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Academic literature on the topic 'Patterns of specialists referrals'

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Published: 10 December 2022
Last updated: 29 January 2023

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Journal articles on the topic "Patterns of specialists referrals"

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Schreiner, Andrew D., Keri T. Holmes-Maybank, Jingwen Zhang, Justin Marsden, Patrick D. Mauldin, and William P. Moran. "Specialty Physician Designation in Referrals from a Vertically Integrated PCMH." Health Services Research and Managerial Epidemiology 6 (January 1, 2019): 233339281985038. http://dx.doi.org/10.1177/2333392819850389.

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Introduction: Primary care referrals to specialty physicians once relied upon the medical skill of the specialist, the quality of past communication, and previous consultative experiences. As health systems vertically integrate, patterns of specialty physician referral designation are not known. Methods: This cross-sectional study from a patient-centered medical home (PCMH) evaluated the proportion of referrals with named specialists. All outpatient specialty referrals from the PCMH between July and December of 2014 were eligible for inclusion, and 410 patients were randomly selected for chart review. The outcome of interest was specialty physician designation. Other variables of interest included PCMH provider experience, the reason for referral, and time to specialty visit. Univariate analysis was performed with Fisher exact tests. Results: Of 410 specialty referrals, 43.7% were made to medical specialties, 41.7% to surgical specialties, and 14.6% to ancillary specialties. Resident physicians placed 224 referrals (54.6%), faculty physicians ordered 155 (37.8%), and advanced practice providers ordered 31 (7.6%). Only 11.2% of the specialty referral orders designated a specific physician. No differences appeared in the reason for referral, the referral destination, the proportion of visits scheduled and attended, or the time to schedule between those referrals with and without specialty physician designation. Faculty physicians identified a specific specialist in 21.4% of referrals compared to residents doing so in 4.9% ( P < .0001). Conclusion: Patient-centered medical home referrals named a specific specialty physician infrequently, suggesting a shift from the historical reliance on the individual characteristics of the specialist in the referral process.
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Winpenny, Eleanor M., Céline Miani, Emma Pitchforth, Sarah King, and Martin Roland. "Improving the effectiveness and efficiency of outpatient services: a scoping review of interventions at the primary–secondary care interface." Journal of Health Services Research & Policy 22, no. 1 (July 8, 2016): 53–64. http://dx.doi.org/10.1177/1355819616648982.

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Objectives Variation in patterns of referral from primary care can lead to inappropriate overuse or underuse of specialist resources. Our aim was to review the literature on strategies involving primary care that are designed to improve the effectiveness and efficiency of outpatient services. Methods A scoping review to update a review published in 2006. We conducted a systematic literature search and qualitative evidence synthesis of studies across five intervention domains: transfer of services from hospital to primary care; relocation of hospital services to primary care; joint working between primary care practitioners and specialists; interventions to change the referral behaviour of primary care practitioners and interventions to change patient behaviour. Results The 183 studies published since 2005, taken with the findings of the previous review, suggest that transfer of services from secondary to primary care and strategies aimed at changing referral behaviour of primary care clinicians can be effective in reducing outpatient referrals and in increasing the appropriateness of referrals. Availability of specialist advice to primary care practitioners by email or phone and use of store-and-forward telemedicine also show potential for reducing outpatient referrals and hence reducing costs. There was little evidence of a beneficial effect of relocation of specialists to primary care, or joint primary/secondary care management of patients on outpatient referrals. Across all intervention categories there was little evidence available on cost-effectiveness. Conclusions There are a number of promising interventions which may improve the effectiveness and efficiency of outpatient services, including making it easier for primary care clinicians and specialists to discuss patients by email or phone. There remain substantial gaps in the evidence, particularly on cost-effectiveness, and new interventions should continue to be evaluated as they are implemented more widely. A move for specialists to work in the community is unlikely to be cost-effective without enhancing primary care clinicians’ skills through education or joint consultations with complex patients.
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Ryan, Bridget L., Joshua Shadd, Heather Maddocks, Moira Stewart, Amardeep Thind, and Amanda L. Terry. "Methods to Describe Referral Patterns in a Canadian Primary Care Electronic Medical Record Database: Modelling Multilevel Count Data." Journal of Innovation in Health Informatics 24, no. 4 (November 17, 2017): 311. http://dx.doi.org/10.14236/jhi.v24i4.888.

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Background: A referral from a family physician (FP) to a specialist is an inflection point in the patient journey, with potential implications for clinical outcomes and health policy. Primary care electronic medical record (EMR) databases offer opportunities to examine referral patterns. Until recently, software techniques were not available to model these kinds of multi-level count data. Objective: To establish methodology for determining referral rates from FPs to medical specialists using the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) EMR database. Method: Retrospective cohort study, mixed effects and multi-level negative binomial regression modelling with 87,258 eligible patients between 2007 and 2012. Mean referrals compared by patient sex, age, chronic conditions, FP visits, and urban/rural practice location. Proportion of variance in referral rates attributable to the patient and practice levels. Results: On average, males had 0.26, and females 0.31 referrals in a 12-month period. Referrals were significantly higher for females, increased with age, FP visits, and number of chronic conditions (p<.0001). Overall, 14% of the variance in referrals could be attributed to the practice level, and 86% to patient level characteristics. Conclusions: Both patient and practice characteristics influenced referral patterns. The methodologic insights gained from this study have relevance to future studies on many research questions that utilize count data, both within primary care and broader health services research. The utility of the CPCSSN database will continue to increase in tandem with data quality improvements, providing a valuable resource to study Canadian referral patterns over time.
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Goulart, Bernardo H. L., Carolina M. Reyes, Catherine R. Fedorenko, David G. Mummy, Sacha Satram-Hoang, Lisel M. Koepl, David K. Blough, and Scott D. Ramsey. "Referral and Treatment Patterns Among Patients With Stages III and IV Non–Small-Cell Lung Cancer." Journal of Oncology Practice 9, no. 1 (January 2013): 42–50. http://dx.doi.org/10.1200/jop.2012.000640.

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Referrals to all types of cancer specialists increased the likelihood of treatment with standard therapies for patients with non–small-cell lung cancer, particularly stage III. But racial and income disparities still prevent optimal referrals to cancer specialists.
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Hendijani, Rosa, and Diane P. Bischak. "The effect of social relationships on the rates of referral to specialists." International Journal of Operations & Production Management 36, no. 4 (April 4, 2016): 384–407. http://dx.doi.org/10.1108/ijopm-02-2015-0086.

