and results. PMID:21729187

  5. Representation or reason: consulting the public on the ethics of health policy.

    PubMed

    Mullen, Caroline

    2008-12-01

    Consulting the public about the ethical approaches underlying health policies can seem an appealing means of addressing concerns about limited public participation in development of health policy. However ambiguity surrounds questions of whether, or how consultation can really contribute to more defensible decisions about ethical aspects of policy. This paper clarifies the role and limits of public consultation on ethics, beginning by separating different senses of defensibility in decisions on ethics. Defensibility of ethical decisions could be understood either in the sense of legitimacy in virtue of reflecting the opinions of the public whose interests are affected, or in the sense of being able to withstand and respond to challenges presented in ethical debate. The question then is whether there are forms of consultation which have the potential to realise more defensible decisions in either of these senses. Problems of adequately accounting for the views of those affected by policy decisions casts doubt on the plausibility of using consultation as a means of determining the opinions of the public. Consultation can have a role by bringing new ideas and challenges to debate, although it is uncertain whether this will increase the defensibility of any decision on ethics.

  6. Institutional policy learning and public consultation: the Canadian xenotransplantation experience.

    PubMed

    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.

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

    PubMed Central

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

    PubMed

    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.

  9. 23 CFR 450.210 - Interested parties, public involvement, and consultation.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 23 Highways 1 2010-04-01 2010-04-01 false Interested parties, public involvement, and consultation. 450.210 Section 450.210 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PLANNING AND RESEARCH PLANNING ASSISTANCE AND STANDARDS Statewide Transportation Planning and Programming § 450...

  10. 23 CFR 450.210 - Interested parties, public involvement, and consultation.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 23 Highways 1 2011-04-01 2011-04-01 false Interested parties, public involvement, and consultation. 450.210 Section 450.210 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PLANNING AND RESEARCH PLANNING ASSISTANCE AND STANDARDS Statewide Transportation Planning and Programming § 450...

  11. 10 CFR 50.91 - Notice for public comment; State consultation.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Notice for public comment; State consultation. 50.91 Section 50.91 Energy NUCLEAR REGULATORY COMMISSION DOMESTIC LICENSING OF PRODUCTION AND UTILIZATION... consideration if it determines that the licensee has abused the emergency provision by failing to make timely...

  12. 75 FR 78709 - Public Comment on the Draft Tribal Consultation Policy

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-16

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Public Comment on the Draft Tribal Consultation Policy AGENCY: Administration for Children and Families, HHS. ACTION... that complement the Department- wide efforts. Since 2005, the Administration for Children and Families...

  13. Is There a Role for Publication Consultants and How Should Their Contribution be Recognized?

    PubMed

    Kendall, Graham; Yee, Angelina; McCollum, Barry

    2016-10-01

    When a scientific paper, dissertation or thesis is published the author(s) have a duty to report who has contributed to the work. This recognition can take several forms such as authorship, relevant acknowledgments and by citing previous work. There is a growing industry where publication consultants will work with authors, research groups or even institutions to help get their work published, or help submit their dissertation/thesis. This help can range from proof reading, data collection, analysis (including statistics), helping with the literature review and identifying suitable journals/conferences. In this opinion article we question whether these external services are required, given that institutions should provide this support and that experienced researchers should be qualified to carry out these activities. If these services are used, we argue that their use should at least be made transparent either by the consultant being an author on the paper, or by being acknowledged on the paper, dissertation or thesis. We also argue that publication consultants should provide an annual return that details the papers, dissertations and thesis that they have consulted on.

  14. 24 CFR 972.133 - Public and resident consultation process for developing a conversion plan.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 4 2012-04-01 2012-04-01 false Public and resident consultation process for developing a conversion plan. 972.133 Section 972.133 Housing and Urban Development... ASSISTANCE Required Conversion of Public Housing Developments Conversion Plans § 972.133 Public and resident...

  15. Consultants, Consultancy and Consultocracy in Education Policymaking in England

    ERIC Educational Resources Information Center

    Gunter, Helen M.; Hall, David; Mills, Colin

    2015-01-01

    The role and contribution of consultants and consultancy in public services has grown rapidly and the power of consultants suggests the emergence of a "consultocracy". We draw on research evidence from the social sciences and critical education policy (CEP) studies to present an examination of the state of the field. We deploy a…

  16. WHO Global Consultation on Public Health Intervention against Early Childhood Caries.

    PubMed

    Phantumvanit, Prathip; Makino, Yuka; Ogawa, Hiroshi; Rugg-Gunn, Andrew; Moynihan, Paula; Petersen, Poul Erik; Evans, Wendell; Feldens, Carlos Alberto; Lo, Edward; Khoshnevisan, Mohammad H; Baez, Ramon; Varenne, Benoit; Vichayanrat, Tippanart; Songpaisan, Yupin; Woodward, Margaret; Nakornchai, Siriruk; Ungchusak, Chantana

    2018-06-01

    Early Childhood Caries (ECC) is prevalent around the world, but in particular the disease is growing rapidly in low- and middle-income countries in parallel with changing diet and lifestyles. In many countries, ECC is often left untreated, a condition which leads to pain and adversely affects general health, growth and development, and quality of life of children, their families and their communities. Importantly, ECC is also a global public health burden, medically, socially and economically. In many countries, a substantial number of children require general anaesthesia for the treatment of caries in their primary teeth (usually extractions), and this has considerable cost and social implications. A WHO Global Consultation with oral health experts on "Public Health Intervention against Early Childhood Caries" was held on 26-28 January 2016 in Bangkok (Thailand) to identify public health solutions and to highlight their applicability to low- and middle-income countries. After a 3-day consultation, participants agreed on specific recommendations for further action. National health authorities should develop strategies and implement interventions aimed at preventing and controlling ECC. These should align with existing international initiatives such as the Sixtieth World Health Assembly Resolution WHA 60.17 Oral health: action plan for promotion and integrated disease prevention, WHO Guideline on Sugars and WHO breastfeeding recommendation. ECC prevention and control interventions should be integrated into existing primary healthcare systems. WHO public health principles must be considered when tackling the effect of social determinants in ECC. Initiatives aimed at modifying behaviour should focus on families and communities. The involvement of communities in health promotion, and population-directed and individual fluoride administration for the prevention and control of ECC is essential. Surveillance and research, including cost-effectiveness studies, should be

  17. A burn center paradigm to fulfill deferred consent public disclosure and community consultation requirements for emergency care research.

    PubMed

    Blackford, Martha G; Falletta, Lynn; Andrews, David A; Reed, Michael D

    2012-09-01

    To fulfill Food and Drug Administration and Department of Health and Human Services emergency care research informed consent requirements, our burn center planned and executed a deferred consent strategy gaining Institutional Review Board (IRB) approval to proceed with the clinical study. These federal regulations dictate public disclosure and community consultation unique to acute care research. Our regional burn center developed and implemented a deferred consent public notification and community consultation paradigm appropriate for a burn study. Published accounts of deferred consent strategies focus on acute care resuscitation practices. We adapted those strategies to design and conduct a comprehensive public notification/community consultation plan to satisfy deferred consent requirements for burn center research. To implement a robust media campaign we engaged the hospital's public relations department, distributed media materials, recruited hospital staff for speaking engagements, enlisted community volunteers, and developed initiatives to inform "hard-to-reach" populations. The hospital's IRB determined we fulfilled our obligation to notify the defined community. Our communication strategy should provide a paradigm other burn centers may appropriate and adapt when planning and executing a deferred consent initiative. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

  18. Cross-Disciplinary Consultancy to Bridge Public Health Technical Needs and Analytic Developers: Asyndromic Surveillance Use Case.

    PubMed

    Faigen, Zachary; Deyneka, Lana; Ising, Amy; Neill, Daniel; Conway, Mike; Fairchild, Geoffrey; Gunn, Julia; Swenson, David; Painter, Ian; Johnson, Lauren; Kiley, Chris; Streichert, Laura; Burkom, Howard

    2015-01-01

    We document a funded effort to bridge the gap between constrained scientific challenges of public health surveillance and methodologies from academia and industry. Component tasks are the collection of epidemiologists' use case problems, multidisciplinary consultancies to refine them, and dissemination of problem requirements and shareable datasets. We describe an initial use case and consultancy as a concrete example and challenge to developers. Supported by the Defense Threat Reduction Agency Biosurveillance Ecosystem project, the International Society for Disease Surveillance formed an advisory group to select tractable use case problems and convene inter-disciplinary consultancies to translate analytic needs into well-defined problems and to promote development of applicable solution methods. The initial consultancy's focus was a problem originated by the North Carolina Department of Health and its NC DETECT surveillance system: Derive a method for detection of patient record clusters worthy of follow-up based on free-text chief complaints and without syndromic classification. Direct communication between public health problem owners and analytic developers was informative to both groups and constructive for the solution development process. The consultancy achieved refinement of the asyndromic detection challenge and of solution requirements. Participants summarized and evaluated solution approaches and discussed dissemination and collaboration strategies. A solution meeting the specification of the use case described above could improve human monitoring efficiency with expedited warning of events requiring follow-up, including otherwise overlooked events with no syndromic indicators. This approach can remove obstacles to collaboration with efficient, minimal data-sharing and without costly overhead.

  19. Old wine in new bottles: Tobacco industry's submission to European Commission tobacco product directive public consultation

    PubMed Central

    Hiilamo, Heikki; Glantz, Stanton A.

    2015-01-01

    Between September and December 2010 the European Commission Health & Consumer Protection Directorate-General (DGSANCO) held a public consultation on a possible revision of the European Union Tobacco Products Directive (2001/37/EC). We used content analysis of the tobacco industry's and related parties' 300 submissions to the public consultation to determine if tobacco industry and its allies in Europe are prepared to reduce harm of the tobacco products as their public statements assert. The industry submission resorted to traditional tobacco industry arguments where illicit trade and freedom of choice were emphasized and misrepresented the conclusions of a DGSANCO-commissioned scientific report on smokeless tobacco products. Retailers and wholesalers referred to employment and economic growth more often than respondents from other categories. The pattern of responses in the submission differed dramatically from independent public opinion polls of EU citizens' support for tobacco control policies. None of the major tobacco manufacturers or their lobbying organizations supported any of the DGSANCO's proposed evidence based interventions (pictorial health warnings, plain packaging or point-of-sale display bans) to reduce harms caused by cigarette smoking. PMID:25467283

  20. 42 CFR 414.506 - Procedures for public consultation for payment for a new clinical diagnostic laboratory test.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... a new clinical diagnostic laboratory test. 414.506 Section 414.506 Public Health CENTERS FOR... FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.506 Procedures for public consultation for payment for a new clinical diagnostic laboratory test...

  1. 42 CFR 414.506 - Procedures for public consultation for payment for a new clinical diagnostic laboratory test.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... a new clinical diagnostic laboratory test. 414.506 Section 414.506 Public Health CENTERS FOR... FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.506 Procedures for public consultation for payment for a new clinical diagnostic laboratory test...

  2. 43 CFR 3420.4-4 - Consultation with Indian tribes.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false Consultation with Indian tribes. 3420.4-4 Section 3420.4-4 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND... § 3420.4-4 Consultation with Indian tribes. The Secretary shall consult with any Indian tribe which may...

  3. 43 CFR 3420.4-4 - Consultation with Indian tribes.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Consultation with Indian tribes. 3420.4-4 Section 3420.4-4 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND... § 3420.4-4 Consultation with Indian tribes. The Secretary shall consult with any Indian tribe which may...

  4. 43 CFR 3420.4-4 - Consultation with Indian tribes.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false Consultation with Indian tribes. 3420.4-4 Section 3420.4-4 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND... § 3420.4-4 Consultation with Indian tribes. The Secretary shall consult with any Indian tribe which may...

  5. 43 CFR 3420.4-4 - Consultation with Indian tribes.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false Consultation with Indian tribes. 3420.4-4 Section 3420.4-4 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND... § 3420.4-4 Consultation with Indian tribes. The Secretary shall consult with any Indian tribe which may...

  6. [Insurance medical consultation in the private health insurance--which questions are asked for to the medical consultant?].

    PubMed

    Hakimi, R

    2013-03-01

    There have been medical consultants in the insurance business since the 19th century. Still the tasks and competences of the medical consultants in private health insurance in Germany are more or less unknown to the public and among doctors. There are only few publications about this topic. All questions submitted to the medical consultant from 1 January 2011 to 31 December 2011 have been examined and classified. Most of the questions to the medical consultant concern the medical necessity of medications, with life style medication playing an especially important role. Alternative medicine, the classification of cure and rehabilitation measures of hospital medical treatments, out-patient operations, new treatments, the length of hospital treatments and out-patient psychotherapy, medical consultation on artificial insemination and cosmetic surgery intervention give more and more reason for a consultation of the medical examiner. The discussion considers the details of individual insurance medicine blocks of consultation in insurance medicine and explains their significance.

  7. 45 CFR 400.57 - Planning and consultation process.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  8. Cross-Disciplinary Consultancy to Bridge Public Health Technical Needs and Analytic Developers: Asyndromic Surveillance Use Case

    PubMed Central

    Faigen, Zachary; Deyneka, Lana; Ising, Amy; Neill, Daniel; Conway, Mike; Fairchild, Geoffrey; Gunn, Julia; Swenson, David; Painter, Ian; Johnson, Lauren; Kiley, Chris; Streichert, Laura

    2015-01-01

    Introduction: We document a funded effort to bridge the gap between constrained scientific challenges of public health surveillance and methodologies from academia and industry. Component tasks are the collection of epidemiologists’ use case problems, multidisciplinary consultancies to refine them, and dissemination of problem requirements and shareable datasets. We describe an initial use case and consultancy as a concrete example and challenge to developers. Materials and Methods: Supported by the Defense Threat Reduction Agency Biosurveillance Ecosystem project, the International Society for Disease Surveillance formed an advisory group to select tractable use case problems and convene inter-disciplinary consultancies to translate analytic needs into well-defined problems and to promote development of applicable solution methods. The initial consultancy’s focus was a problem originated by the North Carolina Department of Health and its NC DETECT surveillance system: Derive a method for detection of patient record clusters worthy of follow-up based on free-text chief complaints and without syndromic classification. Results: Direct communication between public health problem owners and analytic developers was informative to both groups and constructive for the solution development process. The consultancy achieved refinement of the asyndromic detection challenge and of solution requirements. Participants summarized and evaluated solution approaches and discussed dissemination and collaboration strategies. Practice Implications: A solution meeting the specification of the use case described above could improve human monitoring efficiency with expedited warning of events requiring follow-up, including otherwise overlooked events with no syndromic indicators. This approach can remove obstacles to collaboration with efficient, minimal data-sharing and without costly overhead. PMID:26834939

  9. 42 CFR 493.1457 - Standard; Clinical consultant responsibilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Standard; Clinical consultant responsibilities. 493... Testing Laboratories Performing High Complexity Testing § 493.1457 Standard; Clinical consultant responsibilities. The clinical consultant provides consultation regarding the appropriateness of the testing...

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

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Standard; Clinical consultant responsibilities. 493... Testing Laboratories Performing Moderate Complexity Testing § 493.1419 Standard; Clinical consultant responsibilities. The clinical consultant provides consultation regarding the appropriateness of the testing...

  11. Use of public health nurse competencies to develop a childcare health consultant workforce.

    PubMed

    Wold, Judith Lupo; Gaines, Sherry K; Leary, Janie M

    2006-01-01

    The purpose of this article is to describe the efforts in the state of Georgia to train public health nurse-childcare health consultants (PHN-CCHCs) using the framework of the "Core competencies for public health practice." The goal of the training was twofold: (1) to prepare a statewide cadre of PHNs as the primary workforce for Georgia's emerging childcare health consultation (CCHC) system and (2) to prepare their district nurse directors to lead and support CCHCs. Administrators attended a 2-day workshop followed by access to executive coaching for their management teams. PHNs participated in a three-phase training program, with phases 1 and 3 offered as 3-day workshops with field experiences, and phase 2 offered online and as a practicum. Forty-four administrators and over 85 PHN-CCHCs completed the training. Graduates of the program reported satisfaction with training and reported the use of PHN core competencies in CCHC. Graduates also found enhanced skills in using core competencies to be applicable to a variety of population-based practices. Beyond CCHC being instituted in selected health districts, interest in CCHC has occurred statewide. The PHN-CCHC program enhanced the knowledge and use of core competencies and heightened interest in CCHC statewide.

  12. [Influenza telephone consultation target the general public--2003-2004, 2004-2005].

    PubMed

    Yamadera, Shizuko; Kobune, Fumio; Komatsu, Toshihiko; Suzuki, Kazuyoshi; Nakayama, Mikio; Hagiwara, Toshikatsu; Matsumoto, Miyako; Yamamoto, Kiichi; Renard, Junko; Oya, Akira

    2007-07-01

    The NPO Biomedical Science Association provided telephone consultation, including contacts by fax and email, targeting the general public within the framework of influenza control measures worked out by the Japanese Ministry of Health, Labor and Welfare (MHLW). We received 2,813 inquiries during the 2003-2004 flu season and 2,444 inquiries during the 2004-2005 season. By month, the highest number was in October-November, accounting for 42.6%. The preceding season showed a similar trend. By gender, 72.5% of those seeking advice were women. By area of residence, the highest number was living in metropolitan Tokyo, and the remainder lived in the prefectures of Kanagawa, Chiba, Saitama, Nagano, Shizuoka, and Ibaraki in this order. We received no inquiries from the prefectures of Shimane or Saga. By occupation, housewives accounted for 1,114 inquiries (45.6%), followed by private companies with 447 inquiries (18.3%) and health-care providers with 227 inquiries (9.3%), similar to the 2003-2004 flu season. By subject, 1,545 inquiries concerned vaccines (62.2%) mainly, the pros and cons of vaccination, adverse reactions, and the number of inoculations required. Inquiries about pregnancy, infants and young children, and breast-feeding accounted for 19.2%. Inquiries on vaccine shortages during the 2004-2005 flu season (7), SARS (22), and bird flu (22) decreased compared to the previous season, while the number of consultations on antiviral agents increased (209). In discussing how information on influenza should be communicated to the public, we propose that "Influenza Q & A" provided by the Infectious Diseases Surveillance Center of the NIID, MHLW, should include information on influenza specifically addressing pregnant woman and breast-feeding or child-rearing mothers.

  13. 42 CFR 493.1455 - Standard; Clinical consultant qualifications.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Standard; Clinical consultant qualifications. 493.1455 Section 493.1455 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... Testing Laboratories Performing High Complexity Testing § 493.1455 Standard; Clinical consultant...

  14. 42 CFR 493.1417 - Standard; Clinical consultant qualifications.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Standard; Clinical consultant qualifications. 493.1417 Section 493.1417 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... Testing Laboratories Performing Moderate Complexity Testing § 493.1417 Standard; Clinical consultant...

  15. 42 CFR 493.1457 - Standard; Clinical consultant responsibilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Standard; Clinical consultant responsibilities. 493.1457 Section 493.1457 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... Testing Laboratories Performing High Complexity Testing § 493.1457 Standard; Clinical consultant...

  16. 42 CFR 493.1419 - Standard; Clinical consultant responsibilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Standard; Clinical consultant responsibilities. 493.1419 Section 493.1419 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... Testing Laboratories Performing Moderate Complexity Testing § 493.1419 Standard; Clinical consultant...

  17. 42 CFR 431.105 - Consultation to medical facilities.

    Code of Federal Regulations, 2010 CFR

    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...

  18. 43 CFR 2203.4 - Consultation with the Attorney General.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... PROCEDURES Exchanges Involving Fee Federal Coal Deposits § 2203.4 Consultation with the Attorney General. (a... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false Consultation with the Attorney General. 2203.4 Section 2203.4 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF...

  19. 43 CFR 2203.4 - Consultation with the Attorney General.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... PROCEDURES Exchanges Involving Fee Federal Coal Deposits § 2203.4 Consultation with the Attorney General. (a... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Consultation with the Attorney General. 2203.4 Section 2203.4 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF...

  20. 43 CFR 2203.4 - Consultation with the Attorney General.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... PROCEDURES Exchanges Involving Fee Federal Coal Deposits § 2203.4 Consultation with the Attorney General. (a... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false Consultation with the Attorney General. 2203.4 Section 2203.4 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF...

  1. 43 CFR 2203.4 - Consultation with the Attorney General.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... PROCEDURES Exchanges Involving Fee Federal Coal Deposits § 2203.4 Consultation with the Attorney General. (a... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false Consultation with the Attorney General. 2203.4 Section 2203.4 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF...

  2. A national patient and public colorectal research agenda: integration of consumer perspectives in bowel disease through early consultation.

    PubMed

    McNair, A G K; Heywood, N; Tiernan, J; Verjee, A; Bach, S P; Fearnhead, N S

    2017-01-01

    There is a recognized need to include the views of patients and the public in prioritizing health research. This study aimed: (i) to explore patients' views on colorectal research; and (ii) to prioritize research topics with patients and the public. In phase 1, 12 charitable organizations and patient groups with an interest in bowel disease were invited to attend a consultation exercise. Participants were briefed on 25 colorectal research topics prioritized by members of the Association of Coloproctology of Great Britain and Ireland. Focus groups were conducted and discussions were recorded with field notes. Analysis was conducted using principles of thematic analysis. In phase 2, a free public consultation was undertaken. Participants were recruited from newspaper advertisements, were briefed on the same research topics and were asked to rate the importance of each on a five-point Likert scale. Descriptive statistics were used to rank the topics. Univariable linear regression compared recorded demographic details with mean topic scores. Focus groups were attended by 12 patients who highlighted the importance of patient-centred information for trial recruitment and when selecting outcome measures. Some 360 people attended the public consultation, of whom 277 (77%) were recruited. Participants rated 'What is the best way to treat early cancer in the back passage?' highest, with 227 (85%) scoring it 4 or 5. There was no correlation between participant demographics and mean topic scores. The present study prioritized a colorectal research agenda with the input of patients and the public. Further research is required to translate this agenda into real improvements in patient care. © 2016 The Authors. Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.

  3. 76 FR 48865 - Tribal Consultation Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-09

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Tribal Consultation Meetings AGENCY: Administration for Children and Families' Office of Head Start (OHS). ACTION..., Public Law 110-134, notice is hereby given of one-day Tribal Consultation Sessions to be held between the...

  4. Behavior Psychology in the Schools: Innovations in Evaluation, Support, and Consultation.

    ERIC Educational Resources Information Center

    Luiselli, James K., Ed.; Diament, Charles, Ed.

    This volume of "Behavior Psychology in the Schools," discusses key topics in behavioral consultations in public school settings. Following an introduction, articles include: (1) "Focus, Scope, and Practice of Behavioral Consultation to Public Schools" (James K. Luiselli), which describes a four-stage process of consultation and…

  5. 42 CFR 493.1411 - Standard; Technical consultant qualifications.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... training or experience to provide technical consultation for each of the specialties and subspecialties of... responsible. Note: The technical consultant requirements for “laboratory training or experience, or both” in... 42 Public Health 5 2010-10-01 2010-10-01 false Standard; Technical consultant qualifications. 493...

  6. Preparing Special Educators for Teacher Consultation.

    ERIC Educational Resources Information Center

    Warger, Cynthia L., Ed.; Aldinger, Loviah E., Ed.

    The publication defines the nature of special education consultation and presents various options through which training can be provided by college and university departments of special education. The first three papers present the realities of special education consultation as currently practiced: "Serving Special Children through Teacher…

  7. What should be given a priority – costly medications for relatively few people or inexpensive ones for many? The Health Parliament public consultation initiative in Israel

    PubMed Central

    Guttman, Nurit; Shalev, Carmel; Kaplan, Giora; Abulafia, Ahuva; Bin‐Nun, Gabi; Goffer, Ronen; Ben‐Moshe, Roei; Tal, Orna; Shani, Mordechai; Lev, Boaz

    2008-01-01

    Abstract Background  In the past two decades, government and civic organizations have been implementing a wide range of deliberative public consultations on health care‐related policy. Drawing on these experiences, a public consultation initiative in Israel called the Health Parliament was established. Goals  To implement a public consultation initiative that will engage members of the public in the discussion of four healthcare policy questions associated with equity in health services and on priorities for determining which medications and treatments should be included in the basket of national health services. Method  One hundred thirty‐two participants from the general population recruited through a random sample were provided with background materials and met over several months in six regional sites. Dilemma activities were used and consultants were available for questions and clarifications. Participants presented their recommendations in a national assembly to the Minister of Health. Outcomes  Across the regional groups the recommendations were mostly compatible, in particular regarding considering the healthcare system’s monetary state, even at the expense of equity, but for each policy question minority views were also expressed. A strong emphasis in the recommendations was pragmatism. Conclusion  Participants felt the experience was worthwhile; though the actual impact of their recommendations on policy making was indirect, they were willing to participate in future consultations. However, despite enthusiasm the initiative was not continued. Issues raised are whether consultation initiatives must have a direct impact on healthcare policy decisions or can be mainly a venue to involve citizens in the deliberation of healthcare policy issues. PMID:18429997

  8. Library Consultant: Career or Dead-End Job?

    ERIC Educational Resources Information Center

    Holt, Raymond M.

    1984-01-01

    Enumerates characteristics required of the library consultant--motivation; character traits; education and experience; other qualifications (specialized knowledge, financial resources, adequate time, good health, communication skills, objectivity, perspective); special skills. The library-consultant marketplace (e.g., automation, public relations,…

  9. Ethics consultation and autonomy.

    PubMed

    Varelius, Jukka

    2008-03-01

    Services of ethics consultants are nowadays commonly used in such various spheres of life as engineering, public administration, business, law, health care, journalism, and scientific research. It has however been maintained that use of ethics consultants is incompatible with personal autonomy; in moral matters individuals should be allowed to make their own decisions. The problem this criticism refers to can be conceived of as a conflict between the professional autonomy of ethics experts and the autonomy of the persons they serve. This paper addresses this conflict and maintains that when the nature of both ethics consultation and individual autonomy is properly understood, the professional autonomy of ethics experts is compatible with the autonomy of the persons they assist.

  10. 75 FR 26973 - Notice of Public Comment on Tribal Consultation Sessions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-13

    ..., Office of Head Start leadership and the leadership of Tribal Governments operating Head Start (including... Consultation Session with OHS leadership. The Consultation Sessions will take place June 16, 2010, in San...

  11. 36 CFR 1270.50 - Consultation with law enforcement agencies.

    Code of Federal Regulations, 2010 CFR

    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...

  12. A multifaceted approach to spreading palliative care consultation services in California public hospital systems.

    PubMed

    Brousseau, Ruth Tebbets; Jameson, Wendy; Kalanj, Boris; Kerr, Kathleen; O'Malley, Kate; Pantilat, Steven

    2012-01-01

    Historically, California's 17 public hospital systems-those that are county owned and operated, and those University of California medical centers with the mandate to serve low income, vulnerable populations-have struggled to implement Palliative Care Consultation Services (PCCS)-this, despite demonstrated need for these services among the uninsured and Medicaid populations served by these facilities. Since 2008, through a collaborative effort of a foundation, a palliative care training center, and a nonprofit quality improvement organization, the Spreading Palliative Care in Public Hospitals initiative (SPCPH) has resulted in a 3-fold increase in the number of California public hospitals providing PCCS, from 4 to 12. The SPCPH leveraged grant funding, the trusted relationships between California public hospitals and their quality improvement organization, technical assistance and training, peer support and learning, and a tailored business case demonstrating the financial/resource utilization benefits of dedicated PCCS. This article describes the SPCPH's distinctive design, features of the public hospital PCCS, patient and team characteristics, and PCCS provider perceptions of environmental factors, and SPCPH features that promoted or impeded their success. Lessons learned may have implications for other hospital systems undertaking implementation of palliative care services. © 2012 National Association for Healthcare Quality.

  13. The Art Consultant as Writer: A Retrospective of Ontario Publications, 1945-1995

    ERIC Educational Resources Information Center

    Clark, Roger Allen

    2008-01-01

    Consultant, supervisor, coordinator--though the official titles may have changed with locale and decade, the position of art consultant has remained an enduring fixture of the Ontario education system since World War II. In this paper, I will trace the evolution of Ontario art consultancies from 1945 to 1995. My focus will be a novel one: the…

  14. 43 CFR 3420.1-7 - Consultation with states and Indian tribes.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false Consultation with states and Indian tribes. 3420.1-7 Section 3420.1-7 Public Lands: Interior Regulations Relating to Public Lands (Continued... Competitive Leasing § 3420.1-7 Consultation with states and Indian tribes. Before adopting a comprehensive...

  15. 43 CFR 3420.1-7 - Consultation with states and Indian tribes.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false Consultation with states and Indian tribes. 3420.1-7 Section 3420.1-7 Public Lands: Interior Regulations Relating to Public Lands (Continued... Competitive Leasing § 3420.1-7 Consultation with states and Indian tribes. Before adopting a comprehensive...

  16. 43 CFR 3420.1-7 - Consultation with states and Indian tribes.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false Consultation with states and Indian tribes. 3420.1-7 Section 3420.1-7 Public Lands: Interior Regulations Relating to Public Lands (Continued... Competitive Leasing § 3420.1-7 Consultation with states and Indian tribes. Before adopting a comprehensive...

  17. 43 CFR 3420.1-7 - Consultation with states and Indian tribes.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Consultation with states and Indian tribes. 3420.1-7 Section 3420.1-7 Public Lands: Interior Regulations Relating to Public Lands (Continued... Competitive Leasing § 3420.1-7 Consultation with states and Indian tribes. Before adopting a comprehensive...

  18. [Telephone consultations on exposure to nuclear disaster radiation].

    PubMed

    Yashima, Sachiko; Chida, Koichi

    2014-03-01

    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.

  19. 25 CFR 1000.211 - Will the bureau contact the Tribe/Consortium before initiating public consultation process for a...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Will the bureau contact the Tribe/Consortium before initiating public consultation process for a non-BIA AFA under negotiation? 1000.211 Section 1000.211 Indians OFFICE OF THE ASSISTANT SECRETARY, INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR ANNUAL FUNDING AGREEMENTS UNDER THE TRIBAL SELF-GOVERNMENT ACT...

  20. 42 CFR 431.105 - Consultation to medical facilities.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Consultation to medical facilities. 431.105 Section... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS STATE ORGANIZATION AND GENERAL ADMINISTRATION Administrative Requirements: Provider Relations § 431.105 Consultation to medical facilities. (a) Basis and...

  1. 42 CFR 431.105 - Consultation to medical facilities.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Consultation to medical facilities. 431.105 Section... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS STATE ORGANIZATION AND GENERAL ADMINISTRATION Administrative Requirements: Provider Relations § 431.105 Consultation to medical facilities. (a) Basis and...

  2. 42 CFR 431.105 - Consultation to medical facilities.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Consultation to medical facilities. 431.105 Section... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS STATE ORGANIZATION AND GENERAL ADMINISTRATION Administrative Requirements: Provider Relations § 431.105 Consultation to medical facilities. (a) Basis and...

  3. 42 CFR 431.105 - Consultation to medical facilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Consultation to medical facilities. 431.105 Section... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS STATE ORGANIZATION AND GENERAL ADMINISTRATION Administrative Requirements: Provider Relations § 431.105 Consultation to medical facilities. (a) Basis and...

  4. Public health microbiology in Germany: 20 years of national reference centers and consultant laboratories.

    PubMed

    Beermann, Sandra; Allerberger, Franz; Wirtz, Angela; Burger, Reinhard; Hamouda, Osamah

    2015-10-01

    In 1995, in agreement with the German Federal Ministry of Health, the Robert Koch Institute established a public health microbiology system consisting of national reference centers (NRCs) and consultant laboratories (CLs). The goal was to improve the efficiency of infection protection by advising the authorities on possible measures and to supplement infectious disease surveillance by monitoring selected pathogens that have high public health relevance. Currently, there are 19 NRCs and 40 CLs, each appointed for three years. In 2009, an additional system of national networks of NRCs and CLs was set up in order to enhance effectiveness and cooperation within the national reference laboratory system. The aim of these networks was to advance exchange in diagnostic methods and prevention concepts among reference laboratories and to develop geographic coverage of services. In the last two decades, the German public health laboratory reference system coped with all major infectious disease challenges. The European Union and the European Centre for Disease Prevention and Control (ECDC) are considering implementing a European public health microbiology reference laboratory system. The German reference laboratory system should be well prepared to participate actively in this upcoming endeavor. Copyright © 2015 Elsevier GmbH. All rights reserved.

  5. Resident consultant obstetrician presence on the labour ward versus other models of consultant cover: a systematic review of intrapartum outcomes.

    PubMed

    Henderson, J; Kurinczuk, J J; Knight, M

    2017-08-01

    Several key policy documents have advocated 24-hour consultant obstetrician presence on the labour ward as a means of improving the safety of birth. However, it is unclear what published evidence exists comparing the outcomes of intrapartum care with 24-hour consultant labour ward presence and other models of consultant cover. To collate and critically appraise evidence of the effect of continuous resident consultant obstetrician cover on the labour ward on outcomes of intrapartum care compared with other models of consultant cover. Studies were included which quantitatively compared intrapartum outcomes for women and babies where continuous resident consultant obstetric cover was provided with other models of consultant cover. Quantitative studies within healthcare systems with mixed obstetric-midwifery models of care. Two researchers independently screened titles and full-text publications, extracted data and assessed the quality of included studies. Meta-analysis was performed using REVIEW MANAGER 5.3. About 1508 publications were screened resulting in two papers, three conference abstracts and one letter being included. All were single-site time-period comparison studies. The quality of studies overall was poor with significant risk of bias. The only significant finding in meta-analysis related to instrumental deliveries, which occurred more frequently when there was on-call consultant cover (unadjusted risk ratio 1.14; 95% CI 1.04-1.24). No reliable evidence of the effects of 24-hour resident consultant presence on the labour ward on intrapartum outcomes was identified. More robust research is needed to assess intrapartum outcomes with resident consultant labour ward presence. © 2017 The Authors. BJOG An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists.

  6. The Future Development of the European Union Education, Training and Youth Programmes After 2006: A Public Consultation Document.

    ERIC Educational Resources Information Center

    Commission of the European Communities, Brussels (Belgium). Directorate-General for Education and Culture.

