Urbanization is playing a key role in big cities of developing countries, which, in effect, is increasing the population. This study takes care of the mega infrastructure project (Orange Line Metro ...Train (OLMT)) to explore and identify the H&S (Health and Safety) factors that affect the local residents and the main key stakeholders working on the project. A Sequential Mixed-Method approach of the OLMT-project includes qualitative and quantitative methods were adopted. The data have been collected from the targeted population working on the OLMT-project through a questionnaire. The main key finding of the study indicates that poor planning and a lack of communication between the public and government led to frustration. The most significant factors that identified in the study were unsafe to work practice, project scope constraints, lack in technical and material support, unsafe/bad condition, health/environment degradation, declination and loss of resources and time, no proper emergency system, and negligence in adopting safety rules and laws. The study also revealed that the consensus should also be noticed between the key stakeholders (e.g., contractors, clients, safety officials, academia) in the second round of the Delphi survey of the project. The study findings will help the key stakeholders to prioritize their energies towards attaining zero levels of inadequate health and safety practices in infrastructure projects. The study outcomes can also be generalized for the other developing countries having a similar work scenario.
Im Zuge der Weiterentwicklung der Palliativversorgung in Deutschland entstand im Jahr 2017 eine Vereinbarung zur „Besonders qualifizierten und koordinierten palliativmedizinischen Versorgung“ ...(BQKPMV). Hausärzt*innen nehmen bei der BQKPMV eine zentrale Rolle ein und sind u.a. für die Koordination der Versorgung zuständig. Es gibt Hinweise darauf, dass Hürden in der praktischen Umsetzung der BQKPMV bestehen und eine Anpassung erforderlich sein könnte. Diese Arbeit ist Teil des Projekts Polite (Analyse der Implementierung der ‚Besonders qualifizierten und koordinierten palliativmedizinischen Versorgung‘ in der Versorgungsrealität und Empfehlungen zur Weiterentwicklung) und verfolgt das Ziel, Empfehlungen zur Weiterentwicklung der BQKPMV zu konsentieren.
Zwischen Juni und Oktober 2022 erfolgte eine Online-Delphi-Befragung mit Expert*innen für die ambulante Palliativversorgung aus ganz Deutschland (Versorgende, Fachverbände, Kostenträger, Wissenschaft, Selbstverwaltung). Inhaltliche Basis für die Empfehlungen, über die im Rahmen der Delphi-Befragung abgestimmt wurde, waren Ergebnisse aus der ersten Projektphase sowie aus einem Expert*innen-Workshop. Teilnehmende konnten zu jeder Empfehlung auf einer vierstufigen Rangskala angeben, inwiefern sie a) der Deutlichkeit der Formulierung und b) der Relevanz für die Weiterentwicklung der BQKPMV zustimmen. Ein Konsens wurde angenommen, wenn 75% der Teilnehmenden einer Empfehlung bezüglich beider Kriterien (eher) zustimmten. Wurde kein Konsens erreicht, wurden die Empfehlungen mithilfe der Freitextanmerkungen angepasst und in der nächsten Runde erneut präsentiert. Die Analysen erfolgten deskriptiv.
An der ersten Befragungsrunde nahmen 45 Expert*innen teil, an der zweiten 31 und an der dritten 30 (43% weiblich, im Mittel 55 Jahre alt). In Runde 1 wurden sieben, in Runde 2 sechs und in Runde 3 drei Empfehlungen konsentiert. Diese insgesamt 16 Empfehlungen beziehen sich inhaltlich auf vier Themenkomplexe: Bekanntheit und Implementierung der BQKPMV (6 Empfehlungen), Rahmenbedingungen der BQKPMV (3), Abgrenzung der Versorgungsformen (5) und Zusammenarbeit an den Schnittstellen (2).
Mithilfe der Delphi-Methode konnten konkrete und für die Versorgungspraxis relevante Empfehlungen zur Weiterentwicklung der BQKPMV identifiziert werden. Im finalen Set von Empfehlungen liegt ein besonderer Fokus auf einer Steigerung der Bekanntheit und der Vermittlung von Informationen zu Leistungsumfang, Mehrwert und Rahmenbedingungen der BQKPMV.
Die Ergebnisse liefern eine empirisch fundierte Grundlage für die Weiterentwicklung der BQKPMV. Sie zeigen konkreten Veränderungsbedarf auf und unterstreichen, dass eine Optimierung der BQKPMV erforderlich ist.
In the course of the further development of palliative care in Germany, an agreement on an intermediate level of outpatient palliative care, the so-called BQKPMV (specially qualified and coordinated palliative homecare) was realised in 2017. Family physicians play a central role in the BQKPMV; among other things, they are responsible for the coordination of care. There are indications that barriers exist in the practical implementation of the BQKPMV and that an adjustment may be necessary. This work is part of the Polite project (analysis of the implementation of an intermediate level of outpatient palliative care in the reality of care and recommendations for further development) and aims at building consensus on recommendations for the further development of the BQKPMV.