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Purpose – In order to decrease patient waiting time and improve efficiency, healthcare systems in some countries have recently begun to shift away from decentralized systems of patient referral from general practitioners (GPs) to specialists toward centralized ones. From a queueing theory perspective, centralized referral systems can decrease waiting time by reducing the variation in the referral process. However, from a social psychological perspective, a close relationship between referring physician and specialist, which is characteristic of decentralized referral systems, may safeguard against high referral rates; since GPs refer patients directly to the specialists whom they know, they may be reluctant to damage that relationship with an inappropriate referral. The purpose of this paper is to examine the effect upon referral behavior of a relationship between physicians, as is found in a decentralized referral system, vs a centralized referral system, which is characterized by an anonymous GP-specialist relationship. In a controlled experiment where family practice residents made decisions concerning referral to specialists, physicians displaying high confidence referred significantly fewer patients in a close relationship condition than in a centralized referral system, suggesting that for some physicians, referral behavior can be affected by the design of the service system and will, in turn, affect system performance. Design/methodology/approach – The authors used a controlled experiment to test the research hypotheses. Findings – Physicians displaying high confidence referred significantly fewer patients in a close relationship condition than in a centralized referral system, suggesting that for some physicians, referral behavior can be affected by system attributes and will, in turn, affect system performance. Research limitations/implications – The current study has some limitations, however. First, the sample consisted only of family practice residents and did not have the knowledge and experience of GPs regarding the referral process. Second, the authors used hypothetical patient case descriptions instead of real-world patients. Repeating this experiment with primary care physicians in real setting would be beneficial. Practical implications – The study indicates that decentralized referral systems may act (rightly or wrongly) as a restraint on the rate of referrals to specialists. Thus, an implementation of a centralized referral system should be expected to produce an increase in referrals simply due to the change in the operational system setup. Even if centralized referral systems are more efficient and can facilitate the referral process by creating a central queue rather than multiple single queues for patients, the removal of social ties such as long-term social relationships that are developed between GPs and specialists in decentralized referral systems may act to counterbalance these theoretical gains. Social implications – This study provide support for the idea that non-clinical factors play an important role in referrals to specialists and hence in the quality of provided care, as was suggested by previous studies in this area (Hajjaj et al., 2010; Reid et al., 1999). The design of the service system may inadvertently influence some doctors to refer too many patients to specialists when there is no need for a specialist visit. In high-utilization health systems, this may cause some patients to be delayed (or even denied) in obtaining specialist access. Healthcare systems may be able to implement behavioral-based techniques in order to mitigate the negative consequences of a shift to centralized referral systems. One approach would be to try to create a feeling of close relationship among doctors in centralized referral systems. High communication and frequent interaction among GPs and specialists can boost the feelings of teamwork and personal efficacy through social comparison (Schunk, 1989, 1991) and vicarious learning (Zimmerman, 2000), which can in turn motivate GPs to take control of the patient care process when appropriate, instead of referring patients to specialists. Originality/value – The authors’ study is the first examining the effect of social relationships between GPs and specialists on the referral patterns. Considering the significant implications of referral decisions on patients, doctors, and the healthcare systems, the study can shed light into a better understanding of the social and behavioral aspects of the referral process.
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Noor, E., NAN Kamaruzaman, NSM Jeffri, NNN Eezammudden, and NZM Noh. "Periodontal Referral Pattern in Periodontal Specialist Clinic in Faculty of Dentistry, Universiti Teknologi MARA (UiTM): A Retrospective Pilot Study." Compendium of Oral Science 5, no. 1 (September 1, 2018): 37–45. http://dx.doi.org/10.24191/cos.v5i0.17506.

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Objectives: Periodontitis is a chronic disease which remain undiagnosed and untreated without proper examination and referral to specialist clinic for further management Therefore, this study was conducted to evaluate the pattern of referrals to Universiti Teknologi MARA (UiTM) Periodontal Specialist Clinic. Materials and methods: A total of 176 periodontal cases referred to UiTM Periodontal Specialist Clinic in year 2011 and 2016 were identified and patient’s referral forms were collected. The data obtained were the referred cases from undergraduate student clinics, other specialist clinics, UiTM primary dental care clinic and private dental clinics. Descriptive data analysis was conducted using frequency distribution by SPSS. Chi square analysis was used to evaluate the association of source of referral, diagnosis and reason for referrals to Periodontal Specialist Clinic. Results: There was increased referral cases to Periodontal Specialist Clinic in 2016 (86.9%) compared to 2011 (13.1%). Most referral to Periodontal Specialist Clinic were received from faculty’s undergraduate student clinic in both 2011 and 2016 (46%), followed by other specialists (27.3%), primary care clinic (25.6%) and private practice (1.1%). 96% of cases were referred for intervention by periodontist as more than half of the cases were referred for the non-surgical periodontal treatment. Chi square analysis showed the association between source of referral and reason for referral was statistically significant (p value=0.000). Conclusion: Proper periodontal screening in all patients and necessary referral to specialist clinic is crucial to prevent undiagnosed periodontal disease.
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Koch, MD, Nancy V., and Richard J. Butterfield III, MA. "Prescribing patterns and attitudes of primary care providers regarding long-term opioid therapy." Journal of Opioid Management 18, no. 5 (September 1, 2022): 407–20. http://dx.doi.org/10.5055/jom.2022.0735.

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Objective: To assess prescribing and referral patterns and attitudes of primary care providers treating patients receiving long-term opioid therapy (LOT) according to recent guidelines.Design, setting, and participants: An anonymous 25-question survey was distributed to all primary care providers at Mayo Clinic in Arizona (from April 30 through May 22, 2020).Main outcome measures: Knowledge and comfort with LOT guidelines, prescribing patterns, referral patterns to behavioral and pain specialties, patients’ concomitant substance use, and response variability by provider sex and specialty. Results: Most of the 31 survey respondents were familiar with LOT guidelines and were comfortable in prescribing opioids; 36 percent reported no increase in prescribing safety. Patient education on naloxone was infrequent. Access affected referral to behavioral and addiction specialties; 87.1 percent referred patients to pain medicine specialists despite reporting little long-term improvement in symptoms. For a significantly larger proportion of internal medicine and women's health (IM/WH) providers, compared with family medicine (FM) providers, Patient Health Questionnaire 9 and Generalized Anxiety Disorder 7-item scale scores were the reasons for behavioral health referral. Many providers prescribed additional substances. More female providers reported that patients used gabapentin concomitantly (p = .03). More FM providers than IM/WH providers typically referred patients receiving LOT to addiction specialists (p = .02). Most expressed a need for a multispecialty LOT clinic, and 83.9 percent supported buprenorphine prescribing. Conclusions: Despite familiarity with LOT guidelines, many providers felt that patient safety and prescribing diligence have not improved. Patient education on naloxone treatment is needed, and access to behavioral specialists is a barrier to referrals.
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Kunin, Marina, Erin Turbitt, Sarah A. Gafforini, Lena A. Sanci, Neil A. Spike, and Gary L. Freed. "General practitioner referrals to paediatric specialist outpatient clinics: referral goals and parental influence." Journal of Primary Health Care 10, no. 1 (2018): 76. http://dx.doi.org/10.1071/hc17030.