    This document launches a wide public consultation with all those involved in and with an interest in the European Union's (EU's) education, training, and youth programs called Socrates, Tempus, Leonardo da Vinci, and Youth for Europe. It is the first step toward preparing the new generation of programs to start in 2007 and will inform the…

  7. 43 CFR 3425.4 - Consultation and sale procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false Consultation and sale procedures. 3425.4... § 3425.4 Consultation and sale procedures. (a)(1) Prior to holding any lease sale in response to any... environmental impact statement, the proposed sale and the fair market value and maximum economic recovery on the...

  8. 43 CFR 3425.4 - Consultation and sale procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false Consultation and sale procedures. 3425.4... § 3425.4 Consultation and sale procedures. (a)(1) Prior to holding any lease sale in response to any... environmental impact statement, the proposed sale and the fair market value and maximum economic recovery on the...

  9. 43 CFR 3425.4 - Consultation and sale procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false Consultation and sale procedures. 3425.4... § 3425.4 Consultation and sale procedures. (a)(1) Prior to holding any lease sale in response to any... environmental impact statement, the proposed sale and the fair market value and maximum economic recovery on the...

  10. Getting under the skin of the primary care consultation using video stimulated recall: a systematic review

    PubMed Central

    2014-01-01

    Background Video stimulated recall (VSR) is a method of enhancing participants’ accounts of the consultation using a video recording of the event to encourage and prompt recall in a post consultation interview. VSR is used in education and education research, and to a lesser extent in medical and nursing research. Little is known about the sort of research questions that lend themselves best to the use of VSR or the impact of the specific VSR procedure on study quality. This systematic review describes studies in primary care that have used the method and aims to identify the strengths, weaknesses and role of VSR. Methods A systematic literature search has been conducted to identify primary care consultation research using VSR. Two authors undertook data extraction and quality appraisal of identified papers and a narrative synthesis has been conducted to draw together the findings. In addition, theory on classifying VSR procedures derived from other disciplines is used as a lens through which to assess the relevance of VSR technique. Results Twenty eight publications were identified that reported VSR in primary care doctor-patient consultation research. VSR was identified as a useful method to explore specific events within the consultation, mundane or routine occurrences, non-spoken events and appears to particularly add value to doctor’s post consultation accounts. However, studies frequently had insufficient description of methods to properly evaluate both the quality of the study, and the influence of VSR technique on findings. Conclusions VSR is particularly useful for study of specific consultation events when a ‘within case’ approach is used in analysis, comparing and contrasting findings from the consultation and post-consultation interview. Alignment of the choice of VSR procedure and sampling to the study research question was established as particularly important in the quality of studies. Future researchers may consider the role of process

  11. Getting under the skin of the primary care consultation using video stimulated recall: a systematic review.

    PubMed

    Paskins, Zoe; McHugh, Gretl; Hassell, Andrew B

    2014-08-30

    Video stimulated recall (VSR) is a method of enhancing participants' accounts of the consultation using a video recording of the event to encourage and prompt recall in a post consultation interview. VSR is used in education and education research, and to a lesser extent in medical and nursing research. Little is known about the sort of research questions that lend themselves best to the use of VSR or the impact of the specific VSR procedure on study quality. This systematic review describes studies in primary care that have used the method and aims to identify the strengths, weaknesses and role of VSR. A systematic literature search has been conducted to identify primary care consultation research using VSR. Two authors undertook data extraction and quality appraisal of identified papers and a narrative synthesis has been conducted to draw together the findings. In addition, theory on classifying VSR procedures derived from other disciplines is used as a lens through which to assess the relevance of VSR technique. Twenty eight publications were identified that reported VSR in primary care doctor-patient consultation research. VSR was identified as a useful method to explore specific events within the consultation, mundane or routine occurrences, non-spoken events and appears to particularly add value to doctor's post consultation accounts. However, studies frequently had insufficient description of methods to properly evaluate both the quality of the study, and the influence of VSR technique on findings. VSR is particularly useful for study of specific consultation events when a 'within case' approach is used in analysis, comparing and contrasting findings from the consultation and post-consultation interview. Alignment of the choice of VSR procedure and sampling to the study research question was established as particularly important in the quality of studies. Future researchers may consider the role of process evaluation to understand further the impact of

  12. 42 CFR 493.1453 - Condition: Laboratories performing high complexity testing; clinical consultant.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... testing; clinical consultant. 493.1453 Section 493.1453 Public Health CENTERS FOR MEDICARE & MEDICAID... Condition: Laboratories performing high complexity testing; clinical consultant. The laboratory must have a clinical consultant who meets the requirements of § 493.1455 of this subpart and provides clinical...

  13. 42 CFR 493.1415 - Condition: Laboratories performing moderate complexity testing; clinical consultant.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... complexity testing; clinical consultant. 493.1415 Section 493.1415 Public Health CENTERS FOR MEDICARE... § 493.1415 Condition: Laboratories performing moderate complexity testing; clinical consultant. The laboratory must have a clinical consultant who meets the qualification requirements of § 493.1417 of this...

  14. Input analysis for two public consultations on the EU Clinical Trials Regulation.

    PubMed

    Langhof, Holger; Lander, Jonas; Strech, Daniel

    2016-09-17

    The European Union's (EU) Clinical Trials Directive was replaced by an EU-Regulation as of 2016. The policy revision process was subject to a formal impact assessment exercised by the European Commission (EC) from 2008 to 2014. Following the EU principles of Good Governance, deliberation with stakeholders was an integral part of this impact assessment and the policy formulation process. Hence, two public consultations (PCs) were held by the EC in 2009 and 2011, respectively. Various stakeholders contributed and submitted their written input to the EC. Though often cited in the further revision process, the input gathered in the PC was not communicated with full transparency and it is unclear how and to what extent the input has been processed and used in the policy formulation. The objective of this study was an analysis of submissions to both PCs in order to systematically present what topics have been discussed and which possible policy options have been raised by the stakeholders. All written submissions publicly available were downloaded from the EC's homepage and assessed for stakeholder characteristics. Thematic text analysis was applied to assess the full text of a random sample of 33% of these submissions. A total of 198 different stakeholders from the EU and the United States of America contributed to one or both of the two PCs. In total, 44 various themes have been addressed that could be clustered under 24 main themes, including the articulation of problems as well as possible policy solutions to face these problems. The two PCs on the Clinical Trials Directive were highly appreciated by the various stakeholders and their input allowed an in-depth view on their particular interests. This input provided a rich source of information for all stakeholders in the field of clinical trials as well as to the EC's impact assessment. Although the EC obviously gathered a large quantity of expert knowledge on practical implications of trials legislation by

  15. 22 CFR 61.6 - Consultation with subject matter specialists.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Consultation with subject matter specialists. 61.6 Section 61.6 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES WORLD-WIDE FREE FLOW OF AUDIO-VISUAL MATERIALS § 61.6 Consultation with subject matter specialists. (a) The...

  16. 22 CFR 61.6 - Consultation with subject matter specialists.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Consultation with subject matter specialists. 61.6 Section 61.6 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES WORLD-WIDE FREE FLOW OF AUDIO-VISUAL MATERIALS § 61.6 Consultation with subject matter specialists. (a) The...

  17. 22 CFR 61.6 - Consultation with subject matter specialists.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Consultation with subject matter specialists. 61.6 Section 61.6 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES WORLD-WIDE FREE FLOW OF AUDIO-VISUAL MATERIALS § 61.6 Consultation with subject matter specialists. (a) The...

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  19. 22 CFR 61.6 - Consultation with subject matter specialists.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Consultation with subject matter specialists. 61.6 Section 61.6 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES WORLD-WIDE FREE FLOW OF AUDIO-VISUAL MATERIALS § 61.6 Consultation with subject matter specialists. (a) The...

  20. 22 CFR 61.6 - Consultation with subject matter specialists.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Consultation with subject matter specialists. 61.6 Section 61.6 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES WORLD-WIDE FREE FLOW OF AUDIO-VISUAL MATERIALS § 61.6 Consultation with subject matter specialists. (a) The...

  1. 45 CFR 98.12 - Coordination and consultation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Coordination and consultation. 98.12 Section 98.12 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT... local government during the development of the Plan; and (c) Coordinate, to the maximum extent feasible...

  2. 45 CFR 98.12 - Coordination and consultation.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Coordination and consultation. 98.12 Section 98.12 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT... local government during the development of the Plan; and (c) Coordinate, to the maximum extent feasible...

  3. 45 CFR 98.12 - Coordination and consultation.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Coordination and consultation. 98.12 Section 98.12 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT... local government during the development of the Plan; and (c) Coordinate, to the maximum extent feasible...

  4. 45 CFR 98.12 - Coordination and consultation.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Coordination and consultation. 98.12 Section 98.12 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT... local government during the development of the Plan; and (c) Coordinate, to the maximum extent feasible...

  5. 45 CFR 98.12 - Coordination and consultation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Coordination and consultation. 98.12 Section 98.12 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT... local government during the development of the Plan; and (c) Coordinate, to the maximum extent feasible...

  6. E-consult implementation: lessons learned using consolidated framework for implementation research.

    PubMed

    Haverhals, Leah M; Sayre, George; Helfrich, Christian D; Battaglia, Catherine; Aron, David; Stevenson, Lauren D; Kirsh, Susan; Ho, Michael; Lowery, Julie

    2015-12-01

    In 2011, the Veterans Health Administration (VHA) implemented electronic consults (e-consults) as an alternative to in-person specialty visits to improve access and reduce travel for veterans. We conducted an evaluation to understand variation in the use of the new e-consult mechanism and the causes of variable implementation, guided by the Consolidated Framework for Implementation Research (CFIR). Qualitative case studies of 3 high- and 5 low-implementation e-consult pilot sites. Participants included e-consult site leaders, primary care providers, specialists, and support staff identified using a modified snowball sample. We used a 3-step approach, with a structured survey of e-consult site leaders to identify key constructs, based on the CFIR. We then conducted open-ended interviews, focused on key constructs, with all participants. Finally, we produced structured, site-level ratings of CFIR constructs and compared them between high- and low-implementation sites. Site leaders identified 14 initial constructs. We conducted 37 interviews, from which 4 CFIR constructs distinguished high implementation e-consult sites: compatibility, networks and communications, training, and access to knowledge and information. For example, illustrating compatibility, a specialist at a high-implementation site reported that the site changed the order of consult options so that all specialties listed e-consults first to maintain consistency. High-implementation sites also exhibited greater agreement on constructs. By using the CFIR to analyze results, we facilitate future synthesis with other findings, and we better identify common patterns of implementation determinants common across settings.

  7. 42 CFR 493.1413 - Standard; Technical consultant responsibilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Standard; Technical consultant responsibilities. 493.1413 Section 493.1413 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH... Nonwaived Testing Laboratories Performing Moderate Complexity Testing § 493.1413 Standard; Technical...

  8. Stakeholder consultation insights on the future of genomics at the clinical-public health interface.

    PubMed

    Modell, Stephen M; Kardia, Sharon L R; Citrin, Toby

    2014-05-01

    In summer 2011, the Centers for Disease Control and Prevention Office of Public Health Genomics conducted a stakeholder consultation, administered by the University of Michigan Center for Public Health and Community Genomics, and Genetic Alliance, to recommend priorities for public health genomics from 2012 through 2017. Sixty-two responses from health professionals, administrators, and members of the public were pooled with 2 sets of key informant interviews and 3 discussion groups. NVivo 9 and manual methods were used to organize themes. This review offers an interim analysis of progress with respect to the final recommendations, which demonstrated a strong interest in moving genomic discoveries toward implementation and comparative effectiveness (T3/T4) translational research. A translational research continuum exists with familial breast and ovarian cancer at one end and prostate cancer at the other. Cascade screening for inherited arrhythmia syndromes and hypercholesterolemia lags stakeholder recommendations in the United States but not in Europe; implementation of health service-based screening for Lynch syndrome, and integration into electronic health information systems, is on pace with the recommended timeline. A number of options exist to address deficits in the funding of translational research, particularly for oncogenomic gene expression profiling. The goal of personalized risk assessment necessitates both research progress (eg, in whole genome sequencing, as well as provider education in the differentiation of low- vs high-risk status. The public health approach supports an emphasis on genetic test validation while endorsing clinical translation research inclusion of an environmental and population-based perspective. Copyright © 2014 Mosby, Inc. All rights reserved.

  9. Managing Consultants.

    ERIC Educational Resources Information Center

    Malinconico, S. Michael

    1983-01-01

    Guidelines for managing library consulting engagements effectively cover the decision to use a consultant, definition of the problem area, finding the consultant, interviewing and evaluating the consultant, the psychological contract, the formal contract, and abdication of responsibility for the consulting project by the client. Seventeen sources…

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

    ERIC Educational Resources Information Center

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

    2006-01-01

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

  11. Publication Bias in Research Synthesis: Sensitivity Analysis Using A Priori Weight Functions

    ERIC Educational Resources Information Center

    Vevea, Jack L.; Woods, Carol M.

    2005-01-01

    Publication bias, sometimes known as the "file-drawer problem" or "funnel-plot asymmetry," is common in empirical research. The authors review the implications of publication bias for quantitative research synthesis (meta-analysis) and describe existing techniques for detecting and correcting it. A new approach is proposed that is suitable for…

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

    ERIC Educational Resources Information Center

    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)

  13. Use of Pharmacist Consultations for Nonprescription Laxatives in Japan: An Online Survey.

    PubMed

    Shibata, Keita; Matsumoto, Arisa; Nakagawa, Ayumi; Akagawa, Keiko; Nakamura, Akihiro; Yamamoto, Toshinori; Kurata, Naomi

    2016-01-01

    Community pharmacies in Japan have long been advocated as effective sources of nonprescription medicines and health-related advice. Consumers sometimes self-treat symptoms of minor illnesses without consulting a pharmacist because the benefits of such consultations are not adequately recognized. The aim of this study was to investigate the use and impact of pharmacist consultations before purchase of nonprescription laxatives. An online survey was conducted July 14-22, 2012 with 500 respondents (250 men, 250 women), ranging 20-60 years old. All participants had purchased nonprescription laxatives for constipation within the past year. Stratified analysis was used to compare responses in groups that had and had not consulted a pharmacist before purchase. Consulting a pharmacist appears to improve consumers' awareness and makes them more likely to use appropriate medication. Those who consulted a pharmacist were better able to identify side effects and take appropriate action than the group that did not consult the pharmacist. Those who consulted a pharmacist were also significantly more likely to say that they would consult a pharmacist in the future. These results indicate that it is important for consumers to be able to consult with pharmacists, to improve consumers' awareness of side effects and to self-medicate appropriately, and hence improve their quality of life. Pharmacists in community pharmacy could be more active in health promotion campaigns, such as drug safety, campaigns, to raise their public profile. Increased public awareness of what pharmacists in community pharmacy do will make it easier for patients to consult with them.

  14. Burnout in hospital-based medical consultants in the New Zealand public health system.

    PubMed

    Surgenor, Lois J; Spearing, Ruth L; Horn, Jacqueline; Beautrais, Annette L; Mulder, Roger T; Chen, Peggy

    2009-08-07

    To assess the prevalence and severity of burnout in hospital-based medical consultants, and investigate associated demographic and professional characteristics. Utilising standardised measures of burnout (Maslach Burnout Inventory) and job satisfaction (Job Satisfaction Scale) this cross-sectional study recruited 267 consultants working in a large tertiary hospital in Christchurch, New Zealand. Seventy-one percent of all eligible participants were recruited. The prevalence of burnout in each of the three dimensions was as follows: High Emotional Exhaustion=29.7%; High Depersonalisation=24.4%; Low Personal Accomplishment=31.2%. One in five consultants was assessed as having high overall burnout. Considered against the psychometric norms for medical workers, significantly more consultants than expected reported low Emotional Exhaustion (p<0.001) and low Depersonalisation (p<0.01). Working longer hours (p<0.01), lower job satisfaction (p<0.001), and shorter time in the current job (p<0.05) independently increased the risk of high Emotional Exhaustion. Working longer hours (p<0.05) and lower job satisfaction (p<.01) independently increased the risk of high Depersonalisation. Longer time in the same job increased the risk of low Personal Accomplishment (p<0.05). Longer hours worked (p<0.05), shorter vocational experience as a consultant (p<0.05), and lower job satisfaction (p<0.001) independently increased the risk of high overall burnout. An unexpected proportion of consultants experience robust emotional well-being and healthy work engagement. However, for those experiencing high burnout, by severity or dimension, working long hours and low job satisfaction appear to be particularly contributory factors. Whilst remedial interventions should target the minority who experience significant burnout, studies using robust research designs are required to assess the meaningful clinical utility of these. The challenge remains to determine the optimal organisational practices

  15. 78 FR 11891 - Tribal Consultation Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-20

    ... 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). ACTION: Notice of meeting. SUMMARY: Pursuant to the Improving Head Start for School Readiness Act of 2007, Public...

  16. Negotiating the moral order: paradoxes of ethics consultation.

    PubMed

    Crigger, B J

    1995-06-01

    Ethics consultation at the bedside has been hailed as a better way than courts and ethics committees to empower patients and make explicit the value components of treatment decisions. But close examination of the practice of ethics consultation reveals that it in fact risks subverting those ends by interpolating a third (expert) party into the doctor-patient encounter. In addition, the practice of bioethics through consultation does the broader cultural work of fashioning a shared moral order in the face of manifestly plural individual commitments. In doing so, however, bioethics furthers medicine's position as a privileged domain of public moral discourse in contemporary American society.

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

    PubMed

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

    2017-08-01

    To identify whether there have been changes over time in the capacity of paediatric consultants to undertake research and if the activity differs between men and women. Comparison of data from two surveys of UK paediatric consultants. UK consultant members of the Royal College of Paediatrics and Child Health. Surveys carried out in 2011 and 2015. The proportion of consultants with allocated time in job plans for research, academic appointments, postgraduate qualifications, publications, grant funding and supervision of PhD students. The 2015 survey demonstrated 20% of consultants had one or more programmed activities (PAs) for research, but the average paid PA for research was 0.39 PA. Between the surveys, the proportion of consultants with honorary contracts had declined, and the proportion with a PhD or MDRes was 32% in 2011 compared with 26% in 2015 (p<0.001). In 2015, only 12% of consultants had at least one current grant. In 2011 and 2015, 51% and 54% respectively of consultants had not authored a publication in the preceding 2 years. In 2015, 92% of consultants were not currently supervising a PhD student, and 88% had never supervised a PhD student. In 2015, 25% of men and 12% of women had PAs for research (p<0.001). Women were less likely to hold an honorary or primary academic contract, have authored a publication or supervised a PhD student (all p<0.001). Research activity among paediatric consultants remains low, particularly among women. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  18. [Travel medicine and vaccination as a task of infection prevention--data of the special consultation hours of the public health department Frankfurt on the Main, Germany, 2002-2004].

    PubMed

    Heudorf, U; Tiarks-Jungk, P; Stark, S

    2006-05-01

    Infection prevention is one of the main tasks of the Public Health authorities. Because of hundreds of travel associated infections imported by travellers every year and considering increasing travel activities to tropical countries, travel medicine and consultation on the correct prevention measures including vaccination is becoming more and more important. Hence the data of the special consultation hours of the public health department of Frankfurt am Main are reported and discussed with regard to possible improvements. The public health department of Frankfurt am Main has been offering special consultation hours for travel medicine for many years. Here, data derived from the anamneses of the clients from 2002 - 2004 are reported: personal data such as age, sex, travel destination as well as medical data such as vaccination and malaria prevention. 2002 - 2004, more than 14,000 persons were seen in the consultation hours, more than 66% of them asked for travel health advice, about 25% of them asked for standard vaccination (such as influenza), some others asked for attestation or certification. More than 20,000 doses of vaccines were given, the most important vaccination against hepatitis A (n = 5791), hepatitis B (n = 4064), typhoid fever (n = 2718) and yellow fever (n = 2473). 2814 were informed with regard to malaria prevention, including recipes. 7814 persons with complete data on their reason for travel were subjected to more detailed analysis: 75% of them were holiday tourists, 18% travelled as "hikers", 7% were business travellers and less than 1% of them planned a round-the-world tour. The most frequent travel destinations were: Asian or African countries about 33% each, 25% Middle or South America. Thailand, South Africa with Namibia, Brazil and India were the most important countries. The time from health consultation to the beginning of the journey was too short for full vaccine protection against typhoid fever and meningococcal disease in 10% and

  19. Delay to orthopedic consultation for isolated limb injury

    PubMed Central

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

    2009-01-01

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

  20. Educational Consulting: Justification to Partnership

    ERIC Educational Resources Information Center

    Sklarow, Mark H.

    2012-01-01

    This paper is a response to Steven R. Antonoff's article, "Educational Consulting: A Focus for the Profession." More than 20 years ago, when this article first appeared in "The Journal of College Admission," "for profit counselors" (as they were then called by NACAC) were not welcome partners. It was acceptable practice to publicly denigrate the…

  1. Measuring the success of specific health problem consultations in cats and dogs: a systematic review.

    PubMed

    Corah, Louise; Mossop, Liz; Cobb, Kate; Dean, Rachel

    2018-03-15

    Consultations are complex interactions, are central to achieving optimal outcomes for all stakeholders, yet what constitutes a successful consultation has not been defined. The aim of this systematic review was to describe the scope of the literature available on specific health problem consultations and appraise their identified success measures. Searches of CAB Abstracts and MEDLINE were performed in May 2016 using species and consultation terms. Systematic sorting of the results allowed identification of consultation 'success factors' cited in peer-reviewed veterinary literature which were appraised using an appropriate critical appraisal tool (AXIS). Searches returned 11 330 results with a total of 17 publications meeting the inclusion criteria, of which four measured consultation success. Journal of the American Veterinary Medical Association was the most common journal of publication (9 of 17) and the majority of included papers had been published since 2010 (12 of 17). Success factors measured were compliance, client satisfaction and veterinary surgeon satisfaction, and publications primarily used communication analysis tools to measure success. The review highlights the paucity of peer-reviewed literature examining small animal, health problem veterinary consultations. The available evidence is of variable quality and provides weak evidence as to which factors contribute to a successful consultation. © British Veterinary Association (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. 41 CFR 101-1.107 - Agency consultation regarding FPMR.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Agency consultation regarding FPMR. 101-1.107 Section 101-1.107 Public Contracts and Property Management Federal Property Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS GENERAL 1-INTRODUCTION 1.1-Regulation...

  3. 25 CFR 1000.210 - When does a non-BIA bureau use a public consultation process related to the negotiation of an AFA?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false When does a non-BIA bureau use a public consultation process related to the negotiation of an AFA? 1000.210 Section 1000.210 Indians OFFICE OF THE ASSISTANT SECRETARY, INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR ANNUAL FUNDING AGREEMENTS UNDER THE TRIBAL SELF-GOVERNMENT ACT AMENDMENTS TO THE INDIAN...

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

    NASA Technical Reports Server (NTRS)

    1991-01-01

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

  5. Helping by Consulting.

    ERIC Educational Resources Information Center

    Boyd, Stephen D.

    To "consult" with teachers requires making the right people aware that the consultant is available and that the consultant has something to contribute to their skills. Acquiring invitations for consulting work is the main obstacle consultants must overcome. They must get to know school administrators, curriculum supervisors, state…

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

    ERIC Educational Resources Information Center

    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. Consulting--A Potpourri?

    ERIC Educational Resources Information Center

    Brosseau, John

    1973-01-01

    This paper explores the role of consulting in elementary school counseling. In particular, consulting with teachers and parents is reviewed, as well as the efficacy of consulting. A consulting model developed by Caplan in the field of mental health is presented as a comprehensive consulting model which may be of use to elementary school…

  8. Toward More Effective Use of Professor-Consultants by Public School Districts.

    ERIC Educational Resources Information Center

    Mahan, James M.

    1980-01-01

    Results of this study indicate that administrators and teachers seem to be saying that university-based consultants are better at writing about elementary school change than they are at working in the field to implement change. (IRT)

  9. Prospective study of telephone calls to a hotline for infectious disease consultation: analysis of 7,863 solicited consultations over a 1-year period.

    PubMed

    Gennai, S; François, P; Sellier, E; Vittoz, J-P; Hincky-Vitrat, V; Pavese, P

    2011-04-01

    To respond to the increasing requests of non-infectious disease physicians for access to infectious diseases expertise, a hotline was created in the infectious diseases consultation (IDC) unit of the Grenoble university-affiliated hospital (GUH). This study describes the patterns of solicited consultations provided by the hotline during a 1-year period. We conducted a prospective study of consecutive solicited IDCs requested by physicians in 2008. A total of 7,863 consultations were requested by physicians over 1 year; 4,407 (56.0%) by ambulatory physicians, 2,933 (37.3%) by GUH physicians, and 523 (6.7%) by physicians in public or private hospitals. The majority of consultations were requested via cell phone (58.7%). The main reasons for requesting a consultation were related to antimicrobial treatment for hospital-based physicians and prophylaxis for ambulatory physicians (p < 0.001). Recommendations to perform diagnostic or monitoring tests were less frequent in ambulatory medicine (16%) than in the GUH (59%) or other hospitals (63%, p < 0.001). The route of consultation for patients with nosocomial infections was more likely to be formal (p < 0.001). The activity of the IDC hotline attests to an important need for such expertise consultation, both in hospitals and in ambulatory medicine.

  10. Beliefs about using consumer consultants in inpatient psychiatric units.

    PubMed

    McCann, Terence V; Baird, John; Clark, Eileen; Lu, Sai

    2006-12-01

    A key recommendation of consumer organizations and governments has been the employment of consumer consultants in inpatient psychiatric facilities, but the attitudes of mental health clinicians towards this measure remain inconsistent. The aims of this study were to examine mental health clinicians' attitudes about the role of mental health consumer consultants in inpatient psychiatric units, and to ascertain if participants' age, type of inpatient unit, or grade of staff influenced their attitudes towards consultants. The Consumer Participation and Consultant Questionnaire was used, which was adapted from the Mental Health Consumer Participation Questionnaire. A convenience sample of 47 mental health professionals from two adult inpatient psychiatric units located in a large Australian public general hospital participated in the study. The findings, overall, showed that participants supported the inclusion of consumer consultants in psychiatric units in areas that indirectly impinged on their current roles. Age, level of nurses, and place of employment did not affect their beliefs, but type of occupation was influential. Nurses were less supportive of aspects of consumer consultants' roles that overlapped with the traditional roles of the nurse. The findings have implications for clinical practice, education, and further research, and these are discussed.

  11. The application of knowledge synthesis methods in agri-food public health: recent advancements, challenges and opportunities.

    PubMed

    Young, Ian; Waddell, Lisa; Sanchez, Javier; Wilhelm, Barbara; McEwen, Scott A; Rajić, Andrijana

    2014-03-01

    Knowledge synthesis refers to the integration of findings from individual research studies on a given topic or question into the global knowledge base. The application of knowledge synthesis methods, particularly systematic reviews and meta-analysis, has increased considerably in the agri-food public health sector over the past decade and this trend is expected to continue. The objectives of our review were: (1) to describe the most promising knowledge synthesis methods and their applicability in agri-food public health, and (2) to summarize the recent advancements, challenges, and opportunities in the use of systematic review and meta-analysis methods in this sector. We performed a structured review of knowledge synthesis literature from various disciplines to address the first objective, and used comprehensive insights and experiences in applying these methods in the agri-food public health sector to inform the second objective. We describe five knowledge synthesis methods that can be used to address various agri-food public health questions or topics under different conditions and contexts. Scoping reviews describe the main characteristics and knowledge gaps in a broad research field and can be used to evaluate opportunities for prioritizing focused questions for related systematic reviews. Structured rapid reviews are streamlined systematic reviews conducted within a short timeframe to inform urgent decision-making. Mixed-method and qualitative reviews synthesize diverse sources of contextual knowledge (e.g. socio-cognitive, economic, and feasibility considerations). Systematic reviews are a structured and transparent method used to summarize and synthesize literature on a clearly-defined question, and meta-analysis is the statistical combination of data from multiple individual studies. We briefly describe and discuss key advancements in the use of systematic reviews and meta-analysis, including: risk-of-bias assessments; an overall quality

  12. Observations of sexually transmitted disease consultations in India.

    PubMed

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

    1998-03-01

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

  13. Ethics in Consulting and Outside Professional Activities.

    ERIC Educational Resources Information Center

    Dillon, Kristine E.

    Ethical concerns related to faculty consulting and other professional activities for supplemental pay are discussed. Some groups, like students and taxpayers, may find it difficult to view outside professional activities of faculty members in the context of public service and professional development. Universities employing academic professionals…

  14. 49 CFR 7.17 - Consultation with submitters of commercial and financial information.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Consultation with submitters of commercial and financial information. 7.17 Section 7.17 Transportation Office of the Secretary of Transportation PUBLIC AVAILABILITY OF INFORMATION Availability of Reasonably Described Records Under the Freedom of Information Act § 7.17 Consultation with submitters o...

  15. Synthesis in Science.

    ERIC Educational Resources Information Center

    Horsella, Maria

    This paper discusses various techniques that scientists and other professionals can use to keep current in their field despite the large amount of available information, such as consulting abstracts, indexes, reviews, and catalogues. It also examines specific language patterns that are used in the sciences to produce synthesis and abridgement,…

  16. [Tropical medicine consultation].

    PubMed

    Valerio, L; de Balanzó, X

    2006-01-01

    Tropical medicine consultations are fully justified in settings with the latest modern technology, where specific complementary tests are available and there are professionals with experience in tropical questions. That is to say, in tertiary hospitals. If such consultations took place in secondary hospitals or in primary care, they could be considered inefficient or unjustifiable from the point of view of the volume of patients attended to. However, there is a care deficit with respect to preventive activities concerning travellers or immigrants who have recently arrived from countries with a low income and where there is a high prevalence of imported diseases that are less recognised in our normal health milieu. Thus, international health units, which combine preventive and curative activities in a framework of public health provision and in a functional situation between the hospital level and that of primary care, offer a more efficient and suitable profile for the characteristics of the Spanish population. Their implementation depends on policy makers, the offer of a realistic portfolio of services, the existence of quality control monitoring and the possibility of managing information through a computer network.

  17. Talking about human papillomavirus and cancer: protocol for a patient-centred study to develop scripted consultations

    PubMed Central

    Hendry, Maggie; Pasterfield, Di; Adams, Richard; Evans, Mererid; Fiander, Alison; Robling, Michael; Campbell, Christine; Makin, Matthew; Gollins, Simon; Hiscock, Julia; Nafees, Sadia; Bekkers, Marie-Jet; Rose, Jan; Williams, Olwen; Stanley, Margaret; Wilkinson, Clare

    2016-01-01

    Introduction Persistent infection with sexually transmitted, high-risk human papillomavirus (HPV) types is the cause of all cervical cancers and some anogenital and oropharyngeal cancers. HPV is an extremely common asymptomatic infection but little known and poorly understood by the public. Patients with HPV-related cancers have new and challenging information needs due to the complex natural history of HPV and the stigma of sexual transmission. They may ask questions that are outside the remit of the traditional cancer consultation, and there is a lack of guidance on how to counsel them. This study aims to fulfil that need by developing and testing cancer site-specific scripted consultations. Methods and analysis A synthesis of findings generated from previous work, a systematic review of information-based interventions for patients with HPV-related cancers, and interviews with cancer clinicians will provide the evidence base underpinning provisional messages. These will be explored in three phases of face-to-face interviews with 75–90 purposively selected patients recruited in cancer clinics to: (1) select and prioritise the most salient messages, (2) phrase the messages appropriately in plain English and, (3) test their acceptability and usefulness. Phases 1 and 2 will draw on card-sorting methods used in website design. In phase three, we will create cancer site-specific versions of the script and test them using cognitive interviewing techniques. Ethics and dissemination The study has received ethical approval. Findings will be published in a peer-reviewed journal. The final product will be cancer-specific scripted consultations, most likely in the form of a two-sided information sheet with the most important messages to be conveyed in a consultation on one side, and frequently asked questions for later reading on the reverse. However, they will also be appropriate and readily adaptable to web-based uses. PMID:27113240

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

    PubMed

    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.

  19. 42 CFR 493.1409 - Condition: Laboratories performing moderate complexity testing; technical consultant.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Laboratories performing moderate complexity testing; technical consultant. 493.1409 Section 493.1409 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION...

  20. 42 CFR 493.1409 - Condition: Laboratories performing moderate complexity testing; technical consultant.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Condition: Laboratories performing moderate complexity testing; technical consultant. 493.1409 Section 493.1409 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION...

  1. 42 CFR 493.1415 - Condition: Laboratories performing moderate complexity testing; clinical consultant.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Condition: Laboratories performing moderate complexity testing; clinical consultant. 493.1415 Section 493.1415 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION...

  2. Analyzing the Effect of Consultation Training on the Development of Consultation Competence

    ERIC Educational Resources Information Center

    Newell, Markeda L.; Newell, Terrance

    2018-01-01

    The purpose of this study was to examine the effectiveness of one consultation course on the development of pre-service school psychologists' consultation knowledge, confidence, and skills. Computer-simulation was used as a means to replicate the school environment and capture consultants' engagement throughout the consultation process without…

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

    ERIC Educational Resources Information Center

    McClure, Kevin R.

    2017-01-01

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

  4. 42 CFR 493.1453 - Condition: Laboratories performing high complexity testing; clinical consultant.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Condition: Laboratories performing high complexity testing; clinical consultant. 493.1453 Section 493.1453 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY...

  5. Improving utility of evidence synthesis for healthy public policy: the three Rs (relevance, rigor, and readability [and resources]).

    PubMed

    Thomson, Hilary

    2013-08-01

    Systematic reviews have the potential to promote knowledge exchange between researchers and decision-makers. Review planning requires engagement with evidence users to ensure preparation of relevant reviews, and well-conducted reviews should provide accessible and reliable synthesis to support decision-making. Yet, systematic reviews are not routinely referred to by decision-makers, and innovative approaches to improve the utility of reviews is needed. Evidence synthesis for healthy public policy is typically complex and methodologically challenging. Although not lessening the value of reviews, these challenges can be overwhelming and threaten their utility. Using the interrelated principles of relevance, rigor, and readability, and in light of available resources, this article considers how utility of evidence synthesis for healthy public policy might be improved.

