scholarly journals Patterns of Success for Urban 4-H Youth Development in the Near Future

2007 ◽  
Vol 2 (2) ◽  
pp. 74-90
Author(s):  
W. Jack Kerrigan, Jr.
Keyword(s):  
Best Practices ◽  
Youth Development ◽  
Delphi Study ◽  
Qualitative Data ◽  
Delphi Process ◽  
Delphi Panel ◽  
Target Populations ◽  
Modified Delphi ◽  
Development Programming ◽  
Near Future

A Modified Delphi study identified patterns of success for urban Extension 4-H programming in the next five years. The Delphi panel of 20 experts represented all regions, program areas, organizational levels as well as two external friends of Extension. The Delphi process provided both quantitative and qualitative data on the topics of collaboration, target populations, and programming. Fifteen patterns of success were identified for urban 4-H youth development. These patterns should serve as best practices for Extension youth development programming in urban counties for “making the best better!” in the near future.

Abstract 10336: ECPR 2 : Expert Consensus on PeRcutaneous Cannulation for Extracorporeal CardioPulmonary Resuscitation

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Florian F Schmitzberger ◽  
Nathan L Haas ◽  
Ryan A Coute ◽  
Jason Bartos ◽  
Amy E Hackmann ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Best Practices ◽  
Delphi Process ◽  
Expert Consensus ◽  
Snowball Sampling ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Modified Delphi ◽  
Expert Opinions ◽  
International Panel ◽  
Patient Arrival

Introduction: Extracorporeal cardiopulmonary resuscitation (ECPR) has emerged as a promising resuscitation strategy for select patients suffering out-of-hospital cardiac arrest (OHCA), though limited data exists regarding detailed best practices for the complex process of initiating ECPR following OHCA. Hypothesis: Expert consensus using a modified Delphi process can systematically identify detailed best practices for ECPR initiation following adult non-traumatic OHCA. Methods: We utilized a modified Delphi process consisting of two survey rounds and a virtual consensus meeting to systematically identify best practices for ECPR initiation following adult non-traumatic OHCA. A modified Delphi process builds content validity and is an accepted method to develop consensus by eliciting expert opinions through multiple rounds of questionnaires. Consensus was achieved when items reached a high level of agreement, defined as greater than 80% responses for a particular item rated a 4 or 5 on a 5-point Likert scale. Results: Snowball sampling generated a panel of 14 content experts, composed of physicians from four continents and four primary specialties. Seven existing institutional protocols for ECPR cannulation following OHCA were identified and merged into a single comprehensive list of 216 items. The panel ultimately reached consensus on 95 items: Prior to Patient Arrival (8 items), Inclusion Criteria (8), Exclusion Criteria (7), Patient Arrival (8), ECPR Cannulation (21), Go On Pump (17), and Post-Cannulation (26). Conclusion: We present a list of essential items for initiation of ECPR following adult non-traumatic OHCA, generated using a modified Delphi process from an international panel of content experts. These findings can benefit centers currently performing ECPR for OHCA in quality assurance and performance improvement, and can serve as a template for new ECPR programs to follow.

Medications Used Routinely in Primary Care to be Dose-Adjusted or Avoided in People With Chronic Kidney Disease: Results of a Modified Delphi Study

2020 ◽  
Vol 54 (7) ◽  
pp. 625-632 ◽  
Author(s):  
Leena Taji ◽  
Marisa Battistella ◽  
Allan K. Grill ◽  
Jessie Cunningham ◽  
Brenda L. Hemmelgarn ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Delphi Study ◽  
Dose Adjustment ◽  
Sglt2 Inhibitor ◽  
Primary Care Providers ◽  
Delphi Panel ◽  
Care Providers ◽  
Modified Delphi

