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。

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。

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。

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.

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.

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。

Impact of Tools and Techniques for Securing Consultancy Services

In a digital world moving at a breakneck speed,consultancy services have emerged as one of the prominent resources for seeking effective,sustainable and economically viable solutions to a given crisis.The present day consultancy services are aided by the use of multiple tools and techniques.However,ensuring the security of these tools and techniques is an important concern for the consultants because even a slight malfunction of any tool could alter the results drastically.Consultants usually tackle these functions after establishing the clients’needs and developing the appropriate strategy.Nevertheless,most of the consultants tend to focus more on the intended outcomes only and often ignore the security-specific issues.Our research study is an initiative to recommend the use of a hybrid computational technique based on fuzzy Analytical Hierarchy Process(AHP)and fuzzy Technique for Order Preference by Similarity to Ideal Solutions(TOPSIS)for prioritizing the tools and techniques that are used in consultancy services on the basis of their security features and efficacy.The empirical analysis conducted in this context shows that after implementing the assessment process,the rank of the tools and techniques obtained is:A7>A1>A4>A2>A3>A5>A6>A7,and General Electric McKinsey(GE-McKinsey)Nine-box Matrix(A7)obtained the highest rank.Thus,the outcomes show that this order of selection of the tools and techniques will give the most effective and secure services.The awareness about using the best tools and techniques in consultancy services is as important as selecting the most secure tool for solving a given problem.In this league,the results obtained in this study would be a conclusive and a reliable reference for the consultants.

A working model of the Internet-based steel construction consulting system for architects

As Internet becomes largely used in the AEC (architecture, engineering andconstruction) industry, the main focus is in the area of information and project management. In thedynamic engineering consulting, less has been done so far. This research tries to find thepossibility and potential of the Internet application in design and consulting for the AEC industryby proposing a working model in specific area, steel construction. Several issues have beendiscussed: defining and formatting the typical procedure and character of the steel constructionconsulting, behavior approach based on activities among partners, and the model organization.

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.

Physicians’Perception of Palliative Care Consultation Service in a Major General Hospital in China

Objectives The in-hosptial palliative care consultation(PCC) is emerging as a routine service in some medical center in China. The current study evaluated how physicians in primary care team and consultation team perceive the PCC service for the purpose of investigating the effectiveness of this consultation model in a general hospital.Methods In-hosptial palliative care consultations have been carried out at Peking Union Medical College Hosptial by a dedicated consultation team, and 37 consultations were completed in 2016. A questionnaire was designed for physicians in terms of its benefits to patients,their family as well as the primary care team. Physicians who applied for consultation in 2016 formally(requested from the department other than the Geriatrics) and informally(by rotating residents and unemployed visiting doctors in geriatric department) were invited to participate in the survey by scanning a two dimentional code on social networking platform.Results There were 103 physicians participated in the survey, including primary care physicians from the department of Internal Medicine(n=8), Gynaecology(n=16) and Surgery(n=13), rotating residents(n=30), visiting doctors(n=16) in Geriatric department, and PCC team members(n=20). 94.0% of the non-PCC physicians agreed that PCC relieved the suffering of patients; 89.2% thought PCC improved the quality of patients' life; there were 91.6%, 95.2%, 90.4% physicians who felt it relieved the anxiety of patients, of family members and of care providers, respectively. There were 96.4% physicians who felt it could ease the tension in physician-patient relationship; 97.6% felt it lower the risk for medical negligence, and 96.4% of doctors who applied for PPC felt satisfied with PCC service in terms of process and achieving objectives of consultation. More primary-team physician agree "PCC service helps the physicians better understand palliative care" than PCC members(97.6% vs. 80%, P<0.05), while both were interested in learning more on palliative medicine(100% vs. 96.4%, P>0.05).Conclusion Palliative care consultation service in a general hospital is efficacious and acclaimed.The primary care physicians and the PCC members hold positive attitudes to the benefits that the PCC services bring to patients, family members, and physicians themselves. PCC for terminal patients in a general hospital may serve as a good modle for promotion of palliative care in China.

Reliable transmission of consultative committee for space data systems file delivery protocol in deep space communication

In consultative committee for space data systems（CCSDS） file delivery protocol（CFDP） recommendation of reliable transmission,there are no detail transmission procedure and delay calculation of prompted negative acknowledge and asynchronous negative acknowledge models.CFDP is designed to provide data and storage management,story and forward,custody transfer and reliable end-to-end delivery over deep space characterized by huge latency,intermittent link,asymmetric bandwidth and big bit error rate（BER）.Four reliable transmission models are analyzed and an expected file-delivery time is calculated with different trans-mission rates,numbers and sizes of packet data units,BERs and frequencies of external events,etc.By comparison of four CFDP models,the requirement of BER for typical missions in deep space is obtained and rules of choosing CFDP models under different uplink state informations are given,which provides references for protocol models selection,utilization and modification.

