923 resultados para Expert consultation


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Over the last decade issues related to the financial viability of development have become increasingly important to the English planning system. As part of a wider shift towards the compartmentalisation of planning tasks, expert consultants are required to quantify, in an attempt to rationalise, planning decisions in terms of economic ‘viability’. Often with a particular focus on planning obligations, the results of development viability modelling have emerged as a key part of the evidence base used in site-specific negotiations and in planning policy formation. Focussing on the role of clients and other stakeholders, this paper investigates how development viability is tested in practice. It draws together literature on the role of calculative practices in policy formation, client feedback and influence in real estate appraisals and stakeholder engagement and consultation in the planning literature to critically evaluate the role of clients and other interest groups in influencing the production and use of development viability appraisal models. The paper draws upon semi-structured interviews with the main producers of development viability appraisals to conclude that, whilst appraisals have the potential to be biased by client and stakeholder interests, there are important controlling influences on potential opportunistic behaviour. One such control is local authorities’ weak understanding of development viability appraisal techniques which limits their capacity to question the outputs of appraisal models. However, this also is of concern given that viability is now a central feature of the town planning system.

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Pollination services provided by insects play a key role in English crop production and wider ecology. Despite growing evidence of the negative effects of habitat loss on pollinator populations, limited policy support is available to reverse this pressure. One measure that may provide beneficial habitat to pollinators is England’s entry level stewardship agri-environment scheme. This study uses a novel expert survey to develop weights for a range of models which adjust the balance of Entry Level Stewardship options within the current area of spending. The annual costs of establishing and maintaining these option compositions were estimated at £59.3–£12.4 M above current expenditure. Although this produced substantial reduction in private cost:benefit ratios, the benefits of the scheme to pollinator habitat rose by 7–140 %; significantly increasing the public cost:benefit ratio. This study demonstrates that the scheme has significant untapped potential to provide good quality habitat for pollinators across England, even within existing expenditure. The findings should open debate on the costs and benefits of specific entry level stewardship management options and how these can be enhanced to benefit both participants and biodiversity more equitably.

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Background. Oncologists are criticized for fostering unrealistic hope in patients and families, but criticisms reflect a perspective that is oversimplified and “expert” guidance that is ambiguous or impractical. Our aim was to understand how pediatric oncologists manage parents' hope in practice and to evaluate how they address parents' needs. Methods. Participants were 53 parents and 12 oncologists whom they consulted across six U.K. centers. We audio recorded consultations approximately 1–2, 6, and 12 months after diagnosis. Parents were interviewed after each consultation to elicit their perspectives on the consultation and clinical relationship. Transcripts of consultations and interviews were analyzed qualitatively. Results. Parents needed hope in order to function effectively in the face of despair, and all wanted the oncologists to help them be hopeful. Most parents focused hope on the short term. They therefore needed oncologists to be authoritative in taking responsibility for the child's long-term survival while cushioning parents from information about longer-term uncertainties and being positive in providing information about short-term progress. A few parents who could not fully trust their oncologist were unable to hope. Conclusion. Oncologists' pivotal role in sustaining hope was one that parents gave them. Most parents' “faith” in the oncologist allowed them to set aside, rather than deny, their fears about survival while investing their hopes in short-term milestones. Oncologists' behavior generally matched parents' needs, contradicting common criticisms of oncologists. Nevertheless, oncologists need to identify and address the difficulty that some parents have in fully trusting the oncologist and, consequently, being hopeful.

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Observations from the Heliospheric Imager (HI) instruments aboard the twin STEREO spacecraft have enabled the compilation of several catalogues of coronal mass ejections (CMEs), each characterizing the propagation of CMEs through the inner heliosphere. Three such catalogues are the Rutherford Appleton Laboratory (RAL)-HI event list, the Solar Stormwatch CME catalogue, and, presented here, the J-tracker catalogue. Each catalogue uses a different method to characterize the location of CME fronts in the HI images: manual identification by an expert, the statistical reduction of the manual identifications of many citizen scientists, and an automated algorithm. We provide a quantitative comparison of the differences between these catalogues and techniques, using 51 CMEs common to each catalogue. The time-elongation profiles of these CME fronts are compared, as are the estimates of the CME kinematics derived from application of three widely used single-spacecraft-fitting techniques. The J-tracker and RAL-HI profiles are most similar, while the Solar Stormwatch profiles display a small systematic offset. Evidence is presented that these differences arise because the RAL-HI and J-tracker profiles follow the sunward edge of CME density enhancements, while Solar Stormwatch profiles track closer to the antisunward (leading) edge. We demonstrate that the method used to produce the time-elongation profile typically introduces more variability into the kinematic estimates than differences between the various single-spacecraft-fitting techniques. This has implications for the repeatability and robustness of these types of analyses, arguably especially so in the context of space weather forecasting, where it could make the results strongly dependent on the methods used by the forecaster.

