No / Is midwifery knowledge a relevant construct for contemporary practice? In other words, is it useful to think about the things midwives know and the skills they possess in terms of midwifery knowledge? Or, in an era of interprofessional practice, clinical governance and risk management, have midwives lost whatever was unique to their profession about how to help women give birth?

Climate change, with the possibility of an ice free Arctic ocean by 2015, has generated a renewed interest in the Arctic. This interest is being driven by the possibility of easier access to the abundant supply of resources such as oil, gas, minerals, and fisheries. Interest in Arctic tourism is also growing. Retreating sea ice will provide opportunities to avail of shorter routes for maritime traffic to and from Asia, North America, and Asia via the Arctic Ocean and Northwest Passage. In addition, the rate of population growth of local inhabitants in the Canadian Arctic is the fastest in Canada and one of the fastest in the world. A growing population will increase the demand for sealift resupply to Canada's northern communities. This work presents the first attempt to examine the role of privatization of icebreaking services in light of the present and projected shortages of infrastructure to support development in the Arctic. A unique combination of multiple methods within marine transportation, comprising of Delphi, grounded theory, and quantitative survey, is applied to investigate the potential for private involvement in the delivery of icebreaking services in the Canadian Arctic. This includes a novel application of Strauss and Corbin's Grounded Theory approach to develop hypotheses and relationships grounded in expert opinion. Although the Arctic Ocean may be ice free during the summers, there is still the issue of winter freezing and the threat of lingering multi-year ice which will impede marine transportation especially during periods of darkness and fog. The research shows that the future growth and development of the Canadian Arctic will undoubtedly require the use of designated icebreakers and ice strengthened vessels. However, Canada's fleet of Arctic icebreakers is ageing and considered unsuitable for future demands. While Canada has earmarked CAD $750M for the construction of one new icebreaker scheduled for delivery in 2017, the research shows that Icebreakers can be built outside of Canada for considerably less money and in less time. Also, the management and operation of the Canadian Coast Guard is under considerable security by the Auditor General of Canada. The research shows that not unlike others Arctic nations, there is potential for the creation of private-public partnerships in the delivery of Canadian Coast Guard services, principally icebreaking, in the Arctic.

The role of water freight as a sustainable mode of transportation often receives special attention in logistics and transportation. Due to rising environmental concerns UK national policy supports an increase in the amount of freight movements on commercial waterways. Within this context this research investigates the potential for water freight in the South West (SW) UK especially in Cornwall and Devon (CAD). This study is exploratory and following literature searches Delphi methods were selected with which to gather primary data. The research required three rounds of Delphi surveys. Following this, a focus group with the members of the 'Maritime and Waterborne Innovation Group' in the SW UK was conducted to measure the trustworthiness of the Delphi findings. The Delphi study achieved consensus on eight statements. Results indicated that the presence of an extensive coast line with accessibility to several coastal ports is conducive to the effective management of water freight movements in the region. The focus group discussion provided fuller explanations, suggestions and statements of issues which require further exploration for the development of water freight. This study reveals the latest information and possibilities and helped to articulate the importance of using water freight in SW UK. The results of this research also have many implications for the rest of the world where water freight is either in its infancy or aiming to increase its usage. The suggestions, observations and information collected during the Delphi study and from the focus group participants will assist in formulating strategies to improve the efficiency and effectiveness of water transportation within a region or a country.

Meeting observations, literature review, document analysis, and Delphi surveying are used within a “mixed methodology” to tease out emerging patterns of thought in an effort to provide an urban forestry coalition, “Trees for Life” with critical information that could be used to help shape future projects. The purpose of this research is to identify key themes to help direct future Trees for Life (TFL) projects, and to also recognize stakeholders and possible new players to establish more productive partnerships within the coalition. Specific barriers that impede the success of TFL are also outlined. Ecological degradation of the Greater Toronto Area (GTA) watershed continues, despite the many initiatives carried out by the Toronto Region Conservation Authority (TRCA) to protect and conserve ecosystem health. Social change is critical in addressing this issue. The TFL coalition is an umbrella group beneath Green Infrastructure Ontario (GIO), another coalition working towards establishing green infrastructure technologies and practices as required components of urban planning and development to address ecological degradation. This coalition is overseen by a steering committee that includes TRCA. The overarching goal of TFL is to increase tree canopy cover in the GTA to 40%. The TFL is comprised of several urban forestry groups, each with unique roles and perspectives, but all striving to achieve the 40% goal. This research will help TFL to build adaptive capacity and may lead to the adoption of adaptive environmental management techniques. Ultimately, this study will provide some valuable insight into TFL and other programs involved with enhancing social-ecological resilience of the TRCA and the GTA. / Thesis (Master, Environmental Studies) -- Queen's University, 2014-01-22 11:53:22.196