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ABSTRACT INTRODUCTION Previous research on general practitioner (GP) referrals in adult populations demonstrated that patient pressure influenced referral practice. No research has been conducted to investigate how involvement of a parent influences paediatric referrals. AIM To investigate whether GPs who report parental influence on their decision to refer paediatric patients differ in their referral patterns from GPs who do not report parental influence. METHOD A mail survey of 400 GPs who had referred at least two children to paediatric specialist outpatient clinics during 2014 was distributed. RESULTS The response rate was 67% (n = 254). For initial referrals, 27% of GPs stated that parental request frequently or almost always influenced their referral decision. For returning referrals, 63% of GPs experienced parental influence to renew a referral because a paediatrician wanted a child to return; 49% of GPs experienced influence to renew a referral because a parent wanted to continue care with a paediatrician. Experiencing parental influence was associated with increased likelihood for frequent referrals in order for a paediatrician to take over management of a child’s condition. DISCUSSION GPs who frequently refer with a goal for a paediatrician to take over management of a child’s condition also report that parental request almost always influences their decision to refer.
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Ghimire, Anukul, Naima Sultana, Feng Ye, Laura N. Hamonic, Allan K. Grill, Alexander Singer, Ayub Akbari, et al. "Impact of quality improvement initiatives to improve CKD referral patterns: a systematic review protocol." BMJ Open 12, no. 4 (April 2022): e055456. http://dx.doi.org/10.1136/bmjopen-2021-055456.

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IntroductionChronic kidney disease (CKD) is a global-health problem. A significant proportion of referrals to nephrologists for CKD management are early and guideline-discordant, which may lead to an excess number of referrals and increased wait-times. Various initiatives have been tested to increase the proportion of guideline-concordant referrals and decrease wait times. This paper describes the protocol for a systematic review to study the impacts of quality improvement initiatives aimed at decreasing the number of non-guideline concordant referrals, increasing the number of guideline-concordant referrals and decreasing wait times for patients to access a nephrologist.Methods and analysisWe developed this protocol by using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols (2015). We will search the following empirical electronic databases: MEDLINE, Embase, Cochrane Library, CINAHL, Web of Science, PsycINFO and grey literature for studies designed to improve guideline-concordant referrals or to reduce unnecessary referrals of patients with CKD from primary care to nephrology. Our search will include all studies published from database inception to April 2021 with no language restrictions. The studies will be limited to referrals for adult patients to nephrologists. Referrals of patients with CKD from non-nephrology specialists (eg, general internal medicine) will be excluded.Ethics and disseminationEthics approval will not be required, as we will analyse data from studies that have already been published and are publicly accessible. We will share our findings using traditional approaches, including scientific presentations, open access peer-reviewed platforms, and appropriate government and public health agencies.PROSPERO registration numberCRD42021247756.
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Hyder, Omar, David Cosgrove, Hari Nathan, Kenzo Hirose, Christopher Lee Wolfgang, John Bridge, Jean-Francois Geschwind, et al. "Understanding variations in referral patterns and treatment choices for patients with hepatocellular carcinoma." Journal of Clinical Oncology 31, no. 4_suppl (February 1, 2013): 293. http://dx.doi.org/10.1200/jco.2013.31.4_suppl.293.

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293 Background: Patterns of care of physician specialists may differ for patients with hepatocellular carcinoma(HCC). The extent and reasons underlying possible variations are poorly understood. One source of variation may be disparate referral rates to specialists leading to differences in cancer-directed treatments. Methods: We queried the Surveillance, Epidemiology, and End Results(SEER) linked Medicare database for patients with HCC diagnosed between 1998-2007 who consulted one or more physicians following diagnosis. Visit and procedure records were abstracted from Medicare billing records and factors associated with visiting a specialist and subsequent treatment were examined. Results: 6752 patients with HCC were identified;median age was 73 yrs and the majority was male(66%), White(60%) and from a West geographical region(56%). 1379(20%) patients had early-stage disease. In the six months after diagnosis, referral to a specialist varied considerably (hepatology/gastroenterology-60%; medical oncology-62%; surgery-56%; interventional radiology-33%; radiation oncology-9%). 22% patients saw one specialist, while 39% saw ≥3 specialists. Time between diagnosis and visitation with a specialist varied by sub-specialty (surgery-37 days vs. interventional radiology-55 days;P=0.04). Factors associated with referral to a specialist included younger age(OR=2.13), geographic location(Northeast OR=2.09), and presence of early-stage disease(OR=2.21)(all P<0.05). Among patients with early-stage disease, 77% saw a surgeon, while 50% had a medical oncology consultation. Receipt of therapy among patients with early-stage disease varied (no therapy-30%; surgery-39%; interventional radiology-9%; other-22%). Factors associated with receipt of therapy included younger age(OR=2.82), as well as time to consultation with cancer specialist(OR=1.05)(both P<0.05). Conclusions: Following HCC diagnosis, referral to a specialist varied considerably. Both clinical and non-clinical factors were associated with consultation. Variations in referral to a specialist and subsequent therapy need to be better understood to ensure all HCC patients receive appropriate care.
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Dissertations / Theses on the topic "Patterns of specialists referrals"

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Yeung, Sze-ying. "A case control study of the referral pattern and patient non-attendance in medical and surgical specialist outpatient clinics in Hong Kong." Click to view the E-thesis via HKUTO, 2005. http://sunzi.lib.hku.hk/hkuto/record/b39724293.

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Yeung, Sze-ying, and 楊思瑩. "A case control study of the referral pattern and patient non-attendance in medical and surgical specialist outpatient clinics inHong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2005. http://hub.hku.hk/bib/B39724293.

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Lau, Chiu Wai-yee Hilda, and 劉趙慧儀. "Career patterns of senior specialists in the Hong Kong civil service." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1986. http://hub.hku.hk/bib/B3197479X.

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Lau, Chiu Wai-yee Hilda. "Career patterns of senior specialists in the Hong Kong civil service." [Hong Kong : University of Hong Kong], 1986. http://sunzi.lib.hku.hk/hkuto/record.jsp?B12323299.

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Reif, Glenn. "Sources of influence on pedagogical behavior patterns of five elementary physical education specialists." Diss., Virginia Tech, 1990. http://hdl.handle.net/10919/39750.

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Chukwuemeka, Gregory Adjuba. "Profile of paediatric psychosocial disorders in Frere Hospital and analysis of associated patterns of referrals." Thesis, Rhodes University, 2000. http://hdl.handle.net/10962/d1002458.

