基于Consultant Climate导向与斯维尔验证的烟台某售楼处节能改造研究

以烟台某售楼处节能改造项目为例,通过Consultant Climate分析帮助设计者快速找到主要能耗矛盾并进行节能改造,再利用斯维尔进行改造后的评价。结果显示:Consultant Climate能够快速找到地区气候缺陷并提出量化策略,斯维尔能够准确合理给出节能率。结合两者可以帮助设计者快速准确地找到适应气候的设计策略,提高工作效率,避免因气候调节能力不佳导致重新改造所带来的资源浪费。

基于Climate Consultant的现代民居被动式优化策略分析——以豫北地区为例

为改善豫北地区现代民居室内热环境状况,提高民居气候适应能力。采用Climate Consultant软件分析豫北地区的气候数据,得出了适用于该地区的被动式建筑策略组合及各策略有效时间比。结合冬夏两季现代民居室内外的热环境实测数据,针对夏季炎热和冬季寒冷问题分别提出了被动式优化策略:民居功能分区设计采用“向心性”的空间布局、冬季在一层檐廊处增设阳光间、改善围护结构保温隔热设计;夏季疏通建筑自然通风的路径、增设遮阳设施、改善庭院绿化。通过以上适宜性被动式优化策略,提高现代民居室内热舒适性,为豫北地区现代民居的建设和改造提供了重要的理论依据和有价值的参考。

Evaluating the Effectiveness of Consultants’ Roles in Improving Value for Money in Public Infrastructure Projects in Ghana

Ghanaian construction projects encounter a number of challenges, including low health, safety, and environmental requirements, poor performance, and time and cost overruns. To provide value for money (VFM) on government infrastructure projects in Ghana, this research assesses the roles of project consultants, specifically architects and quantity surveyors, and highlights important obstacles. A cross-sectional survey design involving architects and quantity surveyors yielded a 96% response rate after 100 questionnaires were distributed. Consultants’ responsibilities also include monitoring standards compliance, providing advice on delays, controlling budgets, and advising on project completion dates. Difficulties encompass a lack of promptness in decision-making, unethical conduct, political pressure, and inadequate focus on contract administration and construction audits. Project urgency, longevity, political clout, timely decision-making, and team experience are important variables that impact VFM. Policy makers and construction management practitioners should take note of the implications for Ghana’s public infrastructure projects.

基于Climate Consultant的天水传统民居气候适应性分析

天水传统民居建筑由于受到自然环境以及建筑文化的影响导致施工过程中存在较大的盲目性和自主性,缺乏相应的理论支持,同时建筑设计缺乏气候数据的量化设计。采用Climate Consultant分析软件将大量气候数据转化成便于理解的图示,同时得到改善天水传统民居舒适度的被动优化策略,并结合现阶段传统民居建筑特点,对实际气候环境进行检测分析,从而针对天水地区冬季寒冷、夏季炎热的问题分别提出相对应的设计优化策略:冬季增设附加阳光间、加强外墙保温设计、优化门窗节能设计;夏季增设自然通风设计、遮阳措施设计、庭院绿化设计。通过改进传统民居的适宜性技术与设计措施,从而提高民居的热舒适性,为天水地区乃至整个西北地区传统民居的建设和更新提供了相应的理论依据和参考价值。

基于Climate Consultant软件的传统徽派民居气候适应性分析

采用Climate Consultant气候分析软件,结合黄山市气象数据(CSWD)和建筑室内外温湿度实测数据,进行建筑与气候适应性分析,根据焓湿图得到黄山市建筑室内的舒适程度以及最佳被动策略。利用PMV-PPD对室内环境进行评价,总结传统徽派民居在该气候条件下的舒适性优势及缺陷,并针对夏季炎热、冬季寒冷和空气潮湿问题提出应对策略,为当地新建民居的气候适应性设计提供理论参考。

基于Climate Consultant分析的沙巴地区传统民居生态智慧研究

本文运用Climate Consultant气象分析软件,通过对沙巴地区4个主要少数民族传统民居建筑的研究,提炼与总结当地传统民居在应对热湿气候环境时所采用的空间与构造策略;通过挖掘当地传统民居的生态设计价值,探讨了湿热地区的传统民居生态智慧的传承路径。

Utilization of Consultant Doctors’ Competence and Impact on Perceived Psychosocial Work Environment: A Pilot Study