Background: Chronic kidney disease (CKD) affects up to 18% of those over the age of 65 years. Potentially inappropriate medication prescribing in people with CKD is common. Objectives: Develop a pragmatic list of medications used in primary care that required dose adjustment or avoidance in people with CKD, using a modified Delphi panel approach, followed by a consensus workshop. Methods: We conducted a comprehensive literature search to identify potential medications. A group of 17 experts participated in a 3-round modified Delphi panel to identify medications for inclusion. A subsequent consensus workshop of 8 experts reviewed this list to prioritize medications for the development of point-of-care knowledge translation materials for primary care. Results: After a comprehensive literature review, 59 medications were included for consideration by the Delphi panel, with a further 10 medications added after the initial round. On completion of the 3 Delphi rounds, 66 unique medications remained, 63 requiring dose adjustment and 16 medications requiring avoidance in one or more estimated glomerular filtration rate categories. The consensus workshop prioritized this list further to 24 medications that must be dose-adjusted or avoided, including baclofen, metformin, and digoxin, as well as the newer SGLT2 inhibitor agents. Conclusion and Relevance: We have developed a concise list of 24 medications commonly used in primary care that should be dose-adjusted or avoided in people with CKD to reduce harm. This list incorporates new and frequently prescribed medications and will inform an updated, easy to access source for primary care providers.

scholarly journals Safety, efficacy and delivery of isometric resistance training as an adjunct therapy for blood pressure control: a modified Delphi study

2022 ◽  
Author(s):  
Biggie Baffour-Awuah ◽  
Melissa J. Pearson ◽  
Neil A. Smart ◽  
Gudrun Dieberg
Keyword(s):  
Blood Pressure ◽  
Resistance Training ◽  
Delphi Study ◽  
Consensus Meeting ◽  
Expert Consensus ◽  
Uncontrolled Hypertension ◽  
Delphi Panel ◽  
Modified Delphi ◽  
Study Team ◽  
Final Item

AbstractUncontrolled hypertension remains the major risk factor for cardiovascular disease. Isometric resistance training (IRT) has been shown to be a useful nonpharmacological therapy for reducing blood pressure (BP); however, some exercise physiologists and other health professionals are uncertain of the efficacy and safety of IRT. Experts’ consensus was sought in light of the current variability of IRT use as an adjunct treatment for hypertension. An expert consensus-building analysis (Delphi study) was conducted on items relevant to the safety, efficacy and delivery of IRT. The study consisted of 3 phases: (1) identification of items and expert participants for inclusion; (2) a two-round modified Delphi exercise involving expert panelists to build consensus; and (3) a study team consensus meeting for a final item review. A list of 50 items was generated, and 42 international experts were invited to join the Delphi panel. Thirteen and 10 experts completed Delphi Rounds 1 and 2, respectively, reaching consensus on 26 items in Round 1 and 10 items in Round 2. The study team consensus meeting conducted a final item review and considered the remaining 14 items for the content list. A final list of 43 items regarding IRT reached expert consensus: 7/10 items on safety, 11/11 items on efficacy, 10/12 items on programming, 8/10 items on delivery, and 7/7 on the mechanism of action. This study highlights that while experts reached a consensus that IRT is efficacious as an antihypertensive therapy, some still have safety concerns, and there is also ongoing conjecture regarding optimal delivery.

scholarly journals Defining adverse events during trauma resuscitation: a modified RAND Delphi study

2021 ◽  
Vol 6 (1) ◽  
pp. e000805
Author(s):  
Brodie Nolan ◽  
Andrew Petrosoniak ◽  
Christopher M Hicks ◽  
Michael W Cripps ◽  
Ryan P Dumas
Keyword(s):  
Trauma Care ◽  
Classification System ◽  
Delphi Study ◽  
Delphi Panel ◽  
Significant Heterogeneity ◽  
Trauma Resuscitation ◽  
Level Of Evidence ◽  
Modified Delphi ◽  
System A ◽  
Trauma Bay

BackgroundThe majority of preventable adverse event (AEs) in trauma care occur during the initial phase of resuscitation, often within the trauma bay. However, there is significant heterogeneity in reporting these AEs that limits performance comparisons between hospitals and trauma systems. The objective of this study was to create a taxonomy of AEs that occur during trauma resuscitation and a corresponding classification system to assign a degree of harm.MethodsThis study used a modified RAND Delphi methodology to establish a taxonomy of AEs in trauma and a degree of harm classification system. A systematic review informed the preliminary list of AEs. An interdisciplinary panel of 22 trauma experts rated these AEs through two rounds of online surveys and a final consensus meeting. Consensus was defined as 80% for each AE and the final checklist.ResultsThe Delphi panel consisted of 22 multidisciplinary trauma experts. A list of 57 evidence-informed AEs was revised and expanded during the modified Delphi process into a finalized list of 67 AEs. Each AE was classified based on degree of harm on a scale from I (no harm) to V (death).DiscussionThis study developed a taxonomy of 67 AEs that occur during the initial phases of a trauma resuscitation with a corresponding degree of harm classification. This taxonomy serves to support a standardized evaluation of trauma care between centers and regions.Level of evidenceLevel 5.