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Accurate knowledge of species’ habitat associations is important for conservation planning and policy. Assessing habitat associations is a vital precursor to selecting appropriate indicator species for prioritising sites for conservation or assessing trends in habitat quality. However, much existing knowledge is based on qualitative expert opinion or local scale studies, and may not remain accurate across different spatial scales or geographic locations. Data from biological recording schemes have the potential to provide objective measures of habitat association, with the ability to account for spatial variation. We used data on 50 British butterfly species as a test case to investigate the correspondence of data-derived measures of habitat association with expert opinion, from two different butterfly recording schemes. One scheme collected large quantities of occurrence data (c. 3 million records) and the other, lower quantities of standardised monitoring data (c. 1400 sites). We used general linear mixed effects models to derive scores of association with broad-leaf woodland for both datasets and compared them with scores canvassed from experts. Scores derived from occurrence and abundance data both showed strongly positive correlations with expert opinion. However, only for occurrence data did these fell within the range of correlations between experts. Data-derived scores showed regional spatial variation in the strength of butterfly associations with broad-leaf woodland, with a significant latitudinal trend in 26% of species. Sub-sampling of the data suggested a mean sample size of 5000 occurrence records per species to gain an accurate estimation of habitat association, although habitat specialists are likely to be readily detected using several hundred records. Occurrence data from recording schemes can thus provide easily obtained, objective, quantitative measures of habitat association.

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This article describes the integration of the LSD (Logic for Structure Determination) and SISTEMAT expert systems that were both designed for the computer-assisted structure elucidation of small organic molecules. A first step has been achieved towards the linking of the SISTEMAT database with the LSD structure generator. The skeletal descriptions found by the SISTEMAT programs are now easily transferred to LSD as substructural constraints. Examples of the synergy between these expert systems are given for recently reported natural products.

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Friction plays a key role in causing slipperiness as a low coefficient of friction on the road may result in slippery and hazardous conditions. Analyzing the strong relation between friction and accident risk on winter roads is a difficult task. Many weather forecasting organizations use a variety of standard and bespoke methods to predict the coefficient of friction on roads. This article proposes an approach to predict the extent of slipperiness by building and testing an expert system. It estimates the coefficient of friction on winter roads in the province of Dalarna, Sweden using the prevailing weather conditions as a basis. Weather data from the road weather information system, Sweden (RWIS) was used. The focus of the project was to use the expert system as a part of a major project in VITSA, within the domain of intelligent transport systems

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Sistemas de previsão de cheias podem ser adequadamente utilizados quando o alcance é suficiente, em comparação com o tempo necessário para ações preventivas ou corretivas. Além disso, são fundamentalmente importantes a confiabilidade e a precisão das previsões. Previsões de níveis de inundação são sempre aproximações, e intervalos de confiança não são sempre aplicáveis, especialmente com graus de incerteza altos, o que produz intervalos de confiança muito grandes. Estes intervalos são problemáticos, em presença de níveis fluviais muito altos ou muito baixos. Neste estudo, previsões de níveis de cheia são efetuadas, tanto na forma numérica tradicional quanto na forma de categorias, para as quais utiliza-se um sistema especialista baseado em regras e inferências difusas. Metodologias e procedimentos computacionais para aprendizado, simulação e consulta são idealizados, e então desenvolvidos sob forma de um aplicativo (SELF – Sistema Especialista com uso de Lógica “Fuzzy”), com objetivo de pesquisa e operação. As comparações, com base nos aspectos de utilização para a previsão, de sistemas especialistas difusos e modelos empíricos lineares, revelam forte analogia, apesar das diferenças teóricas fundamentais existentes. As metodologias são aplicadas para previsão na bacia do rio Camaquã (15543 km2), para alcances entre 10 e 48 horas. Dificuldades práticas à aplicação são identificadas, resultando em soluções as quais constituem-se em avanços do conhecimento e da técnica. Previsões, tanto na forma numérica quanto categorizada são executadas com sucesso, com uso dos novos recursos. As avaliações e comparações das previsões são feitas utilizandose um novo grupo de estatísticas, derivadas das freqüências simultâneas de ocorrência de valores observados e preditos na mesma categoria, durante a simulação. Os efeitos da variação da densidade da rede são analisados, verificando-se que sistemas de previsão pluvio-hidrométrica em tempo atual são possíveis, mesmo com pequeno número de postos de aquisição de dados de chuva, para previsões sob forma de categorias difusas.

