The diagnosis of chronic inflammatory demyelinating polyneuropathy: a Delphi-method approach.

The diagnosis of chronic inflammatory demyelinating polyneuropathy (CIDP) is based on a set of clinical and neurophysiological parameters. However, in clinical practice, CIDP remains difficult to diagnose in atypical cases. In the present study, 32 experts from 22 centers (the French CIDP study group) were asked individually to score four typical, and seven atypical, CIDP observations (TOs and AOs, respectively) reported by other physicians, according to the Delphi method. The diagnoses of CIDP were confirmed by the group in 96.9 % of the TO and 60.1 % of the AO (p < 0.0001). There was a positive correlation between the consensus of CIDP diagnosis and the demyelinating features (r = 0.82, p < 0.004). The European CIDP classification was used in 28.3 % of the TOs and 18.2 % of the AOs (p < 0.002). The French CIDP study group diagnostic strategy was used in 90 % of the TOs and 61 % of the AOs (p < 0.0001). In 3 % of the TOs and 21.6 % of the AOs, the experts had difficulty determining a final diagnosis due to a lack of information. This study shows that a set of criteria and a diagnostic strategy are not sufficient to reach a consensus for the diagnosis of atypical CIDP in clinical practice.

Malaria chemoprophylaxis recommendations for immigrants to Europe, visiting relatives and friends--a Delphi method study.

BACKGROUND: Numbers of travellers visiting friends and relatives (VFRs) from Europe to malaria endemic countries are increasing and include long-term and second generation immigrants, who represent the major burden of malaria cases imported back into Europe. Most recommendations for malaria chemoprophylaxis lack a solid evidence base, and often fail to address the cultural, social and economic needs of VFRs. METHODS: European travel medicine experts, who are members of TropNetEurop, completed a sequential series of questionnaires according to the Delphi method. This technique aims at evaluating and developing a consensus through repeated iterations of questionnaires. The questionnaires in this study included questions about professional experience with VFRs, controversial issues in malaria prophylaxis, and 16 scenarios exploring indications for prescribing and choice of chemoprophylaxis. RESULTS: The experience of participants was rather diverse as was their selection of chemoprophylaxis regimen. A significant consensus was observed in only seven of 16 scenarios. The analysis revealed a wide variation in prescribing choices with preferences grouped by region of practice and increased prescribing seen in Northern Europe compared to Central Europe. CONCLUSIONS: Improving the evidence base on efficacy, adherence to chemoprophylaxis and risk of malaria and encouraging discussion among experts, using techniques such as the Delphi method, may reduce the variability in prescription in European travel clinics.

The purpose and use of passenger ships in 2058 - Future scenarios generated by the Delphi method

The purpose of the thesis is to generate scenarios of future purposes and of use of ships, suitable for STX Finland Cruise Oy to design and build, over a 50 year time span by applying the Delphi method and an open innovation approach in a future workshop. The scenarios were mapped out with help of two Delphi survey rounds and one future workshop. The number of participants in both surveys and the workshop was some twenty experts in each, representing various fields. On the basis of the first survey round, four different subject areas were selected for analysis: purposes for the use of ships; energy efficiency of cruises and ships; cost efficiency of sea transportation and vacation; and the views and expectations of the customers in the future. As a result of the future workshop, four different themes were established, which were studied further during the second Delphi round. The themes are future service and operation concepts; versatile uses of the space in ships; communication of environmental benefits of ships, future energy solutions and social interaction between passengers onboard. In addition to generating the scenarios, further aim of the thesis is to implement the Delphi method and workshop activity as foresight tools for STX Europe and to produce a chart of a future shipbuilding foresight community to can serve the open innovation processes in the maritime cluster as a whole.