Development of best practices in the utilization and implementation of pediatric cervical spine traction: a modified Delphi study

2021 ◽  
pp. 1-12
Author(s):  
Nikita G. Alexiades ◽  
Belinda Shao ◽  
Bruno P. Braga ◽  
Christopher M. Bonfield ◽  
Douglas L. Brockmeyer ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Best Practices ◽  
Delphi Study ◽  
Best Practice ◽  
Pediatric Patients ◽  
Modified Delphi ◽  
Consensus Statements ◽  
Cervical Traction ◽  
Outcomes For Children ◽  
Strongly Agree

OBJECTIVE Cervical traction in pediatric patients is an uncommon but invaluable technique in the management of cervical trauma and deformity. Despite its utility, little empirical evidence exists to guide its implementation, with most practitioners employing custom or modified adult protocols. Expert-based best practices may improve the care of children undergoing cervical traction. In this study, the authors aimed to build consensus and establish best practices for the use of pediatric cervical traction in order to enhance its utilization, safety, and efficacy. METHODS A modified Delphi method was employed to try to identify areas of consensus regarding the utilization and implementation of pediatric cervical spine traction. A literature review of pediatric cervical traction was distributed electronically along with a survey of current practices to a group of 20 board-certified pediatric neurosurgeons and orthopedic surgeons with expertise in the pediatric cervical spine. Sixty statements were then formulated and distributed to the group. The results of the second survey were discussed during an in-person meeting leading to further consensus. Consensus was defined as ≥ 80% agreement on a 4-point Likert scale (strongly agree, agree, disagree, strongly disagree). RESULTS After the initial round, consensus was achieved with 40 statements regarding the following topics: goals, indications, and contraindications of traction (12), pretraction imaging (6), practical application and initiation of various traction techniques (8), protocols in trauma and deformity patients (8), and management of traction-related complications (6). Following the second round, an additional 9 statements reached consensus related to goals/indications/contraindications of traction (4), related to initiation of traction (4), and related to complication management (1). All participants were willing to incorporate the consensus statements into their practice. CONCLUSIONS In an attempt to improve and standardize the use of cervical traction in pediatric patients, the authors have identified 49 best-practice recommendations, which were generated by reaching consensus among a multidisciplinary group of pediatric spine experts using a modified Delphi technique. Further study is required to determine if implementation of these practices can lead to reduced complications and improved outcomes for children.

Speech-language pathologists in paediatric palliative care: a Delphi study protocol

2018 ◽  
Vol 10 (4) ◽  
pp. e43-e43 ◽  
Author(s):  
Lillian Krikheli ◽  
Lindsay B Carey ◽  
Bernice A Mathisen ◽  
Shane Erickson ◽  
Christa L Carey-Sargeant
Keyword(s):  
Palliative Care ◽  
Clinical Practice ◽  
Delphi Study ◽  
Online Survey ◽  
Delphi Process ◽  
Scope Of Practice ◽  
Delphi Panel ◽  
Speech Language Pathologists ◽  
Paediatric Palliative Care ◽  
Palliative Care Teams

BackgroundGiven the dearth of literature and no clinical practice guidelines written for speech-language pathologists (SLPs) working in paediatric palliative care (PPC), a need has been identified to explore the scope of clinical practice and strategies used by SLPs.ObjectiveThis study aims to undertake an international investigation into the role and scope of practice of SLPs working in PPC to develop consensus-driven ‘Recommendations for Speech-Language Pathologists in Paediatric Palliative Care Teams’ (ReSP3CT).MethodsA modified Delphi process will be used to synthesise consensus-based statements from SLPs in six different countries about their role and practice working in PPC. Initially, preliminary survey data will be collected from SLPs to obtain demographic and caseload information. Respondents will then be invited to participate in an in-depth interview to explore common and unique themes that emerge from the online survey. Participants from the interview will then ‘opt-in’ to become Delphi panel members and receive questionnaires comprising statements for agreement over multiple rounds. Statements will be based on common themes that arise from the literature review, survey and interview data. The Delphi process for each statement will stop if statements achieve ≥ 70 % agreement and an IQR of ≤ 1 (maximum of five rounds).ConclusionThis is the first study to investigate the role and practice of SLPs in PPC across internationally accepted scope of practice areas. The study will use existing frameworks for statistical analysis and a mixed-methods approach to aid in the synthesis of statements/recommendations for international consensus.