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The profile of psychosocial disorders in children and the attendant patterns of referrals and health communication, were investigated within the context of a tertiary referral centre in the Eastern Cape Province. Literature on childhood disorders points to a high level of functional and substance related disorders in technologically developed countries of Europe and North America, in contrast to the developing countries of Asia and Africa, where the burden of infectious diseases and disorders of deprivation and lack still predominate in the profile of psychosocial disorders in children. In South Africa however, there is almost non-existent research on clinical psychosocial disorders profile and the research sets out to be an exploratory study in this area. A combination design was employed in which interviews and observations complemented a primarily quantitative descriptive cross sectional analysis of hospitalcase records. A pilot study was performed using an information gathering questionnaire and interviews, with findings subsequently explored in the main study. The International Classification of Diseases (ICD-10) (WHO, 1992) diagnostic categories were used to create a profile of all ailments in the paediatric unit. Psychosocial disorders both in terms of aetiology and illness course, can be viewed from the perspective of socialadjustment and functioning (in which there is a potential role of social factors as provoking, causal or modifying factors) (Williams &Clare, 1979); and the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) (American Psychiatric Association,1994) criteria was used to create the profile of these disorders in the paediatric unit at Frere Hospital which accounted for 45% of the ailments managed in one year. The derived profile is a picture in between the profile found in technologically advanced countries, and developing countries. While the infection burden and malnutrition appear to be readily contained or curtailed, there appears to be a serious problem with access to health care services which manifest especially at the level of perinatal events, with resultant high level of hypoxic brain damage and consequently mental retardation and varying levels of impairment or disability. These medical consequences in turn are fundamentally psychosocial, requiring psychosocial care with heavy reliance on strategic communication and referrals. The referrals in respect of psychosocial disorders are mainly at primary care level revolving around local health care clinics, private clinics, special schools and rehabilitation centres.
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Hopps, Joshua. "Pattern and content of neuropsychological referral questions across 25 years of outpatient visits in a hospital-based clinic." Diss., University of Iowa, 2009. https://ir.uiowa.edu/etd/379.

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Much of the practice is clinical neuropsychology is performed in the role of consultant and although the neuropsychologist is dependent upon referrals made from outside sources, relatively little attention has been devoted to the investigation of the referral process. Surveys of clinicians and referral sources have reported breakdowns of referral sources by discipline and general topics of referral questions based on recollection, but direct analysis of referral patterns across the same period has not been undertaken. The purpose of the study is to document the advancement of neuropsychology from providing psychological testing to establishing itself as a multifaceted discipline with a significant diagnostic purview that is regularly relied upon to contribute to important decisions in the lives of patients. By examining the referral questions rather than neuropsychologists' or referral sources' recollection of referrals, this study expands what is known about referral content and patterns. In an effort to explain question content without relying upon recollection, a coding rubric was designed to capture the breadth of presenting problems and requests seen in the original referral questions. Two-thousand-six-hundred referral questions were selected from the odd year over the 25 year period from 1983 to 2007, yielding a total of 2600 referral questions. Cochran's Kappa was used to conduct interrater reliability analyses in three stages across the entire rating process. Content analysis showed that 79.1% of all questions had at more than minimal content. The most common request was for assistance with diagnostic considerations, which was present in 66.4% of all cases. Assistance with differential diagnoses was requested in 27.4% of all cases with the majority of these composed of requests for assistance in differentiating between psychiatric and neurological or other medical considerations. There was evidence for a trend over time in the gradual decline of requests for assistance with psychiatric differential diagnosis and requests for the MMPI from 1993 to the present. Memory problems and dementia are the most common presenting problems, although there is evidence of a slight decline in these evaluations beginning in 1997. Requests for specific recommendations, particularly those related to making recommendations regarding treatment planning were found to steadily increase across the sampling period. Limitations and implications for practice were discussed.
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Urbonavičiūtė, Eglė. "Ambulatorinių pacientų depresijos simptomų sąsaja su pirminės asmens sveikatos priežiūros įstaigos apkrova." Master's thesis, Lithuanian Academic Libraries Network (LABT), 2009. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2009~D_20090629_143508-21934.

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Šiame darbe išanalizuota iki šiol Lietuvoje netyrinėta sąsaja tarp depresija sergančių pacientų ambulatorinių apsilankymų ir pirminės asmens sveikatos priežiūros įstaigos apkrovos. Šis tyrimas moksline ir praktine prasme yra vertingas tolesniems depresijos simptomų patiriančių asmenų pirminės sveikatos priežiūros organizavimo bei vystymo tyrinėjimams. Darbo tikslas. Įvertinti depresijos simptomų sąsają su ambulatorinių pacientų apsilankymų kiekiu ir pirminės asmens sveikatos priežiūros įstaigos apkrova. Darbo uždaviniai: 1. Nustatyti depresijos simptomus patiriančių pacientų ambulatorinių apsilankymų per pusmetį pas bendrosios praktikos (šeimos) gydytojus dažnį ir palyginti su depresijos simptomų nepatiriančių pacientų apsilankymų dažniu. 2. Nustatyti depresijos simptomus patiriantiems pacientams per pusmetį suteiktų gydytojų specialistų konsultacijų dažnį ir palyginti su depresijos simptomų nepatiriančių pacientų konsultacijų dažniu. 3. Nustatyti depresijos simptomus patiriantiems pacientams per pusmetį atliktų laboratorinių tyrimų kiekį bei struktūrą ir palyginti su pacientų, nepatiriančių depresijos simptomų, laboratorinių tyrimų dažniu. Tyrimo metodika. Tyrimui atlikti naudoti penki tyrimo metodai: mokslinės literatūros analizė ir apibendrinimas, anketinė apklausa, testavimas HADS skale, laiko biudžeto analizė ir matematinė statistika. Pagal HADS-D rezultatus, visi tyrimo dalyviai buvo suskirstyti į dvi grupes: pirmą (HADS-D>=8) sudarė 24 tiriamieji, kuriems... [toliau žr. visą tekstą]
In this study we investigated the association between the symptoms of depression of ambulatory patients and the rate of outpatient visits and workload of primary health care centre. This problem was investigated for the first time in Lithuania. The results of this study are of great scientific and practical value for further investigations, cocerning the organization and development of the primary health care for patients with symptoms of depression. Aim of the study. To identify the association between the symptoms of depression of ambulatory patients and the rate of outpatient visits and the workload of the primary health care centre. Objectives: 1. To evaluate the rate of outpatient visits that patients with symptoms of depression make to the general practioner during the past six months and to compare with the patients having no symptoms of depression. 2. To evaluate the rate of consultations of specialists for patients with symptoms of depression during the past six months and to compare it with the patients having no symptoms of depression. 3. To evaluate the amount and structure of laboratory tests done for the patients with symptoms of depression during the past six months and to compare it with the patients having no symptoms of depression. Methods. Data was collected using questionnaire, Hospital Anxiety and Depression Scale (HADS), time budget analysis. According to the scores of HADS, 24 participants were assigned to the group of great or undeterminated risk... [to full text]
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Joosten, Dawn Marie. "Aspects of clinical social workers' decision-making with older adult clients with unmet psychosocial and/or physical needs outcomes, patterns, and processes of referrals for services /." Diss., Restricted to subscribing institutions, 2008. http://proquest.umi.com/pqdweb?did=1691805951&sid=1&Fmt=2&clientId=1564&RQT=309&VName=PQD.

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Hoffsten, Per-Ola. "Rarity in boreal stream insects : patterns, causes and consequences /." Doctoral thesis, Umeå University, Ecology and Environmental Science, 2003. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-142.