Kultúraközi szolgáltatásélmények vizsgálata a megalapozott elmélet módszerével (Examination of the intercultural service experiences with grounded theory method)

A cikk fókuszában az interkulturális szolgáltatással való találkozás áll. A téma jelentősége kétségen kívül áll, hiszen a szolgáltatások egyre növekvő térhódítása, valamint a globalizáció terjedése fontossá teszi annak ismeretét, hogy a különböző nemzeti kultúrából érkező szolgáltató és fogyasztó számára hogyan érhető el a legfőbb cél, az elégedettség. A szerzők jelen kutatásukban annak megértését helyezték a középpontba, hogy melyek azok a tényezők, amelyek befolyásolják a felek erőfeszítéseit a találkozás során fellépő problémák megoldásában. Kutatásuk során mélyinterjúkat folytattak mind a szolgáltatói, mind a fogyasztói oldallal, majd a megalapozott elmélet (grounded theory) konstruktivista irányzatának segítségével elemezték ezen interjúkat, és azonosították azokat a tényezőket, amelyek fontossá válhatnak egy kultúraközi szolgáltatásélmény során. A kutatás eredményei rámutatnak, hogy melyek azok a kommunikációs és kulturális korlátok, amelyek problémát okozhatnak, s hogy az e problémák megoldására tett erőfeszítések visszavezethetők az interakció résztvevőinek személyes jellemzőire, tapasztalataira, kulturális nyitottságára és ismereteire. A kutatás eredményeinek egyik fontos menedzseri következtetése, hogy a szállodákban a probléma jelentősége ellenére nem helyeznek elegendő hangsúlyt a kommunikációs és kulturális korlátok leküzdésére irányuló képzésekre, tréningekre. _____ This paper presents an attempt to analyse the possible solutions to problems that can occur during intercultural service encounters (ICSE). Using grounded theory the authors provide a theoretical framework that identifies the factors that lead to ICSE barriers. Based on in-depth interviews with service providers and clients they have defined the relevant characteristics that influence intercultural competence. Intercultural competence with communication and cultural differences lead to problems during ICSE that can be handled by both parties: the service provider and the client, as well. An important finding is that service companies should provide adequate training that concentrates not only on the cultural knowledge but it should create capability in understanding and adapting to cultural differences.

Indicateurs sécurité en obstétrique : une étude Delphi [Patient safety indicators for obstetrics: a Delphi based study]

OBJECTIVE: Clinical indicators are increasingly used to assess safety of patient care. In obstetrics, only a few indicators have been validated to date and none is used across specialties. The purpose of this study was to identify and assess for face and content validity a group of safety indicators that could be used by anaesthetists, obstetricians and neonatologists involved in labour and delivery units. MATERIALS AND METHODS: We first conducted a systematic review of the literature to identify potential measures. Indicators were then validated by a panel of 30 experts representing all specialties working in labour and delivery units. We used the Delphi method, an iterative questionnaire-based consensus seeking technique. Experts determined on a 7-point Likert scale (1=most representative/7=less representative) the soundness of each indicator as a measure of safety and their possible association with errors and complications caused by medical management. RESULTS: We identified 44 potential clinical indicators from the literature. Following the Delphi process, 13 indicators were considered as highly representative of safety during obstetrical care (mean score</=2.3). Experts ranked 6 of these indicators as being strongly associated to potential errors and complications. CONCLUSIONS: We identified and validated for face and content, a group of six clinical indicators to measure potentially preventable iatrogenic complications in labour and delivery units.

Observations on Software Testing Practice

This thesis investigates factors that affect software testing practice. The thesis consists of empirical studies, in which the affecting factors were analyzed and interpreted using quantitative and qualitative methods. First, the Delphi method was used to specify the scope of the thesis. Secondly, for the quantitative analysis 40industry experts from 30 organizational units (OUs) were interviewed. The survey method was used to explore factors that affect software testing practice. Conclusions were derived using correlation and regression analysis. Thirdly, from these 30 OUs, five were further selected for an in-depth case study. The data was collected through 41 semi-structured interviews. The affecting factors and their relationships were interpreted with qualitative analysis using grounded theory as the research method. The practice of software testing was analyzed from the process improvement and knowledge management viewpoints. The qualitative and quantitativeresults were triangulated to increase the validity of the thesis. Results suggested that testing ought to be adjusted according to the business orientation of the OU; the business orientation affects the testing organization and knowledge management strategy, and the business orientation andthe knowledge management strategy affect outsourcing. As a special case, the complex relationship between testing schedules and knowledge transfer is discussed. The results of this thesis can be used in improvingtesting processes and knowledge management in software testing.