scholarly journals Early-Career Challenges of Youth Development Extension Educators and Effective Strategies

2021 ◽  
Vol 13 (16) ◽  
pp. 9017
Author(s):  
Koralalage S. U. Jayaratne ◽  
Daniel P. Collins ◽  
Shannon B. McCollum
Keyword(s):  
Youth Development ◽  
Delphi Method ◽  
Delphi Study ◽  
Research Study ◽  
Expert Panel ◽  
Early Career ◽  
Future Research ◽  
Extension Educators ◽  
Effective Strategies ◽  
Modified Delphi

The purpose of this research study was to determine the challenges faced by early-career youth development extension educators and strategies helpful in managing those challenges. This study used the modified Delphi method of three rounds with a specifically selected expert panel of 24 members to build consensus on the challenges that early-career youth development extension educators faced and managing strategies of those challenges. The expert panel of this Delphi study was selected from two south-eastern states in the U.S. based on their proven success and effectiveness in youth development extension programming in their respective counties. The three-round Delphi study led to building the consensus on 16 challenges faced by early-career youth development extension educators and 14 strategies helpful in managing those challenges. The findings of this study have implications for planning onboarding training programs for early-career youth development extension educators. Future research is needed to understand how identified strategies contribute to managing early-career challenges faced by youth development extension educators.

scholarly journals Development of best practices to minimize wound complications after complex tethered spinal cord surgery: a modified Delphi study

2018 ◽  
Vol 22 (6) ◽  
pp. 701-709 ◽  
Author(s):  
Nikita G. Alexiades ◽  
Edward S. Ahn ◽  
Jeffrey P. Blount ◽  
Douglas L. Brockmeyer ◽  
Samuel R. Browd ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Best Practices ◽  
Delphi Study ◽  
Wound Complications ◽  
Tethered Spinal Cord ◽  
Saline Irrigation ◽  
Gram Negative ◽  
Modified Delphi ◽  
Dural Closure ◽  
Dural Graft

OBJECTIVEComplications after complex tethered spinal cord (cTSC) surgery include infections and cerebrospinal fluid (CSF) leaks. With little empirical evidence to guide management, there is variability in the interventions undertaken to limit complications. Expert-based best practices may improve the care of patients undergoing cTSC surgery. Here, authors conducted a study to identify consensus-driven best practices.METHODSThe Delphi method was employed to identify consensual best practices. A literature review regarding cTSC surgery together with a survey of current practices was distributed to 17 board-certified pediatric neurosurgeons. Thirty statements were then formulated and distributed to the group. Results of the second survey were discussed during an in-person meeting leading to further consensus, which was defined as ≥ 80% agreement on a 4-point Likert scale (strongly agree, agree, disagree, strongly disagree).RESULTSSeventeen consensus-driven best practices were identified, with all participants willing to incorporate them into their practice. There were four preoperative interventions: (1, 2) asymptomatic AND symptomatic patients should be referred to urology preoperatively, (3, 4) routine preoperative urine cultures are not necessary for asymptomatic AND symptomatic patients. There were nine intraoperative interventions: (5) patients should receive perioperative cefazolin or an equivalent alternative in the event of allergy, (6) chlorhexidine-based skin preparation is the preferred regimen, (7) saline irrigation should be used intermittently throughout the case, (8) antibiotic-containing irrigation should be used following dural closure, (9) a nonlocking running suture technique should be used for dural closure, (10) dural graft overlay should be used when unable to obtain primary dural closure, (11) an expansile dural graft should be incorporated in cases of lipomyelomeningocele in which primary dural closure does not permit free flow of CSF, (12) paraxial muscles should be closed as a layer separate from the fascia, (13) routine placement of postoperative drains is not necessary. There were three postoperative interventions: (14) postoperative antibiotics are an option and, if given, should be discontinued within 24 hours; (15) patients should remain flat for at least 24 hours postoperatively; (16) routine use of abdominal binders or other compressive devices postoperatively is not necessary. One intervention was prioritized for additional study: (17) further study of additional gram-negative perioperative coverage is needed.CONCLUSIONSA modified Delphi technique was used to develop consensus-driven best practices for decreasing wound complications after cTSC surgery. Further study is required to determine if implementation of these practices will lead to reduced complications. Discussion through the course of this study resulted in the initiation of a multicenter study of gram-negative surgical site infections in cTSC surgery.