  6. Improving Utility of Evidence Synthesis for Healthy Public Policy: the Three Rs (Relevance, Rigor, and Readability [and Resources])

    PubMed Central

    2013-01-01

    Systematic reviews have the potential to promote knowledge exchange between researchers and decision-makers. Review planning requires engagement with evidence users to ensure preparation of relevant reviews, and well-conducted reviews should provide accessible and reliable synthesis to support decision-making. Yet, systematic reviews are not routinely referred to by decision-makers, and innovative approaches to improve the utility of reviews is needed. Evidence synthesis for healthy public policy is typically complex and methodologically challenging. Although not lessening the value of reviews, these challenges can be overwhelming and threaten their utility. Using the interrelated principles of relevance, rigor, and readability, and in light of available resources, this article considers how utility of evidence synthesis for healthy public policy might be improved. PMID:23763400

  7. High school students' opinions of gynecological consultations in Rio de Janeiro, Southeastern Brazil.

    PubMed

    Pereira, Sandra de Morais; Taquette, Stella Regina; Pérez, Maurício de Andrade

    2013-02-01

    To analyze sociocultural differences and perceptions of gynecological consultations for high school girls. A transversal study with 418 high school girls from three schools of different profiles in the city of Rio de Janeiro, Southeastern Brazil in 2010. A structured questionnaire encompassing socio-demographic characteristics, sexual behavior and evaluation of gynecological consultations was completed. Yates' Chi-square test and the Student's t-test were utilized adopting a value of p < 0.05. The students of private and federal public schools presented similar profiles but both were different from the state school girls. The latter had lower socioeconomic status, and their parents had lower levels of education, the predominance of afro-descendants was observed, as were a larger number of sexual partners, pregnancy and cases of sexual violence. The average age of menarche and sexarche among the students were similar, but the first gynecological consultation was significantly later among the state school students. The majority showed some knowledge of contraception and STDs, although only a minority received guidance from the consultations. Students expressed the desire that the professionals dedicate more time, patience and availability to them during consultations. The provision of gynecological services for teenagers is not satisfactory, according to the teenagers' evaluations. Users of the private health system have gynecological consultations earlier than those who only have access to the public system. It is necessary to create mechanisms that facilitate access and adhesion to a routine of gynecological prevention for this age group.

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

    PubMed Central

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

    2016-01-01

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

  9. Inpatient Consultative Dermatology.

    PubMed

    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.

  10. Developing Knowledge and Value in Management Consulting. Research in Management Consulting.

    ERIC Educational Resources Information Center

    Buono, Anthony F., Ed.

    This document contains 11 papers that explore knowledge and value development in the field of management consulting, with particular emphasis on trends and techniques in the practice of management consulting and the current theory and dynamics of management consulting. The following papers are included: "Introduction" (Anthony F. Buono);…

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

    PubMed

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

    2016-01-29

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

  12. Quality Assurance in Higher Education: Proposals for Consultation.

    ERIC Educational Resources Information Center

    Higher Education Funding Council for England, Bristol.

    This document sets out for consultation proposals for a revised method for quality assurance of teaching and learning in higher education. The proposals cover: (1) the objectives and principles of quality assurance; (2) an approach to quality assurance based on external audit principles; (3) the collection and publication of information; (4)…

  13. Cross-Disciplinary Consultancy to Enhance Predictions of Asthma Exacerbation Risk in Boston

    PubMed Central

    Reid, Margaret; Gunn, Julia; Shah, Snehal; Donovan, Michael; Eggo, Rosalind; Babin, Steven; Stajner, Ivanka; Rogers, Eric; Ensor, Katherine B.; Raun, Loren; Levy, Jonathan I.; Painter, Ian; Phipatanakul, Wanda; Yip, Fuyuen; Nath, Anjali; Streichert, Laura C.; Tong, Catherine

    2016-01-01

    This paper continues an initiative conducted by the International Society for Disease Surveillance with funding from the Defense Threat Reduction Agency to connect near-term analytical needs of public health practice with technical expertise from the global research community. The goal is to enhance investigation capabilities of day-to-day population health monitors. A prior paper described the formation of consultancies for requirements analysis and dialogue regarding costs and benefits of sustainable analytic tools. Each funded consultancy targets a use case of near-term concern to practitioners. The consultancy featured here focused on improving predictions of asthma exacerbation risk in demographic and geographic subdivisions of the city of Boston, Massachusetts, USA based on the combination of known risk factors for which evidence is routinely available. A cross-disciplinary group of 28 stakeholders attended the consultancy on March 30-31, 2016 at the Boston Public Health Commission. Known asthma exacerbation risk factors are upper respiratory virus transmission, particularly in school-age children, harsh or extreme weather conditions, and poor air quality. Meteorological subject matter experts described availability and usage of data sources representing these risk factors. Modelers presented multiple analytic approaches including mechanistic models, machine learning approaches, simulation techniques, and hybrids. Health department staff and local partners discussed surveillance operations, constraints, and operational system requirements. Attendees valued the direct exchange of information among public health practitioners, system designers, and modelers. Discussion finalized design of an 8-year de-identified dataset of Boston ED patient records for modeling partners who sign a standard data use agreement. PMID:28210420

  14. Cross-Disciplinary Consultancy to Enhance Predictions of Asthma Exacerbation Risk in Boston.

    PubMed

    Reid, Margaret; Gunn, Julia; Shah, Snehal; Donovan, Michael; Eggo, Rosalind; Babin, Steven; Stajner, Ivanka; Rogers, Eric; Ensor, Katherine B; Raun, Loren; Levy, Jonathan I; Painter, Ian; Phipatanakul, Wanda; Yip, Fuyuen; Nath, Anjali; Streichert, Laura C; Tong, Catherine; Burkom, Howard

    2016-01-01

    This paper continues an initiative conducted by the International Society for Disease Surveillance with funding from the Defense Threat Reduction Agency to connect near-term analytical needs of public health practice with technical expertise from the global research community. The goal is to enhance investigation capabilities of day-to-day population health monitors. A prior paper described the formation of consultancies for requirements analysis and dialogue regarding costs and benefits of sustainable analytic tools. Each funded consultancy targets a use case of near-term concern to practitioners. The consultancy featured here focused on improving predictions of asthma exacerbation risk in demographic and geographic subdivisions of the city of Boston, Massachusetts, USA based on the combination of known risk factors for which evidence is routinely available. A cross-disciplinary group of 28 stakeholders attended the consultancy on March 30-31, 2016 at the Boston Public Health Commission. Known asthma exacerbation risk factors are upper respiratory virus transmission, particularly in school-age children, harsh or extreme weather conditions, and poor air quality. Meteorological subject matter experts described availability and usage of data sources representing these risk factors. Modelers presented multiple analytic approaches including mechanistic models, machine learning approaches, simulation techniques, and hybrids. Health department staff and local partners discussed surveillance operations, constraints, and operational system requirements. Attendees valued the direct exchange of information among public health practitioners, system designers, and modelers. Discussion finalized design of an 8-year de-identified dataset of Boston ED patient records for modeling partners who sign a standard data use agreement.

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

    ERIC Educational Resources Information Center

    Ingraham, Colette L.

    2017-01-01

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

  16. Ask the eConsultant: Improving access to haematology expertise using an asynchronous eConsult system.

    PubMed

    Fogel, Adam; Khamisa, Karima; Afkham, Amir; Liddy, Clare; Keely, Erin

    2017-04-01

    Introduction The Champlain BASE (Building Access to Specialists through eConsultation) eConsultation service was designed to address the limited access to specialist care in Canada, which can lead to long waiting times and, subsequently, negative patient outcomes. Our primary objective was to perform an in-depth analysis of the use, content, and perceived value of haematology electronic consults (eConsults) submitted by primary care providers (PCPs) to the eConsult service. Methods We conducted a cross-sectional study using descriptive statistics to examine post-eConsult surveys for PCPs and other collected data including PCP designation, time for specialist to complete the eConsult, specialist response time, perceived value of the eConsult by the PCP, and the need for a face-to-face referral following the eConsult. A medically-trained author reviewed all haematology eConsults from April 2011 to January 2015, and categorized them by clinical topic and question type using validated taxonomies. Results Haematology accounted for 436 out of 5601 (7.8%) total eConsults, making it the third most popular service utilized. In 66% of haematology eConsults, a face-to-face consultation was not needed. Anaemia, neutropenia, and hyperferritinemia were the most common clinical queries. Most eConsult question types concerned the management of haematological disorders or the interpretation of laboratory tests. Most eConsults were answered within three days, using less than 15 minutes of the specialists' time. PCPs highly valued the service. Discussion This initiative increases access to haematology care and has the potential to reduce the long waiting times for non-urgent traditional consultation, along with the benefit of cost savings to the healthcare system.

  17. Consultant management estimating tool.

    DOT National Transportation Integrated Search

    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...

  18. 42 CFR 483.360 - Consultation with treatment team physician.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Consultation with treatment team physician. 483.360... treatment team physician. If a physician or other licensed practitioner permitted by the state and the... the resident's treatment team physician, unless the ordering physician is in fact the resident's...

  19. 42 CFR 483.360 - Consultation with treatment team physician.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 false Consultation with treatment team physician. 483.360... treatment team physician. If a physician or other licensed practitioner permitted by the state and the... the resident's treatment team physician, unless the ordering physician is in fact the resident's...

  20. 42 CFR 483.360 - Consultation with treatment team physician.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Consultation with treatment team physician. 483.360... treatment team physician. If a physician or other licensed practitioner permitted by the state and the... the resident's treatment team physician, unless the ordering physician is in fact the resident's...

  1. 42 CFR 483.360 - Consultation with treatment team physician.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 5 2012-10-01 2012-10-01 false Consultation with treatment team physician. 483.360... treatment team physician. If a physician or other licensed practitioner permitted by the state and the... the resident's treatment team physician, unless the ordering physician is in fact the resident's...

  2. 42 CFR 483.360 - Consultation with treatment team physician.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 5 2013-10-01 2013-10-01 false Consultation with treatment team physician. 483.360... treatment team physician. If a physician or other licensed practitioner permitted by the state and the... the resident's treatment team physician, unless the ordering physician is in fact the resident's...

  3. [Medical insurance consultation through the medical society in the PKV--a quantitative analysis].

    PubMed

    Hakimi, R

    2006-06-01

    Insurance medical consultation by a medical consultant or medical director is well established at many companies in the German private health insurance sector. Nevertheless, the field of activity of the medical consultant is hardly known to the public and even less scientifically investigated. The present study deals with a quantitative analysis of insurance medical enquiries to medical consultants. For this, the total of all insurance medical enquiries in a whole year have been checked and classified. The total of 5116 enquiries shows that a large demand for consultation refers to the medical necessity of medicaments, followed by consultation on complementary and alternative medicine (CAM). Further important fields of consultation are the assessment of out-patient and in-patient psychotherapy, the verification of the extent of physical measures, the duration of hospital treatments, the extent of laboratory testing, the examination of new medical methods and the definition of cure measures in comparison with hospital treatment. Increasing demand exists for the definition of the necessity of out-patient and in-patient operations, the definition of cosmetic surgery and medically necessary plastic surgery and for questions of reproductive medicine. There is also increasing demand for consultation regarding lifestyle drugs and anti-aging medicine.

  4. Surgical pathology extradepartmental consultation practices.

    PubMed

    Azam, Muhammad; Nakhleh, Raouf E

    2002-04-01

    To document the practice parameters and case characteristics associated with personal (expert) consultations. We also examine the value, level of participant (customer) satisfaction, turnaround time, and rate of personal consultations. We asked participants in the College of American Pathologists' Q-Probes program to document cases sent for consultation during 4 months or up to 20 cases. They documented patient and specimen characteristics, the turnaround times, and the participants' levels of satisfaction with the consultation experience. One hundred eighty laboratories/surgical pathology practices. One hundred seventy-two (95.6%) were from the United States; the remainder were located in Canada and Australia. Rate and turnaround time of consultations and participant level of satisfaction. A total of 2746 consultation cases were examined for an aggregate consultation rate of 0.5% (median, 0.7%). Institutions with a higher occupied bed size and a greater number of surgical pathology cases both had lower consultation rates (P < or =.05). The median turnaround time (defined as the interval from the date on which the case was sent to the date on which the diagnosis was received) was 6 days. Twenty-nine percent and 68% of cases had a turnaround time within 3 and 7 days, respectively. Fifty-two percent of cases were sent to nationally known experts, and 32% were sent to local experts. Skin (18.0%), hematolymphoid (11.6%), and breast (9.6%) specimens were most commonly sent for consultation. In 70.5% of cases, the consultant confirmed the referring pathologist's original diagnosis, but in 15.9% of cases, the consultant also added significant information. Satisfaction rates were higher with faster turnaround times and verbal reporting. Satisfaction rates were lower for cases in which the patient or the clinician requested the consultation and in which the consultant's diagnosis was ambiguous. This study establishes a multi-institutional consultation rate of 0.5%, defines

  5. Malpractice liability for informal consultations.

    PubMed

    Olick, Robert S; Bergus, George R

    2003-01-01

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

  6. Ecological Consultancy

    ERIC Educational Resources Information Center

    Wilson, Scott McG.; Tattersfield, Peter

    2004-01-01

    This is the first of a new regular feature on careers, designed to provide those who teach biology with some inspiration when advising their students. In this issue, two consultant ecologists explain how their career paths developed. It is a misconception that there are few jobs in ecology. Over the past 20 or 30 years ecological consultancy has…

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

    PubMed

    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.

  8. Economic valuation of health care services in public health systems: a study about Willingness to Pay (WTP) for nursing consultations.

    PubMed

    Martín-Fernández, Jesús; del Cura-González, Ma Isabel; Rodríguez-Martínez, Gemma; Ariza-Cardiel, Gloria; Zamora, Javier; Gómez-Gascón, Tomás; Polentinos-Castro, Elena; Pérez-Rivas, Francisco Javier; Domínguez-Bidagor, Julia; Beamud-Lagos, Milagros; Tello-Bernabé, Ma Eugenia; Conde-López, Juan Francisco; Aguado-Arroyo, Óscar; Sanz-Bayona, Ma Teresa; Gil-Lacruz, Ana Isabel

    2013-01-01

    Identifying the economic value assigned by users to a particular health service is of principal interest in planning the service. The aim of this study was to evaluate the perception of economic value of nursing consultation in primary care (PC) by its users. Economic study using contingent valuation methodology. A total of 662 users of nursing consultation from 23 health centers were included. Data on demographic and socioeconomic characteristics, health needs, pattern of usage, and satisfaction with provided service were compiled. The validity of the response was evaluated by an explanatory mixed-effects multilevel model in order to assess the factors associated with the response according to the welfare theory. Response reliability was also evaluated. Subjects included in the study indicated an average Willingness to Pay (WTP) of €14.4 (CI 95%: €13.2-15.5; median €10) and an average Willingness to Accept [Compensation] (WTA) of €20.9 (CI 95%: €19.6-22.2; median €20). Average area income, personal income, consultation duration, home visit, and education level correlated with greater WTP. Women and older subjects showed lower WTP. Fixed parameters explained 8.41% of the residual variability, and response clustering in different health centers explained 4-6% of the total variability. The influence of income on WTP was different in each center. The responses for WTP and WTA in a subgroup of subjects were consistent when reassessed after 2 weeks (intraclass correlation coefficients 0.952 and 0.893, respectively). The economic value of nursing services provided within PC in a public health system is clearly perceived by its user. The perception of this value is influenced by socioeconomic and demographic characteristics of the subjects and their environment, and by the unique characteristics of the evaluated service. The method of contingent valuation is useful for making explicit this perception of value of health services.

  9. From staff nurse to nurse consultant. Writing for publication part 7: structure and presentation.

    PubMed

    Fowler, John

    John Fowler, independent education consultant, continues his series for clinical nurses hoping to share their experiences with a wider audience, with advice on developing a potential article for a professional journal.

  10. Library Consultants: Client Views.

    ERIC Educational Resources Information Center

    Robbins-Carter, Jane

    1984-01-01

    Reviews the consulting process (two-way interaction focused on seeking, giving, and receiving of help) as it applies to library science and identifies nine process roles of the consultant as teacher, student, detective, barbarian, timekeeper, monitor, talisman, advocate, and ritual pig. Common errors in classifying consultant roles are noted. (9…

  11. Healthy food procurement and nutrition standards in public facilities: evidence synthesis and consensus policy recommendations

    PubMed Central

    Kim D., Raine; Kayla, Atkey; Dana Lee, Dana Lee; Alexa R., Ferdinands; Dominique, Beaulieu; Susan, Buhler; Norm, Campbell; Brian, Cook; Mary, L’Abbé; Ashley, Lederer; David, Mowat; Joshna, Maharaj; Candace, Nykiforuk; Jacob, Shelley; Jacqueline, Street

    2018-01-01

    Abstract Introduction: Unhealthy foods are widely available in public settings across Canada, contributing to diet-related chronic diseases, such as obesity. This is a concern given that public facilities often provide a significant amount of food for consumption by vulnerable groups, including children and seniors. Healthy food procurement policies, which support procuring, distributing, selling, and/or serving healthier foods, have recently emerged as a promising strategy to counter this public health issue by increasing access to healthier foods. Although numerous Canadian health and scientific organizations have recommended such policies, they have not yet been broadly implemented in Canada. Methods: To inform further policy action on healthy food procurement in a Canadian context, we: (1) conducted an evidence synthesis to assess the impact of healthy food procurement policies on health outcomes and sales, intake, and availability of healthier food, and (2) hosted a consensus conference in September 2014. The consensus conference invited experts with public health/nutrition policy research expertise, as well as health services and food services practitioner experience, to review evidence, share experiences, and develop a consensus statement/recommendations on healthy food procurement in Canada. Results: Findings from the evidence synthesis and consensus recommendations for healthy food procurement in Canada are described. Specifically, we outline recommendations for governments, publicly funded institutions, decision-makers and professionals, citizens, and researchers. Conclusion: Implementation of healthy food procurement policies can increase Canadians’ access to healthier foods as part of a broader vision for food policy in Canada. PMID:29323862

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

    ERIC Educational Resources Information Center

    Prasad-Gaur, Archna; And Others

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

  13. Antenatal Consultations at Extreme Prematurity: A Systematic Review of Parent Communication Needs.

    PubMed

    Kharrat, Ashraf; Moore, Gregory P; Beckett, Stéphanie; Nicholls, Stuart G; Sampson, Margaret; Daboval, Thierry

    2018-05-01

    To synthesize and describe parental expectations on how healthcare professionals should interact with them during a peripartum, antenatal consultation for extremely preterm infants. For this systematic literature review with textual narrative synthesis, we included studies that explored parental perspectives regarding the antenatal consultation for an extremely preterm infant. Electronic searches of Medline, CINAHL, PsycInfo, and Embase were conducted, along with a search of the grey literature. Quality appraisal was conducted using the guide by Walsh and Downe. Two independent reviewers reviewed 783 titles, of which 130 abstracts then 40 full-text articles were reviewed. Final data abstraction includes 19 studies. We predetermined 6 topics of interest (setting, timing, preferred healthcare professional, information, resources, and parents-physician interaction) to facilitate thematic analysis. In consideration of the variability of parents' specific desires, six predetermined topics and additional overarching themes such as perception of support, degree of understanding, hope, spirituality, and decision-making influences emerged. Studies suggest the quality of the antenatal consultation is not purely about information content, but also the manner in which it is provided. Limitations include thematic analysis that can potentially lead to the exclusion of important nuances. Relevant studies may have been missed if published outside the healthcare literature. The findings may inform clinical practice guidelines. This paper includes suggested strategies related to parents' perspectives that may facilitate communication during antenatal consultation for an extremely preterm infant. These strategies may also support parental engagement and satisfaction. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. How are European birth-cohort studies engaging and consulting with young cohort members?

    PubMed

    Lucas, Patricia J; Allnock, Debra; Jessiman, Tricia

    2013-04-11

    Birth cohort studies, where parents consent for their child to be enrolled in a longitudinal study prior to or soon after birth, are a powerful study design in epidemiology and developmental research. Participation often continues into adulthood. Where participants are enrolled as infants, provision should be made for consent, consultation and involvement in study design as they age. This study aims to audit and describe the extent and types of consultation and engagement currently used in birth cohorts in Europe. Seventy study groups (representing 84 cohorts) were contacted to ask about their practice in engaging and involving study members. Information was gathered from study websites and publications, 15 cohorts provided additional information via email and 17 cohorts were interviewed over the phone. The cohorts identified confirm the growth of this study design, with more than half beginning since 1990, and 4 since 2011. Most studies maintain a website open to the general public, although many are written for the scientific community only. Five studies have web pages specifically for young cohort members and one study provides a dedicated page for fathers. Cohorts send newsletters, cards, and summaries of findings to participants to stay in touch. Six cohorts use Facebook for this purpose. Five cohorts provide feedback opportunities for participants after completing a round of data collection. We know of just 8 cohorts who have a mechanism for consulting with parents and 3 a mechanism for consulting with young people themselves, although these were 'one off' consultations for some groups. Barriers to further consultation with cohort members were: concerns about impact on quality of research, ethical constraints, resource limitations, lack of importance, and previous adverse experiences. Although the children in some of the cohorts are still young (born in the last 10 years) many are old enough to include some element of consultation. Barriers to greater

  15. "Care and feeding": the Asian environmental tobacco smoke consultants programme.

    PubMed

    Assunta, M; Fields, N; Knight, J; Chapman, S

    2004-12-01

    To review the tobacco industry's Asian environmental tobacco smoke (ETS) consultants programme, focusing on three key nations: China, Hong Kong, and Malaysia. Systematic keyword and opportunistic website searches of formerly private internal industry documents. The release of the 1986 US Surgeon General's report on second hand smoke provoked tobacco companies to prepare for a major threat to their industry. Asian programme activities included conducting national/international symposiums, consultant "road shows" and extensive lobbying and media activities. The industry exploited confounding factors said to be unique to Asian societies such as diet, culture and urban pollution to downplay the health risks of ETS. The industry consultants were said to be "..prepared to do the kinds of things they were recruited to do". The programme was successful in blurring the science on ETS and keeping the controversy alive both nationally and internationally. For the duration of the project, it also successfully dissuaded national policy makers from instituting comprehensive bans on smoking in public places.

  16. 36 CFR 271.8 - Consultation with Association of State Foresters and the Advertising Council.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Consultation with Association of State Foresters and the Advertising Council. 271.8 Section 271.8 Parks, Forests, and Public... Association of State Foresters and the Advertising Council. These regulations in this part have been issued...

  17. Longer-term impact of cardiology e-consults.

    PubMed

    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 < .001). After the introduction of cardiac e-consults, the increase in traditional cardiac visit requests was less than the increase in traditional visit requests for control specialties (4.5% vs 10.1%, P < .001). For e-consults with at least 6 months of follow-up, 75.6% patients did not have any type of traditional 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

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

    PubMed

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

    2008-01-01

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

  19. International variations in primary care physician consultation time: a systematic review of 67 countries

    PubMed Central

    Neves, Ana Luisa; Oishi, Ai; Tagashira, Hiroko; Verho, Anistasiya; Holden, John

    2017-01-01

    Objective To describe the average primary care physician consultation length in economically developed and low-income/middle-income countries, and to examine the relationship between consultation length and organisational-level economic, and health outcomes. Design and outcome measures This is a systematic review of published and grey literature in English, Chinese, Japanese, Spanish, Portuguese and Russian languages from 1946 to 2016, for articles reporting on primary care physician consultation lengths. Data were extracted and analysed for quality, and linear regression models were constructed to examine the relationship between consultation length and health service outcomes. Results One hundred and seventy nine studies were identified from 111 publications covering 28 570 712 consultations in 67 countries. Average consultation length differed across the world, ranging from 48 s in Bangladesh to 22.5 min in Sweden. We found that 18 countries representing about 50% of the global population spend 5 min or less with their primary care physicians. We also found significant associations between consultation length and healthcare spending per capita, admissions to hospital with ambulatory sensitive conditions such as diabetes, primary care physician density, physician efficiency and physician satisfaction. Conclusion There are international variations in consultation length, and it is concerning that a large proportion of the global population have only a few minutes with their primary care physicians. Such a short consultation length is likely to adversely affect patient healthcare and physician workload and stress. PMID:29118053

  20. Quality in ethics consultations.

    PubMed

    Magill, Gerard

    2013-11-01

    There is an increasing need for quality in ethics consultations, though there have been significant achievements in the United States and Europe. However, fundamental concerns that place the profession in jeopardy are discussed from the perspective of the U.S. in a manner that will be helpful for other countries. The descriptive component of the essay (the first two points) explains the achievements in ethics quality (illustrated by the IntegratedEthics program of the Veterans Health Administration) and the progress on standards and competencies for ethics consultations (represented by the Core Competencies of the American Society for Bioethics and Humanities). Based on these achievements, the analytical component of the essay (the final three points) identifies and seeks to resolve three fundamental concerns (with increasing levels of importance) that compromise quality in ethics consultations: standards of quality; professionalism; and credentialing. The analysis argues for clearer standards of quality in ethics consultation and urges further professionalism by explaining the need for the following: interpreting the ASBH core competencies in a normative manner, developing a Code of Ethics, and clarifying the meaning of best practices. However, the most serious concern that threatens quality in ethics consultations is the lack of a credentialing process. This concern can be resolved effectively by developing an independent Ethics Consultation Accreditation Council to accredit and standardize graduate degree programs, fellowship experiences, and qualifying examinations. This credentialing process is indispensable if we are to strategically enhance quality in ethics consultations.

  1. Research perspectives on the public and fire management: a synthesis of current social science on eight essential questions

    Treesearch

    Sarah M. McCaffrey; Christine S. Olsen

    2012-01-01

    As part of a Joint Fire Science Program project, a team of social scientists reviewed existing fire social science literature to develop a targeted synthesis of scientific knowledge on the following questions: 1. What is the public's understanding of fire's role in the ecosystem? 2. Who are trusted sources of information about fire? 3. What are the public...

  2. [Insurance medical consultation in private health insurance - which insurance medical questions are put to the medical consultant?].

    PubMed

    Hakimi, R; Herre, K; Seyffer, R

    2015-03-01

    This study deals with the task areas of the medical consultant in private health insurance. Although insurance medical consultation for the insurance business originated in the 19th century, the tasks and competencies of the medical consultants are still mostly unknown. This study is a complete inventory count of all insurance medical consultation requests for the year 2013. All of the 5493 insurance medical consultation requests have been evaluated. Most of the consultation requests concern the medical necessity for medical drugs, followed by the medical consultation of alternative medicine and the classification of cure and rehabilitation measures of hospital medical treatments. The need for insurance medical consultation on lifestyle drugs, cosmetic operations and artificial insemination has increased significantly in the past 10 years. Since 2009, moreover, the need for medical consultation on the subject of "Ruhensleistungen" with regard to non-payers and "Notlagentarif" has strongly increased.

  3. Starting a nursing consultation practice.

    PubMed

    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.

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

    ERIC Educational Resources Information Center

    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…

  5. ACCC's Response to Industry Canada's Consultation on Improving Canada's Digital Advantage

    ERIC Educational Resources Information Center

    Association of Canadian Community Colleges, 2010

    2010-01-01

    As the national and international voice representing over 150 publicly-funded colleges, institutes, polytechnics, cegeps, university colleges and universities with a college mandate, the Association of Canadian Community Colleges (ACCC) welcomes the opportunity to provide input to Industry Canada's consultation on a Digital Economy Strategy for…

  6. Measuring the cost and effect of current community consultation and public disclosure techniques in emergency care research.

    PubMed

    Matchett, Gerald; Ryan, Timothy J; Sunna, Mary C; Lee, Simon C; Pepe, Paul E

    2018-04-30

    U.S. federal regulations for research involving exception from informed consent (EFIC) include stipulations for community consultation (CC) and public disclosure (PD) (FDA 21 CFR 50.24). Published descriptions of PD campaigns include letters to community leaders, media outreach, paid advertising, and community meetings. Whether or not these activities provide measurable impact is unknown, as few prior works have evaluated PD activities with probabilistic polling. The aim of this study is to use polling to assess how much public awareness PD efforts generate. A 3-month PD campaign similar in scope and scale to PD campaigns described in several recent publications was implemented across a large urban county (pop. 2.55 million). PD included a study website (www.evktrial.org), letters to 300 community leaders/organizations, bilingual media outreach and also phased roll-outs, weeks apart, of newspaper advertisements, mass e-mail messaging, and paid advertising in Facebook ® and Twitter ® augmented by volunteer social media outreach. During PD we used repeated zip code-targeted online polling via Google Consumer Surveys ® to assess community awareness of the proposed EFIC study. Over 3-months all-source exposures to >1 million individuals were estimated, generating ∼5,000 website visits (12-month cumulative, ∼9000). However, general community awareness evaluated through repeated county-wide polling never rose above baseline measurements. CC/PD campaign costs were estimated at $60,000 (USD). A PD campaign in scope and scale common for EFIC studies may not provide measurable impact in a community. Investigators, review boards and regulators could consider these findings when re-examining and/or creating policies for PD for EFIC studies. Copyright © 2018 Elsevier B.V. All rights reserved.

  7. The art of consultation.

    PubMed

    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.

  8. From staff nurse to nurse consultant. Part 9: writing for publication using client case studies.

    PubMed

    Fowler, John

    John Fowler, independent education consultant, continues his series for clinical nurses hoping to share their experiences with a wider audience, with advice on developing a potential article for a professional journal.

  9. From staff nurse to nurse consultant: Writing for publication part 10: publishing a project report.

    PubMed

    Fowler, John

    John Fowler, independent education consultant, continues his series for clinical nurses hoping to share their experiences with a wider audience, with advice on developing a potential article for a professional journal.

  10. Educating for a More Public Journalism: Public Journalism and Its Challenges to Journalism Education.

    ERIC Educational Resources Information Center

    Haas, Tanni

    Given the increasing influence of public journalism on the daily routines of newspapers across the United States, students need to be taught how to find a workable balance between consulting and reporting on conventional information sources and consulting and reporting on the perspectives provided by ordinary citizens. This paper discusses ways in…

  11. Factors that influence the way local communities respond to consultation processes about major service change: A qualitative study

    PubMed Central

    Barratt, Helen; Harrison, David A.; Raine, Rosalind; Fulop, Naomi J.

    2015-01-01

    Objectives In England, proposed service changes such as Emergency Department closures typically face local opposition. Consequently, public consultation exercises often involve protracted, hostile debates. This study examined a process aimed at engaging a community in decision-making about service reconfiguration, and the public response to this process. Methods A documentary analysis was conducted to map consultation methods used in an urban area of England where plans to consolidate hospital services on fewer sites were under discussion. In-depth interviews (n = 20) were conducted with parents, older people, and patient representatives. The analysis combined inductive and deductive approaches, informed by risk communication theories. Results The commissioners provided a large volume of information about the changes, alongside a programme of public events. However, the complexity of the process, together with what members of the public perceived to be the commissioners’ dismissal of their concerns, led the community to question their motivation. This was compounded by a widespread perception that the proposals were financially driven. Discussion Government policy emphasises the importance of clinical leadership and ‘evidence’ in public consultation. However, an engagement process based on this approach fuelled hostility to the proposals. Policymakers should not assume communities can be persuaded to accommodate service change which may result in reduced access to care. PMID:25975768

  12. The Consultant from Oz Syndrome.

    ERIC Educational Resources Information Center

    Smith, Garnett J.

    1998-01-01

    School leaders should realize that consultants cannot substitute for developing collective actions within the organization. The "Consultant from Oz Syndrome" stems from placing undue confidence in external sources, confusing consultants with magicians, and denying their limitations. While journeying down the yellow brick road of…

  13. Experience-based consulting: the value proposition.

    PubMed

    Pliner, Nicole; Thrall, James; Boland, Giles; Palumbo, Denise

    2004-11-01

    Consulting is a profession universally accepted and well entrenched throughout the business world. Whether it is providing objective analysis, supplying a specific expertise, managing a project, or simply adding extra manpower, consultants can add value. However, what are the attributes of a good consultant? In health care, with the rapid pace of emerging technologies, economic intricacies, and the complexities of clinical care, hands-on experience is the key. Recognizing the power of consultants with hands-on experience, the Department of Radiology at Massachusetts General Hospital launched the Radiology Consulting Group, an "experience-based" model for consulting that may potentially shift the profession's paradigm.

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

    PubMed Central

    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

    Main Objective 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. Methods 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. Main Results and Their Significance 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). Conclusion 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. PMID:26301746

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

    PubMed

    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.

  16. Experimental Evaluation of Instructional Consultation Teams on Teacher Beliefs and Practices

    ERIC Educational Resources Information Center

    Vu, Phuong; Shanahan, Katherine Bruckman; Rosenfield, Sylvia; Gravois, Todd; Koehler, Jessica; Kaiser, Lauren; Berger, Jill; Vaganek, Megan; Gottfredson, Gary D.; Nelson, Deborah

    2013-01-01

    Instructional Consultation Teams (IC Teams) are an early intervention service intended to support teachers in working with struggling students. This is a large-scale experimental trial investigating the effects of IC Teams on teacher efficacy, instructional practices, collaboration, and job satisfaction. Public elementary schools (N = 34) were…

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

    PubMed

    Clark, Thomas R

    2008-09-01

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

  18. Economic Valuation of Health Care Services in Public Health Systems: A Study about Willingness to Pay (WTP) for Nursing Consultations

    PubMed Central

    Martín-Fernández, Jesús; del Cura-González, Mª Isabel; Rodríguez-Martínez, Gemma; Ariza-Cardiel, Gloria; Zamora, Javier; Gómez-Gascón, Tomás; Polentinos-Castro, Elena; Pérez-Rivas, Francisco Javier; Domínguez-Bidagor, Julia; Beamud-Lagos, Milagros; Tello-Bernabé, Mª Eugenia; Conde-López, Juan Francisco; Aguado-Arroyo, Óscar; Bayona, Mª Teresa Sanz-; Gil-Lacruz, Ana Isabel

    2013-01-01

    Background Identifying the economic value assigned by users to a particular health service is of principal interest in planning the service. The aim of this study was to evaluate the perception of economic value of nursing consultation in primary care (PC) by its users. Methods and Results Economic study using contingent valuation methodology. A total of 662 users of nursing consultation from 23 health centers were included. Data on demographic and socioeconomic characteristics, health needs, pattern of usage, and satisfaction with provided service were compiled. The validity of the response was evaluated by an explanatory mixed-effects multilevel model in order to assess the factors associated with the response according to the welfare theory. Response reliability was also evaluated. Subjects included in the study indicated an average Willingness to Pay (WTP) of €14.4 (CI 95%: €13.2–15.5; median €10) and an average Willingness to Accept [Compensation] (WTA) of €20.9 (CI 95%: €19.6–22.2; median €20). Average area income, personal income, consultation duration, home visit, and education level correlated with greater WTP. Women and older subjects showed lower WTP. Fixed parameters explained 8.41% of the residual variability, and response clustering in different health centers explained 4–6% of the total variability. The influence of income on WTP was different in each center. The responses for WTP and WTA in a subgroup of subjects were consistent when reassessed after 2 weeks (intraclass correlation coefficients 0.952 and 0.893, respectively). Conclusions The economic value of nursing services provided within PC in a public health system is clearly perceived by its user. The perception of this value is influenced by socioeconomic and demographic characteristics of the subjects and their environment, and by the unique characteristics of the evaluated service. The method of contingent valuation is useful for making explicit this perception of value of

  19. Why do people consult the doctor?

    PubMed

    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.