Background: Work agencies that assign temporary jobs to doctors and nurses are becoming an increasing phenomenon. Aim: The purpose of this pilot study was to explore how consultant doctors (CDs) experience their competence as utilized in practice and what impact this has on their perceived psychosocial work environment. Methods: The findings are based on 11 interviews with CDs working on consultancy assignments in Norway. The CDs were all specialists in fields such as general practice, psychiatry, anesthesia, gynecology, orthopedics, and otolaryngology. Results: The competence that the CDs contributed to their hosting work organization was interpreted differently based on whether the consultant played an active role in the psychosocial work environment and also depended on the doctor’s specialty. Not being integrated into the hosting work organization enhanced the feeling of exclusion and the idea that little or no room was available to contribute one’s competence. Most of the CDs experienced their competence as being utilized to a certain extent, which strengthened their work satisfaction and feeling of playing an active role in the psychosocial work environment.

Are consultants in Colombo, Sri Lanka satisfied with their job?

Introduction: Job stress and job satisfaction play a key role in the work environment of an organization. These influence the behaviour of a doctor towards his or her co-workers, administration and, most importantly towards the patients. Objective: To assess job stress among consultants working in Colombo group of hospitals and to identify the factors that affect job satisfaction. Methods: A descriptive cross sectional study was conducted by using postal questionnaire on 262 consultants working in Colombo group of hospitals. Hospital consultants job stress and job satisfaction questionnaire developed by Amanda Ramirez et al. was used with their permission. Results: Of the 262 questionnaires mailed 171 were returned. Of total responded 84.6% reported extremely satisfied or satisfied with their work. Nearly 92% agreed intellectual stimulation by teaching contributed to their job satisfaction. Nearly 80% reported having a high level of responsibility, being perceived to do the job well by the colleagues, being able to bring about positive changes to the unit, having a high level of autonomy contributed to their job satisfaction. Poor administration and lack of facilities e.g. computers, filing procedures caused job stress in 73%. Threat of being sued for malpractice or having to deal with distressed relatives did not contribute to stress in nearly 80%. Conclusion: In Sri Lanka nearly 85% consultants reported they were satisfied with their job and teaching medical undergraduates and post graduates was one of the major contributory factors. However 73% indicated factors such as lack of resources, and poor administration cause stress at work. Providing computers and basic stationery for patient documentation and efficient and effective administration will improve the work output of consultants by reducing their stress levels.

Drug Prescribing Trends among Consultants and General Practitioners in Sharjah-UAE

Background: Inappropriate prescribing can lead to errors in dispensing medications and serious problems for patients. Objectives: Prescription analysis can identify such drawbacks of prescribing, increase awareness of prescribers of rational prescribing and consequently lead to proper delivery of pharmaceutical care and enhance therapeutic outcomes. Methods: In the present study, prescriptions issued by consultants from a hospital and by general practitioners from private practice in Sharjah-United Arab Emirates were analyzed using indicators suggested by World Health Organizations. These include information with regard to prescriber, patient and the medication prescribed. We also determined the average number of drugs/encounter and % of prescriptions with antibiotics and those with injections. Data were collected and analyzed using Microsoft Excel and expressed in terms of both counts and percentages. Results: Almost all prescriptions were handwritten with easily readable ones being 65% for consultants and 46% for general practitioners. Average number of drugs/encounter was 2.1 and 2.8 for consultants and general practitioners, respectively. Antibiotics were prescribed in 27% and 44%;generic prescribing was 5% and 10% by consultants and general practitioners respectively and 8% of prescriptions by consultants contained injections. Variable results were obtained on information regarding the patient but consultants seem to be better in documenting patient’s age and gender. Consultants and general practitioners tend to prescribe 3 drugs and more in 35% and 25% respectively. The most commonly prescribed therapeutic classes for both groups of prescribers were NSAIDs and antibiotics with ibuprofen and amoxicillin-clavulanic acid combination being the most commonly prescribed drugs of each class. Conclusion: To improve prescription writing, interventions must include, among others, incorporation of topics on prescription writing in medical curriculum and programs of continuing medical education.