Patient Participation in Communication about Treatment Decision-Making for Localized Prostate Cancer during Consultation Visits

Objectives: To describe the communication behaviors of patients and physicians and patient par-ticipation in communication about treatment decision-making during consultation visits for local-ized prostate cancer (LPCa). Methods: This is a secondary analysis of data from 52 men enrolled in the usual care control group of a randomized trial that focused on decision-making for newly diagnosed men with LPCa. We analyzed the patient-physician communication using the transcribed audio-recordings of real-time treatment consultations and a researcher-developed coding tool, including codes for communication behaviors (information giving, seeking, and clarifying/ verifying) and contents of clinical consultations (health histories, survival/mortality, treatment options, treatment impact, and treatment preferences). After qualitative content analysis, we categorized patient participation in communication about treatment-related clinical content, including “none” (content not discussed);“low” (patient listening only);“moderate” (patient providing information or asking questions);and “high” (patient providing information and asking questions). Results: Physicians mainly provided information during treatment decision consultations and patients frequently were not active participants in communication. The participation of patients with low and moderate cancer risk typically was: 1) “moderate and high” in discussing health histories;2) “low” in discussing survival/mortality;3) “low and moderate” in discussing treatment options;4) “none and low” in discussing treatment impacts;and 5) “low” in discussing treatment preferences. Conclusions: Findings suggest opportunities for increasing patient participation in communication about treatment decision-making for LPCa during clinical consultations.

Update summarising the conclusions of the international consultation on male lower urinary tract symptoms

The International Consultation on Urological Disease have recently published comprehensive conclusions, based on evidence reviewed by eight committees, on aspects of male lower urinary tract symptoms(LUTS). In this review, we summarise the conclusions from fourof the committees, namely, the evidence regarding the epidemiology of male LUTS, patient assessment, nocturia and medical management. It is indisputable that with an expanding and ageing global population the prevalence of male LUTS is likely to increase. Therefore symptom prevention and preservation of quality of life(Qo L) feature highly in the guidelines. There are now a number of different medical options, proven to lead to significant improvements in symptom scores, flow rate and Qo L available to men with LUTS. Metaanalyses have shown the benefits for alpha blockers, antimuscarinics, 5-α reductase and phosphodiesterase-5 inhibitors. High level evidence also exists for combinations of all of the above with alpha blockers and so men with concomitant storage symptoms, prostate volume > 30 mL, PSA > 1.4 or erectile dysfunction may be considered for combination treatment of an alpha blocker with an antimuscarinic, 5-α reductase inhibitor or phosphodiesterase-5 inhibitor respectively. In an era of personalised medicine, appropriate patient selection is likely to provide the key to the most effective clinical management strategy.

Function of Management Consultation in Implementation of ERP Project

ERP(enterprise resource planning) is a huge and com pl ex system engineering which costs a great lot of fund and manpower. It is a refo rm in the enterprise management mode, management idea and management method whi ch needs mass fund import, with long period, full of risk, hard to perform and can’t show its effects at once. The essence of the enterprise performing in ERP system is to run a "management engineering", which involves integration of opera tion process. The integration will touch business culture, enterprise system,m eans of operation and the department’s regulatioins amongst the operation conten ts, rights and responsibilities. Totally, the ERP system is the rebuilding of ma ngagement idea, method and means, which needs the common acquaintance from the t op management to the whole stuff.Meantime, it requires a perfect tactic to perfo rm an ERP system. We must confirm a cut-in spot as the right space to start bas ed on the enterprise requirement and the application environment. And to choose a right space decides that the application of ERP system is successful or not. S o, we must make it clear to build which subsystem first, to take the right seque nce for performing all kinds of function modules and the final integrated functi ons . All this prepared work for the implement of ERP system and the management, the recombination and optimization of enterprise management operation flow, ite m management and harmonization, ERP educational training and so on can not be pe rformed well without management consultancy. The effective management consultan cy can lead then implement of ERP system to shorten the executive cycle, to quik en the realization of effect and to harmonize the relationship to the client ent erprises so that to ensure the successful perform of ERP.