  20. The Process of Psychological Consultation

    ERIC Educational Resources Information Center

    Nolan, Anna; Moreland, Neil

    2014-01-01

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

  1. International variations in primary care physician consultation time: a systematic review of 67 countries.

    PubMed

    Irving, Greg; Neves, Ana Luisa; Dambha-Miller, Hajira; Oishi, Ai; Tagashira, Hiroko; Verho, Anistasiya; Holden, John

    2017-11-08

    To describe the average primary care physician consultation length in economically developed and low-income/middle-income countries, and to examine the relationship between consultation length and organisational-level economic, and health outcomes. This is a systematic review of published and grey literature in English, Chinese, Japanese, Spanish, Portuguese and Russian languages from 1946 to 2016, for articles reporting on primary care physician consultation lengths. Data were extracted and analysed for quality, and linear regression models were constructed to examine the relationship between consultation length and health service outcomes. One hundred and seventy nine studies were identified from 111 publications covering 28 570 712 consultations in 67 countries. Average consultation length differed across the world, ranging from 48 s in Bangladesh to 22.5 min in Sweden. We found that 18 countries representing about 50% of the global population spend 5 min or less with their primary care physicians. We also found significant associations between consultation length and healthcare spending per capita, admissions to hospital with ambulatory sensitive conditions such as diabetes, primary care physician density, physician efficiency and physician satisfaction. There are international variations in consultation length, and it is concerning that a large proportion of the global population have only a few minutes with their primary care physicians. Such a short consultation length is likely to adversely affect patient healthcare and physician workload and stress. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. Clinician, patient and general public beliefs about diagnostic imaging for low back pain: protocol for a qualitative evidence synthesis.

    PubMed

    Traeger, Adrian C; Reed, Benjamin J; O'Connor, Denise A; Hoffmann, Tammy C; Machado, Gustavo C; Bonner, Carissa; Maher, Chris G; Buchbinder, Rachelle

    2018-02-10

    Little is known about how to reduce unnecessary imaging for low back pain. Understanding clinician, patient and general public beliefs about imaging is critical to developing strategies to reduce overuse. To synthesise qualitative research that has explored clinician, patient or general public beliefs about diagnostic imaging for low back pain. We will perform a qualitative evidence synthesis of relevant qualitative research exploring clinician, patient and general public beliefs about diagnostic imaging for low back pain. Exclusions will be studies not using qualitative methods and studies not published in English. Studies will be identified using sensitive search strategies in MEDLINE, EMBASE, CINAHL, AMED and PsycINFO. Two reviewers will independently apply inclusion and exclusion criteria, extract data, and use the Critical Appraisal Skills Programme quality assessment tool to assess the quality of included studies. To synthesise the data we will use a narrative synthesis approach that involves developing a theoretical model, conducting a preliminary synthesis, exploring relations in the data, and providing a structured summary. We will code the data using NVivo. At least two reviewers will independently apply the thematic framework to extracted data. Confidence in synthesis findings will be evaluated using the GRADE Confidence in the Evidence from Reviews of Qualitative Research tool. Ethical approval is not required to conduct this review. We will publish the results in a peer-reviewed journal. CRD42017076047. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  3. 21 CFR 211.34 - Consultants.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 4 2011-04-01 2011-04-01 false Consultants. 211.34 Section 211.34 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL... Consultants. Consultants advising on the manufacture, processing, packing, or holding of drug products shall...

  4. 21 CFR 211.34 - Consultants.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Consultants. 211.34 Section 211.34 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL... Consultants. Consultants advising on the manufacture, processing, packing, or holding of drug products shall...

  5. 21 CFR 211.34 - Consultants.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 4 2012-04-01 2012-04-01 false Consultants. 211.34 Section 211.34 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL... Consultants. Consultants advising on the manufacture, processing, packing, or holding of drug products shall...

  6. 21 CFR 211.34 - Consultants.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 4 2013-04-01 2013-04-01 false Consultants. 211.34 Section 211.34 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL... Consultants. Consultants advising on the manufacture, processing, packing, or holding of drug products shall...

  7. 21 CFR 211.34 - Consultants.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 4 2014-04-01 2014-04-01 false Consultants. 211.34 Section 211.34 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL... Consultants. Consultants advising on the manufacture, processing, packing, or holding of drug products shall...

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

    ERIC Educational Resources Information Center

    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…

  9. 42 CFR 137.401 - What role does Tribal consultation play in the IHS annual budget request process?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false What role does Tribal consultation play in the IHS annual budget request process? 137.401 Section 137.401 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF...

  10. Finalizing the Consultant Effectiveness Scale: An Analysis and Validation of the Characteristics of Effective Consultants.

    ERIC Educational Resources Information Center

    Knoff, Howard M.; Hines, Constance V.; Kromrey, Jeffrey D.

    1995-01-01

    Proposes that as consultation becomes a larger part of the school psychologist's role and function, the need to empirically identify characteristics of effective consultants is increasingly important. Describes the Consultant Effectiveness Scale (CES) and reexamines it with a national sample of school psychologists. Evaluates discriminate validity…

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

    PubMed

    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.

  12. 22 CFR 401.21 - Consultation.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Consultation. 401.21 Section 401.21 Foreign Relations INTERNATIONAL JOINT COMMISSION, UNITED STATES AND CANADA RULES OF PROCEDURE Applications § 401.21 Consultation. The Commission may meet or consult with the applicant, the Governments and other persons or their...

  13. "Care and feeding": the Asian environmental tobacco smoke consultants programme

    PubMed Central

    Assunta, M; Fields, N; Knight, J; Chapman, S

    2004-01-01

    Study objective: To review the tobacco industry's Asian environmental tobacco smoke (ETS) consultants programme, focusing on three key nations: China, Hong Kong, and Malaysia. Methods: Systematic keyword and opportunistic website searches of formerly private internal industry documents. Main results: The release of the 1986 US Surgeon General's report on second hand smoke provoked tobacco companies to prepare for a major threat to their industry. Asian programme activities included conducting national/international symposiums, consultant "road shows" and extensive lobbying and media activities. The industry exploited confounding factors said to be unique to Asian societies such as diet, culture and urban pollution to downplay the health risks of ETS. The industry consultants were said to be "...prepared to do the kinds of things they were recruited to do". Conclusions: The programme was successful in blurring the science on ETS and keeping the controversy alive both nationally and internationally. For the duration of the project, it also successfully dissuaded national policy makers from instituting comprehensive bans on smoking in public places. PMID:15564219

  14. The Structure of Clinical Consultation: A Case of Non-Native Speakers of English as Participants

    PubMed Central

    Bagheri, H.; Ibrahim, N. A.; Habil, H.

    2015-01-01

    Background: In many parts of the world, patients may find it difficult to visit doctors who share the same language and culture due to the intermingling of people and international recruitment of doctors among many other reasons. In these multilingual multicultural settings (MMSs), doctor-patient interactions face new communication challenges. This study aims to identify the structure of clinical consultation and its phases in an MMS where both doctors and patients are non-native speakers (NNSs) of English. Method: This study takes on a discourse analytic approach to examine the structure of clinical consultation as an activity type. 25 clinical consultation sessions between non-native speakers of English in a public healthcare centre in Malaysia were audio-recorded. Findings and Discussion: The results show that there are some deviations from the mainstream structure of clinical consultations although, in general, the pattern is compatible with previous studies. Deviations are particularly marked in the opening and closing phases of consultation. Conclusion: In almost all interactions, there is a straightforward manner of beginning medical consultations. The absence of greetings may have naturally reduced the length of talk. Hence, by directly entering medical talks, the doctors voice their concern on the curing aspects of the consultation rather than its caring facets. The preference of curing priority to caring is more goal-oriented and in alignment with the consultation as an activity type. PMID:25560336

  15. The structure of clinical consultation: a case of non-native speakers of English as participants.

    PubMed

    Bagheri, H; Ibrahim, N A; Habil, H

    2014-09-25

    In many parts of the world, patients may find it difficult to visit doctors who share the same language and culture due to the intermingling of people and international recruitment of doctors among many other reasons. In these multilingual multicultural settings (MMSs), doctor-patient interactions face new communication challenges. This study aims to identify the structure of clinical consultation and its phases in an MMS where both doctors and patients are non-native speakers (NNSs) of English. This study takes on a discourse analytic approach to examine the structure of clinical consultation as an activity type. 25 clinical consultation sessions between non-native speakers of English in a public healthcare centre in Malaysia were audio-recorded. The results show that there are some deviations from the mainstream structure of clinical consultations although, in general, the pattern is compatible with previous studies. Deviations are particularly marked in the opening and closing phases of consultation. In almost all interactions, there is a straightforward manner of beginning medical consultations. The absence of greetings may have naturally reduced the length of talk. Hence, by directly entering medical talks, the doctors voice their concern on the curing aspects of the consultation rather than its caring facets. The preference of curing priority to caring is more goal-oriented and in alignment with the consultation as an activity type.

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

    ERIC Educational Resources Information Center

    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…

  17. Ethics consultants and ethics committees.

    PubMed

    La Puma, J; Toulmin, S E

    1989-05-01

    To address moral questions in patient care, hospitals and health care systems have enlisted the help of hospital ethicists, ethics committees, and ethics consultation services. Most physicians have not been trained in the concepts, skills, or language of clinical ethics, and few ethicists have been trained in clinical medicine, so neither group can fully identify, analyze, and resolve clinical ethical problems. Some ethics committees have undertaken clinical consultations themselves, but liability concerns and variable standards for membership hinder their efforts. An ethics consultation service comprising both physician-ethicists and nonphysician-ethicists brings complementary viewpoints to the management of particular cases. If they are to be effective consultants, however, nonphysician-ethicists need to be "clinicians": professionals who understand an individual patient's medical condition and personal situation well enough to help in managing the case. Ethics consultants and ethics committees may work together, but they have separate identities and distinct objectives: ethics consultants are responsible for patient care, while ethics committees are administrative bodies whose primary task is to advise in creating institutional policy.

  18. Frequent consulting and multiple morbidity: a qualitative comparison of ‘high’ and ‘low’ consulters of GPs

    PubMed Central

    Wyke, Sally; Hunt, Kate

    2008-01-01

    Background. Frequent consulting is associated with multiple and complex social and health conditions. It is not known how the impact of multiple conditions, the ability to self-manage and patient perception of the GP consultation combines to influence consulting frequency. Objective. To investigate reasons for frequent consultation among people with multiple morbidity but contrasting consulting rates. Methods. Qualitative study with in-depth interviews in the west of Scotland. Participants were 23 men and women aged about 50 years with four or more chronic illnesses; 11 reported consulting seven or more times in the last year [the frequent consulters (FCs)] and 12, three or fewer times [the less frequent consulters (LFCs)]. The main outcome measures were the participants’ accounts of their symptoms, self-management strategies and reasons for consulting a GP. Results. All participants used multiple self-management strategies. FCs described: more disruptive symptoms, which were resistant to self-management strategies; less access to fewer treatments and resources and more medical monitoring, for unstable conditions and drug regimens. The LFCs reported: less severe and more containable symptoms; accessing more efficacious self-management strategies and infrequent GP monitoring for stable conditions and routine drug regimens. All participants conveyed consulting as a ‘last resort’. However, the GP was seen as ‘ally’, for the FCs, and as ‘innocent bystander’, for the LFCs. Conclusions. This qualitative investigation into the combined significance of multiple morbidities and self-management on the GP consultation suggests that current models of self-management might have limited potential to reduce utilization rates among this vulnerable group. Severity of symptoms, stability of condition and complexity of drug regimens combine to influence the availability of effective resources and influence frequency of GP consultations. PMID:18448858

  19. The role, costs and value for money of external consultancies in the health sector: A study of New Zealand's District Health Boards.

    PubMed

    Penno, Erin; Gauld, Robin

    2017-04-01

    Public spending on external consultancies, particularly within the health sector, is highly controversial in many countries. Yet, despite the apparently large sums of money involved, there is little international analysis surrounding the scope of activities of consultants, meaning there is little understanding of how much is spent, for what purpose and with what result. This paper examines spending on external consultancies in each of New Zealand's 20 District Health Boards (DHB). Using evidence obtained from DHBs, it provides an insight into the cost and activities of consultants within the New Zealand health sector, the policies behind their engagement and the processes in place to ensure value for money. It finds that DHB spending on external consultants is substantial, at $NZ10-60 million annually. However, few DHBs had policies governing when consultants should be engaged and many were unable to easily identify the extent or purpose of consultancies within their organisation, making it difficult to derive an accurate picture of consultant activity throughout the DHB sector. Policies surrounding value for money were uncommon and, where present, were rarely applied. Given the large sums being spent by New Zealand's DHBs, and assuming expenditure is similar in other health systems, our findings point to the need for greater accountability for expenditure and better evidence of value for money of consultancies within publicly funded health systems. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Regulation, consultation and divergent community views: the case of access to ART by lesbian and single women.

    PubMed

    Cannold, Leslie; Gillam, Lynn

    2002-05-01

    In the many countries which have some form of regulation of ART, a public consultation of some sort is a frequent feature of either the process leading up to regulation or of the regulatory mechanism itself. Not surprisingly, widely divergent views on the moral and political acceptability of ART are expressed during such consultations. And while such diversity of opinion is to be expected, and some even argue welcomed, in pluralist liberal democratic societies, it is often unclear how these divergent community views are and ought to be fed into the opinion-forming and decision-making processes of governments or the bodies that advise them. This article discusses first why regulation of ART may be justified, even when there is radical moral disagreement in the community, and why public consultations should play a central role in the work that advisory bodies undertake in making regulatory recommendations to government. Then, it both proposes and justifies a method for dealing with the contradictory moral views expressed by interested parties during the consultation process. To illustrate this method, the example of the attempt by single and lesbian women to access donor insemination services and ART is used.

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

    PubMed

    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

  2. 40 CFR 725.17 - Consultation with EPA.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 32 2013-07-01 2013-07-01 false Consultation with EPA. 725.17 Section... Applicability § 725.17 Consultation with EPA. Persons may consult with EPA, either in writing or by telephone..., ATTN: Biotechnology Notice Consultation. Persons wishing to consult with EPA by telephone should call...

  3. 40 CFR 725.17 - Consultation with EPA.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Consultation with EPA. 725.17 Section... Applicability § 725.17 Consultation with EPA. Persons may consult with EPA, either in writing or by telephone..., ATTN: Biotechnology Notice Consultation. Persons wishing to consult with EPA by telephone should call...

  4. 40 CFR 725.17 - Consultation with EPA.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 31 2014-07-01 2014-07-01 false Consultation with EPA. 725.17 Section... Applicability § 725.17 Consultation with EPA. Persons may consult with EPA, either in writing or by telephone..., ATTN: Biotechnology Notice Consultation. Persons wishing to consult with EPA by telephone should call...

  5. 40 CFR 725.17 - Consultation with EPA.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 31 2011-07-01 2011-07-01 false Consultation with EPA. 725.17 Section... Applicability § 725.17 Consultation with EPA. Persons may consult with EPA, either in writing or by telephone..., ATTN: Biotechnology Notice Consultation. Persons wishing to consult with EPA by telephone should call...

  6. Comparing virtual consults to traditional consults using an electronic health record: an observational case–control study

    PubMed Central

    2012-01-01

    Background Patients have typically received health care through face-to-face encounters. However, expansion of electronic communication and electronic health records (EHRs) provide alternative means for patient and physicians to interact. Electronic consultations may complement regular healthcare by providing “better, faster, cheaper” processes for diagnosing, treating, and monitoring health conditions. Virtual consultation between physicians may provide a method of streamlining care, potentially saving patients the time and expense of added visits. The purpose of this study was to compare physician usage and patient satisfaction with virtual consultations (VCs) with traditional consultations (TCs) facilitated within an EHR. Methods We conducted an observational case–control survey study within Kaiser Permanente, Colorado. A sample of patients who had VCs requested by physicians (N = 270) were matched with patients who had TCs requested by physicians (N = 270), by patient age, gender, reason for the consult, and specialty department. These patients (VC and TC), were invited to participate in a satisfaction survey. In addition, 205 primary care physicians who submitted a VC or TC were surveyed. Results During the study period, 58,146 VC or TC were requested (TC = 96.3%). Patients who completed a satisfaction survey (267 out of 540 patients, 49.4% response rate) indicated they were satisfied with their care, irrespective of the kind of consult (mean 10-point Likert score of 8.5). 88 of 205 primary care physicians surveyed (42.9%) returned at least one survey; VC and TC survey response rates and consulted departments were comparable (p = 0.13). More TCs than VCs requested transfer of patient care (p = 0.03), assistance with diagnosis (p = 0.04) or initiating treatment (p =0.04). Within 3 weeks of the consultation request, 72.1% of respondents reported receiving information from VCs, compared with 33.9% of the TCs (p < 0.001). Utility of information provided by

  7. Factors that influence the way local communities respond to consultation processes about major service change: A qualitative study.

    PubMed

    Barratt, Helen; Harrison, David A; Raine, Rosalind; Fulop, Naomi J

    2015-09-01

    In England, proposed service changes such as Emergency Department closures typically face local opposition. Consequently, public consultation exercises often involve protracted, hostile debates. This study examined a process aimed at engaging a community in decision-making about service reconfiguration, and the public response to this process. A documentary analysis was conducted to map consultation methods used in an urban area of England where plans to consolidate hospital services on fewer sites were under discussion. In-depth interviews (n=20) were conducted with parents, older people, and patient representatives. The analysis combined inductive and deductive approaches, informed by risk communication theories. The commissioners provided a large volume of information about the changes, alongside a programme of public events. However, the complexity of the process, together with what members of the public perceived to be the commissioners' dismissal of their concerns, led the community to question their motivation. This was compounded by a widespread perception that the proposals were financially driven. Government policy emphasises the importance of clinical leadership and 'evidence' in public consultation. However, an engagement process based on this approach fuelled hostility to the proposals. Policymakers should not assume communities can be persuaded to accommodate service change which may result in reduced access to care. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  8. Implementation of Teacher Consultation and Coaching in Urban Schools: A Mixed Method Study

    PubMed Central

    Cappella, Elise; Jackson, Daisy R.; Kim, Ha Yeon; Bilal, Caroline; Holland, Sibyl; Atkins, Marc S.

    2015-01-01

    Guided by implementation science scholarship and school mental health research, the current study uses qualitative and quantitative data to illuminate the barriers, opportunities, and processes underlying the implementation of a teacher consultation and coaching model (BRIDGE) in urban elementary schools. Data come from five public elementary schools, 12 school mental health staff (BRIDGE consultants), and 18 teachers participating in a classroom-randomized trial of BRIDGE. Findings from directed content analysis of teacher focus group and interview data suggest that aspects of the BRIDGE intervention model, school organization and classroom contexts, and teachers/consultants and their relationship were relevant as implementation facilitators or barriers. In addition, case study analysis of intervention materials and fidelity tools from classrooms with moderate-to-high dosage and adherence suggest variation in consultation and coaching by initial level of observed classroom need. Results illuminate the need for implementation research to extend beyond simple indicators of fidelity to the multiple systems and variation in processes at play across levels of the implementation context. PMID:27293490

  9. A Systematic Review of Asynchronous, Provider-to-Provider, Electronic Consultation Services to Improve Access to Specialty Care Available Worldwide.

    PubMed

    Liddy, Clare; Moroz, Isabella; Mihan, Ariana; Nawar, Nikhat; Keely, Erin

    2018-06-21

    Electronic consultation (eConsult) is an asynchronous electronic communication tool allowing primary care providers to obtain a specialist consultant's expert opinion in a timely manner, thereby offering a potential solution to excessive wait times for specialist care, which remain a serious concern in many countries. Our 2014 review of eConsult services demonstrated feasibility and high acceptability among patients and providers. However, gaps remain in knowledge regarding eConsult's impact on system costs and patient outcomes. Following the PRISMA guidelines, we conducted a systematic review in May 2017 of English and French literature on OVID Medline, EMBASE, ERIC, and CINAHL databases, examining all studies on eConsult services published since our previous review. The Quadruple Aim Framework was used to synthesize outcomes. Articles reporting on the impact of eConsult on access, patient safety and satisfaction, utilization rates, clinical workflow, and continuing medical education were analyzed using a narrative synthesis approach. The initial search yielded 1,021 results, 50 of which were included on abstract and received a quality assessment and full text review. Of these, 43 were included in our final analysis. Results demonstrated the worldwide presence of eConsult services in North America and countries beyond, including Brazil, Australia, Spain, and The Netherlands. The breadth of specialty services offered has greatly expanded beyond dermatology and includes cardiology, nephrology, and hematology among others. Overall impact on access measures, acceptability, cost, and provider satisfaction remain positive. There is limited research on population health outcomes of morbidity and mortality. The availability of eConsult services has spread both geographically and in terms of specialty services offered. By allowing for a greater population to be served, access to care is being improved; however, long-term impact should continue to be assessed with a focus

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

    PubMed

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

    2000-07-01

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

  11. 50 CFR 402.11 - Early consultation.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... OF COMMERCE); ENDANGERED SPECIES COMMITTEE REGULATIONS SUBCHAPTER A INTERAGENCY COOPERATION-ENDANGERED SPECIES ACT OF 1973, AS AMENDED Consultation Procedures § 402.11 Early consultation. (a) Purpose. Early consultation is designed to reduce the likelihood of conflicts between listed species or critical...

  12. 50 CFR 402.11 - Early consultation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... OF COMMERCE); ENDANGERED SPECIES COMMITTEE REGULATIONS SUBCHAPTER A INTERAGENCY COOPERATION-ENDANGERED SPECIES ACT OF 1973, AS AMENDED Consultation Procedures § 402.11 Early consultation. (a) Purpose. Early consultation is designed to reduce the likelihood of conflicts between listed species or critical...

  13. 50 CFR 402.11 - Early consultation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... OF COMMERCE); ENDANGERED SPECIES COMMITTEE REGULATIONS SUBCHAPTER A INTERAGENCY COOPERATION-ENDANGERED SPECIES ACT OF 1973, AS AMENDED Consultation Procedures § 402.11 Early consultation. (a) Purpose. Early consultation is designed to reduce the likelihood of conflicts between listed species or critical...

  14. 50 CFR 402.11 - Early consultation.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... OF COMMERCE); ENDANGERED SPECIES COMMITTEE REGULATIONS SUBCHAPTER A INTERAGENCY COOPERATION-ENDANGERED SPECIES ACT OF 1973, AS AMENDED Consultation Procedures § 402.11 Early consultation. (a) Purpose. Early consultation is designed to reduce the likelihood of conflicts between listed species or critical...

  15. 50 CFR 402.11 - Early consultation.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... OF COMMERCE); ENDANGERED SPECIES COMMITTEE REGULATIONS SUBCHAPTER A INTERAGENCY COOPERATION-ENDANGERED SPECIES ACT OF 1973, AS AMENDED Consultation Procedures § 402.11 Early consultation. (a) Purpose. Early consultation is designed to reduce the likelihood of conflicts between listed species or critical...

  16. Lay Consultations in Heart Failure Symptom Evaluation.

    PubMed

    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.

  17. Lay Consultations in Heart Failure Symptom Evaluation

    PubMed Central

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

    2017-01-01

    Purpose 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. Methods 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. Results 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. Conclusions Findings have implications for optimizing heart failure self-management interventions, improving outcomes, and reducing hospital readmissions. PMID:29399657

  18. Case Complexity and Quality Attestation for Clinical Ethics Consultants.

    PubMed

    Spielman, Bethany; Craig, Jana; Gorka, Christine; Miller, Keith

    2015-01-01

    A proposal by the American Society for Bioethics and Humanities (ASBH) to identify individuals who are qualified to perform ethics consultations neglects case complexity in candidates' portfolios. To protect patients and healthcare organizations, and to be fair to candidates, a minimum case complexity level must be clearly and publicly articulated. This proof-of-concept study supports the feasibility of assessing case complexity. Using text analytics, we developed a complexity scoring system, and retrospectively analyzed more than 500 ethics summaries of consults performed at an academic medical center during 2013. We demonstrate its use with seven case summaries that range in complexity from uncomplicated to very complicated. We encourage the ASBH to require a minimum level of case complexity, and recommend that attestation portfolios include several cases of moderate complexity and at least one very complex case. Copyright 2015 The Journal of Clinical Ethics. All rights reserved.

  19. Directory of Environmental Consultants.

    ERIC Educational Resources Information Center

    Cate, Bill, Ed.

    Over 400 inter-field professionals are named as environmental consultants in this 1972 annual directory. Primarily, they are faculty members at colleges and universities in Canada, Puerto Rico, and the United States who will provide free environmental consulting services to interested government, industry, and citizen organizations, but are not…

  20. 50 CFR 402.13 - Informal consultation.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ..., DEPARTMENT OF COMMERCE); ENDANGERED SPECIES COMMITTEE REGULATIONS SUBCHAPTER A INTERAGENCY COOPERATION-ENDANGERED SPECIES ACT OF 1973, AS AMENDED Consultation Procedures § 402.13 Informal consultation. (a..., that the action is not likely to adversely affect listed species or critical habitat, the consultation...

  1. 50 CFR 402.13 - Informal consultation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., DEPARTMENT OF COMMERCE); ENDANGERED SPECIES COMMITTEE REGULATIONS SUBCHAPTER A INTERAGENCY COOPERATION-ENDANGERED SPECIES ACT OF 1973, AS AMENDED Consultation Procedures § 402.13 Informal consultation. (a..., that the action is not likely to adversely affect listed species or critical habitat, the consultation...

  2. 50 CFR 402.13 - Informal consultation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ..., DEPARTMENT OF COMMERCE); ENDANGERED SPECIES COMMITTEE REGULATIONS SUBCHAPTER A INTERAGENCY COOPERATION-ENDANGERED SPECIES ACT OF 1973, AS AMENDED Consultation Procedures § 402.13 Informal consultation. (a..., that the action is not likely to adversely affect listed species or critical habitat, the consultation...

  3. 50 CFR 402.13 - Informal consultation.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ..., DEPARTMENT OF COMMERCE); ENDANGERED SPECIES COMMITTEE REGULATIONS SUBCHAPTER A INTERAGENCY COOPERATION-ENDANGERED SPECIES ACT OF 1973, AS AMENDED Consultation Procedures § 402.13 Informal consultation. (a..., that the action is not likely to adversely affect listed species or critical habitat, the consultation...

  4. 50 CFR 402.13 - Informal consultation.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ..., DEPARTMENT OF COMMERCE); ENDANGERED SPECIES COMMITTEE REGULATIONS SUBCHAPTER A INTERAGENCY COOPERATION-ENDANGERED SPECIES ACT OF 1973, AS AMENDED Consultation Procedures § 402.13 Informal consultation. (a..., that the action is not likely to adversely affect listed species or critical habitat, the consultation...

  5. Practice Parameter for Psychiatric Consultation to Schools

    ERIC Educational Resources Information Center

    Journal of the American Academy of Child and Adolescent Psychiatry, 2005

    2005-01-01

    This practice parameter reviews the topic of psychiatric consultation to schools. The review covers the history of school consultation and current consultative models; the process of developing a consultative relationship; school administrative procedures, personnel, and milieu; legal protections for students with mental disabilities; and issues…

  6. Assessment of Consultation and Intervention Implementation: A Review of Conjoint Behavioral Consultation Studies

    ERIC Educational Resources Information Center

    Collier-Meek, Melissa A.; Sanetti, Lisa M. H.

    2014-01-01

    Reviews of treatment outcome literature indicate treatment integrity is not regularly assessed. In consultation, two levels of treatment integrity (i.e., consultant procedural integrity [CPI] and intervention treatment integrity [ITI]) provide relevant implementation data. Specifically, assessment of CPI and ITI are necessary to conclude (a)…

  7. 23 CFR 450.210 - Interested parties, public involvement, and consultation.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... opportunities for public review and comment at key decision points. (1) The State's public involvement process... agencies, representatives of public transportation employees, freight shippers, private providers of... comment at key decision points, including but not limited to a reasonable opportunity to comment on the...

  8. 23 CFR 450.210 - Interested parties, public involvement, and consultation.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... opportunities for public review and comment at key decision points. (1) The State's public involvement process... agencies, representatives of public transportation employees, freight shippers, private providers of... comment at key decision points, including but not limited to a reasonable opportunity to comment on the...

  9. 23 CFR 450.210 - Interested parties, public involvement, and consultation.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... opportunities for public review and comment at key decision points. (1) The State's public involvement process... agencies, representatives of public transportation employees, freight shippers, private providers of... comment at key decision points, including but not limited to a reasonable opportunity to comment on the...

  10. Improving Methods of Consulting with Young People: Piloting a New Model of Consultation

    ERIC Educational Resources Information Center

    Woolfson, Richard C.; Bryce, Donna; Mooney, Lindsay; Harker, Michael; Lowe, Dorothy; Ferguson, Ellen

    2008-01-01

    National and international legislation has increasingly placed a duty on professionals to consult with young people about matters affecting their lives. Consequently, conducting consultation exercises with young people in order to improve the quality of services available is becoming established practice in many areas. Following on from previous…

  11. Academic Development for Careers in Management Consulting

    ERIC Educational Resources Information Center

    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…

  12. Geothermal Project Consulting | Geothermal Technologies | NREL

    Science.gov Websites

    Geothermal Project Consulting Geothermal Project Consulting When consulting on projects, NREL focuses on identifying specific barriers or challenges that are likely to impact geothermal project , validation, and deployment of geothermal technologies Assess and evaluate geothermal R&D projects

  13. Measuring Quality in Ethics Consultation.

    PubMed

    Bliss, Sally E; Oppenlander, Jane; Dahlke, Jacob M; Meyer, Gordon J; Williford, Eva M; Macauley, Robert C

    2016-01-01

    For all of the emphasis on quality improvement-as well as the acknowledged overlap between assessment of the quality of healthcare services and clinical ethics-the quality of clinical ethics consultation has received scant attention, especially in terms of empirical measurement. Recognizing this need, the second edition of Core Competencies for Health Care Ethics Consultation1 identified four domains of ethics quality: (1) ethicality, (2) stakeholders' satisfaction, (3) resolution of the presenting conflict/dilemma, and (4) education that translates into knowledge. This study is the first, to our knowledge, to directly measure all of these domains. Here we describe the quality improvement process undertaken at a tertiary care academic medical center, as well as the tools developed to measure the quality of ethics consultation, which include post-consultation satisfaction surveys and weekly case conferences. The information gained through these tools helps to improve not only the process of ethics consultation, but also the measurement and assurance of quality. Copyright 2016 The Journal of Clinical Ethics. All rights reserved.

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

    PubMed

    Groot, Marieke M; Vernooij-Dassen, Myrra J F J; Courtens, Annemie M; Kuin, Annemieke; van der Linden, Barbara A; van Zuylen, Lia; Crul, Ben J P; Grol, Richard P T M

    2005-11-01

    Professional care providers need a substantial basis of competence and expertise to provide appropriate palliative care. Little is known about the problems professionals experience in their palliative care provision in daily practice or about the nature of the advice and support they request from experts. Our aim was to investigate the extent to which professionals requested assistance from palliative care consultation teams and the reasons behind these requests to trace any gaps they experience in the provision of palliative care. As part of a large national palliative care development programme, we studied requests for consultation made by professional care providers over a 2-year period. The requests for consultation were recorded on a specially developed standard registration form and classified according to 11 domains relevant to palliative care. Professional care providers requested 4351 consultations on account of 8413 specific problems in 11 quality-of-life and quality-of-care domains. The distribution of problems over these domains was unbalanced: 42.2% of the specific problems were physical, while the percentages of psychological, pharmacological and organizational problems were 7.7, 12.5 and 12.8%, respectively. In contrast, issues of a spiritual nature or concerned with daily functioning were raised infrequently (1.1 and 0.9%). Details of the specific problems in all the domains are described in the text and tables. The results of our study form a valid basis on which to develop and implement improvements in palliative care. We recommend that future well-founded policies for palliative care should incorporate palliative care consultation as well as educational and organizational interventions.

  15. 18 CFR 4.38 - Consultation requirements.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Consultation... original license commences first stage pre-filing consultation on or after July 23, 2005 it shall file a... potential applicant for an original license that commences pre-filing consultation on or after July 23, 2005...

  16. 18 CFR 4.38 - Consultation requirements.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 18 Conservation of Power and Water Resources 1 2011-04-01 2011-04-01 false Consultation... original license commences first stage pre-filing consultation on or after July 23, 2005 it shall file a... potential applicant for an original license that commences pre-filing consultation on or after July 23, 2005...

  17. 18 CFR 4.38 - Consultation requirements.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false Consultation... original license commences first stage pre-filing consultation on or after July 23, 2005 it shall file a... potential applicant for an original license that commences pre-filing consultation on or after July 23, 2005...

  18. 18 CFR 4.38 - Consultation requirements.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 18 Conservation of Power and Water Resources 1 2014-04-01 2014-04-01 false Consultation... original license commences first stage pre-filing consultation on or after July 23, 2005 it shall file a... potential applicant for an original license that commences pre-filing consultation on or after July 23, 2005...

  19. 18 CFR 4.38 - Consultation requirements.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 18 Conservation of Power and Water Resources 1 2012-04-01 2012-04-01 false Consultation... original license commences first stage pre-filing consultation on or after July 23, 2005 it shall file a... potential applicant for an original license that commences pre-filing consultation on or after July 23, 2005...

  20. Learning to consult with computers.

    PubMed

    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. Defense mechanisms in ethics consultation.