Relationship between Project Consultants’ Performance and Project Success in the Rwandan Construction Industry

As discovered, today’s Rwandan construction industry is developing day by day, which plays a very important role in the country’s economic growth. In the construction industry, project consultants play a very significant role in providing services for such projects. The project consultants provide services from the beginning of the project to the completion of the project. Using project consultants is very useful for construction projects because it can ameliorate project efficiency and effectiveness. The main purpose of this paper is to investigate the relationship between project consultants’ performance and project success in the Rwandan construction industry. The data used in this study were obtained from primary and secondary sources. The secondary data was attained through an elaborated literature review of various books, articles, and papers related to this research to outlining and describing the chief ideas of this research title. The primary data was compiled through a questionnaire survey that was directed to 110 selected professionals in the construction projects in Rwanda to collect data from the site for statistical analysis of the research to test the hypothesis. However, a total of 90 usable responses were received within the scheduled period representing the response rate of 81.82%, which is likely to be representative and acceptable. Data collected from the questionnaire surveys were analyzed using the Statistical Package for Social Scientists (SPSS), excel spreadsheets, and Relative Importance Index (RII), which provide more merit presentations. The survey results show that even if there are many obstacles in the use of project consultants in the Rwandan construction industry such as lack of knowledge and practice in project consulting, lack of well-trained project consulting professionals, lack of training opportunities in project consulting, lack of knowledge and experience in addition to the senior management opposition, and lack of local project consulting guidelines and information;they are needed in the construction project to make it more successful through reducing and saving the overall project’s life cycle cost according to client’s wishes, keeping time of construction project, improving quality of the project products in the present and future, removing major variations that affect construction project with its attendant cost overrun, and advising on construction project process. Therefore, it is more important to remark that the good performance of the project consultants in any industry especially in the construction industry will contribute to the successful implementation of the project. From the results of the study, the performance of project consultants is closely related to the success of the construction industry in Rwanda. The project consultants’ leading skills and knowledge automatically guide the project to complete with accurate time, budget, and quality to make the project successful. In this paper, we will also consider the project success criteria;the role and responsibility of project consultants;the factors affecting the performance of project consultants;and the reasons that hinder the implementation of project consulting in the Rwandan construction industry.

Knowledge Transfer and Management Consulting:The Effect of Consultant and Client Characteristics

Knowledge transfer(KT)from the consultant to the client is an important area that needs to be repeatedly addressed and thoroughly understood.The aim of this research was to examine the assumption that client characteristics and consultant competencies play a defining role in the effective transfer of knowledge to the client party.The authors examined the critical aspects and competencies required of the consultant,and the characteristics and attitudes required of the client,which would contribute to a successful transfer of knowledge,through unstructured in-depth interviews and concise questionnaires.Eighty consulting assignments were studied from both the client side and the consultant side.A conceptual model is presented,factor analysis was used to validate the constructs,and partial least squares were used to test the model.The findings showed that the consultants’professionalism,skills,and behavior were significant contributors to KT to the client.Surprisingly,neither the consultant knowledge nor client characteristics had any significance to the KT to the client.

Beijing Guo Xun International Consultants Co., Ltd.

China has become a "hot spot" of foreign investment based on sustained development of its economy and huge potential market since implementing the reform and opening policy. In order to offer quality professional consultant service to foreign businessmen, the Beijing Guo Xun International Consultants Co., Ltd. was established in October 1993 by

Accidental placement of venous return catheter in the superior vena cava during venovenous extracorporeal membrane oxygenation for severe pneumonia: A case report

BACKGROUND Venovenous extracorporeal membrane oxygenation(V-V ECMO)has become an important treatment for severe pneumonia,but there are various complications during the treatment.This article describes a case with severe pneumonia success-fully treated by V-V ECMO,but during treatment,the retrovenous catheter,which was supposed to be in the right internal vein,entered the superior vena cava directly in the mediastinum.The ECMO was safely withdrawn after multidiscip-linary consultation.Our experience with this case is expected to provide a reference for colleagues who will encounter similar situations.CASE SUMMARY A 64-year-old man had severe pulmonary infection and respiratory failure.He was admitted to our hospital and was given ventilation support(fraction of inspired oxygen 100%).The respiratory failure was not improved and he was treated by V-V ECMO,during which the venous return catheter,which was supposed to be in the right internal vein,entered the superior vena cava directly in the mediastinum.There was a risk of massive mediastinal bleeding if the catheter was removed directly when the ECMO was withdrawn.Finally,the patient underwent vena cava angiography+balloon attachment+ECMO with-drawal in the operating room(prepared for conversion to thoracotomy for vascular exploration and repair at any time during surgery)after multidiscip-linary consultation.ECMO was safely withdrawn,and the patient recovered and was discharged.CONCLUSION Patients may have different vascular conditions.Multidisciplinary cooperation can ensure patient safety.Our experience will provide a reference for similar cases.