Information seeking and anxiety among colonoscopy-na?ve adults: direct-to-colonoscopy vs traditional consult-first pathways

AIM To investigate the effects of direct to colonoscopy pathways on information seeking behaviors and anxiety among colonoscopy-na?ve patients.METHODS Colonoscopy-na?ve patients at two tertiary care hospitals completed a survey immediately prior to their scheduled outpatient procedure and before receiving sedation.Survey items included clinical pathway(direct or consult),procedure indication(cancer screening or symptom investigation),telephone and written contact from the physician endoscopist office,information sources,and pre-procedure anxiety.Participants reported pre-procedure anxiety using a 10 point scale anchored by "very relaxed"(1) and "very nervous"(10).At least three months following the procedure,patient medical records were reviewed to determine sedative dose,procedure indications and any adverse events.The primary comparison was between the direct and consult pathways.Given the very different implications,a secondary analysis considering the patient-reported indication for the procedure(symptoms or screening).Effects of pathway(direct vs consult) were compared both within and between the screening and symptom subgroups.RESULTS Of 409 patients who completed the survey,34% followed a direct pathway.Indications for colonoscopy were similar in each group.The majority of the participants were women(58%),married(61%),and internet users(81%).The most important information source was family physicians(Direct) and specialist physicians(Consult).Use of other information sources,including the internet(20% vs 18%) and Direct family and friends(64% vs 53%),was similar in the Direct and Consult groups,respectively.Only 31% of the 81% who were internet users accessed internet health information.Most sought fundamental information such as what a colonoscopy is or why it is done.Pre-procedure anxiety did not differ between care pathways.Those undergoing colonoscopy for symptoms reported greater anxiety [mean 5.3,95%CI: 5.0-5.7(10 point Likert scale)] than those for screening colonoscopy(4.3,95%CI: 3.9-4.7).CONCLUSION Procedure indication(cancer screening or symptom investigation) was more closely associated with information seeking behaviors and pre-procedure anxiety than care pathway.

On-table hepatopancreatobiliary surgical consults for difficult cholecystectomies:A 7-year audit

Background: Cholecystectomy is considered a general surgical operation. However, general surgeons are not trained to manage severe complications such as bile duct injury(BDI) and should refer to hepatopancreatobiliary(HPB) surgeons when difficulty arises. This study aimed to investigate the outcomes of patients who had on-table HPB consults during cholecystectomy. Methods: This is an audit of 50 patients who required on-table HPB consult during cholecystectomy from 2011 to 2017. Consultations were classified as “proactive” and “reactive”, where consults were made before or after surgical incision, respectively. Patient demographics and perioperative details were collected. Results: The median age of the patients was 62.5 years [interquartile range(IQR) 50.8–71.3 years]. Eight(16%) patients had underlying HPB co-morbidity. Gallbladder wall was thickened in all patients(median 5 mm, IQR 4–7 mm), and common bile duct was of normal caliber in all patients(median 5 mm, IQR 4–6 mm). Median length of operation and length of stay were 165 min(IQR 124–209 min) and five days(IQR 3–7 days), respectively. Subtotal cholecystectomy was performed in 18(36%) patients. Forty-eight patients were initially managed by laparoscopic approach, 15(31%) required open conversion;majority(9/15, 60%) were initiated before on-table consult. Majority of referrals(98%) were reactive. Common reasons for referral included unclear anatomy or anatomical variations(30%), presence of dense adhesions and/or contracted gallbladder(18%) and impacted stones in Hartmann’s pouch(16%). Three(6%) patients were referred for BDI(2 Strasberg D and 1 Strasberg E1), and two(4%) were referred for torrential bleeding from arterial injury(1 cystic artery and 1 right hepatic artery). Any morbidity and 30-day readmission were 22% and 6%, respectively. There was no 90-day mortality. Conclusions: Calling for help in BDI is obligatory, but in other instances is a personal choice. Calling for help prior to open conversion is lacking and this awareness should be raised. Whether surgical outcomes could be improved by early HPB consult needs to be determined by larger multicenter reports.

Annual Consultation on the Likelihood of Earthquakes in Continental China: Its Scientific and Practical Merits

Since the 1970s, Chinese seismologists have started to conduct the Annual Consultation on the Likelihood of Coming Earthquakes in the Next Year. This approach has unique scientific and practical merits either as an active response to the social needs in the situation that earthquake prediction research meets many difficulties, or as a real forward prediction test persistently conducted for 1/3 century. It is a pity that such an approach has not been well-known by international seismological community, and the scientific merits of such an endeavor is sometimes regrettably underestimated.

Family Forest Owners’ Motivation to Control Understory Vegetation: Implications for Consulting Forestry

Forest vegetation management has evolved as a recognized component of intensive forest management practice. It involves the management of competing vegetation necessary to obtain the high yields expected in modern forest plantations via control of interfering plants that influence regeneration outcome, impact timber stand development, and limit native plant and wildlife diversity. It includes cultural control, fire control, mechanical control, biological control, and chemical control. The public perception of forest vegetation management, especially chemical control, is sometimes negative due to health and environmental concerns. It is an important tool in the forest management alternatives available to consulting foresters managing family forest lands (the vast majority of private forest land in the United States). We report on a study that addresses the motivations of family forest owners that implement forest vegetation management practices and the motivation of those who chose not to implement after forester recommendations to do so. For those who do implement forest vegetation management, improvement of wildlife habitat and increased timber growth was the main motivation. For those who did not, cost was the main concern. Size of forest holding plays a major role in determining who will practice intensive forestry.