    PubMed

    Agich, George J

    2011-12-01

    While there is no denying the relevance of ethical knowledge and analytical and cognitive skills in ethics consultation, such knowledge and skills can be overemphasized. They can be effectively put into practice only by an ethics consultant, who has a broad range of other skills, including interpretive and communicative capacities as well as the capacity effectively to address the psychosocial needs of patients, family members, and healthcare professionals in the context of an ethics consultation case. In this paper, I discuss how emotion can play an important interpretive role in clinical ethics consultation and why attention to the role of defense mechanisms can be helpful. I concentrate on defense mechanisms, arguing first, that the presence of these mechanisms is understandable given the emotional stresses and communicative occlusions that occur between the families of patients and critical care professionals in the circumstances of critical care; second, that identifying these mechanisms is essential for interpreting and managing how these factors influence the way that the "facts" of the case are understood by family members; and, third, that effectively addressing these mechanisms is an important component for effectively doing ethics consultation. Recognizing defense mechanisms, understanding how and why they operate, and knowing how to deal with these defense mechanisms when they pose problems for communication or decision making are thus essential prerequisites for effective ethics consultation, especially in critical care.

  2. NICU consultants and support staff

    MedlinePlus

    Newborn intensive care unit - consultants and support staff; Neonatal intensive care unit - consultants and support staff ... test a baby's hearing and provide follow-up care to those with hearing problems. Most newborns have ...

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

    PubMed

    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.

  4. What Consultation and Freelance Writing Can Do for You and for Your Students.

    ERIC Educational Resources Information Center

    Muller, John A.

    This paper advises teachers of technical writing to "practice what they preach" by occasionally doing field work in technical communication. The possibilities for off-campus work include consultation, perhaps for an in-house manual of technical writing procedures and skills, editing assignments for businesses and public agencies, and freelance…

  5. Entry-Level Activities in System Consultation

    ERIC Educational Resources Information Center

    Hylander, Ingrid

    2014-01-01

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

  6. 20 CFR 404.1519 - The consultative examination.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... pediatrician when appropriate. The decision to purchase a consultative examination will be made on an... consultative examination. A consultative examination is a physical or mental examination or test purchased for...

  7. 20 CFR 416.919 - The consultative examination.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... pediatrician when appropriate. The decision to purchase a consultative examination will be made on an... consultative examination. A consultative examination is a physical or mental examination or test purchased for...

  8. [The free delivery of drugs during hospital consultations].

    PubMed

    Haus, Rachel; Moutel, Grégoire; Montuclard, Luc; François, Irène; Frebault, Marie; Rozenbaum, Luc; Bertrandon, Richard; Hervé, Christian

    2003-09-06

    In France, the access to treatment has become a priority and a right. Hence, the supply of care has been reorganised in order to improve the management of the health scourges for all the patients, whether they can pay for what they need or not. The free delivery of drugs (FDD) is part of the services offered by the public hospitals for the low income patients or those who do not yet benefit from social security coverage. As such, it is inscribed within the context of the right to treatment and is a corner stone to a new mission of the public hospital services and care networks. The polyclinic of the Max Fourestier hospital is one of hospitals in the Paris area that supplies medical and surgical consultations to the population and provides drugs free of charge. From April 1, 1999 to the end of June 2000, all the FDD were studied for all the non-hospitalised outpatients who came to the consultations with a prescription for drugs, which could not be supplied in a pharmacy because of lack of revenues or social security coverage. The diseases encountered in the context of FDD were the same as those of the general population. No specificity was revealed in the prescriptions related to vulnerability. If it were necessary, this would confirm the fact that the management of persons in difficulty should be integrated in the provisions of common rights. The treatments concerned were essential, and for some persons life saving, and justifying the interest of FDD without which the health of these individuals would rapidly decline. Furthermore, this study shows the need for careful management of FDD in order to avoid the anarchical and uncontrolled delivery of several prescriptions, source of deleterious drug interactions and iatrogenia. This is the reason for the recommendation to all the staff delivering free drugs that they systematically ask the patients to meet a referring physician and contact the hospital pharmacist when necessary. The FDD request is an ideal occasion for

  9. International consultation on long-term global health research priorities, research capacity and research uptake in developing countries.

    PubMed

    Conalogue, David Mc; Kinn, Sue; Mulligan, Jo-Ann; McNeil, Malcolm

    2017-03-21

    In recognition of the need for long-term planning for global health research, and to inform future global health research priorities, the United Kingdom Department for International Development (DfID) carried out a public consultation between May and June 2015. The consultation aimed to elicit views on the (1) the long-term future global health research priorities; (2) areas likely to be less important over time; (3) how to improve research uptake in low-income countries; and (4) how to build research capacity in low-income countries. An online consultation was used to survey a wide range of participants on global health research priorities. The qualitative data was analysed using a thematic analysis, with frequency of codes in responses tabulated to approximate relative importance of themes and sub-themes. The public consultation yielded 421 responses. The survey responses confirmed the growing importance of non-communicable disease as a global health research priority, being placed above infectious diseases. Participants felt that the key area for reducing funding prioritisation was infectious diseases. The involvement of policymakers and other key stakeholders was seen as critical to drive research uptake, as was collaboration and partnership. Several methods to build research capacity in low-income countries were described, including capacity building educational programmes, mentorship programmes and research institution collaboration and partnership. The outcomes from this consultation survey provide valuable insights into how DfID stakeholders prioritise research. The outcomes from this survey were reviewed alongside other elements of a wider DfID consultation process to help inform long-term research prioritisation of global health research. There are limitations in this approach; the opportunistic nature of the survey's dissemination means the findings presented may not be representative of the full range of stakeholders or views.

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

    PubMed

    Neal, R D; Colledge, M

    2000-12-01

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

  11. Factors influencing consultation length in general/family practice.

    PubMed

    Orton, Peter K; Pereira Gray, Denis

    2016-10-01

    The length of consultations is an important factor affecting the quality of care in general practice. It is however difficult to study as many factors are simultaneously involved. Much that is known is about patient factors as so far, doctor factors have been neglected. To investigate multiple factors affecting consultation length, how they interact and the association between consultation length and patient-centredness. Previously collected observational data from 38 National Health Service NHS GPs in England stratified according to doctor's gender, experience and degree of emotional exhaustion were used. Multiple regression analyses were applied to 822 audio-recorded and timed consultations. Each consultation was analysed for the doctor's gender, patient's gender, experience, level of emotional exhaustion and patient-centredness. We previously reported that 261/564 (46%) of GPs in Essex England were emotionally exhausted. Here, we found that male and female doctors respond differently to both experience and emotional exhaustion, which are associated with differences in their consultation length. The effect of experience on consultation length is only observed in male doctors: the more experienced, the shorter their consultation. Emotional exhaustion affected consultation length in opposite ways for females and male GPs: exhausted female GPs had shorter consultations, while exhausted male doctors had longer ones. Longer consultations were significantly more patient-centred and were associated with female patients. We found five factors affecting consultation length significantly. Moreover, these factors can predict the consultation length. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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

    PubMed

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

    2016-10-01

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

  13. Acoustical consulting-Reflections on a challenging career

    NASA Astrophysics Data System (ADS)

    Braslau, David

    2004-05-01

    The acoustical consulting profession can be entered in a number of ways. The most direct approach is to obtain a degree in acoustics and join a large consulting firm immediately after graduation. Acoustical consulting can also be entered indirectly from various fields of engineering or physics which can provide a somewhat broader background. These disciplines might include, for example, structural engineering and structural dynamics, mechanics of materials, dynamic behavior of solids or geophysics. Acoustical consulting specialization can be very broad or very narrow as seen from the National Council of Acoustical Consultants capability listing. As an acoustical consultant, one must address a wide range of problems which provides both the challenges and joys of this profession. Technical capabilities and professional judgment are constantly developed from exposure to these problems and through interaction with other members of the profession. Selected case studies including sound isolation in buildings, noise and vibration from blasting, control of noise from environmental sources, acoustical design of classrooms and performing spaces, and product design demonstrate the variety of challenges faced by an acoustical consultant.

  14. Strangers at the Benchside: Research Ethics Consultation

    PubMed Central

    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

  15. 49 CFR 260.29 - Third party consultants.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... REHABILITATION AND IMPROVEMENT FINANCING PROGRAM Applications for Financial Assistance § 260.29 Third party consultants. Applicants may utilize independent third-party consultants to prepare a financial evaluation of... to process the application. We encourage the use of third party consultants. ...

  16. 49 CFR 260.29 - Third party consultants.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... REHABILITATION AND IMPROVEMENT FINANCING PROGRAM Applications for Financial Assistance § 260.29 Third party consultants. Applicants may utilize independent third-party consultants to prepare a financial evaluation of... to process the application. We encourage the use of third party consultants. ...

  17. 49 CFR 260.29 - Third party consultants.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... REHABILITATION AND IMPROVEMENT FINANCING PROGRAM Applications for Financial Assistance § 260.29 Third party consultants. Applicants may utilize independent third-party consultants to prepare a financial evaluation of... to process the application. We encourage the use of third party consultants. ...

  18. 49 CFR 260.29 - Third party consultants.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... REHABILITATION AND IMPROVEMENT FINANCING PROGRAM Applications for Financial Assistance § 260.29 Third party consultants. Applicants may utilize independent third-party consultants to prepare a financial evaluation of... to process the application. We encourage the use of third party consultants. ...

  19. 48 CFR 1552.211-78 - Management consulting services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Management consulting... 1552.211-78 Management consulting services. As prescribed in 1511.011-78, insert the following contract clause in all contracts for management consulting services. Management Consulting Services (APR 1985) All...

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

    PubMed

    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.

  1. Fifteen-minute consultation: public health for paediatricians-adolescent public health.

    PubMed

    Hargreaves, Dougal S; Williams, Bhanu; Straw, Fiona; Gregorowski, Anna; Yassaee, Arrash; Devakumar, Delan

    2016-10-01

    Paediatricians have a key role to play in ensuring a holistic, integrated approach is taken to meeting adolescent health needs. There is increasing evidence that failure to do so can lead to poor healthcare experience, avoidable ill health and increased need for healthcare services, both in the short term and in adult life. This article aims to guide paediatricians in answering the questions 'How well are the public health and clinical needs of the adolescent population in my area being met? And how can we improve?' 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/

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

    PubMed

    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.

  3. An Exploratory Study in School Counselor Consultation Engagement

    ERIC Educational Resources Information Center

    Perera-Diltz, Dilani M.; Moe, Jeffry L.; Mason, Kimberly L.

    2011-01-01

    Consultation, an indirect school counselor service, is provided by 79% (n = 998) school counselor currently. Most frequently consultation occurs with teachers, parents, and principals. MANOVA and post hoc analysis indicate differences in consultation practices across academic levels. Choosing a consultation model based on the type of service…

  4. Challenges of the Administrative Consultation Wiki Research Project as a Learning and Competences Development Method for MPA Students

    ERIC Educational Resources Information Center

    Kovac, Polonca; Stare, Janez

    2015-01-01

    Administrative Consultation Wiki (ACW) is a project run under the auspices of the Faculty of Administration and the Ministry of Public Administration in Slovenia since 2009. A crucial component thereof is the involvement of students of Master of Public Administration (MPA) degree programs to offer them an opportunity to develop competences in…

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

    PubMed

    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.

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

    PubMed

    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.

  7. Collaborative Relationships in Evaluation Consulting

    ERIC Educational Resources Information Center

    Maack, Stephen C.; Upton, Jan

    2006-01-01

    People are often driven to become "independent" as part of the desire to go out on their own. Independent evaluation consultants, however, frequently collaborate with others on evaluation projects. This chapter explores such collaborative relationships from both sides: those leading evaluations with subcontracted consultants and those who work as…

  8. The Lawyer-Therapist Consultation Team.

    ERIC Educational Resources Information Center

    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.…

  9. 34 CFR 75.190 - Consultation.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 1 2014-07-01 2014-07-01 false Consultation. 75.190 Section 75.190 Education Office of... Curricula Or Instructional Materials § 75.190 Consultation. Each applicant that intends to develop curricula... other individuals experienced in dissemination. (Authority: 20 U.S.C. 1221e-3 and 3474) ...

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

    PubMed Central

    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 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 issues with patients who

  11. 5 CFR 2426.13 - Obligation to consult.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  12. The Relationship between Gender of Consultant and Social Power Perceptions within School Consultation. Research Brief

    ERIC Educational Resources Information Center

    Erchul, William P.; Raven, Bertram H.; Wilson, Kristen E.

    2004-01-01

    This study's focus was on school psychologists' perceived effectiveness of 11 social power bases (Raven, 1993) that may be drawn upon when consulting with initially resistant teachers. Specifically, the relationship between consultant gender and perceptions of power base effectiveness was examined. The Interpersonal Power Inventory-Form CT…

  13. 34 CFR 75.191 - Consultation costs.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Development of Curricula Or Instructional Materials § 75.191 Consultation costs. An applicant may budget reasonable consultation fees or planning costs in connection with the development of curricula or...

  14. 34 CFR 75.191 - Consultation costs.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 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...

  15. Factors related to consultation time: Experience in Slovenia

    PubMed Central

    Petek Šter, Marija; Švab, Igor; Živčec Kalan, Gordana

    2008-01-01

    Objective Consultation time has a serious impact on physicians’ work and patient satisfaction. No systematic study of consultation time in general practice in Slovenia has yet been carried out. The aim of the present study was to measure consultation time, to identify the factors influencing it, and to study the influence of the workload of general practitioners on consultation time. Design A total of 42 general practitioners participated in this cross-sectional study. Each physician collected data from 300 consecutive consultations and measured the length of the visit. Setting Forty-two randomly selected general practices in Slovenia. Subjects Patients of 42 general practices. Main outcome measures Average consultation time in general practice in Slovenia; factors influencing consultation time in Slovenia. Results Data from 12 501 visits to the surgery were collected. A quarter of all visits (25.5%) were administrative. The mean consultation time was 6.9 minutes (median 6.0 minutes, 5%–95% interval: 1.0–16.0 minutes). Longer consultation time was predicted by: patient-related factors (female gender, higher age, higher level of education, higher number of health problems, change of physician within the last year), physician-related factors (higher age), physicians’ workload (absence of high workload), and the type of visit (consultation and/or clinical examination). Conclusion Consultation time in general practice is short, and depends on the characteristics of the patient and the physician, the physician's workload, and the type of visit. A reduction of high workload in general practice should be one of the priorities of the healthcare system. PMID:18297560

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

    ERIC Educational Resources Information Center

    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…

  17. Core Competencies for Training Effective School Consultants

    ERIC Educational Resources Information Center

    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…

  18. 41 CFR 101-5.307 - Public Health Service.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 41 Public Contracts and Property Management 2 2014-07-01 2012-07-01 true Public Health Service... AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.307 Public Health Service. (a) The only authorized contact point for assistance of and consultation with the Public Health Service is the Federal...

  19. 41 CFR 101-5.307 - Public Health Service.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 41 Public Contracts and Property Management 2 2011-07-01 2007-07-01 true Public Health Service... AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.307 Public Health Service. (a) The only authorized contact point for assistance of and consultation with the Public Health Service is the Federal...

  20. 41 CFR 101-5.307 - Public Health Service.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 41 Public Contracts and Property Management 2 2012-07-01 2012-07-01 false Public Health Service... AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.307 Public Health Service. (a) The only authorized contact point for assistance of and consultation with the Public Health Service is the Federal...

  1. 41 CFR 101-5.307 - Public Health Service.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Public Health Service... AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.307 Public Health Service. (a) The only authorized contact point for assistance of and consultation with the Public Health Service is the Federal...

  2. 41 CFR 101-5.307 - Public Health Service.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 41 Public Contracts and Property Management 2 2013-07-01 2012-07-01 true Public Health Service... AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.307 Public Health Service. (a) The only authorized contact point for assistance of and consultation with the Public Health Service is the Federal...

  3. Inconsistency of residents' communication performance in challenging consultations.

    PubMed

    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.

  4. Pediatricians' Experience with Clinical Ethics Consultation: A National Survey.

    PubMed

    Morrison, Wynne; Womer, James; Nathanson, Pamela; Kersun, Leslie; Hester, D Micah; Walsh, Corbett; Feudtner, Chris

    2015-10-01

    To conduct a national survey of pediatricians' access to and experience with clinical ethics consultation. We surveyed a randomly selected sample of 3687 physician members of the American Academy of Pediatrics. We asked about their experiences with ethics consultation, the helpfulness of and barriers to consultation, and ethics education. Using a discrete choice experiment with maximum difference scaling, we evaluated which traits of ethics consultants were most valuable. Of the total sample of 3687 physicians, 659 (18%) responded to the survey. One-third of the respondents had no experience with clinical ethics consultation, and 16% reported no access to consultation. General pediatricians were less likely to have access. The vast majority (90%) who had experience with consultation had found it helpful. Those with fewer years in practice were more likely to have training in ethics. The most frequently reported issues leading to consultation concerned end-of-life care and conflicts with patients/families or among the team. Intensive care unit physicians were more likely to have requested consultation. Mediation skills and ethics knowledge were the most highly valued consultant characteristics, and representing the official position of the hospital was the least-valued characteristic. There is variability in pediatricians' access to ethics consultation. Most respondents reported that consultation had been helpful in the past. Determining ethically appropriate end-of-life care and mediation of disagreements are common reasons that pediatricians request consultation. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Met or matched expectations: what accounts for a successful back pain consultation in primary care?

    PubMed Central

    Georgy, Ehab E.; Carr, Eloise C.J.; Breen, Alan C.

    2011-01-01

    Abstract Background  Patients’ as well as doctors’ expectations might be key elements for improving the quality of health care; however, previous conceptual and theoretical frameworks related to expectations often overlook such complex and complementary relationship between patients’ and doctors’ expectations. The concept of ‘matched patient–doctor expectations’ is not properly investigated, and there is lack of literature exploring such aspect of the consultation. Aim  The paper presents a preliminary conceptual model for the relationship between patients’ and doctors’ expectations with specific reference to back pain management in primary care. Methods  The methods employed in this study are integrative literature review, examination of previous theoretical frameworks, identification of conceptual issues in existing literature, and synthesis and development of a preliminary pragmatic conceptual framework. Outcome  A simple preliminary model explaining the formation of expectations in relation to specific antecedents and consequences was developed; the model incorporates several stages and filters (influencing factors, underlying reactions, judgement, formed reactions, outcome and significance) to explain the development and anticipated influence of expectations on the consultation outcome. Conclusion  The newly developed model takes into account several important dynamics that might be key elements for more successful back pain consultation in primary care, mainly the importance of matching patients’ and doctors’ expectations as well as the importance of addressing unmet expectations. PMID:21679288

  6. The Future of Public Forests: An Institutional Blending Approach to Forest Governance in England

    ERIC Educational Resources Information Center

    Hodge, Ian D.; Adams, William M.

    2013-01-01

    Early in 2011, the Government initiated a consultation on the potential sale of the Public Forest Estate in England. This proposal leads to vociferous negative public reaction and the consultation was withdrawn and an Independent Panel established. This paper reviews the arguments as to the options and appropriate institutional arrangements for…

  7. Antenatal group consultations: Facilitating patient-patient education.

    PubMed

    Nisbeth Jensen, Matilde; Fage-Butler, Antoinette Mary

    2016-12-01

    This article investigates the perspectives of pregnant women attending antenatal group consultations to gain their understandings of whether and how peer learning is facilitated in this setting. We conducted semi-structured individual interviews with 16 women who had participated in group consultations at Aarhus University Hospital, Denmark, and analysed the data using qualitative content analysis. Our research design also included observations and patient guest book data. Women who were pregnant for the first time greatly appreciated the experiential knowledge of multiparous women in the group. Group consultations provided new learning opportunities, as individuals' questions prompted learning within the groups, as well as questions and answers. There was more time for reflection in group consultations than in dyadic communication. Midwives played a key role in facilitating peer learning. Some topics were not deemed appropriate for discussion. Antenatal group consultations can support learning, as individuals participate positively both in their own knowledge acquisition and that of others. We call such peer learning patient-patient education. Our study indicates the strengths of group consultations for learning from the perspective of the group members. It highlights how learning may be facilitated in group consultations, and thus has broad practical relevance. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. Cloud-based image sharing network for collaborative imaging diagnosis and consultation

    NASA Astrophysics Data System (ADS)

    Yang, Yuanyuan; Gu, Yiping; Wang, Mingqing; Sun, Jianyong; Li, Ming; Zhang, Weiqiang; Zhang, Jianguo

    2018-03-01

    In this presentation, we presented a new approach to design cloud-based image sharing network for collaborative imaging diagnosis and consultation through Internet, which can enable radiologists, specialists and physicians locating in different sites collaboratively and interactively to do imaging diagnosis or consultation for difficult or emergency cases. The designed network combined a regional RIS, grid-based image distribution management, an integrated video conferencing system and multi-platform interactive image display devices together with secured messaging and data communication. There are three kinds of components in the network: edge server, grid-based imaging documents registry and repository, and multi-platform display devices. This network has been deployed in a public cloud platform of Alibaba through Internet since March 2017 and used for small lung nodule or early staging lung cancer diagnosis services between Radiology departments of Huadong hospital in Shanghai and the First Hospital of Jiaxing in Zhejiang Province.

  9. Teaching Evaluation: A Student-Run Consulting Firm

    ERIC Educational Resources Information Center

    Cundiff, Nicole; Nadler, Joel; Scribner, Shauna

    2011-01-01

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

  10. Ethnic differences in consultation rates in urban general practice.

    PubMed Central

    Gillam, S. J.; Jarman, B.; White, P.; Law, R.

    1989-01-01

    OBJECTIVE--To determine the patterns of consultations with the general practitioner among different ethnic groups and the outcome of these consultations. DESIGN--Retrospective analysis of data from one urban group general practice collected during 1979-81 as part of a research project in seven practices. SETTING--Group general practice in the London borough of Brent with a list size of 10,877 patients in July 1980. SUBJECTS--Patients registered with the practice during the 23 months to April 1981 who accounted for 67,197 consultations. MAIN OUTCOME MEASURES--Ethnic state, sex and social class distribution, and diagnosis of patients consulting and frequency of consultations analysed as standardised consultation ratios and standardised patient consultation ratios. RESULTS--Compared with other ethnic groups male Asians (that is, including those born in Britain and those originating from the Indian subcontinent and east Africa) had a substantially increased standardised patient consultation ratio. Consultation rates for mental disorders--in particular, anxiety and depression--were reduced in all groups of immigrant descent. West Indians consulted more frequently for hypertension and asthma, and their children less frequently with otitis media. Asians consulted more frequently with upper respiratory tract infections and non-specific symptoms. Native British patients were more likely to leave the surgery with a follow up appointment, prescription, or certificate. CONCLUSION--Notwithstanding the limitations of this study, ethnic differences in consultation rates were apparent. These differences require further investigation if the needs of minority ethnic groups are not to be overlooked. PMID:2508951

  11. A retrospective analysis of medical record use in e-consultations.

    PubMed

    Pecina, Jennifer L; North, Frederick

    2017-06-01

    Introduction Under certain circumstances, e-consultations can substitute for a face-to-face consultation. A basic requirement for a successful e-consultation is that the e-consultant has access to important medical history and exam findings along with laboratory and imaging results. Knowing just what information the specialist needs to complete an e-consultation is a major challenge. This paper examines differences between specialties in their need for past information from laboratory, imaging and clinical notes. Methods This is a retrospective study of patients who had an internal e-consultation performed at an academic medical centre. We reviewed a random sample of e-consultations that occurred in the first half of 2013 for the indication for the e-consultation and whether the e-consultant reviewed data in the medical record that was older than one year to perform the e-consultation. Results Out of 3008 total e-consultations we reviewed 360 (12%) randomly selected e-consultations from 12 specialties. Questions on management (35.8%), image results (27.2%) and laboratory results (25%) were the three most common indications for e-consultation. E-consultants reviewed medical records in existence more than one year prior to the e-consultation 146 (40.6%) of the time with e-consultants in the specialties of endocrinology, haematology and rheumatology, reviewing records older than one year more than half the time. Labs (20.3%), office notes (20%) and imaging (17.8%) were the types of medical data older than one year that were reviewed the most frequently overall. Discussion Management questions appear to be the most common reason for e-consultation. E-consultants frequently reviewed historical medical data that is older than one year at the time of the e-consultation, especially in endocrinology, haematology and rheumatology specialties. Practices engaging in e-consultations that require transfer of data may want to include longer time frames of historical information

  12. 21 CFR 20.84 - Disclosure to consultants, advisory committees, State and local government officials commissioned...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... the same restrictions with respect to the disclosure of such data and information as any other Food... 21 Food and Drugs 1 2014-04-01 2014-04-01 false Disclosure to consultants, advisory committees... AND HUMAN SERVICES GENERAL PUBLIC INFORMATION Limitations on Exemptions § 20.84 Disclosure to...

  13. 21 CFR 20.84 - Disclosure to consultants, advisory committees, State and local government officials commissioned...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... the same restrictions with respect to the disclosure of such data and information as any other Food... 21 Food and Drugs 1 2012-04-01 2012-04-01 false Disclosure to consultants, advisory committees... AND HUMAN SERVICES GENERAL PUBLIC INFORMATION Limitations on Exemptions § 20.84 Disclosure to...

  14. 21 CFR 20.84 - Disclosure to consultants, advisory committees, State and local government officials commissioned...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... the same restrictions with respect to the disclosure of such data and information as any other Food... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Disclosure to consultants, advisory committees... AND HUMAN SERVICES GENERAL PUBLIC INFORMATION Limitations on Exemptions § 20.84 Disclosure to...

  15. 21 CFR 20.84 - Disclosure to consultants, advisory committees, State and local government officials commissioned...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... the same restrictions with respect to the disclosure of such data and information as any other Food... 21 Food and Drugs 1 2011-04-01 2011-04-01 false Disclosure to consultants, advisory committees... AND HUMAN SERVICES GENERAL PUBLIC INFORMATION Limitations on Exemptions § 20.84 Disclosure to...

  16. 21 CFR 20.84 - Disclosure to consultants, advisory committees, State and local government officials commissioned...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... the same restrictions with respect to the disclosure of such data and information as any other Food... 21 Food and Drugs 1 2013-04-01 2013-04-01 false Disclosure to consultants, advisory committees... AND HUMAN SERVICES GENERAL PUBLIC INFORMATION Limitations on Exemptions § 20.84 Disclosure to...

  17. Psychiatric consultation and substance use disorders.

    PubMed

    Specker, Sheila; Meller, William H; Thurber, Steven

    2009-01-01

    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. 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. Consecutive one-year referrals (524) to consultation-liaison psychiatric services were scrutinized for chemically-related problems by psychiatric consultants. 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. 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 gathering. Although the results are encouraging in that individuals

  18. Surgeon-industry conflict of interest: survey of North Americans' opinions regarding surgeons consulting with industry.

    PubMed

    DiPaola, Christian P; Dea, Nicolas; Noonan, Vanessa K; Bailey, Christopher S; Dvorak, Marcel F S; Fisher, Charles G

    2014-04-01

    Surgeon-industry conflict of interest (COI) has become a source of considerable interest. Professional medical societies, industry, and policy makers have attempted to regulate potential COI without consideration for public opinion. The objective of this study was to report on the opinions of individuals representing the general public regarding surgeon-industry consulting relationships. Web-based survey. Survey was administered using a "spine Web site," and opinions are collected on surgeon-industry consulting and regulation. Associations among responses to similar questions were assessed to ensure validity and subgroup analysis performed for respondent age, sex, education, insurance, employment, and patient status. Six hundred ten of 642 surveys had complete data. The sample population comprised more females and was older and more educated than the American population. About 80% of respondents felt it was ethical and either beneficial or of no influence to the quality of health care if surgeons were consultants for surgical device companies. Most felt disclosure of an industry relationship was important and paying surgeons royalties for devices, other than those they directly implant, would not affect quality of care. Respondents support multidisciplinary surgeon-industry COI regulation and trust doctors and their professional societies to head this effort. Despite the known potential negative impact of surgeon-industry COI on patient care, this study revealed that this does not seem to be reflected in the opinion of the general public. The respondents felt that disclosure is deemed one of the most important means of self-regulation and COI management, which is in agreement with current trends of most spine societies and journals that are increasing the stringency of disclosure policies. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Disparities in Care for Publicly Insured Women With Pregestational Diabetes.

    PubMed

    Easter, Sarah Rae; Rosenthal, Emily W; Morton-Eggleston, Emma; Nour, Nawal; Tuomala, Ruth; Zera, Chloe A

    2017-11-01

    To investigate the association among public health insurance, preconception care, and pregnancy outcomes in pregnant women with pregestational diabetes. This is a retrospective cohort of pregnant women with pregestational type 1 or type 2 diabetes from 2006 to 2011 in Massachusetts-a state with universal insurance coverage since 2006. Women delivering after 24 weeks of gestation and receiving endocrinology and obstetric care in a multidisciplinary clinic were included. Rates of preconception consultation, our primary outcome of interest, were then compared between publicly and privately insured women. We used univariate analysis followed by logistic regression to compare receipt of preconception consultation and other secondary diabetes care measures and pregnancy outcomes according to insurance status. Fifty-four percent (n=106) of 197 women had public insurance. Publicly insured women were younger (median age 30.4 compared with 35.3 years, P<.01) with lower rates of college education (12.3% compared with 45.1%, P<.01). Women with public insurance were less likely to receive a preconception consult (5.7% compared with 31.9%, P<.01), had lower rates of hemoglobin A1C less than 6% at the onset of pregnancy (37.2% compared with 58.4%, P=.01), and experienced higher rates of pregnancies affected by congenital anomalies (10.4% compared with 2.2%, P=.02) compared with those with private insurance. In adjusted analyses controlling for educational attainment, maternal age, and body mass index, women with public insurance were less likely to receive a preconception consult (adjusted odds ratio [OR] 0.21, 95% CI 0.08-0.58), although the odds of achieving the target hemoglobin A1C (adjusted OR 0.45, 95% CI 0.20-1.02) and congenital anomaly (adjusted OR 2.23, 95% CI 0.37-13.41) were similar after adjustment. Despite continuous access to health insurance, publicly insured women were less likely than privately insured women to receive a preconception consult-an evidence

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

    PubMed

    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.

  1. 50 CFR 402.14 - Formal consultation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... OF COMMERCE); ENDANGERED SPECIES COMMITTEE REGULATIONS SUBCHAPTER A INTERAGENCY COOPERATION-ENDANGERED SPECIES ACT OF 1973, AS AMENDED Consultation Procedures § 402.14 Formal consultation. (a... time to determine whether any action may affect listed species or critical habitat. If such a...

  2. 50 CFR 402.14 - Formal consultation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... OF COMMERCE); ENDANGERED SPECIES COMMITTEE REGULATIONS SUBCHAPTER A INTERAGENCY COOPERATION-ENDANGERED SPECIES ACT OF 1973, AS AMENDED Consultation Procedures § 402.14 Formal consultation. (a... time to determine whether any action may affect listed species or critical habitat. If such a...

  3. Can't see the woods for the trees: exploring the range and connection of tobacco industry argumentation in the 2012 UK standardised packaging consultation.

    PubMed

    Lie, Jessamina Lih Yan; Fooks, Gary; de Vries, Nanne K; Heijndijk, Suzanne M; Willemsen, Marc C

    2017-07-25

    Transnational tobacco company (TTC) submissions to the 2012 UK standardised packaging consultation are studied to examine TTC argumentation in the context of Better Regulation practices. A content analysis was conducted of Philip Morris International and British American Tobacco submissions to the 2012 UK consultation. Industry arguments concerning expected costs and (contested) benefits of the policy were categorised into themes and frames. The inter-relationship between frames through linked arguments was mapped to analyse central arguments using an argumentation network. 173 arguments were identified. Arguments fell into one of five frames: ineffectiveness, negative economic consequences, harm to public health, increased crime or legal ramifications. Arguments highlighted high costs to a wide range of groups, including government, general public and other businesses. Arguments also questioned the public health benefits of standardised packaging and highlighted the potential benefits to undeserving groups. An increase in illicit trade was the most central argument and linked to the greatest variety of arguments. In policy-making systems characterised by mandatory impact assessments and public consultations, the wide range of cost (and contested benefits) based arguments highlights the risk of TTCs overloading policy actors and causing delays in policy adoption. Illicit trade related arguments are central to providing a rationale for these arguments, which include the claim that standardised packaging will increase health risks. The strategic importance of illicit trade arguments to industry argumentation in public consultations underlines the risks of relying on industry data relating to the scale of the illicit trade. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  4. 77 FR 2732 - Tribal Consultation; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-19

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Tribal Consultation; Notice of Meeting AGENCY: Administration for Children and Families, Department of Health and... Services (HHS), Administration for Children and Families (ACF) will host a Tribal Consultation to consult...

  5. 50 CFR 402.14 - Formal consultation.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ..., DEPARTMENT OF COMMERCE); ENDANGERED SPECIES COMMITTEE REGULATIONS SUBCHAPTER A INTERAGENCY COOPERATION-ENDANGERED SPECIES ACT OF 1973, AS AMENDED Consultation Procedures § 402.14 Formal consultation. (a... time to determine whether any action may affect listed species or critical habitat. If such a...

  6. 50 CFR 402.14 - Formal consultation.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ..., DEPARTMENT OF COMMERCE); ENDANGERED SPECIES COMMITTEE REGULATIONS SUBCHAPTER A INTERAGENCY COOPERATION-ENDANGERED SPECIES ACT OF 1973, AS AMENDED Consultation Procedures § 402.14 Formal consultation. (a... time to determine whether any action may affect listed species or critical habitat. If such a...

  7. 50 CFR 402.14 - Formal consultation.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ..., DEPARTMENT OF COMMERCE); ENDANGERED SPECIES COMMITTEE REGULATIONS SUBCHAPTER A INTERAGENCY COOPERATION-ENDANGERED SPECIES ACT OF 1973, AS AMENDED Consultation Procedures § 402.14 Formal consultation. (a... time to determine whether any action may affect listed species or critical habitat. If such a...

  8. [Phacoemulsification: advantages of a consultation the day after surgery?].