Experts' consensus on use of electronic cigarettes: a Delphi survey from Switzerland.

OBJECTIVES: In some countries, nicotine-containing electronic cigarettes (e-cigarettes) are considered a consumer product without specific regulations. In others (eg, Switzerland), the sale of e-cigarettes containing nicotine is forbidden, despite the eagerness of many smokers to obtain them. As scientific data about efficacy and long-term safety of these products are scarce, tobacco control experts are divided on how to regulate them. In order to gain consensus among experts to provide recommendations to health authorities, we performed a national consensus study. SETTING: We used a Delphi method with electronic questionnaires to bring together the opinion of Swiss experts on e-cigarettes. PARTICIPANTS: 40 Swiss experts from across the country. OUTCOME MEASURES: We measured the degree of consensus between experts on recommendations regarding regulation, sale, use of and general opinion about e-cigarettes containing nicotine. New recommendations and statements were added following the experts' answers and comments. RESULTS: There was consensus that e-cigarettes containing nicotine should be made available, but only under specific conditions. Sale should be restricted to adults, using quality standards, a maximum level of nicotine and with an accompanying list of authorised ingredients. Advertisement should be restricted and use in public places should be forbidden. CONCLUSIONS: These recommendations encompass three principles: (1) the reality principle, as the product is already on the market; (2) the prevention principle, as e-cigarettes provide an alternative to tobacco for actual smokers, and (3) the precautionary principle, to protect minors and non-smokers, since long-term effects are not yet known. Swiss authorities should design specific regulations to sell nicotine-containing e-cigarettes.

Características y funciones para marcas de lugar a partir de un método Delphi

[ES] Introducción. La representación de territorios mediante el uso de marcas es una cuestión recurrente en la sociedad contemporánea que vivimos. Este artículo tiene por objetivo principal determinar algunas de las características y funciones que presentan las marcas asociadas a espacios geográficos. Metodología. Se ha optado por una investigación cualitativa vehiculada a partir de un método Delphi conformado por un panel de catorce expertos en marcas de lugar. Resultados. En relación con las marcas comerciales, se constata que las marcas de lugar, por su naturaleza de bien público, requieren de una gestión más compleja, preferentemente a tres niveles: administración pública, organizaciones privadas y ciudadanía. Conclusiones. En función de los resultados obtenidos, se concluye que la gestión de los lugares se encuentra nuevamente ocupada en la proyección de identidades espaciales singulares, en el marco de una creciente competencia entre territorios.

The Future of Physical Education in Higher Education: A Delphi Investigation

Despite the profound and widespread concern for the future of higher education physical education, there has been little systematic study on the topic. This research investigated the future by utilizing a two-round interview Delphi method. Five international experts were asked to project possible, probable, preferable and undesirable futures of the academic discipline in fifteen years time; specifically in regards to issues within the undergraduate degree programs, and the research sub-disciplines. The results of quantitative descriptive statistics and qualitative content analysis reveal an ever-changing higher education environment in the postmodern information age, which presents a complicating future for the academic discipline. The experts expressed concern that some disciplinarians will be a-futuristic and unable to operationalize the vast potential of the discipline at the institutional level, by continuing to use outdated and inappropriate frameworks of a modern era gone by.

Restorative dentistry and restorative materials over the next 20 years: A Delphi survey

OBJECTIVES The aim of this study was to forecast trends in restorative dentistry over the next 20 years and to identify treatment goals and corresponding properties of restorative materials. METHODS Using the Delphi method, a panel of 3 experts identified 8 key questions, which were sent to experts in restorative and preventive dentistry. In round 1 of this survey, 15 international experts devised a clearer semantic definition of the key questions and the completion of respective items for two additional rounds. In round 2, 125 experts from 35 countries rated the items developed in round 1 using a Likert scale. In round 3, the same 125 experts received the ratings of round 2 and were asked to agree or disagree to these ratings by re-voting on all key questions and items. A total of 105 experts re-voted and finally took part in the complete survey. Among the 8 key questions, two questions were selected for the present report: (Q1) "What will be the future role of restorative treatment?" and (Q6) "What will be the key qualities for clinical success of restorations?" For both questions and the respective items, the experts were asked to evaluate the importance and the feasibility for later calculation of the scientific value (i.e. the opportunity, where opportunity=importance+[importance-feasibility]). RESULTS The three items of highest importance for Q1 were "preservation of existing enamel and dentin tissue," "prevention of secondary caries," and "maintenance of the pulp vitality," and for Q6 they were "optimization of adhesion," "biocompatibility," and "minimizing technical sensitivity." SIGNIFICANCE Bioactivity toward the pulp-dentin complex and prevention of secondary caries were the items generally rated as having the highest opportunity.