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Patterns of site occupancy among boreal stream insects were studied in central Sweden with focus on sparsely distributed species and the role of dispersal and niche limitations.

In the study of dispersal limitation, I found that effects of an extraordinarily harsh winter in small to medium-sized streams were strongest in sites located in small streams and far from lake outlets. Species richness and the total abundance of macroinvertebrates and trout returned to pre-disturbance levels after three years. However, some species showed slow recolonization and the proportion of holoaquatic taxa was still reduced after three years. In a second study, I found a positive correlation between site occupancy in stream caddisflies and morphological traits associated with fast and energy-efficient flight, whereas specialized spring caddisflies showed a negative correlation to these traits compared to stream species. This suggested that streams, but not springs, select for strong dispersal ability in caddisflies. In a survey of springs in central Sweden, hydrogeology was found to be a useful predictor of the occurrence of spring specialists. Two of these, Crunoecia irrorata Curtis and Parachiona picicornis (Pictet), were found exclusively in glaciofluvial springs, characterized by a stable discharge and temperature. Less specialized members of the spring fauna (i.e. species also occurring in streams, ponds or lakes) also occurred in moraine and limestone springs characterized by more unstable conditions.

Niche limitations were studied by contrasting large-scale distributions of closely related rare and common stoneflies. Differences in temperature requirements in the juvenile stages and life cycles suggested that the rare species, Isogenus nubecula Newman, was restricted by a limited tolerance to low stream temperatures, whereas the two common species, Isoperla grammatica (Poda) and Diura nanseni (Kempny), appeared to have a broader tolerance to climatic conditions in the study area. In a second study of niche limitations, macroinvertebrate assemblages in 88 streams in Central Sweden showed a nested distribution pattern. Most species deviating from expected distributions occurred in small streams, indicating competitive exclusion from species-rich sites, predator avoidance, or specialization to unique habitat features of small streams. In the last paper, the longitudinal distribution of filter-feeding caddisflies in a lake-outlet stream demonstrated patterns concordant to feeding specialization.

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Books on the topic "Patterns of specialists referrals"

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Rosenbach, Margo L. A profile of emergency medicine specialists, 1984-85: Demographic characteristics, practice patterns, and income. Needham, MA: Health Economics Research, Inc., 1986.

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Klyuchnikova, Valentina, and Valentina Kostyleva. Anthropological and biomechanical foundations of the design of leather products. ru: INFRA-M Academic Publishing LLC., 2021. http://dx.doi.org/10.12737/1145262.

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The textbook provides the basics of the anatomy and physiology of the upper and lower extremities, their structure, the functions of the skeleton and muscles, the activity of the vascular and nervous systems. Contact and non-contact measuring devices for obtaining dimensional signs of feet, methods of processing anthropometric data, patterns in the distribution of sizes of feet and hands are considered. The issues of biomechanics of human movements are highlighted. Meets the requirements of the federal state educational standards of higher education of the latest generation. It is intended for bachelors of the training directions 29.03.01 "Technology of light industry products", 29.03.05 "Design of light industry products", undergraduates of the training directions 29.04.01 "Technology of light industry products", 29.04.05 "Design of light industry products" when studying the disciplines "Fundamentals of anthropology and biomechanics", "Design of leather products", "Design of technological equipment". It will be useful to students when performing course projects and works, research and final qualifying works, when independently studying these disciplines, as well as to specialists of shoe and leather goods enterprises.
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Groshev, Igor', Yuliya Davydova, and Anton Gorbenko. Psychology of regional elections: candidates and voters. ru: INFRA-M Academic Publishing LLC., 2021. http://dx.doi.org/10.12737/1163948.

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The monograph is devoted to the study of the socio-psychological features of regional elections that influence the socio-political behavior of the electorate. The authors propose a new understanding of the psychological nature of the processes of forming the voting choice, which brings us closer to a more correct understanding of the complex political and psychological mechanisms of the strategy and tactics of regional election campaigns. The identified individual and personal indicators of the influence of the electoral characteristics of candidates on the voting of various categories of voters were developed and tested at the regional level. A number of practical recommendations on the organization of election campaigns, designed to take into account the psychological specifics of the behavior of the electorate in the framework of regional elections (elections with weak content), are empirically proved. It is intended for managers and specialists of regional election commissions, political scientists and psychologists who study issues related to the patterns of electoral behavior, graduate students and undergraduates engaged in research in the field of political psychology, as well as political strategists who ensure the effectiveness of election campaigns.
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Coulter, Angela, Peter Brooks, and Jean Bradlow. Patterns of Referral: A Study of Referrals to Outpatient Clinics from General Practices in the Oxford Region. Health Services Research Unit, 1992.

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Côté, Pierre. The association between patterns of visits to general practitioners, chiropractors and specialists and time-to-recovery from acute whiplash injuries: A population-based cohort study. 2002.

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Shaibani, Aziz. Gait Disorders. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190661304.003.0001.

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Gait is a complicated process that is initiated and maintained by different mechanisms, both neurological (including neuromuscular) and nonneurological (including musculoskeletal). Neuromuscular clinics receive referrals about patients who may have nonneuromuscular disorders such as Parkinson disease, focal foot dystonia, and multiple sclerosis (MS). It is important for neuromuscular specialists to be aware of other gait disorders as well. Important neuromuscular disorders of gait include neuropathies (foot drop, sensory ataxia), myopathies, muscle stiffness and spasms, myotonia, and motor neuron disease. Functional gait disorder comprises a significant entity that may lead to extensive, unnecessary investigations that can be saved if the specialist is aware of the characteristic features of these symptoms.
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Demidov, Valeriy, and Oleg Makarov. THE PHYSICAL BASIS OF SOIL EROSION: MECHANISM, PATTERNS OF EXPRESSION AND PREDICTION. LCC MAKS Press, 2021. http://dx.doi.org/10.29003/m2428.978-5-317-06630-7.

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The monograph summarizes the information over the past 20 years on the currently widely used. The textbook is intended for students of higher educational institutions, studying in the specialty of soil science, as well as specializing in erosion and soil protection. The textbook describes the physical basis and mechanism of erosion processes, based on some sections of hydraulics, hydrology, hydro-and aeromechanics, knowledge of which is necessary to understand the mechanism of water, wind and irrigation soil erosion. The main mathematical models and principles of forecasting the values of soil losses as a result of erosion processes are considered. The textbook will be useful not only for students and postgraduates studying in the specialty of soil science, but also for geographers, ecologists and a wide range of specialists interested in the problems of soil cover conservation and environmental protection.
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Olsen, Jan Abel. Primary care: paying general practitioners. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780198794837.003.0014.