    PubMed

    Pajot, O; Mazit, C; Jallet, G; Ebran, J-M; Cochereau, I

    2010-03-01

    Cataract surgery is the most frequent surgery in France. The D1 consultation limits the extension of ambulatory care to patients who can return on their own the day after sugery. We assessed the usefulness of this systematic D1 consultation in terms of therapeutic modifications. MATERIAL AND MéTHODE: Retrospective study of patients who underwent cataract surgery in a teaching hospital from february to july 2006. The major parameter was the modification of postsurgical treatment after the D1 consultation. Of the 380 operated eyes studied, the patients included 145 men and 235 women, the mean age was 73.8 years (range, 43-92), 86% underwent conventional hospitalization, 70% had been operated by a senior surgeon, and 66% had no suture. At the D1 visit, 11 modifications (2.9%) were recorded: one case of athalamia, one Seidel-positive test, four cases of high IOP (>30mmHg), and five severe inflammations of the anterior segment. All the treatment changes were reported in the group of hospitalized patients, none were reported in the ambulatory patients. Of the 380 eyes studied, only one required sutures at D1, the other treatment changes were minor. The low output of the D1 visit raises the problem of its relevance in terms of public health. In most of the English-speaking and Scandinavian countries, patients have only one postoperative visit at 1 month. Patients could receive written and oral recommendations and a hotline number to contact the surgical team, which could allow the D1 visit to be discontinued for standard patients with uncomplicated surgery.

  9. 29 CFR 1690.303 - Consultation with affected agencies.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ....303 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES....303 Consultation with affected agencies. At the start of consultation, the EEOC shall determine which... parties. During the consultation period, the EEOC shall seek to resolve any disputes with the initiating...

  10. 29 CFR 1690.303 - Consultation with affected agencies.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ....303 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES....303 Consultation with affected agencies. At the start of consultation, the EEOC shall determine which... parties. During the consultation period, the EEOC shall seek to resolve any disputes with the initiating...

  11. 29 CFR 1690.303 - Consultation with affected agencies.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ....303 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES....303 Consultation with affected agencies. At the start of consultation, the EEOC shall determine which... parties. During the consultation period, the EEOC shall seek to resolve any disputes with the initiating...

  12. 29 CFR 1690.303 - Consultation with affected agencies.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ....303 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES....303 Consultation with affected agencies. At the start of consultation, the EEOC shall determine which... parties. During the consultation period, the EEOC shall seek to resolve any disputes with the initiating...

  13. 29 CFR 1690.303 - Consultation with affected agencies.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ....303 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES....303 Consultation with affected agencies. At the start of consultation, the EEOC shall determine which... parties. During the consultation period, the EEOC shall seek to resolve any disputes with the initiating...

  14. Managing outpatient consultations: from referral to discharge.

    PubMed

    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/.

  15. Results of a transparent expert consultation on patient and public involvement in palliative care research.

    PubMed

    Daveson, Barbara A; de Wolf-Linder, Susanne; Witt, Jana; Newson, Kirstie; Morris, Carolyn; Higginson, Irene J; Evans, Catherine J

    2015-12-01

    Support and evidence for patient, unpaid caregiver and public involvement in research (user involvement) are growing. Consensus on how best to involve users in palliative care research is lacking. To determine an optimal user-involvement model for palliative care research. We hosted a consultation workshop using expert presentations, discussion and nominal group technique to generate recommendations and consensus on agreement of importance. A total of 35 users and 32 researchers were approached to attend the workshop, which included break-out groups and a ranking exercise. Descriptive statistical analysis to establish consensus and highlight divergence was applied. Qualitative analysis of discussions was completed to aid interpretation of findings. Participants involved in palliative care research were invited to a global research institute, UK. A total of 12 users and 5 researchers participated. Users wanted their involvement to be more visible, including during dissemination, with a greater emphasis on the difference their involvement makes. Researchers wanted to improve productivity, relevance and quality through involvement. Users and researchers agreed that an optimal model should consist of (a) early involvement to ensure meaningful involvement and impact and (b) diverse virtual and face-to-face involvement methods to ensure flexibility. For involvement in palliative care research to succeed, early and flexible involvement is required. Researchers should advertise opportunities for involvement and promote impact of involvement via dissemination plans. Users should prioritise adding value to research through enhancing productivity, quality and relevance. More research is needed not only to inform implementation and ensure effectiveness but also to investigate the cost-effectiveness of involvement in palliative care research. © The Author(s) 2015.

  16. Results of a transparent expert consultation on patient and public involvement in palliative care research

    PubMed Central

    Daveson, Barbara A; de Wolf-Linder, Susanne; Witt, Jana; Newson, Kirstie; Morris, Carolyn; Higginson, Irene J; Evans, Catherine J

    2015-01-01

    Background: Support and evidence for patient, unpaid caregiver and public involvement in research (user involvement) are growing. Consensus on how best to involve users in palliative care research is lacking. Aim: To determine an optimal user-involvement model for palliative care research. Design: We hosted a consultation workshop using expert presentations, discussion and nominal group technique to generate recommendations and consensus on agreement of importance. A total of 35 users and 32 researchers were approached to attend the workshop, which included break-out groups and a ranking exercise. Descriptive statistical analysis to establish consensus and highlight divergence was applied. Qualitative analysis of discussions was completed to aid interpretation of findings. Setting/participants: Participants involved in palliative care research were invited to a global research institute, UK. Results: A total of 12 users and 5 researchers participated. Users wanted their involvement to be more visible, including during dissemination, with a greater emphasis on the difference their involvement makes. Researchers wanted to improve productivity, relevance and quality through involvement. Users and researchers agreed that an optimal model should consist of (a) early involvement to ensure meaningful involvement and impact and (b) diverse virtual and face-to-face involvement methods to ensure flexibility. Conclusion: For involvement in palliative care research to succeed, early and flexible involvement is required. Researchers should advertise opportunities for involvement and promote impact of involvement via dissemination plans. Users should prioritise adding value to research through enhancing productivity, quality and relevance. More research is needed not only to inform implementation and ensure effectiveness but also to investigate the cost-effectiveness of involvement in palliative care research. PMID:25931336

  17. The International Consultant: Substance and Culture.

    ERIC Educational Resources Information Center

    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…

  18. 34 CFR 75.191 - Consultation costs.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 1 2014-07-01 2014-07-01 false Consultation costs. 75.191 Section 75.191 Education... Development of Curricula Or Instructional Materials § 75.191 Consultation costs. An applicant may budget... instructional materials. (Authority: 20 U.S.C. 1221e-3 and 3474) ...

  19. Characteristics of a Breast Pathology Consultation Practice.

    PubMed

    East, Ellen G; Zhao, Lili; Pang, Judy C; Jorns, Julie M

    2017-04-01

    - Intradepartmental consultation is a routine practice commonly used for new diagnoses. Expert interinstitutional case review provides insight into particularly challenging cases. - To investigate the practice of breast pathology consultation at a large tertiary care center. - We reviewed breast pathology cases sent for private consultation and internal cases reviewed by multiple pathologists at a tertiary center. Requisitions and reports were evaluated for diagnostic reason for consultation, rate of multiple pathologist review at the tertiary center, use of immunohistochemistry, and, for private consultation cases, type of sender and concordance with the outside diagnosis. - In the 985 private consultation cases, the most frequent reasons for review were borderline atypia (292 of 878; 33.3%), papillary lesion classification (151 of 878; 17.2%), evaluating invasion (123 of 878; 14%), subtyping carcinoma (75 of 878; 8.5%), and spindle cell (67 of 878; 7.6%) and fibroepithelial (65 of 878; 7.4%) lesion classification. Of 4981 consecutive internal cases, 358 (7.2%) were reviewed, most frequently for borderline atypia (90 of 358; 25.1%), subtyping carcinoma (63 of 358; 17.6%), staging/prognostic features (59 of 358; 16.5%), fibroepithelial lesion classification (45 of 358; 12.6%), evaluating invasion (37 of 358; 10.3%), and papillary (20 of 358; 5.6%) and spindle cell (18 of 358; 5.0%) lesion classification. Of all internal cases, those with a final diagnosis of atypia had a significantly higher rate of review (58 of 241; 24.1%) than those with benign (119 of 2933; 4.1%) or carcinoma (182 of 1807; 10.1%) diagnoses. Immunohistochemistry aided in diagnosis of 39.7% (391 of 985) and 21.2% (76 of 359) of consultation and internally reviewed cases, respectively. - This study confirms areas of breast pathology that represent diagnostic challenge and supports that pathologists are appropriately using expert consultation.

  20. NRC Perspectives on Waste Incidental to Reprocessing Consultations and Monitoring - 13398

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    McKenney, Christepher A.; Suber, Gregory F.; Felsher, Harry D.

    2013-07-01

    largely NRC's role will change from doing both consultation and monitoring to being focused on monitoring activities within NDAA. DOE has identified other activities at the Hanford Nuclear Reservation that would continue consultation activities but outside of the NDAA in the future. During the past seven years of consultations and monitoring a number of lessons learned about the process, communication issues, and technical guidance have been identified. With the change in focus from reviewing initial performance assessments and draft waste determinations to long-term monitoring (e.g., individual waste tank closure, at F Tank Farm or complete tank farm closure at INTEC expected in the near future), the NRC is going to revise and update its guidance over the next few years to reflect the lessons learned and the change in focus. In addition to the lessons learned, improvements in the guidance will have to account possible rule and guidance changes underway within Part 61. This paper will discuss the initial plans, approaches, and time lines to revise the guidance within NUREG-1854, including opportunities for public involvement. (authors)« less

  1. Contemporary use of social media by consultant colorectal surgeons.

    PubMed

    McDonald, J J; Bisset, C; Coleman, M G; Speake, D; Brady, R R W

    2015-02-01

    There is evidence of significant growth in the engagement of UK health-care professionals with 'open' social media platforms, such as Twitter and LinkedIn. Social media communication provides many opportunities and benefits for medical education and interaction with patients and colleagues. This study was undertaken to evaluate the uptake of public social media membership and the characteristics of use of such media channels amongst contemporary UK consultant colorectal surgeons. Colorectal surgeons were identified from the Association of Coloproctology of Great Britain and Ireland (ACPGBI) national registry of colorectal mortality outcomes and were cross-referenced with the General Medical Council (GMC) register. Individuals were identified by manual searching on a number of social media platforms. Matching accounts were then examined to confirm ownership and to evaluate key markers of use. Six-hundred and eighteen individual consultant colorectal surgeons from 142 health authorities were studied (79.5% were ACPGBI members and 90.8% were male). Two-hundred and twenty-nine (37.1%) had LinkedIn profiles (37.7% male surgeons, 29.8% female surgeons; P = 0.2530). LinkedIn membership was significantly higher in ACPGBI members (P < 0.001) and in those with GMC registration before 1997 vs after this date (39% before 1997 vs 30% after 1997; P = 0.03). LinkedIn members had a mean of 62 connections (median = 22), and 19 (3.1%) surgeons had Twitter profiles with a mean of 82 (median = 16; range: 0-914) followers and their accounts were followed by a mean of 87 (median = 27; range: 0-642) persons. UK consultant colorectal surgeons are less engaged with social media than reported studies from other health-care professional groups. Further education and appropriate guidance on usage may encourage uptake and confidence, particularly in younger consultants. Colorectal Disease © 2014 The Association of Coloproctology of Great Britain and Ireland.

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

    ERIC Educational Resources Information Center

    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…

  3. Guidelines for education and training at the doctoral and postdoctoral levels in consulting psychology/organizational consulting psychology.

    PubMed

    2007-12-01

    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 intent of these guidelines is to improve the quality of teaching and learning in the area of the practice of CP, especially OCP, within the scientific discipline and profession of psychology. Towards these ends, this document is intended as guidance for psychologists who teach or plan curricula for teaching CP/OCP at doctoral or postdoctoral levels of professional education and training in psychology. The guidelines are structured in the form of overarching principles, general competencies, and domain-specific competencies that are ideally obtained by persons receiving training at the doctoral or postdoctoral level in CP/OCP. (Copyright) 2007 APA.

  4. Technology-Enhanced Consultation in Counselling: A Comparative Study

    ERIC Educational Resources Information Center

    Astramovich, Randall L.; Jones, W. Paul; Coker, J. Kelly

    2004-01-01

    Two quasi-experimental studies comparing technology-enhanced counselling consultation were conducted with a sample of 147 students enrolled in an undergraduate counselling and consultation course for elementary and secondary teachers. Study 1 (N = 76) compared the effectiveness of counselling consultation using telephone, text chat, or text chat…

  5. 24 CFR 242.28 - Allowable costs for consultants.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Allowable costs for consultants... AUTHORITIES MORTGAGE INSURANCE FOR HOSPITALS Mortgage Requirements § 242.28 Allowable costs for consultants.... Allowable consulting fees include those for analysis of market demand, expected revenues, and costs; site...

  6. 24 CFR 242.28 - Allowable costs for consultants.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 2 2014-04-01 2014-04-01 false Allowable costs for consultants... AUTHORITIES MORTGAGE INSURANCE FOR HOSPITALS Mortgage Requirements § 242.28 Allowable costs for consultants.... Allowable consulting fees include those for analysis of market demand, expected revenues, and costs; site...

  7. 24 CFR 242.28 - Allowable costs for consultants.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Allowable costs for consultants... AUTHORITIES MORTGAGE INSURANCE FOR HOSPITALS Mortgage Requirements § 242.28 Allowable costs for consultants.... Allowable consulting fees include those for analysis of market demand, expected revenues, and costs; site...

  8. Options for change in the NHS consultant contract.

    PubMed

    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.

  9. Options for change in the NHS consultant contract.

    PubMed Central

    Clarke, R. W.; Gray, C.

    1994-01-01

    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. PMID:8086915

  10. 78 FR 68837 - Pesticide Program Dialogue Committee; Notice of Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-15

    ... growers; animal rights groups; pest consultants; State, local, and tribal governments; academia; public... on the current PPDC: Environmental/public interest and animal rights groups; farm worker...

  11. 24 CFR 92.358 - Consultant activities.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 1 2014-04-01 2014-04-01 false Consultant activities. 92.358 Section 92.358 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development HOME INVESTMENT PARTNERSHIPS PROGRAM Other Federal Requirements § 92.358 Consultant activities. No...

  12. 24 CFR 92.358 - Consultant activities.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 1 2011-04-01 2011-04-01 false Consultant activities. 92.358 Section 92.358 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development HOME INVESTMENT PARTNERSHIPS PROGRAM Other Federal Requirements § 92.358 Consultant activities. No...

  13. 24 CFR 92.358 - Consultant activities.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  14. 24 CFR 92.358 - Consultant activities.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 1 2013-04-01 2013-04-01 false Consultant activities. 92.358 Section 92.358 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development HOME INVESTMENT PARTNERSHIPS PROGRAM Other Federal Requirements § 92.358 Consultant activities. No...

  15. 24 CFR 92.358 - Consultant activities.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 1 2012-04-01 2012-04-01 false Consultant activities. 92.358 Section 92.358 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development HOME INVESTMENT PARTNERSHIPS PROGRAM Other Federal Requirements § 92.358 Consultant activities. No...

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

    ERIC Educational Resources Information Center

    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.…

  17. Consultant selection guidebook : procedures for selecting consultants for FHWA federal-aid projects and state funded projects. [Rev. 2002

    DOT National Transportation Integrated Search

    2002-01-01

    This Guidebook provides an overview of procedures for consultant selection. The local agencies that intend to request federal and state funds for reimbursement of consultant services should follow specific selection and contracting procedures. These ...

  18. Does patient coaching make a difference in patient-physician communication during specialist consultations? A systematic review.

    PubMed

    Alders, Irèn; Smits, Carolien; Brand, Paul; van Dulmen, Sandra

    2017-05-01

    To systematically review the literature on the effectiveness of a patient coach intervention on patient - physician communication in specialists consultations. PubMed, Cochrane, PsycInfo, Cinahl and Embase were searched until November 2015. Included were papers describing interventions directed at adult outpatients in secondary care with a variety of somatic diseases. Outcomes had to be measured in communication effectivity from a patient's perspective. Seventeen publications met the inclusion criteria (involving 3787 patients), describing 13 unique interventions. Most interventions were single one-on-one sessions taking between 20 and 40min before consultation. Research quality in ten studies was high. These studies showed significant improvement on immediate, intermediate and long term patient - physician communication. We found limited evidence suggesting an improvement of patient - physician communication by having multiple patient coaching encounters during which questions are prepared and rehearsed and consultations are evaluated and reflected upon, sometimes supported by audio recording the consultation. The results of this review contribute to the (re-)design of an effective model for patient coaching, a profile and training approach of patient coaches. Future research should aim at determining which patients will benefit most from coaching interventions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Cultural Sensitive Care Provision in a Public Child and Adolescent Mental Health Centre: A Case Study from the Toulouse University Hospital Intercultural Consultation.

    PubMed

    Sturm, Gesine; Bonnet, Sylvie; Coussot, Yolaine; Journot, Katja; Raynaud, Jean-Philippe

    2017-12-01

    Child and adolescent mental health services in Europe are confronted with children with increasingly diverse socio-cultural backgrounds. Clinicians encounter cultural environments of hyperdiversity in terms of languages and countries of origin, growing diversity within groups, and accelerated change with regards to social and administrational situations (Hannah, in: DelVecchio Good et al. (eds) Shattering culture: American medicine responds to cultural diversity, Russel Sage Foundation, New York, 2011). Children and families who live in these complex constellations face multiple vulnerabilizing factors related to overlapping or intersecting social identities (Crenshaw in Univ Chic Leg Forum 140:139-167, 1989). Mobilizing existing resources in terms of social and family support, and encouraging creative strategies of interculturation in therapeutic work (Denoux, in: Blomart and Krewer (eds) Perspectives de l'interculturel, L'Harmattan, Paris, 1994) may be helpful in order to enhance resilience. Drawing from experiences in the context of French transcultural and intercultural psychiatry, and inspired by the Mc Gill Cultural Consultation in Child Psychiatry, we developed an innovative model, the Intercultural Consultation Service (ICS). This consultation proposes short term interventions to children and families with complex migration experiences. It has been implemented into a local public health care structure in Toulouse, the Medical and Psychological Centre la Grave. The innovation includes the creation of a specific setting for short term therapeutic interventions and team training via shared case discussions. Our objectives are (a) to improve outcomes of mental health care for the children through a better understanding of the child's family context (exploration of family dynamics and their relatedness to complex migration histories), (b) to enhance intercultural competencies in professionals via shared case discussions, and, (c) to improve the therapeutic

  20. Mycoplasma genitalium From Basic Science to Public Health: Summary of the Results From a National Institute of Allergy and Infectious Disesases Technical Consultation and Consensus Recommendations for Future Research Priorities.

    PubMed

    Martin, David H; Manhart, Lisa E; Workowski, Kimberly A

    2017-07-15

    This article lays out the research priorities for Mycoplasma genitalium research agreed upon by the participants in a 2016 National Institutes of Allergy and Infectious Diseases-funded Technical Consultation focused on this organism. The state of current knowledge concerning the microbiology, epidemiology, clinical manifestations of infection, treatment, and public health significance of M. genitalium reviewed at the meeting is described in detail in the individual articles included in this supplemental edition of the Journal of Infectious Diseases. Here we summarize the points made in these articles most relevant to the formulation of the research priorities listed in this article. The most important recommendation resulting from this Technical Consultation is the initiation of clinical trials designed to determine definitively whether screening for and treatment of M. genitalium infections in women and their sexual partners improve reproductive health in women and/or prevent human immunodeficiency virus transmission. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  1. 77 FR 31348 - Boott Hydropower, Inc.; Notice of Consulting Parties and Agenda for Section 106 Consultation Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    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...

  2. Psychiatric Consultation and Substance Use Disorders

    PubMed Central

    Specker, Sheila; Meller, William H.; Thurber, Steven

    2009-01-01

    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 gathering. Although

  3. Medico-legal issues in radiological consultation.

    PubMed

    Mozumdar, Biswita C; Jones, Gary

    2003-01-01

    Providers increasingly use radiological services for diagnosis and treatment. Both the referring physician and the radiological consultant can contribute to efficient and effective consultation, and direct interaction may facilitate the process further. Furthermore, inadequate communication can influence poor patient outcome. We examine the roles and responsibilities of referring physicians and consultant radiologists, and present a malpractice case, Townsend v. Turk 218 Cal. App. 3d 278 (1990), to identify medico-legal issues in radiological consultation. Important issues are implied by the Townsend case. First, it is the clinician's responsibility to include clinical information that is appropriate and adequate. Further, the radiologist is a valuable resource in the selection of the optimal procedure, provided that he or she is aware of the patient's history. The second issue discussed by the court represents a possibly more pervasive problem. The interaction between a consulting radiologist--indeed any specialist--and a treating physician is subject to difficulties caused by different conceptions of professional boundaries. The position taken by the court in the Townsend case is consistent with the traditional view that a consulting radiologist has an attenuated duty to the patient. It also would seem to receive at least some support from the language contained in the current revision of the ACR Standard for Communication: Diagnostic Radiology, effective Jan. 1, 2002: ...The referring physician or healthcare provider also shares in the responsibility of obtaining results of imaging studies they have ordered. Despite the result of the Townsend case and the current formulation of the ACR Standards, however, radiologists face risks of litigation. Indeed, the emerging trend in radiological consultation is the direct communication of results to the patient. It is clear that improved communication between radiologists and referring physicians is both desirable and

  4. The Evidence Base for Mental Health Consultation in Early Childhood Settings: Research Synthesis Addressing Staff and Program Outcomes

    ERIC Educational Resources Information Center

    Brennan, Eileen M.; Bradley, Jennifer R.; Allen, Mary Dallas; Perry, Deborah F.

    2008-01-01

    Research Findings: One strategy to support early childhood providers' work with children exhibiting challenging behavior is offering mental health consultation services in order to build staff skills and confidence and reduce staff stress and turnover. Through systematic search procedures, 26 recent studies were identified that addressed the…

  5. New frontiers in design synthesis

    NASA Technical Reports Server (NTRS)

    Goldin, D. S.; Venneri, S. L.; Noor, A. K.

    1999-01-01

    The Intelligent Synthesis Environment (ISE), which is one of the major strategic technologies under development at NASA centers and the University of Virginia, is described. One of the major objectives of ISE is to significantly enhance the rapid creation of innovative affordable products and missions. ISE uses a synergistic combination of leading-edge technologies, including high performance computing, high capacity communications and networking, human-centered computing, knowledge-based engineering, computational intelligence, virtual product development, and product information management. The environment will link scientists, design teams, manufacturers, suppliers, and consultants who participate in the mission synthesis as well as in the creation and operation of the aerospace system. It will radically advance the process by which complex science missions are synthesized, and high-tech engineering Systems are designed, manufactured and operated. The five major components critical to ISE are human-centered computing, infrastructure for distributed collaboration, rapid synthesis and simulation tools, life cycle integration and validation, and cultural change in both the engineering and science creative process. The five components and their subelements are described. Related U.S. government programs are outlined and the future impact of ISE on engineering research and education is discussed.

  6. Development of a teledermatopathology consultation system using virtual slides

    PubMed Central

    2012-01-01

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

  7. Information giving and receiving in hematological malignancy consultations.

    PubMed

    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.

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

    PubMed

    Bali, Surya; Singh, Amar Jeet

    2007-01-01

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

  9. 20 CFR 410.472 - Consultative examinations.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Consultative examinations. 410.472 Section... Consultative examinations. Upon reasonable notice of the time and place thereof, any individual filing a claim... physical examinations or tests, at the expense of the Administration, by a physician or other professional...

  10. Sustainability of a Primary Care-Driven eConsult Service.

    PubMed

    Liddy, Clare; Moroz, Isabella; Afkham, Amir; Keely, Erin

    2018-03-01

    Excessive wait times for specialist appointments pose a serious barrier to patient care. To improve access to specialist care and reduce wait times, we launched the Champlain BASE (Building Access to Specialists through eConsultation) eConsult service in April 2011. The objective of this study is to report on the impact of our multiple specialty eConsult service during the first 5 years of use after implementation, with a focus on growth and sustainability. We conducted a cross-sectional study of all eConsult cases submitted between April 1, 2011 and April 30, 2016, and measured impact with system utilization data and mandatory close-out surveys completed at the end of each eConsult. Impact indicators included time interval to obtain specialist advice, effect of specialist advice on the primary care clinician's course of action, and rate of avoidance of face-to-face visits. A total of 14,105 eConsult cases were directed to 56 different medical specialty groups, completed with a median response time of 21 hours, and 65% of all eConsults were resolved without a specialist visit. We observed rapid growth in the use of eConsult during the study period: 5 years after implementation the system was in use by 1,020 primary care clinicians, with more than 700 consultations taking place per month. This study presents the first in-depth look at the growth and sustainability of the multispecialty eConsult service. The results show the positive impact of an eConsult service and can inform other regions interested in implementing similar systems. © 2018 Annals of Family Medicine, Inc.

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

    ERIC Educational Resources Information Center

    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…

  12. Using Technology in Consultation: Enhancing Relationships

    ERIC Educational Resources Information Center

    Pease, Terrie; Copa, Annette; Proulx, Gregory A.; Boss, Jennifer

    2004-01-01

    Jennifer Boss, Senior Program Associate at ZERO TO THREE, spoke with three infant mental health consultants who worked with three different Early Head Start programs as part of the Pathways to Prevention (PTP) initiative. The interviews particularly focused on how to infuse technology into consultation arrangements that center around building and…

  13. Partnerships for Change: Maximizing Consultative Services

    ERIC Educational Resources Information Center

    Reinhardt, Patricia

    2011-01-01

    Consultation offers a cost-effective option that can develop into a satisfying, collaborative relationship that is highly productive, given the right ingredients: content and process knowledge on the part of the consultant, a systemic approach to change, and a foundation of professional and ethical standards on which to build a trustworthy…

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

    ERIC Educational Resources Information Center

    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)

  15. Group Work in Schools: A Process Consultation Approach

    ERIC Educational Resources Information Center

    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…

  16. The counter and consultation room work explored in the Netherlands.

    PubMed

    Mobach, Mark P

    2008-08-01

    To determine the frequency and nature of conversations at the counter and of private consultations at three Dutch community pharmacies. In a purposive and convenience sample of three Dutch community pharmacies two work categories were investigated: counter work and consultation room work with self-reporting tally. The study took 6 weeks: 2 weeks at each pharmacy. The number of care related conversations and consultations emerging in the counter work and consultation room work. About 43% of all counter conversations consisted of the provision of pharmaceutical information and 72% of the consultations in the separate consultation room dealt with care related activities. However, only 18 consultations were held in this latter room: 0.4% of all reported conversations. The proportion of care related work at the counter and in the consultation room did have significant substance. There are however serious possibilities to change pharmaceutical care for the better. It is suggested that standard procedures at the counter may help increasing care related work. The presence of a separate consultation room may increase the number of consultations held in private, when combined with raising patient awareness of its existence.

  17. 10 CFR 960.3-3 - Consultation.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false Consultation. 960.3-3 Section 960.3-3 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3-3 Consultation. The DOE shall provide to designated officials of the affected...

  18. 10 CFR 960.3-3 - Consultation.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false Consultation. 960.3-3 Section 960.3-3 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3-3 Consultation. The DOE shall provide to designated officials of the affected...

  19. 10 CFR 960.3-3 - Consultation.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Consultation. 960.3-3 Section 960.3-3 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3-3 Consultation. The DOE shall provide to designated officials of the affected...

  20. 10 CFR 960.3-3 - Consultation.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false Consultation. 960.3-3 Section 960.3-3 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3-3 Consultation. The DOE shall provide to designated officials of the affected...

  1. Contemporary public perceptions of nursing: a systematic review and narrative synthesis of the international research evidence.

    PubMed

    Girvin, June; Jackson, Debra; Hutchinson, Marie

    2016-11-01

    To investigate the current public understanding and perceptions of nursing. In recent years, attention to large scale health-care failures has focused considerable concern upon nursing standards. To avoid short-term solutions, and the temptation to see individual failures as representative of the wider profession, it is important to understand contemporary public perceptions of nursing. A systematic review and narrative synthesis of peer reviewed papers from January 2010 to September 2015. Four main themes were identified: (1) media portrayal of nursing as a troubled profession; (2) entertainment value in demeaning nursing; (3) role incongruity - nursing trusted but not respected; and (4) nursing roles remain poorly understood. Although there is evidence of strong public trust, this does not generally appear to be born out of an understanding of nursing work and impact; rather it appears to stem from the respect held for the traditional, more sentimental stereotypes of selfless, hardworking young females. A long-term, strategic solution is required that focuses on public engagement and interaction with the profession in a context wider than personal health/ill-health, and that goes beyond the marketing campaigns seen in the past to address recruitment crises. © 2016 John Wiley & Sons Ltd.

  2. Improving access to urologists through an electronic consultation service

    PubMed Central

    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. Simulated consultations: a sociolinguistic perspective.

    PubMed

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

    2016-01-15

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

  4. Single-site community consultation for emergency research in a community hospital setting.

    PubMed

    Galbraith, Kyle L; Keck, Anna-Sigrid; Little, Charletta

    2014-01-01

    The purpose of this study was to evaluate community member feedback from community consultation and public disclosure activities performed for a clinical investigation involving a device designed to treat traumatic brain injury in prehospital contexts. The clinical investigation of that device was to be performed under the federal regulations providing an exception from prospective informed consent requirements in emergency settings. Secondarily, we sought to assess the community consultation process by measuring the levels of outreach provided by the different communication methods used in these activities, with special attention to the effectiveness of social media for community outreach. The medical device investigation consists of a single-site pilot study based at a 345-bed community hospital in east central Illinois, which also serves as the area's only level I trauma center. Investigators, in collaboration with the local institutional review board, fulfilled community consultation and public disclosure requirements through four public town hall meetings, seven targeted focus groups, targeted mailings to 884 community leaders and researchers, a press conference and press release, internal and external websites, and multiple postings to the hospital's Facebook and Twitter accounts. Community members provided feedback by completing paper or electronic comment cards. A total of 428 community members attended the four town hall meetings and seven focus group sessions. Attendance at each meeting ranged from 4 to 20 attendees for the town hall meetings and 8 to 140 attendees for the focus groups. The investigation's external website received 626 unique visitors and the intranet website received 528 unique visits. Social media postings on Facebook and Twitter received six comments and eight "likes" to indicate that an individual read the posting. In total, attendees completed 175 comment cards to provide their feedback. Community member attitudes regarding the

  5. CRP for Pesticides - Child Resistant Packaging Consultants

    EPA Pesticide Factsheets

    This list includes consultants who have indicated an expertise in the area of child-resistant packaging. This list is not intended to indicate EPA approval, certification, or endorsement of these consultants, nor is it necessarily comprehensive.

  6. Suicide attempts and emergency room psychiatric consultation.

    PubMed

    Zeppegno, Patrizia; Gramaglia, Carla; Castello, Luigi Mario; Bert, Fabrizio; Gualano, Maria Rosaria; Ressico, Francesca; Coppola, Isabella; Avanzi, Gian Carlo; Siliquini, Roberta; Torre, Eugenio

    2015-02-05

    Suicidal behaviours are major public health concerns worldwide. They are associated with risk factors that vary with age and gender, occur in combination, and may change over time. The aim of our study was to investigate how frequently patients visiting a hospital emergency room (ER) require a psychiatric consultation for attempted suicide, and to outline the characteristics of this population. Determinants of emergency room visits for psychiatric reasons were studied prospectively from 2008 to 2011 at the "Maggiore" Hospital in Novara. 280 out of 1888 patients requiring psychiatric consultation were referred to the ER because of suicide attempt. Suicide attempters were more often female. The rate of suicide attempters among Italian people was 14.2%, compared to 19.5% in foreigners. Subjects living with parents or own family and those having a permanent job had a higher frequency of suicide attempt. Suicide attempts were more frequent among patients with a history of psychiatric disorders; nonetheless, suicide attempts were more common among those who had not previously been hospitalized in a psychiatric ward or were not under the care of a psychiatrist. The multivariate analysis found that female gender was a risk factor for suicide attempt, while being in the colder months of the year and, surprisingly, unemployment were protective factors. A better understanding of patients referring to the ER due to attempted suicide may allow the identification of at-risk subjects and the implementation of targeted treatment approaches.

  7. Language in Consultation: The Effect of Affect and Verb Tense

    ERIC Educational Resources Information Center

    Newman, Daniel S.; Guiney, Meaghan C.; Barrett, Courtenay A.

    2017-01-01

    This study was an exploration of school consultation interactions between instructional consultants and consultees. Of specific interest was how consultants (n = 18) and consultees (n = 18) used verb tense and emotion words during the problem identification and analysis instructional consultation stage, similarities and differences in…

  8. The Consulting Challenge: A Case Competition

    ERIC Educational Resources Information Center

    Sachau, Daniel A.; Naas, Patricia A.

    2010-01-01

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

  9. Inpatient allergy/immunology consultations in a tertiary care setting.

    PubMed

    Otto, Hans F; England, Ronald W; Quinn, James M

    2010-01-01

    Few studies have examined inpatient referral patterns for fellowship training programs and none for allergy/immunology (AI) since 2003. The primary end point was the reason for consultation, and secondary end points included the AI diagnosis made and outcomes. We retrospectively reviewed all inpatient AI consultations from July 1, 2001 through June 30, 2007. These 6 years of data were combined with 14 years of data examining the reason for consult from a previous study. The data were analyzed for trends and changes over the entire 20-year period. A total of 254 AI inpatient consults were reviewed over the 6 years studied. Thirty-six percent (92/254) of inpatient consults were for evaluation of adverse drug reactions (ADRs), 22% (55/254) miscellaneous reasons, 17% (43/254) urticaria/angioedema, 13% (32/254) for possible immunodeficiency, 9% (23/254) for anaphylaxis, and 3% (8/254) for asthma. AI inpatient consults show a significant decline over the recent 6-year period (p = 0.0023) despite stable total hospital admissions since 1998. Over the last 20 years, an 85% decrease (p < 0.00001) in inpatient asthma consults and increases (p < 0.05) in immunodeficiency, rash, and urticaria/angioedema evaluations have been observed. Not following AI recommendations resulted in a 16.6 odds ratio (95% CI, 5.55-49.93) that a patient's clinical status would be worse or unchanged. Inpatient AI consults have declined with associated reduction in asthma inpatient consults. Although ADRs and anaphylaxis consults have been stable, evaluations for immunodeficiency, rash, and urticaria/angioedema have increased. Following inpatient AI recommendations is associated with improved patient outcomes.

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

    PubMed

    Barnes, M L; Hussain, S S M

    2011-12-01

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

  11. [The Humanitarian Consultation-hour in Frankfurt am Main: Utilization by Gender, Age, Country of Origin].