Between June and October 2022, an online Delphi survey was conducted among experts for outpatient palliative care from all over Germany (providers, professional associations, funders, science, self-government). The content of the recommendations, which were voted on as part of the Delphi survey, was based on the results of both the first project phase and an expert workshop. Participants rated the extent to which they agree with a) the clarity of the wording, and b) the relevance for the further development of the BQKPMV on a four-point Likert scale. Consensus was assumed when 75% of the participants (rather) agreed to a recommendation with regard to both criteria. If no consensus was reached, the recommendations were adjusted using the free text comments and presented again in the next round. Descriptive analyses were applied.
Forty-five experts participated in the first Delphi round, 31 in the second, and 30 in the third round (43% female, average age 55). Consensus was obtained for seven recommendations in round 1, for six in round 2 and for three in round 3. These final 16 recommendations relate to four topics: awareness and implementation of the BQKPMV (6 recommendations), framework conditions of the BQKPMV (3), discrimination of forms of care (5), and cooperation at the interfaces of care (2).
The Delphi method was used to identify concrete recommendations for the further development of the BQKPMV that are relevant to health care practice. In the final set of recommendations, a particular focus lies on increasing awareness and communicating information about the scope of the health care service, added value and framework conditions of the BQKPMV.
The results provide an empirically sound basis for the further development of the BQKPMV. They show a concrete need for change and highlight that an optimisation of the BQKPMV is necessary.
Introduction:
Nasal irrigation is regularly used in infants to relieve upper airway symptoms. However, because there is no consensus on good practice, nasal irrigation in infants is described and ...applied heterogeneously among clinicians and between clinical trials.
Objective:
The aim of this study was to establish consensus regarding the use of nasal irrigation in infants.
Methods:
A panel of Belgian physiotherapists and physicians experienced in performing nasal irrigation in infants were surveyed using the Delphi technique. Three survey rounds were used. Participants rated their level of (dis)agreement to each statement in each round using a 6-point Likert scale. Consensus was defined for statements which collected at least 75% of responses in agreement or disagreement. The questionnaire of Round 1 was built on nasal irrigation practice habits previously collected from parents, childcare workers, and healthcare professionals. Questionnaires from rounds 2 and 3 were amended based on experts written feedback.
Results:
Thirty experts (12 physicians and 18 physiotherapists) completed all 3 questionnaires. Consensus was achieved for 47 of 75 statements (63%) distributed over the following domains: “contraindications,” “indications and frequency of use,” “irrigation means,” “solution preparation,” “solution volume,” “realization of the technique,” and “assessment of the efficacy of nasal irrigation.”
Conclusion:
This study provides the first well-constructed consensus on good practice on nasal irrigation in infants. Consensus on several statements across different domains were established but require validation in future trials. This study also proposes direction for future research focusing on statements that did not reach consensus.
To develop an operational definition of contextual factors (CF) 1.
Based on previously conducted interviews, we presented three CF types in a Delphi survey; Effect Modifying -, Outcome Influencing - ...and Measurement Affecting CFs. Subsequently, a virtual Special Interest Group (SIG) session was held for in depth discussion of Effect Modifying CFs.
Of 161 Delphi participants, 129 (80%) completed both rounds. After two rounds, we reached consensus (≥70% agreeing) for all but two statements. The 45 SIG participants were broadly supportive.
Through consensus we developed an operational definition of CFs, which was well received by OMERACT members.
•We present a transdisciplinary approach for developing soil indicators using stakeholders.•A set of soil indicators for sustainable development is provided.•Soils need to be sustainably used to ...fulfil many of the Sustainable Development Goals.
Sustainable management of soils is needed to accomplish many of the United Nations’ Sustainable Development Goals, but it can be problematic in practice as soils are complex and to manage them sustainably requires the co-operation of multiple stakeholders on various level of society. We present the outcome of a transdisciplinary approach towards indicator development, where we created a set of soil indicators for sustainable development with stakeholder group participation from scientists, policymakers and soil practitioners. The groups evaluated 49 indicators, through a Delphi survey technique, and selected a set of 30 indicators. Of these 14 were common to all stakeholder groups and represented a final set of core soil indicators for sustainable development. The Delphi survey did suffer from high attrition rate and low response rate, especially among the policy makers, which limits somewhat its findings. Nevertheless, the survey illustrated the usefulness of relevant stakeholder involvement in an indicator development process and the role of survey based instruments in aiding the selection of common indicators, whilst showing the different views of stakeholders groups. Given that the stakeholder groups have to consider a multitude of variables and impacts on soil and may have different focus and management goals in mind, a process such as this can serve as a starting point for discussion between stakeholder groups on various levels of governance about how to manage soil sustainably and help to fulfil the UN’s Sustainable Development Goals.
