A cohort study of early neurological consultation by telemedicine on the care of neurological inpatients

Objectives: To find out the effect of early neurological consultation using a real time video link on the care of patients with neurological symptoms admitted to hospitals without neurologists on site. Methods: A cohort study was performed in two small rural hospitals: Tyrone County Hospital (TCH), Omagh, and Erne Hospital, Enniskillen. All patients over 12 years of age who had been admitted because of neurological symptoms, over a 24 week period, to either hospital were studied. Patients admitted to TCH, in addition to receiving usual care, were offered a neurological consultation with a neurologist 120 km away at the Neurology Department of the Royal Victoria Hospital, Belfast, using a real time video link. The main outcome measure was length of hospital stay; change of diagnosis, mortality at 3 months, inpatient investigation, and transfer rate and use of healthcare resources within 3 months of admission were also studied. Results: Hospital stay was significantly shorter for those admitted to TCH (hazard ratio 1.13; approximate 95% Cl 1.003 to 1.282; p = 0.045). No patients diagnosed by the neurologist using the video link subsequently had their diagnosis changed at follow up. There was no difference in overall mortality between the groups. There were no differences in the use of inpatient hospital resources and medical services in the follow up period between TCH and Erne patients. Conclusions: Early neurological assessment reduces hospital stay for patients with neurological conditions outside of neurological centres. This can be achieved safely at a distance using a real time video link.

An exploration of the needs and goals of the health professional and patient in a medical consultation

This Study is the first phase of a three-phase study continuing over three years. Twent)' health professionals from different disciplinary backgrounds (medical doctors, nurses, allied health professionals) and 20 patients across a range of medical condidons, education, gender, and socio-economic backgrounds, pardcipated in one-on-one semi-structured interviews. Participants described their experiences and percepdons of both effecdve and sadsfying medical consultations and dissadsf)'ing and ineffecdve ones. They also discussed their individual goals and needs in the consultation process. Results indicated that while there were some similarides in consultation goals and needs between health professionals, there were also clear differences across the different discipUnes. In addition, there were clear differences in goals and needs across the twenty padents. These findings are discussed within the framework of communicadon accommodadon theor}' (CAT) and the linguisdc model of padent pardcipadon (LMOPP) and focus on understanding the different dynamics that underpin varying health professional and padent interacdons.

Embodied expertise: women's perceptions of the contraception consultation

This research, based on qualitative interviews and non-participant observation, emerges from a larger study investigating what factors influence the ‘contraceptive careers’ of British women in their 30s. The women informants recognized that contraceptive products often impacted on their health, but viewed them as distinct from ‘medical matters’. Rather than doctors being seen as having expertise, it was women health professionals, be they nurses, midwives, health visitors or doctors, who were perceived as the ones who ‘know’ about contraception, through an assumption that they are contraception users.This embodied knowledge is valued by the women above their formal medical training. I will also show how general practice surgeries and family planning clinics were viewed as gendered spaces, which altered the expectations and experiences of the women during contraceptive consultations. This study found that as ‘real’ expertise over contraception stems from embodied rather than textual knowledge, the women’s choices were grounded by a gendered sense of trust.

Working together to protect crowded places:a consultation document

Aims to help local partners understand their role and the contributions they can make to reducing the vulnerability of crowded places at risk to terrorist attack by incorporating counter terrorist protective security advice into their existing work to improve community safety. Provides advice about how risk will be assessed and local performance managed and explains the roles of key partners in delivering reductions in the vulnerabilities of crowded places to terrorist attack.

Society of Legal Scholars Criminal Justice Section Response to Sexual Offences Guideline Consultation (Sentencing Council Consultation 2012-2013)

Consultation Report

Representation and misrepresentation of scientific evidence in contemporary tobacco regulation:a review of tobacco industry submissions to the UK Government consultation on standardised packaging

BACKGROUND: Standardised packaging (SP) of tobacco products is an innovative tobacco control measure opposed by transnational tobacco companies (TTCs) whose responses to the UK government's public consultation on SP argued that evidence was inadequate to support implementing the measure. The government's initial decision, announced 11 months after the consultation closed, was to wait for 'more evidence', but four months later a second 'independent review' was launched. In view of the centrality of evidence to debates over SP and TTCs' history of denying harms and manufacturing uncertainty about scientific evidence, we analysed their submissions to examine how they used evidence to oppose SP. METHODS AND FINDINGS: We purposively selected and analysed two TTC submissions using a verification-oriented cross-documentary method to ascertain how published studies were used and interpretive analysis with a constructivist grounded theory approach to examine the conceptual significance of TTC critiques. The companies' overall argument was that the SP evidence base was seriously flawed and did not warrant the introduction of SP. However, this argument was underpinned by three complementary techniques that misrepresented the evidence base. First, published studies were repeatedly misquoted, distorting the main messages. Second, 'mimicked scientific critique' was used to undermine evidence; this form of critique insisted on methodological perfection, rejected methodological pluralism, adopted a litigation (not scientific) model, and was not rigorous. Third, TTCs engaged in 'evidential landscaping', promoting a parallel evidence base to deflect attention from SP and excluding company-held evidence relevant to SP. The study's sample was limited to sub-sections of two out of four submissions, but leaked industry documents suggest at least one other company used a similar approach. CONCLUSIONS: The TTCs' claim that SP will not lead to public health benefits is largely without foundation. The tools of Better Regulation, particularly stakeholder consultation, provide an opportunity for highly resourced corporations to slow, weaken, or prevent public health policies.

Social media and sentiment in bioenergy consultation

he push to widen participation in public consultation suggests social media as an additional mechanism through which to engage the public. Bioenergy companies need to build their capacity to communicate in these new media and to monitor the attitudes of the public and opposition organisations towards energy development projects. Design/methodology/approach This short paper outlines the planning issues bioenergy developments face and the main methods of communication used in the public consultation process in the UK. The potential role of social media in communication with stakeholders is identified. The capacity of sentiment analysis to mine opinions from social media is summarised, and illustrated using a sample of tweets containing the term ‘bioenergy’ Findings Social media have the potential to improve information flows between stakeholders and developers. Sentiment analysis is a viable Purpose The push to widen participation in public consultation suggests social media as an additional mechanism through which to engage the public. Bioenergy companies need to build their capacity to communicate in these new media and to monitor the attitudes of the public and opposition organisations towards energy development projects. Design/methodology/approach This short paper outlines the planning issues bioenergy developments face and the main methods of communication used in the public consultation process in the UK. The potential role of social media in communication with stakeholders is identified. The capacity of sentiment analysis to mine opinions from social media is summarised, and illustrated using a sample of tweets containing the term ‘bioenergy’ Findings Social media have the potential to improve information flows between stakeholders and developers. Sentiment analysis is a viable methodology, which bioenergy companies should be using to measure public opinion in the consultation process. Preliminary analysis shows promising results. Research limitations/implications Analysis is preliminary and based on a small dataset. It is intended only to illustrate the potential of sentiment analysis and not to draw general conclusions about the bioenergy sector. Originality/value Opinion mining, though established in marketing and political analysis, is not yet systematically applied as a planning consultation tool. This is a missed opportunity.

Policy Consultation and Political Styles : Renewable energy consultations in the UK and Denmark

Peer reviewed

Policy Consultation and Political Styles : Renewable energy consultations in the UK and Denmark

Peer reviewed