    PubMed

    Schade, M; Heudorf, U; Tiarks-Jungk, P

    2015-07-01

    The humanitarian consultation-hour is a voluntary, anonymous offer provided by the City of Frankfurt am Main, which was established in December 2001. Here, people without health insurance or undocumented migrants can be treated for free. The aim of this analysis is to investigate the utilization of the consultation-hour by gender, age, country of origin and diagnosis since 2008. The digital data documentation is available since 2008. Data from the years 2008-2013 were considered. The examination date, the date of birth, sex, country of origin, frequency of visits, diseases and medication amongst other data were examined. In the period from 2008 to 2013, 8,574 consultations were counted and 2,384 patients were treated during office hours. The amount of consultations has doubled between 2008 (n=673) and 2009 (n=1,154) and is rising steadily since then (1,911 visits in 2013). The majority of patients come from Africa. Since 2008, an increase of patients from Bulgaria and Romania has been recorded. Approximately two-thirds of the patients are female, one third male. One fifth of those seeking help are children and adolescents under 20 years and adults over 60 years. The most common age group is between 20-40 years old. The main diagnoses include diseases of the cardiovascular and vascular system and the musculoskeletal system, metabolic diseases (diabetes mellitus), digestive diseases and pregnancy/childbirth. The humanitarian consultation-hour is an important offer provided by the Public Health Department of the City of Frankfurt am Main and is used by a large number of people who are seeking help. In particular, people from South Eastern Europe are increasingly visiting the consultation-hour. Activities such as the humanitarian consultation-hour can take over subsidiary activities for a transitional period, however long-term structural solutions must be provided to ensure access to health care for this vulnerable group. © Georg Thieme Verlag KG Stuttgart · New York.

  12. Participants' Evaluation of Consultation: Implications for Training in School Psychology

    ERIC Educational Resources Information Center

    Klose, Laurie McGarry; Plotts, Cynthia; Lasser, Jon

    2012-01-01

    Evaluation of graduate students' consultation skills is essential to competent practice in school settings. Congruence of evaluation of the consultation experience has been shown as an important factor in the development of competent consultants in other, related disciplines. The current study analysed student consultant and teacher consultee…

  13. The Berkeley UNIX Consultant Project

    DTIC Science & Technology

    1987-08-01

    of the National Conference on Artifcial Intelligence . Pittsburgh, PA. (2) Chin, D. N. 1986. User modeling in UC, the UNIX consultant. In Proceedings of...Codes Avalt and I1of Dis Special 1. Introduction Several years ago, we began a project called UC (UNIX Consultant). UC was to function as an intelligent ...English. We sometimes refer to UC as "an intelligent ’help’ facility" to emphasize our intention to construct a consul- tation system, rather than a

  14. Consultation for Parents of Young Gifted Children.

    ERIC Educational Resources Information Center

    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)

  15. Electronic Medical Consultation: A New Zealand Perspective

    PubMed Central

    Brebner, Campbell; Jones, Raymond; Marshall, Wendy; Parry, Graham

    2001-01-01

    Electronic medical consultation is available worldwide through access to the World Wide Web (WWW). This article outlines a research study on the adoption of electronic medical consultation as a means of health delivery. It focuses on the delivery of healthcare specifically for New Zealanders, by New Zealanders. It is acknowledged that the WWW is a global marketplace and that it is therefore difficult to identify New Zealanders' use of such a global market; nevertheless, we attempt to provide a New Zealand perspective on electronic medical consultation. PMID:11720955

  16. The Child Welfare Agency as School Consultant

    ERIC Educational Resources Information Center

    Schild, Judith S.; And Others

    1976-01-01

    Describes the School Consultation Program offered by the Jewish Children's Bureau (JCB) to the special education personnel of four elementary schools in a suburban school district. Discusses problems and special techniques of applying child welfare to school consultation. (JH)

  17. Size and consistency of problem-solving consultation outcomes: an empirical analysis.

    PubMed

    Hurwitz, Jason T; Kratochwill, Thomas R; Serlin, Ronald C

    2015-04-01

    In this study, we analyzed extant data to evaluate the variability and magnitude of students' behavior change outcomes (academic, social, and behavioral) produced by consultants through problem-solving consultation with teachers. Research questions were twofold: (a) Do consultants produce consistent and sizeable positive student outcomes across their cases as measured through direct and frequent assessment? and (b) What proportion of variability in student outcomes is attributable to consultants? Analyses of extant data collected from problem-solving consultation outcome studies that used single-case, time-series AB designs with multiple participants were analyzed. Four such studies ultimately met the inclusion criteria for the extant data, comprising 124 consultants who worked with 302 school teachers regarding 453 individual students. Consultants constituted the independent variable, while the primary dependent variable was a descriptive effect size based on student behavior change as measured by (a) curriculum-based measures, (b) permanent products, or (c) direct observations. Primary analyses involved visual and statistical evaluation of effect size magnitude and variability observed within and between consultants and studies. Given the nested nature of the data, multilevel analyses were used to assess consultant effects on student outcomes. Results suggest that consultants consistently produced positive effect sizes on average across their cases, but outcomes varied between consultants. Findings also indicated that consultants, teachers, and the corresponding studies accounted for a significant proportion of variability in student outcomes. This investigation advances the use of multilevel and integrative data analyses to evaluate consultation outcomes and extends research on problem-solving consultation, consultant effects, and meta-analysis of case study AB designs. Practical implications for evaluating consultation service delivery in school settings are

  18. Consulting Opportunities: Working with Student-Athletes at a University.

    ERIC Educational Resources Information Center

    Gabbard, Clint; Halischak, Kate

    1993-01-01

    Relates opportunities for consulting psychologists to work with specific population within university setting. Describes consulting relationships between counseling psychologist, academic advising office for student-athletes, and athletic department at University of Notre Dame; and outlines possibilities for consultation with student-athletes in…

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

    ERIC Educational Resources Information Center

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

    2016-01-01

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

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

    PubMed

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

    2014-05-01

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

  1. 12 CFR 1320.11 - Consultation with financial market utility.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... materials timely submitted by the financial market utility under this section before making a proposed... 12 Banks and Banking 10 2014-01-01 2014-01-01 false Consultation with financial market utility... FINANCIAL MARKET UTILITIES Consultations, Determinations and Hearings § 1320.11 Consultation with financial...

  2. 12 CFR 1320.11 - Consultation with financial market utility.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... materials timely submitted by the financial market utility under this section before making a proposed... 12 Banks and Banking 9 2013-01-01 2013-01-01 false Consultation with financial market utility... FINANCIAL MARKET UTILITIES Consultations, Determinations and Hearings § 1320.11 Consultation with financial...

  3. 12 CFR 1320.11 - Consultation with financial market utility.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... materials timely submitted by the financial market utility under this section before making a proposed... 12 Banks and Banking 9 2012-01-01 2012-01-01 false Consultation with financial market utility... FINANCIAL MARKET UTILITIES Consultations, Determinations and Hearings § 1320.11 Consultation with financial...

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

    PubMed

    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

  5. 14 CFR 413.5 - Pre-application consultation.

    Code of Federal Regulations, 2010 CFR

    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...

  6. A School-Based Mental Health Consultation Curriculum.

    ERIC Educational Resources Information Center

    Sandoval, Jonathan; Davis, John M.

    1984-01-01

    Presents one position on consultation that integrates a theoretical model, a process model, and a curriculum for training school-based mental health consultants. Elements of the proposed curriculum include: ethics, relationship building, maintaining rapport, defining problems, gathering data, sharing information, generating and supporting…

  7. 42 CFR 493.1413 - Standard; Technical consultant responsibilities.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... consultant responsibilities. The technical consultant is responsible for the technical and scientific... of performance of instrument maintenance and function checks; (v) Assessment of test performance...

  8. 42 CFR 493.1413 - Standard; Technical consultant responsibilities.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... consultant responsibilities. The technical consultant is responsible for the technical and scientific... of performance of instrument maintenance and function checks; (v) Assessment of test performance...

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

    PubMed

    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.

  10. A Primer on Consultation Theory: Building a Flexible Worldview.

    ERIC Educational Resources Information Center

    Brack, Greg; And Others

    1993-01-01

    Presents broad introduction to learning, gestalt, systems, organizational, psychoanalytic, and chaos theories of consultation. Demonstrates how consultant can map each of these theories onto consultation environment to produce unique perspective that each theory alone cannot provide. Describes each theory as to how it views and frames consultation…

  11. Consultation of the U.S. Commission on Civil Rights. (Washington, DC, June 6-7, 1984). Volume 1.

    ERIC Educational Resources Information Center

    Commission on Civil Rights, Washington, DC.

    A result of the United States Commission on Civil Rights consultation on the concept of equal pay for work of comparable value, this publication presents all papers submitted by participants. The papers are: "The Earnings Gap in Historical Perspective" (Claudia Goldin); "Occupational Segregation and the Earnings Gap" (Andrea H.…

  12. Ethics Committee Consultation and Extracorporeal Membrane Oxygenation.

    PubMed

    Courtwright, Andrew M; Robinson, Ellen M; Feins, Katelyn; Carr-Loveland, Jennifer; Donahue, Vivian; Roy, Nathalie; McCannon, Jessica

    2016-09-01

    The clinical ethics literature on extracorporeal membrane oxygenation (ECMO) has been focused primarily on identifying hypothetical ethical dilemmas that may arise with the use of this technology. Little has been written on the actual experience with ECMO-related ethical questions. To describe the role of an ethics consultation service during the expansion of a single-center ECMO program in a cardiothoracic surgery intensive care unit (CSICU) and to identify common ethical themes surrounding the use of ECMO. We conducted a retrospective, descriptive cohort study of all ECMO ethics consultation cases in the CSICU at a large academic hospital between 2013 and 2015. During the study period, 113 patients were placed on ECMO in the CSICU, 45 (39.5%) of whom were seen by the ethics committee. In 2013, 10 of 46 (21.7%) patients received ethics consults. By 2015, 28 of 30 (93.3%) of patients were seen by ethics consultants. Initial consultation occurred at a median of 2 days (interquartile range, 1-6 d) following initiation of ECMO. The most common ethical issue involved disagreement about the ongoing use of ECMO, which included multiple axes: Disagreement among health care providers, disagreement among surrogates, and disagreement between health care providers and surrogates over stopping or continuing ECMO. In our experience with integrating ethics consultation into the routine care of ECMO patients, most of the ethical questions more closely resembled traditional concerns about the appropriate use of any life-sustaining treatment rather than the novel dilemmas imagined in the current literature.

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

    ERIC Educational Resources Information Center

    Bone, John

    1996-01-01

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

  14. 49 CFR 260.29 - Third party consultants.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... REHABILITATION AND IMPROVEMENT FINANCING PROGRAM Applications for Financial Assistance § 260.29 Third party consultants. Applicants may utilize independent third-party consultants to prepare a financial evaluation of... assist FRA in the evaluation of the application and would significantly reduce the time necessary for FRA...

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

    ERIC Educational Resources Information Center

    Spencer, Gregory P.

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

  16. The preoperative cardiology consultation: indications and risk modification.

    PubMed

    Groot, M W; Spronk, A; Hoeks, S E; Stolker, R J; van Lier, F

    2017-11-01

    The cardiologist is regularly consulted preoperatively by anaesthesiologists. However, insights into the efficiency and usefulness of these consultations are unclear. This is a retrospective study of 24,174 preoperatively screened patients ≥18 years scheduled for elective non-cardiac surgery, which resulted in 273 (1%) referrals to the cardiologist for further preoperative evaluation. Medical charts were reviewed for patient characteristics, main reason for referring, requested diagnostic tests, interventions, adjustment in medical therapy, 30-day mortality and major adverse cardiac events. The most common reason for consultation was the evaluation of a cardiac murmur (95 patients, 35%). In 167 (61%) patients, no change in therapy was initiated by the cardiologist. Six consultations (2%) led to invasive interventions (electrical cardioversion, percutaneous coronary intervention or coronary artery bypass surgery). On average, consultation delayed clearance for surgery by two weeks. In most patients referred to the cardiologist after being screened at an outpatient anaesthesiology clinic, echocardiography is performed for ruling out specific conditions and to be sure that no further improvement can be made in the patient's health. In the majority, no change in therapy was initiated by the cardiologist. A more careful consideration about the potential benefits of consulting must be made for every patient.

  17. An investigation of the questions posted on medical consultation websites.

    PubMed

    Chiu, Ming-Hsin Phoebe

    2016-12-01

    Online medical consultation has recently become a more and more popular alternative venue for healthcare. It allows patients and caregivers to discuss their health problems and symptoms with qualified medical health professionals via the Internet. This study investigates the questions posted on an asynchronous online medical consultation website, Taiwan eDoctor. Five research themes are explored: (1) length of questions, (2) moment of seeking consultation, (3) strategies of communicating chief complaints, (4) purpose of seeking consultation and (5) identity disclosure. Data collection was conducted by randomly selecting 50 resolved consultation Q&As for each of 24 medical specialties, resulting in a total of 1200 entries in the primary data set. Data analysis was conducted qualitatively and quantitatively. Average length of questions was 161.21 words. Online medical consultation was sought when healthy, healthy but not robust, when suspicious of illness, when diagnosed as ill and during treatment/recovery. In communicating chief complaints, consultation seekers were engaged in contextual, focal or emotional communication styles. Nine distinct purposes to seek online consultation were identified and can be broadly interpreted as intellectual, social and emotional. The finding also suggests that more than two-third of questions were asked for by the patients themselves. Through content analysis of questions posted on an online medical consultation website, this study characterises communication patterns during the health information seeking process. These findings can help guide the design of more effective patient-centred online medical consultation services. © 2016 Health Libraries Group.

  18. Do photographic images of pain improve communication during pain consultations?

    PubMed

    Padfield, Deborah; Zakrzewska, Joanna M; Williams, Amanda C de C

    2015-01-01

    Visual images may facilitate the communication of pain during consultations. To assess whether photographic images of pain enrich the content and⁄or process of pain consultation by comparing patients' and clinicians' ratings of the consultation experience. Photographic images of pain previously co-created by patients with a photographer were provided to new patients attending pain clinic consultations. Seventeen patients selected and used images that best expressed their pain and were compared with 21 patients who were not shown images. Ten clinicians conducted assessments in each condition. After consultation, patients and clinicians completed ratings of aspects of communication and, when images were used, how they influenced the consultation. The majority of both patients and clinicians reported that images enhanced the consultation. Ratings of communication were generally high, with no differences between those with and without images (with the exception of confidence in treatment plan, which was rated more highly in the image group). However, patients' and clinicians' ratings of communication were inversely related only in consultations with images. Methodological shortcomings may underlie the present findings of no difference. It is also possible that using images raised patients' and clinicians' expectations and encouraged emotional disclosure, in response to which clinicians were dissatisfied with their performance. Using images in clinical encounters did not have a negative impact on the consultation, nor did it improve communication or satisfaction. These findings will inform future analysis of behaviour in the video-recorded consultations.

  19. Identifying challenges in project consultants engagement practices

    NASA Astrophysics Data System (ADS)

    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.

  20. Getting Good Advice. How and When to Use Consultants.

    ERIC Educational Resources Information Center

    Radock, Michael

    1981-01-01

    Suggestions on when to seek a consultant and how to select the one best suited to collegiate needs are discussed. Reliance on recognized firms, professional organizations, and selective free-lance consultants is recommended. Being well-prepared, planning the consultant's time schedule carefully, clarifying arrangements, and setting the terms are…

  1. A Computer-Based Nursing Diagnosis Consultant

    PubMed Central

    Evans, Steven

    1984-01-01

    This consultant permits a nurse to enter patient signs and symptoms which are then interpreted by the system in order to relate them to well-established nursing-related dysfunctional patterns. The system attempts to confirm the pattern by soliciting additional patient information from the nurse. This process provides an educational prompt to the nurse, and the suggestions of the system also provide a clinical support tool that can be of practical value. As our testing hones the system and subtlety is added to the weighing of the evidence the nurse provides, it is expected that this tool will be a useful adjunct to computer-based nursing services in support of health care. This Nursing Diagnosis Consultant is yet another element in the COMMES family of consultants for health professionals.

  2. Pharmacotherapy consultation on polypharmacy patients in ambulatory care.

    PubMed

    Jameson, J P; VanNoord, G R

    2001-01-01

    To investigate actual cost and adverse effect outcomes associated with a phamacotherapy consultation in ambulatory care patients receiving polypharmacy. Patients receiving five or more chronic medications were randomized to receive pharmacotherapy consultation or usual medical care. Outcomes measured were changes in drug costs, medical costs, and drug-related symptoms six months after the consultation. Data were analyzed with unpaired Student's t-test for continuous data. Chi2 Analysis was used for categorical data. Patients and physicians were surveyed about their perceptions of the consultations after the study period. Drug and medical costs did not differ before and after the consultation. More patients in the consultation group had adverse symptom scores improve by two or more points, and fewer had symptom scores worsen by two or more points than in the control group. Seventy percent of patients and 76% of physicians believed that the consult was beneficial. Polypharmacy patients are the most likely to have drug-related problems and require intervention. Of all the interventions performed in this study, 73% of the original problems were recognized only through a patient interview, suggesting that an interpersonal relationship remains critical to the provision of pharmaceutical care. Although patients and physicians see intuitive value in pharmaceutical care, pharmacists need to exert more energy in the direction of marketing the profession. Finally, there are numerous difficulties in measuring the benefits of these interventions, possibly making broad-based interventions in complicated patients too difficult to assess accurately. Future studies should focus on patients with limited, specific problems or on interventions with narrow goals.

  3. Mental Health Consultation in Early Childhood Classrooms

    ERIC Educational Resources Information Center

    Bernzweig, Jane; Ramler, Malia; Alkon, Abbey

    2009-01-01

    Early childhood mental health consultation is a relationship-based intervention that promotes children's social and emotional development. Benefits include improved childhood behaviors, improved staff self-efficacy, and lowered parental stress. Child care center directors are more likely to be satisfied with consultation when they are involved in…

  4. Variations on a Theme: Colleague Consultant Networks.

    ERIC Educational Resources Information Center

    Garth, Russell; Rehnke, Mary Ann

    1991-01-01

    Although the use of formal consulting networks based in higher education's professional associations has declined somewhat, other, less formal strategies for identifying colleague consultants show promise. Flexible networks are being built on the principle of cooperative self-help, without centralized facilitation, to enable colleges to find…

  5. Crisis Communication Consultation of the Federal Reserve Bank System

    ERIC Educational Resources Information Center

    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…

  6. Consulting with Media for Health Education: Some New Directions.

    ERIC Educational Resources Information Center

    De Foe, James R.; Breed, Warren

    A case study examined the cooperative consultation between a writer for the television serial "All My Children" and a health educator. The consultation spanned six years. The story of the alcoholic "Arlene" began to air on the serial in January 1991. Scenes involving Arlene were recorded. Consultation between the health…

  7. [The representations of adolescents about gynecological consultation].

    PubMed

    Gomes, Vera Lúcia de Oliveira; Fonseca, Adriana Dora da; Oliveira, Denize Cristina de; Silva, Camila Daiane; Acosta, Daniele Ferreira; Pereira, Fabiani Weiss

    2014-06-01

    To analyze the social representation of adolescents about gynecological consultation and the influence of those in searching for consultations. 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. 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. For an effective health education, professionals, including nurses, need to clarify the youth individually and collectively about their rights to privacy, secrecy, in addition to focus the gynecological consultation as a promotion measure to sexual and reproductive health.

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

    PubMed

    Afifi, Ladan; Shinkai, Kanade

    2017-03-01

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

  9. Quantum Leap--A Teacher and a Consultant Exchange Jobs.

    ERIC Educational Resources Information Center

    Lier, Jacquie; Bufe, Bruce

    1993-01-01

    To gain appreciation for each others' perspectives, a Mississippi language arts consultant and a third-grade teacher from Iowa traded jobs for a year. As a consultant, the teacher found that classroom teachers were more interested in whole-language instruction practicalities than in theory. As a teacher, the consultant learned that classroom…

  10. The Feasibility and Acceptability of Google Glass for Teletoxicology Consults.

    PubMed

    Chai, Peter R; Babu, Kavita M; Boyer, Edward W

    2015-09-01

    Teletoxicology offers the potential for toxicologists to assist in providing medical care at remote locations, via remote, interactive augmented audiovisual technology. This study examined the feasibility of using Google Glass, a head-mounted device that incorporates a webcam, viewing prism, and wireless connectivity, to assess the poisoned patient by a medical toxicology consult staff. Emergency medicine residents (resident toxicology consultants) rotating on the toxicology service wore Glass during bedside evaluation of poisoned patients; Glass transmitted real-time video of patients' physical examination findings to toxicology fellows and attendings (supervisory consultants), who reviewed these findings. We evaluated the usability (e.g., quality of connectivity and video feeds) of Glass by supervisory consultants, as well as attitudes towards use of Glass. Resident toxicology consultants and supervisory consultants completed 18 consults through Glass. Toxicologists viewing the video stream found the quality of audio and visual transmission usable in 89 % of cases. Toxicologists reported their management of the patient changed after viewing the patient through Glass in 56 % of cases. Based on findings obtained through Glass, toxicologists recommended specific antidotes in six cases. Head-mounted devices like Google Glass may be effective tools for real-time teletoxicology consultation.

  11. Advising Consultations: Spectral Images of Faculty Power.

    ERIC Educational Resources Information Center

    Kramer, Howard C.

    A perception of "faculty power" frequently expressed during consultant/consultee interactions is analyzed, and approaches to dealing with the perception and also meeting the consultation objectives are suggested. This commonly expressed perception is that faculty hold untested strength that should not be bothered, challenged, or antagonized. In a…

  12. 29 CFR 401.13 - Labor relations consultant.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 2 2010-07-01 2010-07-01 false Labor relations consultant. 401.13 Section 401.13 Labor Regulations Relating to Labor OFFICE OF LABOR-MANAGEMENT STANDARDS, DEPARTMENT OF LABOR LABOR-MANAGEMENT STANDARDS MEANING OF TERMS USED IN THIS SUBCHAPTER § 401.13 Labor relations consultant. Labor relations...

  13. Moral mediation in interpreted health care consultations.

    PubMed

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

    2013-12-01

    This paper reports on the moral work done in routine diabetes review consultations in primary care with nurses. Consultations with fluent English speakers are compared with consultations where an interpreter was present, largely involving patients of Bangladeshi origin. The study setting was Tower Hamlets in London, where type 2 diabetes is particularly common. Existing research has shown some dissatisfaction with diabetes care amongst Bangladeshi patients, and studies of care providers in other locations suggest that they at times experience the care of this group as particularly challenging. Through analysis of video-recorded consultations recorded in 2010-2011 we shed light on possible reasons for these difficulties. The 12 non-English speakers often experienced difficulties in raising issues that concerned them, particularly if their interpreter did not translate their utterance because it was deemed to be unrelated to diabetes. These difficulties were not shared by the 24 fluent English speakers, who also found it easier to convey a positive moral reputation and to excuse behaviour that deviated from recommended self-management practices. Interpreters at times also acted as moral mediators. For example, where a participant in the consultation made statements that appeared to convey a negative moral judgement of an other participant, these would often go untranslated. Probably, neither health care providers nor patients are fully aware of the nature of their communication difficulties. Given this, interpreters possess considerable power to influence matters. Understanding the moral work of consultations is important in explaining the findings of other studies showing difficulties in the provision of diabetes care to people with limited English language skills. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Consultancy as Temporary Leadership: Negotiating Power in Everyday Practice

    ERIC Educational Resources Information Center

    Mowles, Chris

    2009-01-01

    Orthodox theories of consultancy address power relations between the consultant and their contractors. However, they can suggest that either the consultant should manipulate those they work with "for the good", or they should give up their power "for the good". This article offers an ethical critique of these points of view and argues for an…

  15. Development of a Remote Consultation System Using Avatar Technology

    NASA Astrophysics Data System (ADS)

    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.

  16. International telemedicine consultations for neurodevelopmental disabilities.

    PubMed

    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

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

    PubMed

    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 <0.001). High preoperative consulting hospitals (rate >66%) had a reduction in poMI (OR, 0.52; confidence interval: 0.28-0.98; P <0.05) compared with all other hospitals. These hospitals also had a statistically greater consultation rate with a variety of medical specialties. Preoperative 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

  18. Counselors as Consultants during a National Crisis.

    ERIC Educational Resources Information Center

    Kaplan, Leslie S.; And Others

    1993-01-01

    Describes how counselors served as consultants to school division that had large student population of military dependents during Persian Gulf War. Examines impact of Persian Gulf War on the school division and its students and presents model for counselors who serve as consultants during crisis. Discusses counselors working as team with teachers,…

  19. Consulting Careers: A Profile of Three Occupations

    ERIC Educational Resources Information Center

    Mullins, John

    2011-01-01

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

  20. An empirical study of multidimensional fidelity of COMPASS consultation.

    PubMed

    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).

  1. [A successful attempt with a consulting service for boys].

    PubMed

    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.

  2. Inpatient Palliative Care Consultation and 30-Day Readmissions in Oncology.

    PubMed

    DiMartino, Lisa D; Weiner, Bryan J; Hanson, Laura C; Weinberger, Morris; Birken, Sarah A; Reeder-Hayes, Katherine; Trogdon, Justin G

    2018-01-01

    Prior research indicates that hospice and palliative care delivered in outpatient settings are associated with reduced hospital readmissions for cancer patients. However, little is known about how inpatient palliative care affects readmissions in oncology. To examine associations among inpatient palliative care consultation, hospice use (discharge), and 30-day readmissions among patients with solid tumor cancers. We identified all live discharges from a large tertiary cancer hospital between 2010 and 2016. Palliative care consult data were abstracted from medical charts and linked to hospital encounter data. Propensity scores were used to match palliative care consult to usual care encounters. Modified Poisson regression models estimated adjusted relative risk (aRR) and 95% confidence intervals (CI) of 30-day readmissions and hospice discharge. We compared predicted probabilities of readmission for palliative care consultation with hospice discharge, without hospice discharge, and usual care. Of 8085 eligible encounters, 753 involved a palliative care consult. The likelihood of having a 30-day readmission did not differ between palliative care consult and usual care groups (p > 0.05). However, the palliative care consult group was more likely than usual care to have a hospice discharge (aRR = 4.09, 95% CI: 3.07-5.44). The predicted probability of 30-day readmission was lower when palliative care consultation was combined with hospice discharge compared to usual care or consultation with discharge to nonhospice postacute care (p < 0.001). The effect of inpatient palliative care on readmissions in oncology is largely driven by hospice enrollment. Strategies that combine palliative care consultation with hospice discharge may decrease hospital readmissions and improve cancer care quality.

  3. Communication with patients and the duration of family medicine consultations.

    PubMed

    Valverde Bolívar, Francisco Javier; Pedregal González, Miguel; Moreno Martos, Herminia; Cózar García, Inmaculada; Torío Durántez, Jesús

    2017-10-17

    To determine the distribution of consultation times, the factors that determine their length, and their relationship with a more participative, patient-centred consulting style. Cross-sectional multicentre study. Primary Healthcare Centres in Andalusia, Spain. A total of 119 tutors and family medicine physician residents. Consultation length and communication with the patient were analysed using the CICCAA scale (Connect, Identify, Understand, Consent, Help) during 436 interviews in Primary Care. The mean duration of consultations was 8.8min (sd: 3.6). The consultation tended to be longer when the physician had a patient-centred approach (10.37±4.19min vs 7.54±2.98min; p=0.001), and when there was joint decision-making (9.79±3.96min vs 7.73±3.42min: p=0.001). In the multivariable model, longer consultations were associated with obtaining higher scores on the CICAA scale, a wider range of reasons for consultation, whether they came accompanied, in urban centres, and a smaller number of daily visits (r 2 =0.32). There was no correlation between physician or patient gender, or problem type. A more patient centred medical profile, increased shared decision-making, a wider range of reasons for consultation, whether they came accompanied, in urban centres, and less professional pressure all seem to be associated with a longer consultation. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  4. An integrated occupational hygiene consultation model for the catering industry.

    PubMed

    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.

  5. Academic Primer Series: Five Key Papers for Consulting Clinician Educators.

    PubMed

    Chan, Teresa M; Gottlieb, Michael; Quinn, Antonia; London, Kory; Conlon, Lauren W; Ankel, Felix

    2017-02-01

    Clinician educators are often asked to perform consultations for colleagues. Invitations to consult and advise others on local problems can help foster great collaborations between centers, and allows for an exchange of ideas between programs. In this article, the authors identify and summarize several key papers to assist emerging clinician educators with the consultation process. A consensus-building process was used to generate a list of key papers that describe the importance and significance of educational consulting, informed by social media sources. A three-round voting methodology, akin to a Delphi study, determined the most impactful papers from the larger list. Summaries of the five most highly rated papers on education consultation are presented in this paper. These papers were determined by a mixed group of junior and senior faculty members, who have summarized these papers with respect to their relevance for their peer groups. Five key papers on the educational consultation process are presented in this paper. These papers offer background and perspective to help junior faculty gain a grasp of consultation processes.

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

    PubMed

    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.

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

    PubMed

    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."

  8. A Review of Gerald Caplan's "Theory and Practice of Mental Health Consultation."

    ERIC Educational Resources Information Center

    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…

  9. 34 CFR 75.515 - Use of consultants.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Office of the Secretary, Department of Education DIRECT GRANT PROGRAMS What Conditions Must Be Met by a Grantee? Project Staff § 75.515 Use of consultants. (a) Subject to Federal statutes and regulations, a... the project staff. (b) The grantee may not use its grant to pay a consultant unless: (1) There is a...

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

    ERIC Educational Resources Information Center

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

    2016-01-01

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

  11. Consulting as a Strategy for Knowledge Transfer

    PubMed Central

    Jacobson, Nora; Butterill, Dale; Goering, Paula

    2005-01-01

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

  12. Prenatal diagnosis and telemedicine consultation of fetal urologic disorders.

    PubMed

    Rabie, Nader Z; Canon, Stephen; Patel, Ashay; Zamilpa, Ismael; Magann, Everett F; Higley, Jared

    2016-06-01

    In Arkansas, telemedicine is used commonly in obstetrics through Antenatal and Neonatal Guidelines, Education and Learning System (ANGELS), the existing statewide telemedicine network. This network is used primarily for tele-ultrasound and maternal-fetal medicine consultation. This study is a retrospective case series, describing all the patients who had a prenatally diagnosed urologic anomaly that required prenatal urologic consultation. From 2009-2013, approximately 1300 anomalies were recorded in the Arkansas Fetal Diagnosis and Management (AFDM) database, 14% of which were urologic anomalies. Twenty-six cases required prenatal urologic consultation, 25 of which were conducted via telemedicine. Teleconsultation allowed patients to combine maternal-fetal medicine and urologic consultations in one visit, saving time and effort and ultimately, for most patients, providing reassurance that delivery could be accomplished locally with postnatal follow-up already arranged. While there are several studies reporting the use of telemedicine for various subspecialty consultations, to our knowledge, this is the first to describe the use of telemedicine for prenatal urology consultation. Future research could randomize patients prospectively to allow comparison of both the outcomes as well as the patient experience. © The Author(s) 2015.

  13. An Alternative Teacher Consultation Model: A Case Study.

    ERIC Educational Resources Information Center

    Langhorne, John E., Jr.; And Others

    1979-01-01

    This case history describes intervention techniques used with a nine-year-old male with behavior problems. The procedures used were classroom observation and teacher consultation; drug (Ritalin) withdrawal; direct consultant intervention; and class change and follow-up. (MH)

  14. 24 CFR 200.190 - HUD list of qualified 203(k) consultants.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 2 2012-04-01 2012-04-01 false HUD list of qualified 203(k... Participation in FHA Programs Section 203(k) Rehabilitation Loan Consultants § 200.190 HUD list of qualified 203(k) consultants. (a) Qualified consultant list. HUD maintains a list of qualified consultants for use...

  15. 24 CFR 200.190 - HUD list of qualified 203(k) consultants.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false HUD list of qualified 203(k... Participation in FHA Programs Section 203(k) Rehabilitation Loan Consultants § 200.190 HUD list of qualified 203(k) consultants. (a) Qualified consultant list. HUD maintains a list of qualified consultants for use...

  16. 24 CFR 200.190 - HUD list of qualified 203(k) consultants.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 2 2013-04-01 2013-04-01 false HUD list of qualified 203(k... Participation in FHA Programs Section 203(k) Rehabilitation Loan Consultants § 200.190 HUD list of qualified 203(k) consultants. (a) Qualified consultant list. HUD maintains a list of qualified consultants for use...

  17. 24 CFR 200.190 - HUD list of qualified 203(k) consultants.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false HUD list of qualified 203(k... Participation in FHA Programs Section 203(k) Rehabilitation Loan Consultants § 200.190 HUD list of qualified 203(k) consultants. (a) Qualified consultant list. HUD maintains a list of qualified consultants for use...

  18. 24 CFR 200.190 - HUD list of qualified 203(k) consultants.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 2 2014-04-01 2014-04-01 false HUD list of qualified 203(k... Participation in FHA Programs Section 203(k) Rehabilitation Loan Consultants § 200.190 HUD list of qualified 203(k) consultants. (a) Qualified consultant list. HUD maintains a list of qualified consultants for use...

  19. Reporting observational studies of the use of information technology in the clinical consultation. A position statement from the IMIA Primary Health Care Informatics Working Group (IMIA PCI WG).

    PubMed

    de Lusignan, S; Pearce, C; Kumarapeli, P; Stavropoulou, C; Kushniruk, A; Sheikh, A; Shachak, A; Mendis, K

    2011-01-01

    To develop a classification system to improve the reporting of observational studies of the use of information technology (IT) in clinical consultations. Literature review, workshops, and development of a position statement. We grouped the important aspects for consistent reporting into a "faceted classification"; the components relevant to a particular study to be used independently. The eight facets of our classification are: (1) Theoretical and methodological approach: e.g. dramaturgical, cognitive; (2) DATA COLLECTION: Type and method of observation; (3) Room layout and environment: How this affects interaction between clinician, patient and computer. (4) Initiation and Interaction: Who starts the consultation, and how the participants interact; (5) Information and knowledge utilisation: What sources of information or decision support are used or provided; (6) Timing and type of consultation variables: Standard descriptors that can be used to allow comparison of duration and description of continuous activities (e.g. speech, eye contact) and episodic ones, such as prescribing; (7) Post-consultation impact measures: Satisfaction surveys and health economic assessment based on the perceived quality of the clinician-patient interaction; and (8) Data capture, storage, and export formats: How to archive and curate data to facilitate further analysis. Adoption of this classification should make it easier to interpret research findings and facilitate the synthesis of evidence across studies. Those engaged in IT-consultation research shouldconsider adopting this reporting guide.