Assessment of Cardiovascular Risk Factors During Pregnancy: A Multicenter Study in West Africa, Dakar, Senegal

Context: Non-communicable diseases, including hypertension, are major causes of complications during pregnancy, posing significant risks to maternal and fetal health. Pregnancy increases cardiovascular risks, particularly through the development of gestational hypertension and preeclampsia, requiring early screening and close monitoring to prevent adverse outcomes. Objectives: This study aimed to evaluate the frequency of cardiovascular risk factors in pregnant women in Senegal and identify associated socio-behavioral and economic determinants. Methodology: A descriptive, analytical cross-sectional study with prospective data collection was conducted over three months (April 10 to July 10, 2023). The study included pregnant women aged 15 and older from three public hospital maternity wards in Senegal. We studied sociodemographic aspects, cardiovascular risk factors, and collected information on previous and current pregnancies, including the number of pregnancies, parity, miscarriages, the number of prenatal consultations, and the number of fetuses. Written consent was obtained. A p-value ≤ 0.05 was considered statistically significant. Results: A total of 222 pregnant women were enrolled, representing 28% of prenatal consultations. The average age was 29.18 years (range 15 - 47). Most participants (90%) lived in Dakar suburbs, 74.20% had no medical coverage, 84% worked in the informal sector (p = 0.043), and 18% had no education. Among them, 30.63% were in their first pregnancy, 34% were nulliparous, and 3.15% were grand multiparous. The average number of prenatal visits was 3.5, with about 40% having more than four visits. Risk factors included hypertension (17%), more prevalent in women over 30 (p = 0.043), diabetes (4%), and smoking (2%). Conclusion: The study highlights critical prenatal health needs and socio-economic challenges faced by pregnant women, emphasizing the need for targeted strategies to improve healthcare access and health education.

傣族传统民居建筑原型对气候设计策略的回应与补充研究

随着美丽乡村的建设与乡村振兴步伐的驱动,一些不当思潮与建设的侵袭,传统民居被大量模仿现代城市建筑的新建民居取代,简单实现了功能空间多样化的需求,却成为生态脆弱、品质较差、文化缺失的代表,民居发展面临种种困境。为了科学有效地助力传统民居传承及美丽乡村建设,如何深入挖掘潜藏于传统民居建筑原型中的绿色属性与生态经验,成为在理论研究方面人们关注的热点问题。选择云南省勐腊地区的水傣干栏式傣家竹楼传统民居为研究对象,基于被动式气候设计理论,针对傣家竹楼建筑原型,提炼民居应对湿热气候的被动式设计原型策略,比对Climate Consultant软件分析所得的被动式设计标准策略,探讨民居建筑原型的原型策略对标准策略的回应率。研究结果表明:傣家竹楼建筑原型在遮阳、防热、防雨、防潮、保温与节能等方面对标准策略的最低、最高回应率分别为67%与100%,平均回应率84.8%。受材料及技术条件的限制,部分策略的回应不足,但是通过其他的方法及措施可以得到很好的补充。傣族传统民居建筑原型的绿色特性及生态智慧,揭示了地域性传统建筑以地域自然、社会环境为约束,以建筑综合性能为核心的生态设计理论控制的科学原理。本研究的结果对湿热地区民居的设计建造及现代传承提供理论依据。

Medical consultation in ulcerative colitis:Key elements for improvement

Ulcerative colitis(UC)is a chronic inflammatory disease with a high impact.In order to improve patient outcomes,the clinician-patient relationship in daily practice is critical.Clinical guidelines provide a framework for UC diagnosis and treatment.However,standard procedures and the medical content focused upon medical consultations in UC patients has not yet been defined.Moreover,UC is a complex disease,given that patient characteristics and patient needs have been proven to vary during clinical consultation since establishing the diagnosis and upon the course of the disease.In this article,we have discussed the key elements and specific objectives to consider in medical consultation,such as diagnosis,first visits,follow-up visits,active disease patients,patients on topical therapies,new treatment initiation,refractory patients,extra-intestinal manifestations,as well as challenging situations.The key elements have been mentioned to comprise effective communication techniques,motivational interviewing(MI),as well as information and educational aspects,or organizational issues.The key elements to be implemented in daily practice were reported to comprise several general principles like duly prepared consultations,in addition to honesty and empathy with patients,as well as effective communication techniques,MI,information and educational points,or organizational issues.The role of other healthcare professionals such as specialized nurses,psychologists,or the use of checklists was also discussed and commented on.