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This chapter discusses the three most widely used remuneration systems for general practitioners (GPs): fee-for-service, capitation, and salary. Each system has its pros and cons, so in practice some sort of blended system would often be chosen. A concern with the fee-for-service system is that it might make doctors provide too many services, that is, supplier-induced demand. Capitation breaks the link between payment and amount of services provided by giving the GP a fixed fee for each patient registered on the list. This system may lead GPs to selectively attract healthy patients and make unnecessary referrals to specialists. A salary system does not include an incentive mechanism, and is therefore assumed to involve lower productivity. After a comparison of the three payment systems, the chapter suggests a typology of GPs’ motivations along two dimensions: financial versus non-financial rewards, and selfish versus altruistic.
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Goddard, Shannon L., and Brian H. Cuthbertson. ICU Follow-Up Clinics. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199653461.003.0053.

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ICU follow-up clinics have been proposed and, in some cases, adopted in an effort to improve post-ICU care. Clinics are heterogeneous in staffing and organization and may provide a range of services, from drug reconciliation to mental health referrals. Some clinics integrate support services for family members and caregivers. In other cases, the clinics exist largely as a research environment where they may help to better understand long-term outcomes of survivors of critical illness. Thus far, clinical trials have not shown these clinics to improve patient-centred outcomes or to be cost-effective. However, qualitative literature does suggest a subjective sense of benefit for patients and family members. The lack of quantitative evidence in support of clinics does not mean that the long-term needs of ICU patients cannot be addressed in a formal way. However, it does suggest that clinics are not effective as delivered in the trials. Critical care researchers should be directed by both the qualitative and quantitative literature in conceiving new interventions and testing them in clinical trials. The model of an interdisciplinary clinic including rehabilitation specialists should be further explored.
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Robinson, Max, Keith Hunter, Michael Pemberton, and Philip Sloan. Soames' & Southam's Oral Pathology. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780199697786.001.0001.

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A sound understanding of clinical oral pathology is essential if a dental clinician is to navigate successfully through clinical guidelines, make timely referrals to specialists, and provide good care for patients. This new edition of Soames' & Southam's Oral Pathology provides a clear and friendly guide for students, practitioners, and the whole dental team. Thoroughly updated for today's clinical practice, this textbook covers 'must-know' oral pathology and integrates key aspects of oral medicine. It begins by explaining the principles of clinical assessment, the synthesis of a differential diagnosis, and the selection of further investigations including laboratory tests. Ten chapters bring this theory to life by looking at the clinical and pathological features of a wide range of common oral diseases including oral cancer, salivary gland disorders, and diseases of the jaws. Two new chapters address skin diseases affecting the oro-facial region and neck lumps. A final chapter highlights the importance of clinical oral pathology in the context of systemic human disease. New radiology content includes examples of cross-sectional imaging. Photomicrographs have been replaced with carefully selected images to illustrate key pathological features. Each chapter includes key points boxes and tables to aid learning. Written by experts in both oral pathology and oral medicine, this new edition is a must-have for dentistry students, and those working in the field, providing current and trustworthy information.
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Book chapters on the topic "Patterns of specialists referrals"

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Marshall, Jenny, and Phil Willmot. "From ‘Anxious and Sad’ to ‘Risky and Bad’: Changing Patterns of Referrals to the Personality Disorder Service." In Working Positively with Personality Disorder in Secure Settings, 11–21. Chichester, UK: John Wiley & Sons, Ltd, 2011. http://dx.doi.org/10.1002/9780470973110.ch1.

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Hanretty, Chris. "Political Patterns of Dissent." In A Court of Specialists, 193–238. Oxford University Press, 2020. http://dx.doi.org/10.1093/oso/9780197509234.003.0008.

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This chapter—the longest in the book—tackles the issue of whether the judges of the Supreme Court disagree on political grounds. The chapter reviews a number of methods for analyzing disagreement, before describing a model that assigns judges positions on a spectrum, so that judges who are further apart are less likely to agree in non-unanimous cases. The results of that model show that there is a divide that characterizes the court; that Baroness Hale and Lord Kerr are at one hand, and Lords Brown, Rodger, and Sumption at the other end; and that this divide can be characterized as a left-right divide. Most of the chapter is spent describing the particular cases that divided these groups of judges, and arguing for the importance of viewing these cases through the lens of left and right.
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Allam, Nour, Bissan Audeh, Marie-Christine Jaulent, and Cedric Bousquet. "Visualising Patterns Associated with Adverse Drug Reactions in French Forums." In Studies in Health Technology and Informatics. IOS Press, 2021. http://dx.doi.org/10.3233/shti210368.

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As social media are an interesting source of information for pharmacovigilance, we implemented a novel visualisation method for pharmacovigilance specialists applied to French discussion forums. A word embedding model was trained on posts to facilitate the identification of patterns associated with adverse drug reactions.
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Willmer, Pat. "Syndromes and Webs: Specialists and Generalists." In Pollination and Floral Ecology. Princeton University Press, 2011. http://dx.doi.org/10.23943/princeton/9780691128610.003.0020.

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This chapter examines the core issues raised by critiques of pollination syndromes and alternative approaches to characterizing pollination in communities, in the context of floral and pollinator specialization. It first considers theoretical arguments against syndromes and specialization before discussing practical evidence against syndromes, along with proposed alternative approaches, focusing in particular on ecological models of specialization and generalization. It then explores some problems with pollination webs, several key issues relating to specialization and generalization, and selection for specialization in flower–pollinator interactions. It also compares patterns of generalization and specialization in different ecosystems and asks whether generalization can be reversed. The chapter concludes with some reflections on the debate over generalization, specialization, and pollination syndromes.
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Klitzman, Robert L. "Becoming an Infertility Patient." In Designing Babies, edited by Robert L. Klitzman, 31–40. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780190054472.003.0003.

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For many patients, the first step in using these technologies is getting a referral to an infertility specialist, yet even that step can pose challenges. Several types of healthcare provider can serve as gatekeepers and refer patients to fertility specialists—obstetricians and gynecologists, general practitioners, oncologists, and genetic counselors. Yet these clinicians often have knowledge gaps regarding infertility and thus delay or fail to make referrals. Patients encounter financial barriers as well. Patients may postpone or not seek treatment because they fail to appreciate how much age can diminish fertility. Both doctors and patients can feel awkward discussing sexual activity, reproduction, and infertility because of stigma. Usually, infertile patients who pursue treatment first undergo tests to determine whether the infertility stems from the man, the woman, or both. Before proceeding to in vitro fertilization, women ordinarily attempt medications and intrauterine insemination but face a range of challenges and questions.
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Schwab, Roxana, Andrea Kiemen, Joachim Weis, and Annette Hasenburg. "Provision of Onco-Fertility Support." In Sexual Health, Fertility, and Relationships in Cancer Care, 1–18. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780190934033.003.0001.