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

    PubMed

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

    2017-01-05

    Since 1879, the year of the first documented medical telephone consultation, the ability to consult by telephone has become an integral part of modern patient-centred healthcare systems. Nowadays, upwards of a quarter of all care consultations are conducted by telephone. Studies have quantified the impact of medical telephone consultation on clinicians' workload and detected the need for quality improvement. While doctors routinely receive training in communication and consultation skills, this does not necessarily include the specificities of telephone communication and consultation. Several studies assessed the short-term effect of interventions aimed at improving clinicians' telephone consultation skills, but there is no systematic review reporting patient-oriented outcomes or outcomes of interest to clinicians. To assess the effects of training interventions for clinicians' telephone consultation skills and patient outcomes. We searched CENTRAL, MEDLINE, Embase, five other electronic databases and two trial registers up to 19 May 2016, and we handsearched references, checked citations and contacted study authors to identify additional studies and data. We considered randomised controlled trials, non-randomised controlled trials, controlled before-after studies and interrupted time series studies evaluating training interventions compared with any control intervention, including no intervention, for improving clinicians' telephone consultation skills with patients and their impact on patient outcomes. Two review authors independently selected studies for inclusion, extracted data and assessed the risk of bias of eligible studies using standard Cochrane and EPOC guidance and the certainty of evidence using GRADE. We contacted study authors where additional information was needed. We used standard methodological procedures expected by Cochrane for data analysis. We identified one very small controlled before-after study performed in 1989: this study used a

  1. What factors affect evidence-informed policymaking in public health? Protocol for a systematic review of qualitative evidence using thematic synthesis.

    PubMed

    Verboom, Ben; Montgomery, Paul; Bennett, Sara

    2016-04-14

    Claims of and calls for evidence-informed policymaking pervade public health journals and the literature of governments and global health agencies, yet our knowledge of the arrangements most conducive to the appropriate use of evidence is incomplete and fragmented. Designing interventions to encourage evidence use by policymakers requires an understanding of the processes through which officials access, assess and use research, including technical and political factors related to evidence uptake, and the ways in which the policymaking context can affect these processes. This review aims to systematically locate, synthesise and interpret the existing qualitative work on the process of evidence use in public health policymaking, with the aim of producing an empirically derived taxonomy of factors affecting evidence use. This review will include primary qualitative studies that examined the use of research evidence by policymakers to inform decisions about public health. To locate studies, we will search nine bibliographic databases, hand-search nine public health and policy journals and scan the websites of relevant organisations and the reference lists of previous reviews of evidence use in policymaking. Two reviewers will independently screen studies, apply inclusion criteria and appraise the quality of included studies. Data will be coded inductively and analysed using thematic synthesis. An augmented version of the CASP Qualitative Checklist will be used to appraise included studies, and the CERQual tool will be used to assess confidence in the review's findings. The review's results will be presented narratively and in tabular form. Synthesis findings will be summarised as a taxonomy of factors affecting evidence use in public health policymaking. A conceptual framework explaining the relationships between key factors will be proposed. Implications and recommendations for policy, practice and future research will be discussed. This review will be the most

  2. Using social media for community consultation and public disclosure in exception from informed consent trials.

    PubMed

    Stephens, Shannon W; Williams, Carolyn; Gray, Randal; Kerby, Jeffrey D; Wang, Henry E; Bosarge, Patrick L

    2016-06-01

    The US Food and Drug Administration and the Department of Health and Human Services outline regulations allowing an exception from informed consent (EFIC) for research conducted in an emergency setting. Acute care clinical trials using EFIC must include community consultation and public disclosure (CC/PD) activities. We describe our experience using social media to facilitate the CC/PD process in two trauma resuscitation clinical trials. We conducted local CC/PD activities for two multicenter trauma clinical trials, Pragmatic, Randomized Optimal Platelet and Plasma Ratios (PROPPR) and Prehospital Tranexamic Acid Use for Traumatic Brain Injury (ROC-TXA). As part of the CC/PD process, we developed research study advertisements using the social media Web site Facebook. The Facebook advertisements directed users to a regional study Web site that contained trial information. We targeted the advertisements to specific demographic users, in specific geographic areas. We analyzed the data using descriptive statistics. During the study periods, the PROPPR Facebook advertisement was displayed 5,001,520 times (12 displays per target population) with 374 individuals selecting the advertisement. The ROC-TXA Facebook advertisement was displayed 3,806,448 times (8 per target population) with 790 individuals selecting the advertisement. Respondents to both Facebook advertisements were mostly male (52.6%), with the highest proportion between the ages 15 years and 24 years (28.2%). Collectively, 26.9% of individuals that clicked on the Facebook advertisement spent more than 3 minutes on the study Web site (3-49 minutes). Commonly accessed Web pages were "contact us" (PROPPR, 5.5%; ROC-TXA, 7.7%), "study-specific FAQs" (PROPPR, 2.4%; ROC-TXA, 6.7%), and "opt out of research" (PROPPR, 2.5%; ROC-TXA, 3.8%). Of 51 total individuals viewing the opt out of research information (PROPPR, 19; ROC-TXA, 32), time spent on that specific page was modest (PROPPR, 62 seconds; ROC-TXA, 55 seconds

  3. Enhancing communication in oncology outpatient consultations: critical reflections from doctors

    PubMed Central

    Murphy, Roger; Cox, Karen; Steward, William

    2011-01-01

    Objectives The experiences of patients diagnosed with advanced incurable cancer and the doctors who conducted their medical consultations were studied in order to improve the understanding of what happens in consultations, when bad news is disclosed. The major objective of the study was to critically reflect upon doctor-patient communication, in such situations, with a view to considering future strategies for doctors’ continuing professional development. Methods Sixteen patients and sixteen Oncologists, from a cancer centre in the UK were recruited into this ethnographic study. One hundred and fifteen episodes of data were collected from audio recorded consultations; interviews with doctors and patients and their relatives and observations of consultations. These data were analysed using a constant comparison method. Results Interactions between doctors and patients are complex and consultations can be challenging for both of them. Some doctors spoke openly about their need for additional support to enhance their communication related competencies within Oncology consultations. These doctors wanted to observe their peers conducting consultations. They also wanted to receive feedback about their own clinical practices. These doctors stated that they wanted an open culture whereby they could talk freely about difficult and emotionally challenging consultations without fear of being considered incompetent by their Consultants, who act in a clinical supervisory role. Conclusions To help practitioners consolidate their practice in such settings it is necessary to develop better collaborations among practitioners within clinical practice. Providing individual supervisory sessions or group workshops can facilitate reflective learning and provide an open and supportive learning culture.

  4. Business Communication Consulting and Research in Multinational Companies.

    ERIC Educational Resources Information Center

    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)

  5. Defining the Role of the Professional Security Consultant.

    ERIC Educational Resources Information Center

    Webster, Jim

    2002-01-01

    Discusses the skill set that should be available in security consultants to higher education, including the ability to work with mechanical, architectural, electrical, landscaping, and telecommunications systems. Addresses the need to bring consultants into the building design phase. (EV)

  6. Effects of revised consultation room design on patient-physician communication.

    PubMed

    Ajiboye, Folaranmi; Dong, Fanglong; Moore, Justin; Kallail, K James; Baughman, Allison

    2015-01-01

    To evaluate the impact of a revised consultation room design on patient-physician interaction in an outpatient setting. The growth of ambulatory medical care makes outpatient facilities the primary point of health care contact for many Americans. However, the outpatient consultation room design remains largely unchanged, despite its increased use and the adoption of technology-mediated information sharing in clinical encounter. A randomized controlled trial used a postvisit questionnaire to assess six domains of interest (satisfaction with the visit and the consultation room, mutual respect, patient trust in the physician, communication quality, people-room interaction, and interpersonal-room interaction) in two different room designs (a traditional room and an experimental room in which a pedestal table had replaced the examination table). Interpersonal-room interaction was enhanced in the experimental consultation room when compared to the traditional consultation room (p = .0038). Participants in the experimental consultation room had better access to the computer screen, increased provider information sharing, and more time engaging providers in conversation about information on the monitor. Changing the layout of a consultation room has the potential to improve interpersonal communication through better information sharing. Clinicians who are interested in maximizing the benefits of their clinical encounter should consider changing the layout of their consultation room, especially the positioning of the computer screen. © The Author(s) 2014.

  7. Promising Directions in School-Based Systems Level Consultation: A Commentary on "Has Consultation Achieved Its Primary Prevention Potential?," an Article by Joseph E. Zins

    ERIC Educational Resources Information Center

    Hojnoski, Robin L.

    2007-01-01

    From his review of research on consultation, Zins (1995) concluded (a) that a paradigm shift to a more prevention-oriented approach was necessary; (b) that systems-level consultation held significant potential; and (c) that systems-level consultation had the most data to support its use in preventive efforts. This commentary reviews promising…

  8. Patients' unvoiced agendas in general practice consultations: qualitative study

    PubMed Central

    Barry, Christine A; Bradley, Colin P; Britten, Nicky; Stevenson, Fiona A; Barber, Nick

    2000-01-01

    Objective To investigate patients' agendas before consultation and to assess which aspects of agendas are voiced in the consultation and the effects of unvoiced agendas on outcomes. Design Qualitative study. Setting 20 general practices in south east England and the West Midlands. Participants 35 patients consulting 20 general practitioners in appointment and emergency surgeries. Results Patients' agendas are complex and multifarious. Only four of 35 patients voiced all their agendas in consultation. Agenda items most commonly voiced were symptoms and requests for diagnoses and prescriptions. The most common unvoiced agenda items were: worries about possible diagnosis and what the future holds; patients' ideas about what is wrong; side effects; not wanting a prescription; and information relating to social context. Agenda items that were not raised in the consultation often led to specific problem outcomes (for example, major misunderstandings), unwanted prescriptions, non-use of prescriptions, and non-adherence to treatment. In all of the 14 consultations with problem outcomes at least one of the problems was related to an unvoiced agenda item. Conclusion Patients have many needs and when these are not voiced they can not be addressed. Some of the poor outcomes in the case studies were related to unvoiced agenda items. This suggests that when patients and their needs are more fully articulated in the consultation better health care may be effected. Steps should be taken in both daily clinical practice and research to encourage the voicing of patients' agendas. PMID:10797036

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

    PubMed

    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.

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

    ERIC Educational Resources Information Center

    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…

  11. Practically Speaking: A Sourcebook for Instructional Consultants in Higher Education.

    ERIC Educational Resources Information Center

    Brinko, Kathleen T., Ed.; Menges, Robert J., Ed.

    The selections in this sourcebook offer a blend of research-based principles and practical advice to the instructional consultant. The first section, Skills and Techniques of Instructional Consultation, contains: (1) The Interactions of Teaching Improvement (Kathleen T. Brink); (2) Instructional Consulting: A Guide for Developing Professional…

  12. Developing and Testing a Checklist to Enhance Quality in Ethics Consultation

    PubMed Central

    Flicker, Lauren Sydney; Rose, Susannah L.; Eves, Margot M.; Flamm, Anne Lederman; Sanghani, Ruchi; Smith, Martin L.

    2015-01-01

    Checklists have been used to improve quality in many industries, including healthcare. The use of checklists, however, has not been extensively evaluated in clinical ethics consultation. This article seeks to fill this gap by exploring the efficacy of using a checklist in ethics consultation, as tested by an empirical investigation of the use of the checklist at a large academic medical system (Cleveland Clinic). The specific aims of this project are as follows: (1) to improve the quality of ethics consultations by providing reminders to ethics consultants about process steps that are important for most patient-centered ethics consultations, (2) to create consistency in the ethics consultation process across the medical system, and (3) to establish an effective educational tool for trainers and trainees in clinical ethics consultation. The checklist was developed after a thorough literature review and an iterative process of revising and testing by a group of experienced ethics consultants. To pilot test the checklist, it was distributed to 46 ethics professionals. After a six-month pilot period in which ethics professionals used the checklist during their clinical activities, a survey was distributed to all of those who used the checklist. The 10-item survey examined consultants' perceptions regarding the three aims listed above. Of the 25 survey respondents, 11 self-reported as experts in ethics consultation, nine perceived themselves to have mid-level expertise, and five self-reported as novices. The majority (68 percent) of all respondents, regardless of expertise, believed that the checklist could be a “helpful” or “very helpful” tool in the consultation process generally. Novices were more likely than experts to believe that the checklist would be useful in conducting consultations. The limitations of this study include: reduced generalizability given that this project was conducted at one medical system, utilized a small sample size, and used self

  13. Periodic gastroenterology and hepatology meetings with primary care. Reasons for consultation.

    PubMed

    Mata-Román, Laura; del Olmo-Martínez, Lourdes; Briso-Montiano, Raquel; García-Pascual, Agustina; Catón-Valdés, Manuela; Jiménez-Rodríguez-Vila, Manuel; Castellanos-Alonso, Maria Jose; Laso, Lucinio; Gómez-Gómez, Pilar; Otero, Antonio; Pinilla-Gimeno, Jose Ignacio; del-Río-Hortega, Juan; Pradera-Leonardo, Juan; Vallelado, Rosario; Villuela-González, Fernando; Ibañes-Jalón, Elisa; Sañudo, Soledad; Mayo, Agustin; Caro-Patón, Agustin; Almaraz-Gómez, Ana

    2013-10-01

    care overload, aging of population, and increased chronic diseases lead to increased referrals from primary care, which may sometimes overload the health system. Thus, different interventions have been carried out attempting to improve these aspects. to assess the most frequent causes of consultation of general physicians, both in joint consultations and clinical sessions held jointly with specialist consultant in primary care, in the urban and rural setting, and the influence on referrals to first consultations of gastroenterology. a mainly training type of intervention was carried out, consisting of regular meetings in both urban and rural primary care center, to perform joint consultations and clinical sessions on patients and topics related to the specialty of gastroenterology. The intervention period (divided in two subperiods) was compared with a control period. most reasons for consultation were those corresponding to lower gastrointestinal tract, followed by liver disease and upper gastrointestinal tract. Significant differences were only found in distribution of diagnoses between the two centers in joint consultations. There was a relative (percent) decrease in referrals at the global level in both subperiods, only significant in the first (51.45 %), as well as in rural setting (45.24 %). common consultations motifs were similar in urban and rural settings, with some relevance of lower gastrointestinal tract disease. Most of them can be solved at primary care, with the help of consultant specialist. There is impact on referrals to the outpatient first consultations of gastroenterology, mainly in rural setting.

  14. Sharing Expertise: Consulting

    ERIC Educational Resources Information Center

    Graves, Bill

    2011-01-01

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

  15. HEALTH TECHNOLOGY ASSESSMENT OF PUBLIC HEALTH INTERVENTIONS: A SYNTHESIS OF METHODOLOGICAL GUIDANCE.

    PubMed

    Mathes, Tim; Antoine, Sunya-Lee; Prengel, Peggy; Bühn, Stefanie; Polus, Stephanie; Pieper, Dawid

    2017-01-01

    The evaluation of public health interventions poses some challenges. As a consequence, health technology assessment (HTA) methods for public health interventions (PHI) have to be adapted. This study aimed to summarize the available guidance on methods for HTA of PHI. We systematically searched for methodological guidance on HTA of PHIs. Our focus was on research synthesis methods to evaluate effectiveness. Relevant information was synthesized narratively in a standardized way. Only four guidance documents were identified specifically for HTAs of PHI. The approaches used for HTAs of PHIs are broader and more flexible than those for medical interventions. For this reason, there is a tendency to identify the intervention components and context factors that influence the effectiveness and transferability of an intervention rather than to assess its effectiveness in general. The details in the guidance vary without justification. Unjustified heterogeneity between the different guidance approaches is most pronounced for quality assessment, assessment of applicability, and methods to integrate qualitative and quantitative evidence. Descriptions for the assessment of integrity, heterogeneity, sustainability, context factors, and applicability are often vague. The heterogeneity in approaches indicates that there is currently no consensus on methods to deal with the challenges of the PHI evaluations. A possible explanation for this may be that the methods are not sufficiently developed, and advantages and disadvantages of a certain method in relation to the research question (e.g., broad/focused) have not yet been sufficiently evaluated.

  16. 40 CFR 161.40 - Consultation with the Agency.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Consultation with the Agency. 161.40 Section 161.40 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS DATA REQUIREMENTS FOR REGISTRATION OF ANTIMICROBIAL PESTICIDES General Provisions § 161.40 Consultation...

  17. Addressing Cultural Responsiveness in Consultation: An Empirical Demonstration

    ERIC Educational Resources Information Center

    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…

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  19. The challenges of a home-based nursing consultation business.

    PubMed

    Schulmeister, L

    1999-03-01

    The transition from working in a traditional setting to working at home alone can be challenging for new nurse consultants. Home-based consultants can use a variety of strategies to stay focused and connected, such as having a designated work area, limiting distractions, and networking. Nurse consultants can obtain information about business management from community resources, and computer on-line services offer a means of contacting other small-business owners. Ongoing business evaluations, which include professional accomplishments as well as an examination of income and expenses, help in planning. Home-based nurse consultants can increase the likelihood of business success by setting objectives, working diligently, and networking with others in the business community.

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

    PubMed

    Walsh, Cian; Ryan, Patrick; Flynn, Daniel

    2018-01-01

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

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

    ERIC Educational Resources Information Center

    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)

  2. Hart's Hardware and Supply: An Independent Consulting Dilemma

    ERIC Educational Resources Information Center

    Williams, Sandra L.

    2017-01-01

    The practice of Human Resource Development (HRD) work often occurs in consulting opportunities at ongoing businesses, agencies and non-profit organizations. These are the spaces where human resources development (HRD) consultants hone their skills and affect change in work settings. Consultants in HRD utilize skills not only across the HRD field…

  3. Educational Consultation in Two Emerging Democracies: Kazakstan and South Africa.

    ERIC Educational Resources Information Center

    Rothenberg, Julia Johnson; McDermott, Peter M.

    In this paper two educational consultants, one a researcher in South African issues and the other a researcher in Kazakstan issues, share their respective experiences of teaching in South Africa and Kazakstan and examine their assumptions and methods of consultation. The paper analyzes how the consultants' observations of education in these…

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

    PubMed

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

    2010-03-01

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

  5. Service Learning In Physics: The Consultant Model

    NASA Astrophysics Data System (ADS)

    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.

  6. 20 CFR 416.919t - Consultative examination oversight.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Consultative examination oversight. 416.919t Section 416.919t Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE... will also perform ongoing special management studies of the quality of consultative examinations...

  7. 20 CFR 416.919t - Consultative examination oversight.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Consultative examination oversight. 416.919t Section 416.919t Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE... will also perform ongoing special management studies of the quality of consultative examinations...

  8. 20 CFR 416.919t - Consultative examination oversight.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Consultative examination oversight. 416.919t Section 416.919t Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE... will also perform ongoing special management studies of the quality of consultative examinations...

  9. 20 CFR 416.919t - Consultative examination oversight.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Consultative examination oversight. 416.919t Section 416.919t Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE... will also perform ongoing special management studies of the quality of consultative examinations...

  10. 20 CFR 404.1519t - Consultative examination oversight.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Consultative examination oversight. 404.1519t Section 404.1519t Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND... will also perform ongoing special management studies of the quality of consultative examinations...

  11. 20 CFR 404.1519t - Consultative examination oversight.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Consultative examination oversight. 404.1519t Section 404.1519t Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND... will also perform ongoing special management studies of the quality of consultative examinations...

  12. 20 CFR 416.919t - Consultative examination oversight.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Consultative examination oversight. 416.919t Section 416.919t Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE... will also perform ongoing special management studies of the quality of consultative examinations...

  13. 20 CFR 404.1519t - Consultative examination oversight.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Consultative examination oversight. 404.1519t Section 404.1519t Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND... will also perform ongoing special management studies of the quality of consultative examinations...

  14. 20 CFR 404.1519t - Consultative examination oversight.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Consultative examination oversight. 404.1519t Section 404.1519t Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND... will also perform ongoing special management studies of the quality of consultative examinations...

  15. 20 CFR 404.1519t - Consultative examination oversight.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Consultative examination oversight. 404.1519t Section 404.1519t Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND... will also perform ongoing special management studies of the quality of consultative examinations...

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

    ERIC Educational Resources Information Center

    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…

  17. Publications - GMC 320 | Alaska Division of Geological & Geophysical

    Science.gov Websites

    DGGS GMC 320 Publication Details Title: Summary results of short-wave infrared spectroscopy of the gold Reference PetraScience Consultants Inc., 2005, Summary results of short-wave infrared spectroscopy of the

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

    PubMed

    Jiwa, Moyez; Meng, Xingqiong

    2013-06-19

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

  19. Consultancy research as a barrier to strengthening social science research capacity in Uganda.

    PubMed

    Wight, Daniel; Ahikire, Josephine; Kwesiga, Joy C

    2014-09-01

    There is a shortage of senior African social scientists available to lead or manage research in Africa, undermining the continent's ability to interpret and solve its socio-economic and public health problems. This is despite decades of investment to strengthen research capacity. This study investigated the role of individually commissioned consultancy research in this lack of capacity. In 2006 structured interviews (N = 95) and two group discussions (N = 16 total) were conducted with a fairly representative sample of Ugandan academic social scientists from four universities. Twenty-four senior members of 22 Ugandan and international commissioning organizations were interviewed. Eight key actors were interviewed in greater depth. Much of Ugandan social science research appears to take the form of small, individually contracted consultancy projects. Researchers perceived this to constrain their professional development and, more broadly, social science research capacity across Uganda. Conversely, most research commissioners seemed broadly satisfied with the research expertise available and felt no responsibility to contribute to strengthening research capacity. Most consultancy research does not involve institutional overheads and there seems little awareness of, or interest in, such overheads. Although inequalities in the global knowledge economy are probably perpetuated primarily by macro-level factors, in line with Dependency Theory, meso-level factors are also important. The current research market and institutional structures in Uganda appear to create career paths that seriously impede the development of high quality social science research capacity, undermining donor investments and professional effort to strengthen this capacity. These problems are probably generic to much of sub-Saharan Africa. However, both commissioning and research organizations seem ready, in principle, to establish national guidelines for institutional research consultancies. These

  20. The present and future role of the consultant physician with an interest in infection. Council of the British Society for the Study of Infection.

    PubMed

    1993-09-01

    The Council of the British Society for the Study of Infection (BSSI) has considered the present and future role of the Consultant Physician with an interest in infection. The BSSI is anxious to set standards and improve the quality of care delivered to patients with infection; to give advice on the prevention and management of infection and to provide such services economically to assist Health Managers in the purchase of infection-related medical services appropriate to the needs of the community they serve. New approaches to the care of infected patients are reviewed where the Clinical Specialist, Microbiologist and Consultant in Communicable Disease Control (CCDC)--in Scotland, Consultant in Public Health Medicine (CPHM)--work together in a team. As the U.K. moves closer to its European partners in 1992, it seems timely for each specialty to make a clear statement about its training programme and the requirements expected of a fully trained Consultant in each discipline. Comparisons between the ratio of Consultants with a special interest in infection and the population are made, where known, between U.K. and other European countries. A model job description for the U.K. clinical specialist is therefore being made available, the present inadequate numbers of consultants are stated and recommendations made to expand urgently the number of Consultant Physicians with an interest in infection.

  1. Developing a Consulting Practice. Survival Skills for Scholars. Volume 3.

    ERIC Educational Resources Information Center

    Metzger, Robert O.

    This book discusses the content consultation process as undertaken by scholars (professors or advanced graduate students) in all fields to be performed as a regular activity and run as a business. Chapter 1 offers an overview and description of consultation practice. Chapter 2 discusses indirect marketing of consultation services for scholars.…

  2. A comparison of the effectiveness between Western medicine and Chinese medicine outpatient consultations in primary care.

    PubMed

    Wong, Wendy; Lam, L K Cindy; Li, Rita; Ho, Sze Hon; Fai, Leung Kwok; Li, Zhao

    2011-10-01

    Traditional Chinese medicine (TCM) plays an important role in the primary care system in many places, but research evidence on its effectiveness is largely lacking. The aim of the present study was to compare the effectiveness between TCM and Western medicine (WM) consultations in primary care. To evaluate whether medical consultations could improve the quality of life and health condition of patients in primary care and to find out whether there was any difference in the effectiveness bewteen TCM and WM. This was a prospective, longitudinal study on 290 patients of one TCM public and 841 patients of two WM general outpatient clinics (GOPC) in Hong Kong when they consulted for an episodic illness. All patients attending a TCM GOPC in TWH, and the two WM GOPC (TWH and ALC), who fullfilled the inclusion criteria were invited to participate. Each patient answered a structured questionnaire on the presenting complaint, socio-demography, chronic morbidity and service utilization, the Chinese Quality of Life instrument (ChQOL) and the SF-36V2 Health Survey immediately before and two weeks after the doctor consultation. The Global Rating on change Scale (GRS) was also administered in the week 2 assessment. The primary outcomes were changes in the ChQOL and SF-36V2 HRQOL scores. Secondary outcomes included the GRS score. The significance of the change within individual were tested by paired t-tests. The differences in change in scores between WM and TCM were tested by independent sample-t-tests or chi-square, as appropriate. Multivariate regresions were used to determine the independent effect of type of medicine on the change in HRQOL scores. Mean ChQOL and SF-36V2 scores of subjects improved significantly two weeks after TCM or WM consultations in all domains except for the Physical form domain of ChQOL. The greatest improvements were found in the SF-36V2 physical-health related domains. 78% TCM clinics and 71% of subjects WM clinics reported an improvement in GRS. The

  3. 48 CFR 3452.237-71 - Services of consultants.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Services of consultants. 3452.237-71 Section 3452.237-71 Federal Acquisition Regulations System DEPARTMENT OF EDUCATION... set forth, $150, exclusive of travel costs, or if the services of any consultant under this contract...

  4. Towards capturing meaningful outcomes for people with dementia in psychosocial intervention research: A pan-European consultation.

    PubMed

    Øksnebjerg, Laila; Diaz-Ponce, Ana; Gove, Dianne; Moniz-Cook, Esme; Mountain, Gail; Chattat, Rabih; Woods, Bob

    2018-06-19

    People with dementia are often marginalized and excluded from influence, also in relation to dementia research. There is, however, a growing requirement for inclusion through Patient and Public Involvement (PPI), but there is still limited knowledge on how researchers can fully benefit from the involvement of people with dementia in the development and testing of psychosocial interventions. This paper describes the results of a pan-European consultation with people with dementia, synthesizing their views on outcomes of psychosocial interventions. To involve people with dementia in establishing what are meaningful outcomes when participating in psychosocial interventions. Consultations took place at four divergent sites across Europe, involving twenty-five people with dementia from nine European countries. The methods used for the consultation were developed through an iterative process involving people with dementia. Data from the consultation were analysed from a thematic analysis approach. The results suggested that people with dementia wish to participate in interventions that enhance their well-being, confidence, health, social participation and human rights. This highlights a need for improvements in psychosocial research to capture these outcomes. Involving people with dementia in discussions of psychosocial interventions has enhanced our understanding about meaningful outcome measures in research and methods of data collection. This study suggests that new outcome measures in psychosocial research are needed where concepts of positive psychology and social health can guide innovation and outcome measurement. © 2018 The Authors. Health Expectations published by John Wiley & Sons Ltd.

  5. Optimizing education on the inpatient dermatology consultative service.

    PubMed

    Afifi, Ladan; Shinkai, Kanade

    2017-03-01

    A consultative dermatology service plays an important role in patient care and education in the hospital setting. Optimizing education in balance with high-quality dermatology consultative services is both a challenge and an opportunity for dermatology consultation teams. There is an emergence of new information about how dermatology can best be taught in the hospital, much of which relies on principles of workplace learning as well as the science of how learning and teaching best happen in work settings. These best practices are summarized in this narrative review with integrated discussion of concepts from outpatient dermatology education and lessons learned from other inpatient teaching models. In addition, consultative dermatology curricula should utilize a blended curriculum model comprised of patient care and active learning and self-study modalities. Specific educational methods will discuss 2 strategies: (1) direct patient-care activities (ie, bedside teaching rounds) and (2) nonpatient care activities (ie, case presentations, didactic sessions, online modules, and reading lists). ©2017 Frontline Medical Communications.

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

    PubMed

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

    2012-04-01

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

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

    PubMed

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

    2016-02-12

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

  8. Comparison of disagreement and error rates for three types of interdepartmental consultations.

    PubMed

    Renshaw, Andrew A; Gould, Edwin W

    2005-12-01

    Previous studies have documented a relatively high rate of disagreement for interdepartmental consultations, but follow-up is limited. We reviewed the results of 3 types of interdepartmental consultations in our hospital during a 2-year period, including 328 incoming, 928 pathologist-generated outgoing, and 227 patient- or clinician-generated outgoing consults. The disagreement rate was significantly higher for incoming consults (10.7%) than for outgoing pathologist-generated consults (5.9%) (P = .06). Disagreement rates for outgoing patient- or clinician-generated consults were not significantly different from either other type (7.9%). Additional consultation, biopsy, or testing follow-up was available for 19 (54%) of 35, 14 (25%) of 55, and 6 (33%) of 18 incoming, outgoing pathologist-generated, and outgoing patient- or clinician-generated consults with disagreements, respectively; the percentage of errors varied widely (15/19 [79%], 8/14 [57%], and 2/6 [33%], respectively), but differences were not significant (P >.05 for each). Review of the individual errors revealed specific diagnostic areas in which improvement in performance might be made. Disagreement rates for interdepartmental consultation ranged from 5.9% to 10.7%, but only 33% to 79% represented errors. Additional consultation, tissue, and testing results can aid in distinguishing disagreements from errors.

  9. 30 CFR 27.3 - Consultation.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... MINING PRODUCTS METHANE-MONITORING SYSTEMS General Provisions § 27.3 Consultation. By appointment... qualified MSHA personnel proposed methane-monitoring systems to be submitted in accordance with the...

  10. Assessing communication quality of consultations in primary care: initial reliability of the Global Consultation Rating Scale, based on the Calgary-Cambridge Guide to the Medical Interview.

    PubMed

    Burt, Jenni; Abel, Gary; Elmore, Natasha; Campbell, John; Roland, Martin; Benson, John; Silverman, Jonathan

    2014-03-06

    To investigate initial reliability of the Global Consultation Rating Scale (GCRS: an instrument to assess the effectiveness of communication across an entire doctor-patient consultation, based on the Calgary-Cambridge guide to the medical interview), in simulated patient consultations. Multiple ratings of simulated general practitioner (GP)-patient consultations by trained GP evaluators. UK primary care. 21 GPs and six trained GP evaluators. GCRS score. 6 GP raters used GCRS to rate randomly assigned video recordings of GP consultations with simulated patients. Each of the 42 consultations was rated separately by four raters. We considered whether a fixed difference between scores had the same meaning at all levels of performance. We then examined the reliability of GCRS using mixed linear regression models. We augmented our regression model to also examine whether there were systematic biases between the scores given by different raters and to look for possible order effects. Assessing the communication quality of individual consultations, GCRS achieved a reliability of 0.73 (95% CI 0.44 to 0.79) for two raters, 0.80 (0.54 to 0.85) for three and 0.85 (0.61 to 0.88) for four. We found an average difference of 1.65 (on a 0-10 scale) in the scores given by the least and most generous raters: adjusting for this evaluator bias increased reliability to 0.78 (0.53 to 0.83) for two raters; 0.85 (0.63 to 0.88) for three and 0.88 (0.69 to 0.91) for four. There were considerable order effects, with later consultations (after 15-20 ratings) receiving, on average, scores more than one point higher on a 0-10 scale. GCRS shows good reliability with three raters assessing each consultation. We are currently developing the scale further by assessing a large sample of real-world consultations.

  11. Developing public affairs counseling skills to support a public participation focus at Fernald

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hoopes, J.

    To provide closer coordination between the Public Affairs Division and environmental restoration management and technical staff, the Fernald Environmental Restoration Management Corporation (FERMCO) matrixed Public Affairs staffers as counselors to project teams within FERMCO. Close coordination between technical staff and public affairs staff is essential for effective public communication in a public participation, environmental risk communication environment. Two-way symmetrical communication (public participation) represents a paradigm shift for public affairs staff who have developed skills primarily in a public information (asymmetrical communication) environment. While there has been much focus in the literature and workshops on management changes needed to support amore » public participation environment, less attention has been paid to identifying and developing the skills needed by public affairs professionals to support public participation. To support the new counseling role of public affairs staffers, FERMCO used a public affairs training consultant to design and deliver a workshop to initiate development of the skills needed for the public affairs counseling role. This paper describes FERMCO`s matrixed counseling program and the training to develop public affairs counseling skills for the public participation environment.« less

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

    PubMed

    Lee, Jinhee; Danes, Sharon M

    2012-06-01

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

  13. Playing with Mirrors: Narrative Inquiry and Congregational Consultation

    ERIC Educational Resources Information Center

    Yust, Karen Marie

    2009-01-01

    This article proposes that narrative inquiry methods fruitfully shape the role and strategies of persons who consult with religious communities. It suggests that the composition of field texts and transition from research notes to narratives enables consultants to mirror the stories of congregations so congregants can recognize, claim, and…

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

    PubMed

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

    2014-07-01

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

  15. 40 CFR 255.21 - Local consultation on boundaries.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 25 2011-07-01 2011-07-01 false Local consultation on boundaries. 255... § 255.21 Local consultation on boundaries. Any chief executive of a general purpose government within... these comments are to assure that the experience of local agencies is used to fullest advantage in...

  16. 40 CFR 255.21 - Local consultation on boundaries.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Local consultation on boundaries. 255... § 255.21 Local consultation on boundaries. Any chief executive of a general purpose government within... these comments are to assure that the experience of local agencies is used to fullest advantage in...

  17. Advancing Knowledge in Schools through Consultative Knowledge Linking.

    ERIC Educational Resources Information Center

    Kratochwill, Thomas R.

    Consultation services have been considered an essential and important role for school psychologists throughout the history of the field. Traditionally consultation has been cast as a problem-solving process, nevertheless, it can be thought of as a knowledge-linking process in which psychologists advance knowledge in schools to various mediators…

  18. 10 CFR 51.40 - Consultation with NRC staff.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 2 2011-01-01 2011-01-01 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...

  19. 10 CFR 51.40 - Consultation with NRC staff.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 2 2014-01-01 2014-01-01 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...

  20. 10 CFR 51.40 - Consultation with NRC staff.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 2 2012-01-01 2012-01-01 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...