Two surgical pathways for isolated hip fractures:A comparative study

BACKGROUND Hip fractures(HF)are common among the aging population,and surgery within 48 h is recommended.Patients can be hospitalized for surgery through different pathways,either trauma or medicine admitting services.AIM To compare management and outcomes among patients admitted through the trauma pathway(TP)vs medical pathway(MP).METHODS This Institutional Review Board-approved retrospective study included 2094 patients with proximal femur fractures(AO/Orthopedic Trauma Association Type 31)who underwent surgery at a level 1 trauma center between 2016-2021.There were 69 patients admitted through the TP and 2025 admitted through the MP.To ensure comparability between groups,66 of the 2025 MP patients were propensity matched to 66 TP patients by age,sex,HF type,HF surgery,and American Society of Anesthesiology score.The statistical analyses included multivariable analysis,group characteristics,and bivariate correlation comparisons with theχ^(2)test and t-test.RESULTS After propensity matching,the mean age in both groups was 75-years-old,62%of both groups were females,the main HF type was intertrochanteric(TP 52%vs MP 62%),open reduction internal fixation was the most common surgery(TP 68%vs MP 71%),and the mean American Society of Anesthesiology score was 2.8 for TP and 2.7 for MP.The majority of patients in TP and MP(71%vs 74%)were geriatric(≥65-years-old).Falls were the main mechanism of injury in both groups(77%vs 97%,P=0.001).There were no significant differences in pre-surgery anticoagulation use(49%vs 41%),admission day of the week,or insurance status.The incidence of comorbidities was equal(94%for both)with cardiac comorbidities being dominant in both groups(71%vs 73%).The number of preoperative consultations was similar for TP and MP,with the most common consultation being cardiology in both(44%and 36%).HF displacement occurred more among TP patients(76%vs 39%,P=0.000).Time to surgery was not statistically different(23 h in both),but length of surgery was significantly longer for TP(59 min vs 41 min,P=0.000).Intensive care unit and hospital length of stay were not statistically different(5 d vs 8 d and 6 d for both).There were no statistical differences in discharge disposition and mortality(3%vs 0%).CONCLUSION There were no differences in outcomes of surgeries between admission through TP vs MP.The focus should be on the patient’s health condition and on prompt surgical intervention.

Determinants of the Frequency of Prenatal Consultations among Women Giving Birth in the Maternity Wards of the Commune of Agbangnizoun (Zou), Benin

Antenatal care is a safe way to prevent pregnancy-related health problems, difficult deliveries and even further to anticipate low birth weight [1]. But pregnant women, especially in Africa, do not attend antenatal clinics as recommended by the WHO. The general objective of this study was to study the norm in terms of Antenatal Consultation (ANC) frequency as well as the determinants of the frequency among women who gave birth in the maternity hospitals of Agbangnizoun. Our research was a cross-sectional, descriptive, retrospective and quantitative type, which was carried out among 335 women in Agbangnizoun, Benin from 1 February to 3 April 2020 (3 months), in order to find out the general or specific characteristics of women that we associate with the frequency of prenatal consultation. At the end of the study, we found that 60%, 68% and 15% of the surveyed population had received ANC in the first, second and third trimesters, respectively. Ethnicity, income level of spouses over the three trimesters as well as the level of their knowledge and overall practice of ANC are determinants of the frequency of prenatal consultation.

Quality of Antenatal Care at the Referral Health Center of the Fourth Commune of Bamako District

Purpose: To contribute to the improvement of the quality of prenatal consultation at the reference health center of the commune IV of the district of Bamako. Patients Methods: This was a qualitative cross-sectional study to assess the quality of prenatal consultation that took place from December 1, 2017 to January 31, 2018. It included 139 pregnant women whose consultations were monitored by the investigator and then the women were interviewed upon discharge from the facility to collect their opinions on the services they received. Results: The age group of 20 to 29 years was the most represented with 60.44%. In our study, 50% of our patients were managed by midwives. Among the antecedents constituting the risk factors sought in pregnant women, scar uterus was more frequent with 33.93% followed by arterial hypertension with 14.28% and multiparity with 7.14%. Conclusion: This study shows that the evaluation of the quality of services is an absolute necessity for the improvement of services in integrated reproductive health care centers.