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Background. Patients who develop acute kidney injury (AKI) in the intensive care unit (ICU) have extremely high rates of mortality and morbidity. The objectives of this study were to compare clinical and laboratory characteristics of AKI patients evaluated and not evaluated by nephrologists in ICU and generate the hypothesis of the relationship between timing of nephrology consultation and outcome.Methods. We explored associations among presence and timing of nephrology consultation with ICU stay and in-ICU mortality in 148 ICU patients with AKI at a Brazilian teaching hospital from July 2008 to May 2010. Multivariable logistic regression was used to adjust confounding and selection bias.Results. AKI incidence was 30% and 52% of these AKI patients were evaluated by nephrologists. At multivariable analysis, AKI patients evaluated by nephrologists showed higher Acute Tubular Necrosis-Index Specific Score and creatinine level, more dialysis indications, lower urine output and longer ICU stay. The mortality rate was similar to AKI patients who were not evaluated. Nephrology consultation was delayed (>= 48 h) in 62.3% (median time to consultation, 4.7 days). Lower serum creatinine levels (P - 0.009) and higher urine output (P = 0.002) were associated with delayed consultation. Delayed consultation was associated with increased ICU mortality (65.4 versus 88.2%, P < 0.001).Conclusions. In AKI, patients evaluated by nephrologists seem to be more seriously ill than those not evaluated and present similar mortality rate. The delayed nephrology consultation can be associated with increased ICU mortality.

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Oil spills cause great damage to coastal habitats, especially when rapid and suitable response measures are not taken. Establishing high priority areas is fundamental for the operation of response teams. Under this context and considering the need for keeping all geographical information up-to-date for emergencial use, the present study proposes employing a decision tree coupled with a knowledge-based approach using GIS to assign oil sensitivity indices to Brazilian coastal habitats. The modelled system works based on rules set by the official standards of Brazilian Federal Environment Organ. We tested it on one of the littoral regions of Brazil where transportation of petroleum is most intense: the coast of the municipalities of Sao Sebastiao and Caraguatatuba in the northern littoral of São Paulo state, Brazil. The system automatically ranked the littoral sensitivity index of the study area habitats according to geographical conditions during summer and winter; since index ranks of some habitats varied between these seasons because of sediment alterations. The obtained results illustrate the great potential of the proposed system in generating ESI maps and in aiding response teams during emergency operations. (C) 2009 Elsevier Ltd. All rights reserved.

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O objetivo foi implantar a Consulta de Enfermagem para indivíduos hipertensos, utilizando-se a teoria do autocuidado de Orem e sistematizar a assistência de enfermagem. Foram entrevistados 56 pacientes, sendo 58,9% mulheres, 75% na faixa etária de 50 a 80 anos, 76,4% casados, 42,9% donas de casa, 47,2% aposentados e 67,3% com ensino fundamental completo. Utilizou-se instrumento estruturado abordando os requisitos de autocuidado universal, de desenvolvimento e de desvios de saúde. A análise dos dados possibilitou avaliar os requisitos de autocuidado alterados. No planejamento da assistência, as ações de apoio-educação foram prioridades. A teoria do autocuidado possibilitou identificar aspectos importantes para serem trabalhados pelo enfermeiro.