Water quality has been an issue of concern since the settlement of man and continues to be of great concern today in many locations around the world. In the United States, to address the issues of water pollution, the U.S. Congress passed the Clean Water Act (CWA) in 1972. This study examines the implementation and prioritization of impaired water bodies listed on the Illinois CWA section 303(d) list between 1992 and 2004. This study used the Delphi survey method to obtain opinions from water quality/management experts that reside in the state of Illinois. The goal of this study was to determine if a consensus could be reached amongst water quality experts on the severity of individual water pollutants for a given designated use of a water body by assigning weights, determining if any prioritization trends exist within the current Illinois 303(d) process, as well as identifying any shortcomings of the process and suggesting possible modes of improvement. The survey identified four major shortcomings of Illinois' current approach to water quality management: 1) limited funding and manpower, 2) lack of coordination/monitoring, 3) failure to regulate point sources, and 4) lack of biological monitoring. The survey respondents indicated that the entire state needs attention in terms of water quality improvement and that agriculture and urban runoff are the most important sources of water pollution and water body impairment. They rated the current prioritization system as being between "average" and "good" and identified that development of a weighting scheme could be feasible as long as it received adequate funding and adequate stakeholder support. The measure of consensus among respondents regarding weights for individual pollutants and designated uses varied significantly; however, the overwhelming majority of consensus values improved after participants were asked to revise their original responses in an effort to move towards central tendency in the distribution of assigned ranks.

<p><strong>Introduction. </strong>Treatment decisions for locally recurrent prostate cancer are difficult due to the number of available treatment options, varied evidence about their effectiveness and differences in side effects. It has been shown that decision aids improve information delivery and patient confidence in treatment decision-making.</p> <p><strong>Purpose.</strong> The purpose of this study was to identify and describe the decisional support needs of men with locally recurrent prostate cancer.</p> <p><strong>Methods.</strong> A two-phase descriptive needs assessment study employing both quantitative and qualitative methods was conducted to identify and describe the treatment decision-making needs of men with recurrent prostate cancer. Through a two-round Delphi process in Phase 1, physician consensus on treatment options for the decision aid was established. Phase 2 involved patient interviews to determine treatment decision-making needs.</p> <p><strong>Results.</strong> Oncologists and patients agreed that the treatment decision-making process took time, and may take several months. Some patients described feelings of regret and/or uncertainty about their treatment decision. Individualized patient needs for information and support were recognized. Key barriers to effective treatment decision-making included information overload and lack of access to unbiased information sources. Establishing a centralized information resource such as nurse-led information sessions was recommended by patients.</p> <p><strong>Conclusions.</strong> Treatment decision-making is time consuming for oncologists and patients. Despite these efforts, patients report unmet information needs and are not always confident in their treatment decision. Time efficient and effective ways of improving patient confidence in treatment decision-making, as well as implications for nursing practice and future research are discussed.</p> / Master of Science in Nursing (MSN)

Face à l’engouement de la presse professionnelle pour l’innovation logistique (IL) et à une profusion de solutions logistiques innovantes émanant du terrain, nous avons constaté une production scientifique limitée sur ce champ de recherche, des incertitudes demeurant sur la définition du concept d’IL et sur sa gestion. A partir de ces observations, nous avons tenté d’éclairer le concept d’IL à partir d’un état de l’art et de différentes méthodes qualitatives (analyse scientométrique et bibliométrique, enquête Delphi). Ensuite, nous avons analysé le processus d’adoption de l’IL sur la base de quatre études de cas. Le dispositif empirique offre une variété dans le choix des cas, avec des IL à dominante technologique ou organisationnelle adoptées dans des organisations issues de secteurs différents (prestataires de services logistiques, distributeur, industriel, clinique privée). Sur le concept de l’IL, nous avons proposé un bilan de la production scientifique actuelle ainsi qu’une définition et une caractérisation de l’IL. Sur le processus d’adoption de l’IL, il ressort du travail réalisé des facteurs déterminants liés à l’organisation adoptante, à l’IL adoptée, au management stratégique de l’organisation adoptante et au personnel adoptant ainsi que des obstacles. / Notwithstanding the enthusiasm of the professional press for logistics innovation (LI) and the number of innovative logistics solutions accessible to firms, we observe a limited scientific production on this field of research, leaving uncertainties as regards the definition of the concept of LI and its management. From these observations, we tried to clarify the concept of LI using a state of the art and different qualitative methods (scientometric and bibliometric analysis, Delphi survey). Then we analyzed the process of LI adoption on the basis of four case studies. The empirical setting offers variety in the selection of the cases with technological or organizational oriented LIs adopted in different organizations (logistics service providers, retailer, manufacturer, private hospital).As for the concept of LI, we proposed a review of the current scientific production and a definition and characterisation of LI. As for the process of LI adoption, the research resulted in the identification of determinants related to the adoptive organization, the adopted LI, the strategic management of the adopting organization and the adopting personnel, as well as obstacles.