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The chapter considers issues where oncologic therapy can lead to partial or complete damage to the gonads (ovaries or testes), thus impairing fertility or reducing the fertile lifespan. We discuss the relatively new discipline of onco-fertility, which considers patients’ psychosocial needs, including sexual health, intimate relationships, and the affordability of fertility-preservation measures. Referral and counseling for fertility preservation should be performed as soon as possible after the cancer diagnosis. Assessment of reproductive potential should be offered to all cancer patients. Healthcare professionals should be proactive regarding fertility-preservation counseling. A multidisciplinary team consisting of oncologists, fertility specialists, specialized nurses, mental health professionals, psycho-oncologists, social workers, and support groups should be available when dealing with infertility as a side effect of cancer therapy. Shared decision making regarding fertility preservation is an important issue. Partners may need psychological counseling referrals as well, or couple counseling on communication and sexuality.
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Sartori, Enrico, Franco E. Odicino, Federico Ferrari, and Valentina Zizioli. "Fertility Sparing Team." In NEOPLASIA and FERTILITY, 129–47. BENTHAM SCIENCE PUBLISHERS, 2022. http://dx.doi.org/10.2174/9789815050141122010009.

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Cancer is a leading cause of death in the female population, accounting for 6.7 million of new diagnoses worldwide. Cancer and its treatment can often impair the chances of having children, and the fertility sparing issueis an emerging need. In fact, more often, women are delaying conception and therefore, an increasing number of women are diagnosed with malignancy before the desired completion of childbearing. The care of these patients is challenging, and complex, and there is a total lack of validated guidelines. The problem of fertility in a cancer patient encounters not only clinical and technical problems, but it raises many other queries about ethical and psychological perspectives. Since an international consensus statement should be produced, the need for a dedicated multidisciplinary approach is mandatory to offer a clinical range of treatment options. Cancer survivors and the medical community have acknowledged the importance of patient counseling and the pursuit of options for fertility preservation. In 2006, the American Society of Clinical Oncology published the first recommendations on fertility preservation; however, despite the increasing awareness regarding these recommendations, fertility preservation services are still underutilized. ASCO guidelines advised oncologists to discuss fertility risks and preservation strategies and make referrals to fertility specialists for interested patients as early as possible. There are some programmatic requirements to set up a fertility preservation service, the most significant of which is the availability of a multidisciplinary medical team. A treatment planning approach in which medical figures are experts in different specialties aims to deliver a global treatment tailored to the patient and its disease. A multidisciplinary approach to debating with fertility-sparing issue in oncological patients has mainly two objectives: firstly, to ensure the oncological safety and, in second place, the verification of the fertility preservation desire, that should be not only the intention of the patient but also compliant to “minimum requirements” and therefore a step-wise and careful selection of the women candidate to conservative treatment is necessary. Counseling of patients pursuing fertility preservation should include a discussion of all methods of fertility preservation as well as the alternatives. Because of the sensitive and urgent nature of fertility preservation, a team approach to patient counseling is recommended. Effective provision of fertility preservation options requires an ongoing collaborative relationship among medical and surgical oncologists, reproductive endocrinologists and other medical figures. Oncologists have the initial responsibility to discuss the reproductive risks of intended therapies with the patient and subsequently make referrals to experienced specialists to discuss available reproductive options, which have to be discussed both for surgical decisions and chemotherapy and/or radiotherapy administration. Multidisciplinary teams should include: oncologists, gynecologic oncologists, radiation therapy specialists, reproductive endocrinology and infertility specialists, andrologists, fertility.dedicated biologists, and nurses in the specialties of oncology and infertility, onco.psychologists and social workers. All of these are required to work together in order to achieve a successful collaborative approach
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Brodmann, Marianne. "Lower extremity artery disease." In ESC CardioMed, edited by Victor Aboyans, 2720–33. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0782.

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Most patients with LEAD are asymptomatic. Walking capacity must be assessed to detect clinically masked LEAD. The clinical signs vary broadly. Atypical symptoms are frequent. Even asymptomatic patients with LEAD are at high risk of CV events and must benefit from most CV preventive strategies, especially strict control of risk factors. Antithrombotic therapies are indicated in patients with symptomatic LEAD. There is no proven benefit for their use in asymptomatic patients. Ankle-brachial index is indicated as first-line test for screening and diagnosis of LEAD. DUS is the first imaging method. Data from anatomical imaging tests should always be analysed in conjunction with symptoms and haemodynamic tests prior to treatment decision. In patients with intermittent claudication, CV prevention and exercise training are the cornerstones of management. If daily life activity is severely compromised, first-line revascularization can be proposed, along with exercise therapy. Chronic limb-threatening ischaemia specifies clinical patterns with a vulnerable limb viability related to several factors. The risk is stratified according to the severity of ischaemia, wounds, and infection. Early recognition of tissue loss and/or infection and referral to the vascular specialist is mandatory for limb salvage by a multidisciplinary approach. Revascularization is indicated whenever feasible. Acute limb ischaemia with neurological deficit mandates urgent revascularization.
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Shokrollahi, Kayvan, and Susie Yao. "The burns management pathway II: receiving and initially managing a patient with burns." In Burns (OSH Surgery), 43–52. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780199699537.003.0006.

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The burns multidisciplinary team includes surgeons, specialist nurses, anaesthetic and critical care specialists, operating theatre staff, physiotherapists, occupational therapist, play specialists, clinical psychologists and dieticians, with input from other specialties (eg. microbiology). Burns units receive referrals from primary and secondary care, usually by telephone. Referral proformas help to document these calls and any information provided about patients, their burns and associated injuries, the treatments provided and their planned transfer. The clinician accepting the patient for transfer must ensure that there is an available ward or ICU bed, as required, prior to arranging transfer. Care should be taken to minimize the risk of a patient deteriorating during transfer. Fluid resuscitation and patient warming should continue during a prompt transfer by an ambulance team with the appropriate equipment and expertise, along with a medical escort if required. Upon arrival, the patient should be formally and systematically assessed (including an ATLS primary and secondary survey and anaesthetic assessment if indicated) and any remaining investigations undertaken. The burn wounds should be cleaned, photographed, swabbed and dressed, and any resuscitation fluids recalculated and prescribed. Appropriate medications and adjuncts should be prescribed including tetanus, deep vein thrombosis and stress ulceration prophylaxis, analgesia, usual medications, and nutritional supplements along with enteral or parenteral feeds. An admission proforma helps junior medical staff to ensure that all required information is collected and all components of the standard management plan are instituted.
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Zesiewicz, Theresa A., Nicolas Dohse, Clifton L. Gooch, Yarema B. Bezchlibynk, and Shaila Ghanekar. "Diversity and Inclusivity in Parkinson Disease and Essential Tremor." In Tremors, edited by Claudia M. Testa and Dietrich Haubenberger, 211–17. Oxford University PressNew York, 2022. http://dx.doi.org/10.1093/med/9780197529652.003.0017.