Practitioners' Views of Family Strengths: A Delphi Study

Reported is a research study to assess the opinions of family practitioners on the status of families in Oklahoma. Researchers employed the Delphi method to achieve consensus among key informants in the family practice field about the strengths and weaknesses of Oklahoma families, threats facing families in the state, and means to strengthening family life in Oklahoma. The study yielded qualitative data from the key informants, which the researchers then condensed into response categories to feed back to informants to rate. Family practitioners identified resilience, spirituality, and access to support systems as the greatest strengths, and listed substance abuse, poverty, and generational cycles of dysfunction as the greatest weaknesses of Oklahoma families. Recommendations by these practitioners are given for improvements in addressing family needs.

Use of a modified delphi process for establishing occupational exposure limits in support of health surveillance for space travelers

On-orbit exposures can come from numerous factors related to the space environment as evidenced by almost 50 years of environmental samples collected for water analysis, air analysis, radiation analysis, and physiologic parameters. For astronauts and spaceflight participants the occupational exposures can be very different from those experienced by workers performing similar tasks in workplaces on Earth, because the duration of the exposure could be continuous for very long orbital, and eventually interplanetary, missions. The establishment of long-term exposure standards is vital to controlling the quality of the spacecraft environment over long periods. NASA often needs to update and revise its prior exposure standards (Spacecrafts Maximum Allowable Concentrations (SMACs)). Traditional standards-setting processes are often lengthy, so a more rapid method to review and establish standards would be a substantial advancement in this area. This project investigates use of the Delphi method for this purpose. ^ In order to achieve the objectives of this study a modified Delphi methodology was tested in three trials executed by doctoral students and a panel of experts in disciplines related to occupational safety and health. During each test/trial modifications were made to the methodology. Prior to submission of the Delphi Questionnaire to the panel of experts a pilot study/trial was conducted using five doctoral students with the goals of testing and adjusting the Delphi questionnaire to improve comprehension, work out any procedural issues and evaluate the effectiveness of the questionnaire in drawing the desired responses. The remainder of the study consisted of two trials of the Modified Delphi process using 6 chemicals that currently have the potential of causing occupational exposures to NASA astronauts or spaceflight participants. To assist in setting Occupational Exposure Limits (OEL), the expert panel was established consisting of experts from academia, government and industry. Evidence was collected and used to create close-ended questionnaires which were submitted to the Delphi panel of experts for the establishment of OEL values for three chemicals from the list of six originally selected (trial 1). Once the first Delphi trial was completed, adjustments were made to the Delphi questionnaires and the process above was repeated with the remaining 3 chemicals (trial 2). ^ Results indicate that experience in occupational safety and health and with OEL methodologies can have a positive effect in minimizing the time experts take in completing this process. Based on the results of the questionnaires and comparison of the results with the SMAC already established by NASA, we conclude that use of the Delphi methodology is appropriate for use in the decision-making process for the selection of OELs.^

Delphi study for the design and validation of a questionnaire about digital competences in higher education

The study of digital competence remains an issue of interest for both the scientific community and the supranational political agenda. This study uses the Delphi method to validate the design of a questionnaire to determine the perceived importance of digital competence in higher education. The questionnaire was constructed from different framework documents in digital competence standards (NETS, ACLR, UNESCO). The triangulation of non-parametric techniques made it possible to consolidate the results obtained through the Delphi panel, the suitability of which was highlighted through the expert competence index (K). The resulting questionnaire emerges as a good tool for undertaking future national and international studies on digital competence in higher education.