Nach der Herleitung und Skizzierung der ‚szenariobasierten Delphi-Studie’ als Untersuchungsmethode und Präsentation des Forschungsdesigns werden Konzepte von Wissensmanagement über einen Literatur-Review in den Kontext des aktuellen Forschungsstandes gestellt. Diese Bestandsaufnahme der Gegenwart ist in erster Linie abgeleitet aus Fachveröffentlichungen zum Wissensmanagement im Allgemeinen und denen der BID-Community im Besonderen. Welche Rolle spielt Wissensmanagement gegenwärtig in der bibliothekarischen Praxis Öffentlicher Bibliotheken der im Untersuchungsfokus stehenden Nationen? Was verbindet die Arbeit mit Wissensmanagement in den Öffentlichen Bibliotheken der beiden Nationen und (wo) sind Unterschiede zu finden? Diese Verifizierung des Status quo ist nur ein Teil der vorliegenden Arbeit, Schwerpunkt bildet der Blick in die kommende Zeit. Hat Wissensmanagement eine Zukunft in der Öffentlichen Bibliothek? Wenn ja, wie sieht diese aus und in welcher Intention wird Wissensmanagement eingesetzt? Stellt es mehr als nur ein Instrument der innerbetrieblichen Organisationsoptimierung dar? Wird Wissensmanagement im Sinne des Erwerbs von Demokratiekompetenz an den Endkunden quasi als Werkzeugkoffer weitergegeben? Hilft es den Öffentlichen Bibliotheken im Sinne einer systemischen kommunalen Legitimierung? Mit den Methoden Szenariotechnik und Delphi-Studie werden auf Basis der Aussagen ausgewählter Wissensexperten aus den Großstadtbibliotheken beider Länder Trendprojektionen erstellt, die ihrerseits in einem die Studie abschließenden konsensualen Szenario münden. Auf dem Weg dorthin werden im Laufe von iterativen Befragungen zudem für die Praxis adaptierbare Handlungsoptionen für die Öffentliche Bibliothek der Zukunft generiert und anhand ausgewählter Expertenaussagen im Sinne von Best-Practise-Beispielen und -Ideen in die Arbeit integriert. / Following the establishment and outline evaluation of the “scenario based Delphi-Study” as a medium of examination and presentation of research design, knowledge management concepts were put into context in alignment with the current research status by means of a literary review. This inventory of present conditions is primarily based on scientific publications on the subject of knowledge management in general and those of the LIS commu-nity in particular. What is the current role of knowledge management in the practical operation of public libraries in the two countries that provided the study focus? Which areas in the application of knowledge management in public libraries show similarities, and where can we identify specific differences? Whilst verification of the status quo is part of the study, the main focus is on looking into the future. Does knowledge management actually have a future within public libraries? If so, what does this future look like and what does it hold for the intended application of knowledge management? Will knowledge management become more than an instrument aimed at optimising organisational potential, and as a result develop into a quasi-education tool to be passed on directly to the end consumer? Will it serve to assist public libraries in achieving a sense of systemic, communal legitimacy? Through the application of the Scenario-technique and Delphi-study concept trend projections were established for both countries based on the statements by selected ‘knowledge experts’ of public libraries in both Germany and the UK, and subsequently fused into a conclusive consensual scenario. Along the way, practical and adaptable application options for the public library of the future were generated and integrated with a view to best practice examples and ideas from the selected expert testimonials.

The evolution of supply chain management has made significant and continuous contributions to logistical processes. This is highly relevant to crude oil logistics in Nigeria, because both indigenous and multinational oil companies who distribute crude oil from Nigerian ports are yet to adopt an integrated export logistics operation. Besides, the study explores the philosophy of supply chain management applying theoretic frameworks of supply chain process management, demand variability, and vertical integration to encourage integrated export logistics for the distribution of crude oil from Nigeria to China. In addition, the research objectives are: to identify the components of crude oil exports; to review the principles of integrated supply chain management; to analyse crude oil demand in China; to evaluate the efficiency of oil distribution, and to propose strategies that will raise the efficiency of crude oil exports to China from Nigeria. A conceptual model was developed to identify relevant issues that guide the synergy of China’s requirement for energy security and Nigeria’s crude oil supply capability. Also, both a Delphi survey and an archival research method’s were adopted to elucidate on the characteristics of the research population, the shipment frequencies between the two countries, and the sources of competing crude oil exports to China. Measures of central tendency from respondent feedback and non-parametric tests support the study’s findings. Furthermore, recommendations for strategic, operational, and tactical organisation of resources were identified to raise integrated crude oil export efficiency from Nigeria to China directed by the theoretic framework. Moreover, their implications for sustainable logistics practice in the short, medium, and long-term are considered. Finally, it was found that adopting vertical integration in a crude oil supply chain will ensure responsiveness to support export efficiency, and enhance the geographic characteristics of Nigeria for increased export shipments to China.