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Abstract Despite millions of people being affected by tremor worldwide, information regarding tremor patients’ ethnicity and racial diversity is limited. We examined diversity and inclusivity in two diseases, essential tremor (ET) and Parkinson disease (PD), primarily in the United States. There is little information regarding regional and ethnic differences of ET, although several studies suggest that Blacks are less likely to be affected by PD than Whites. Blacks appear to have less chance of being diagnosed with PD, reduced access to outpatient care, and less chance of being treated with newer PD medications. Black patients with PD may also be less likely to undergo DBS than White patients. There appears to be a disproportionate lack of minority representation in PD clinical trials. Education regarding ET and PD is essential so that first line healthcare providers can make appropriate referrals to specialists. Greater diversity and inclusion of non-White ET and PD patients is needed in clinical research, and better and more equal access to healthcare is vital and long overdue.
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Conference papers on the topic "Patterns of specialists referrals"

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Ahrari, A., S. S. Barrett, S. Rohekar, P. Basharat, G. Rohekar, S. Haig, and J. Pope. "OP0302 An evaluation of utilisation patterns and appropriateness of laboratory tests among new referrals to rheumatologists: choosing unwisely!" In Annual European Congress of Rheumatology, EULAR 2018, Amsterdam, 13–16 June 2018. BMJ Publishing Group Ltd and European League Against Rheumatism, 2018. http://dx.doi.org/10.1136/annrheumdis-2018-eular.4212.

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Guo, Jia-Wen, Heather Bennett, Barbara I. Crouch, and Mollie R. Cummins. "Reference Website Use Patterns of Poison Control Center Specialists." In 2017 IEEE International Conference on Healthcare Informatics (ICHI). IEEE, 2017. http://dx.doi.org/10.1109/ichi.2017.40.

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Holt, Emily, and Deborah A. Sunter. "Historical Patterns for Rooftop Solar Adoption Growth Rates in Connecticut." In 2021 IEEE 48th Photovoltaic Specialists Conference (PVSC). IEEE, 2021. http://dx.doi.org/10.1109/pvsc43889.2021.9518878.

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Wong, Johnson. "Griddler: Intelligent computer aided design of complex solar cell metallization patterns." In 2013 IEEE 39th Photovoltaic Specialists Conference (PVSC). IEEE, 2013. http://dx.doi.org/10.1109/pvsc.2013.6744296.

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Ouyang, Zi, Derwin Lau, Pei Hsuan Lu, Jie Cui, and Alison Lennon. "Formation of metal-metal oxide patterns using masked light-induced anodization." In 2015 IEEE 42nd Photovoltaic Specialists Conference (PVSC). IEEE, 2015. http://dx.doi.org/10.1109/pvsc.2015.7355875.

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Mints, Paula. "Photovoltaic industry price behavior 1975 through 2015, drivers, patterns and outcomes." In 2016 IEEE 43rd Photovoltaic Specialists Conference (PVSC). IEEE, 2016. http://dx.doi.org/10.1109/pvsc.2016.7750283.

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Weng, Haiqing, Kunlun Chen, Jianmei Zhang, Rajib Datta, Xianghui Huang, Luis J. Garces, Robert Wagoner, Allen M. Ritter, and Paola Rotondo. "A Four-Level Converter with Optimized Switching Patterns for High-Speed Electric Drives." In 2007 IEEE Power Electronics Specialists Conference. IEEE, 2007. http://dx.doi.org/10.1109/pesc.2007.4342232.

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Ferry, Vivian E., Marc A. Verschuuren, Claire van Lare, Ruud E. I. Schropp, Albert Polman, and Harry A. Atwater. "Conformal plasmonic a-Si:H solar cells with non-periodic light trapping patterns." In 2011 37th IEEE Photovoltaic Specialists Conference (PVSC). IEEE, 2011. http://dx.doi.org/10.1109/pvsc.2011.6186025.

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Lin, Yu-Hsuan, Li-Yu Li, Sung-Yu Chen, Shih-Peng Hsu, Yu-Shen Chen, Tzu-Huan Cheng, Chun-Ping Chen, and Peichen Yu. "New designed electrode patterns on rear side of bifacial PERC solar cells." In 2019 IEEE 46th Photovoltaic Specialists Conference (PVSC). IEEE, 2019. http://dx.doi.org/10.1109/pvsc40753.2019.8980623.

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Gupta, Deepak K., Matthijs Langelaar, Marco Barink, and Fred van Keulen. "Topology optimization: An effective method for designing front metallization patterns of solar cells." In 2014 IEEE 40th Photovoltaic Specialists Conference (PVSC). IEEE, 2014. http://dx.doi.org/10.1109/pvsc.2014.6925431.

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Reports on the topic "Patterns of specialists referrals"

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Lundgren, Jonathan, Moshe Coll, and James Harwood. Biological control of cereal aphids in wheat: Implications of alternative foods and intraguild predation. United States Department of Agriculture, October 2014. http://dx.doi.org/10.32747/2014.7699858.bard.

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The overall objective of this proposal is to understand how realistic strategies for incorporating alternative foods into wheat fields affect the intraguild (IG) interactions of omnivorous and carnivorous predators and their efficacy as biological control agents. Cereal aphids are a primary pest of wheat throughout much of the world. Naturally occurring predator communities consume large quantities of cereal aphids in wheat, and are partitioned into aphid specialists and omnivores. Within wheat fields, the relative abilities of omnivorous and carnivorous predators to reduce cereal aphids depend heavily on the availability, distribution and type of alternative foods (alternative prey, sugar, and pollen), and on the intensity and direction of IG predation events within this community. A series of eight synergistic experiments, carefully crafted to accomplish objectives while accounting for regional production practices, will be conducted to explore how cover crops (US, where large fields preclude effective use of field margins) and field margins (IS, where cover crops are not feasible) as sources of alternative foods affect the IG interactions of predators and their efficacy as biological control agents. These objectives are: 1. Determine the mechanisms whereby the availability of alternative prey and plant-provided resources affect pest suppression by omnivorous and carnivorous generalist predators; 2. Characterize the intensity of IGP within generalist predator communities of wheat systems and assess the impact of these interactions on cereal aphid predation; and 3. Evaluate how spatial patterns in the availability of non-prey resources and IGP affect predation on cereal aphids by generalist predator communities. To accomplish these goals, novel tools, including molecular and biochemical gut content analysis and geospatial analysis, will be coupled with traditional techniques used to monitor and manipulate insect populations and predator efficacy. Our approach will manipulate key alternative foods and IG prey to determine how these individual interactions contribute to the ability of predators to suppress cereal aphids within systems where cover crop and field margin management strategies are evaluated in production scale plots. Using these strategies, the proposed project will not only provide cost-effective and realistic solutions for pest management issues faced by IS and US producers, but also will provide a better understanding of how spatial dispersion, IG predation, and the availability of alternative foods contribute to biological control by omnivores and carnivores within agroecosystems. By reducing the reliance of wheat producers on insecticides, this proposal will address the BARD priorities of increasing the efficiency of agricultural production and protecting plants against biotic sources of stress in an environmentally friendly and sustainable manner.
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UK-wide study reveals a pattern of delay in referrals to specialist end-of-life care. National Institute for Health Research, August 2018. http://dx.doi.org/10.3310/signal-000635.

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