Introduction
This survey of international experts in obesity management was conducted to achieve consensus on standardized definitions and to identify areas of consensus and non-consensus in ...metabolic bariatric surgery (MBS) to assist in an algorithm of clinical practice guidelines for the management of obesity.
Methods
A three-round Delphi survey with 136 statements was conducted by 43 experts in obesity management comprising 26 bariatric surgeons, 4 endoscopists, 8 endocrinologists, 2 nutritionists, 2 counsellors, an internist, and a pediatrician spanning six continents over a 2-day meeting in Hamburg, Germany. To reduce bias, voting was unanimous, and the statements were neither favorable nor unfavorable to the issue voted or evenly balanced between favorable and unfavorable. Consensus was defined as ≥ 70% inter-voter agreement.
Results
Consensus was reached on all 15 essential definitional and reporting statements, including initial suboptimal clinical response, baseline weight, recurrent weight gain, conversion, and revision surgery. Consensus was reached on 95/121 statements on the type of surgical procedures favoring Roux-en-Y gastric bypass, sleeve gastrectomy, and endoscopic sleeve gastroplasty. Moderate consensus was reached for sleeve gastrectomy single-anastomosis duodenoileostomy and none on the role of intra-gastric balloons. Consensus was reached for MBS in patients > 65 and < 18 years old, with a BMI > 50 kg/m
2
, and with various obesity-related complications such as type 2 diabetes, liver, and kidney disease.
Conclusions
In this survey of 43 multi-disciplinary experts, consensus was reached on standardized definitions and reporting standards applicable to the whole medical community. An algorithm for treating patients with obesity was explored utilizing a thoughtful multimodal approach.
Graphical Abstract
•This paper integrates Delphi method into Scenario panning and proposes a four-step analytical procedure.•This paper uses the integrated method to analyze China's renewable energy development to ...2030.•The three-dimensional scenario analytical framework composed of eight future scenarios is constructed.•This paper constructs the five development scenarios of China's renewable energy to 2030.•Policy guidance is supposed to pave the way to the development of China's renewable energy to 2030.
Although scenario planning and the Delphi survey are widely used in long-term strategy planning, their combinations have not received enough attention, especially in the improvement of efficacy in scenario planning. The crucial step of scenario planning is the effective identification of the uncertain and most influential drivers and key factors. This paper integrates the Delphi survey into scenario planning. It proposes a four-step analytical procedure of Delphi survey-based scenario planning: identifying the key ingredients from Delphi results, establishing the causal relationships among key ingredients, scenario development, and scenario description. The integrated method has been adopted in the planning practice for the renewable energy development strategy towards 2030 in China. Based on the three uncertain and most influential drivers, “technology development,” “ecological awareness,” and “national energy pricing,” most possibly influencing the renewable energy development towards 2030 in China, a novel three-dimensional scenario analytical framework composed of eight future scenarios is constructed. Considering the possibility in China's practice, five scenarios are selected as possible development scenarios of China's renewable energy towards 2030. This paper develops possible policy choices for each selected scenario.
Zu einer bedarfsgerechten, patient:innenenorientierten Hospiz- und Palliativversorgung zählen auch Tageshospize als spezialisierte ambulante Versorgungsangebote. Aufbau und Entwicklung von ...Tageshospizen in Deutschland erfolgten bislang individuell und eigeninitiativ. Zur langfristigen Sicherstellung der Qualität und Bedarfsangemessenheit von Tageshospizen bedarf es wissenschaftlicher Erkenntnisse und Grundlagen.
Von November 2022 bis Februar 2023 erfolgte eine deutschlandweite Online-Delphi-Befragung mit Expert:innen, in der Empfehlungen für den Auf- und Ausbau von Tageshospizen in Deutschland konsentiert wurden. Teilnehmende gaben zu jeder Empfehlung auf einer vierstufigen Rangskala an, wie sehr sie a) der Relevanz der Empfehlung und b) der Umsetzbarkeit der Empfehlung im Versorgungsalltag (nicht) zustimmen. Konsens wurde erreicht, wenn 80% der Teilnehmenden einer Empfehlung in beiden Kriterien (eher) zustimmten. Wurde kein Konsens erreicht, wurden die Empfehlungen basierend auf Freitextkommentaren der Teilnehmenden angepasst und in der darauffolgenden Runde erneut zur Abstimmung gestellt. Die Analysen erfolgten deskriptiv.