Quality of Care in Ulcerative Colitis: A Modified Delphi Panel Approach

2018 ◽  
Vol 36 (5) ◽  
pp. 346-353
Author(s):  
Laurent Peyrin-Biroulet ◽  
Daniel C. Baumgart ◽  
Alessandro Armuzzi ◽  
Paolo Gionchetti ◽  
Shaji Sebastian ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Quality Of Care ◽  
Literature Review ◽  
Best Practices ◽  
Delphi Panel ◽  
Treatment Goals ◽  
Web Based ◽  
Modified Delphi ◽  
Novel Technology

Objectives: To establish clinical consensus on important and relevant quality-of-care (QoC) attributes in ulcerative colitis (UC) treatment that may improve treatment outcomes and guide best practices. Methods: Thirty-eight QoC attributes were identified in a literature review. Sixteen European-based experts were selected based on their contributions to UC guidelines, publications, and patient care. A 3-round, modified Delphi panel was conducted including an interview round, and 2 web-based rounds to reach consensus and finalize a QoC attribute list. Results: The draft QoC attribute list derived from a literature review and Round 1, expert interviews, comprised 63 attributes. In Rounds 2 and 3, the QoC attributes frequently rated as critically important were diagnosis (n = 15, 93.8%), treatment adherence (n = 15, 93.8%), and access to care/treatment (Round 2: n = 14, 87.5%; Round 3: n = 15, 93.8%). The final QoC attribute list consisted of 61 attributes across 20 domains, with the most attributes reported in the “treatment goals” domain (n = 9). Conclusion: QoC is a complex and evolving concept that can improve outcomes while maximizing healthcare resources. Limited time and resources hamper clinicians’ ability to openly and empathetically communicate with patients; novel technology may help to offer solutions.

scholarly journals Scientific, professional and experiential validation of the model of preventive behaviours at work: protocol of a modified Delphi Study

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e035606
Author(s):  
Alexandra Lecours
Keyword(s):  
Working Conditions ◽  
Thematic Analysis ◽  
Delphi Study ◽  
Quantitative Data ◽  
Qualitative Data ◽  
Empirical Studies ◽  
Modified Delphi ◽  
Validity Indicators ◽  
Analysis Strategy ◽  
Services Sociaux

IntroductionTo offer an in-depth understanding of preventive behaviours, those complex behaviours considered as levers to foster work prevention, recent theoretical and empirical studies permitted to develop the model of preventive behaviours at work. The next step is to validate the model with researchers, professionals and workers. This article aims to describe the study protocol that will be used to validate the model of preventive behaviours at work.Methods and analysisThis Delphi Study proposes seven systematic steps to conduct a scientifically rigorous validation study based on scientific and professional experts’ opinion. A focus group to collect workers’ opinion about the model has also been included in the protocol. Thirty experts (researchers and professionals) will be selected regarding their experience (eg, at least 5 years of experience) and expertise (eg, having published at least one article as the first author in the last 3 years) towards workers’ health or organisational behaviours. Workers will be recruited to have a diversity in terms of age, gender and working conditions. Quantitative data will be analysed to calculate the percentage of experts’ agreement on four content validity indicators (ie, comprehensiveness, representativeness, relevance and clarity). Qualitative data will be examined through a thematic analysis strategy.Ethics and disseminationApproval of the research ethics board of the Centre intégré universitaire de santé et de services sociaux de la Capitale Nationale has been obtained. Findings will be shared with various stakeholders inclusive of researchers, professionals and workers. Findings will be disseminated in workshops, peer-reviewed journals and conferences.

Sign in / Sign up

Export Citation Format

Share Document