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。

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。

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.

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.

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.

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

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.

A Prospective Survey Comparing Patients’ Experience of a Nurse-Led Clinic and Consultant-Led Clinic for Surveillance of Patients with Dilatation of the Intrathoracic Aorta

Background: Increasing workload in consultant-led clinics often means patients to wait a long time for clinic appointments. To address this, there is an increasing trend in developing nurse-led clinics across many specialities in the National Health Service. This study aims to assess whether the implementation of a nurse-led clinic in thoracic aortic surgery will optimise the utilisation of health care services and improve overall patient satisfaction. Methods: 80 follow-up patients were asked to complete a questionnaire following their appointment in an aortic clinic, which was led either by a consultant (n = 40) or an aortic specialist nurse (n = 40). All patients seen by a nurse in the clinic were assessed by a consultant surgeon prior to the clinic for suitability. No new patients were seen by a nurse. Any patient with an aortic dimension of 5 cm or greater was seen by the consultant. If there were any complicated clinical features, the patient was seen in the consultant-led clinic. Patients were asked questions about their time spent with the respective health care professionals across 12 categories (punctuality, preparedness, understanding of concerns, clarity of speech, listening, respect, explaining, letting you talk, putting you at ease, emotional support, advice and advice for next follow-up). Patients rated each category using an ordinal scale from 0 - 10. Results: Patient scores were greater in nurse-led clinics compared to consultant-led clinics across a number of categories although only punctuality reached significance (mean 9.2 vs. 6.8, p 0.05). Conclusion: Patients were highly satisfied with the nurse-led clinic across all categories, with greater satisfaction for punctuality. These findings suggest that a nurse-led clinic can be implemented for the management of carefully selected thoracic aortic surgery patient without reduction in patient satisfaction.

共病药物治疗决策--全科医生接诊病案研究

慢性病共病患者常联合使用多种药物,疾病与药物之间潜在的复杂相互作用使全科医生面临着难以合理评估共病药物治疗获益与风险的决策困境。本文以1例在社区卫生服务中心就诊的慢性病共病患者为例,展示和阐述了全科医生运用共病药物治疗决策框架进行科学决策的过程,并基于阿里阿德涅原则为共病管理过程提出的多阶段目标,分析了全科医生在评估、沟通与制定治疗方案等方面的要点和注意事项。希望本文可以为改善社区慢性病共病药物治疗决策的质量提供借鉴。

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.

爱思唯尔——MD consult临床医学的综合图书馆

随着网络的普及与信息技术的发展,利用互联网获取信息已成为人们重要的信息渠道。外文医学期刊是医学工作者的重要信息源,目前电子版及网络版期刊发展迅速,一些网络期刊建立了自己的网站;大型出版商、信息服务机构、数据库生产商等组织了一定数量的电子期刊集中上网,形成了有自己特点的数据库或综合电子图书馆,本文系统介绍MD—consult数据库所包含的十大项目,以其内容丰富、数据权威、快捷方便的检索功能和实用性等特点,为临床专家、医师、药剂师、护士、医学图书馆及其医学院校的学生和病患等人员提供全方位的信息服务。

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.