An der ersten Befragungsrunde beteiligten sich 64 und an der zweiten 44 Expert:innen. In Runde 1 wurden 34 und in Runde 2 sechs Empfehlungen konsentiert. Das finale Set enthält insgesamt 40 Empfehlungen: 18 zu Aufgaben, 13 zur Zusammenarbeit, 7 zur Finanzierung und 2 zur Öffentlichkeitsarbeit von Tageshospizen.
Es konnten konkrete Empfehlungen zum Auf- und Ausbau von Tageshospizen in Deutschland entwickelt werden. Die Empfehlungen sollten aufgrund ihrer hoch bewerteten Umsetzbarkeit direkt in die Versorgungspraxis überführbar sein. Inwiefern die Empfehlungen in der Neuverhandlung der Rahmenvereinbarung für Tageshospize berücksichtigt werden, gilt es abzuwarten.
Die vorliegenden Empfehlungen können handlungsweisend bei der aktuell sehr dynamischen Weiterentwicklung der Hospizarbeit und Palliativversorgung in Deutschland genutzt werden.
A needs-based and patient-oriented hospice and palliative care also includes day hospices as a specialised semi-inpatient care offer. The establishment and development of these facilities in Germany has been rather unsystematic. In order to ensure quality and adequacy of these structures, research is needed.
A Delphi consensus study was conducted online from November 2022 to February 2023 aiming at generating recommendations for the development and expansion of day hospices in Germany. For each recommendation, the participants indicated on a four-point verbal rating scale how much they agreed upon a) the relevance and b) the feasibility of the recommendation. Items were considered consented when 80% of the participants (strongly) agreed with the recommendation regarding both criteria. If no consensus was reached, the recommendations were revised according to the participants’ free text comments and presented in the next Delphi round. Descriptive analyses were applied.
A total of 64 experts participated in the first Delphi round and 44 in the second. In round 1, 34 recommendations and in round 2 six recommendations were consented. The final set contains a total of 40 recommendations: 18 on the tasks of day hospices, 13 on cooperation, 7 on funding, and 2 on public relations.
Recommendations for the development and expansion of day hospices in Germany were developed. Due to their highly rated feasibility, the recommendations should be directly transferable into care practice. It remains to be seen to what extent they will be taken into account in the renegotiation of the framework agreement for day hospices.
The Delphi-consented recommendations provide a basis to guide action in the currently very dynamic development of hospice work and palliative care in Germany.
To establish an international consensus on the definition of food security, measures and advocacy priorities in high-income countries.
A two-round online Delphi survey with closing in March 2020 and ...December 2021. Consensus was set a priori at 75 %. Qualitative data were synthesised and priorities were ranked.
High-income countries.
Household food security experts in academia, government and non-government organisations who had published in the last 5 years.
Up to thirty-two participants from fourteen high-income countries responded to the Delphi with a 25 % response rate in Round 1 and a 38 % response rate in Round 2. Consensus was reached on the technical food security definition and its dimensions. Consensus was not reached on a definition suitable for the general public. All participants agreed that food security monitoring systems provide valuable data for in-country decision-making. Favoured interventions were those that focused on upstream social policy influencing income. Respondents agreed that both national and local community level strategies were required to ameliorate food insecurity, reinforcing the complexity of the problem.
This study furthers the conceptual understanding of the commonly used definition of food security and its constituent dimensions. Strong advocacy is needed to ensure food security monitoring, policy and mitigation strategies are implemented. The consensus on the importance of prioritising actions that address the underlying determinants of household food security by experts in the field from across wealthy nations provides evidence to focus advocacy efforts and generate public debate.
Purpose
Particularly in volatile, uncertain, complex and ambiguous (VUCA) business conditions, staff in supply chain management (SCM) look to real-time (RT) data processing to reduce uncertainties. ...However, based on the premise that data processing can be perfectly mastered, such expectations do not reflect reality. The purpose of this paper is to investigate whether RT data processing reduces SCM uncertainties under real-world conditions.
Design/methodology/approach
Aiming to facilitate communication on the research question, a Delphi expert survey was conducted to identify challenges of RT data processing in SCM operations and to assess whether it does influence the reduction of SCM uncertainty. In total, 14 prospective statements concerning RT data processing in SCM operations were developed and evaluated by 68 SCM and data-science experts.
Findings
RT data processing was found to have an ambivalent influence on the reduction of SCM complexity and associated uncertainty. Analysis of the data collected from the study participants revealed a new type of uncertainty related to SCM data itself.
Originality/value
This paper discusses the challenges of gathering relevant, timely and accurate data sets in VUCA environments and creates awareness of the relationship between data-related uncertainty and SCM uncertainty. Thus, it provides valuable insights for practitioners and the basis for further research on this subject.
PDF
