Overarching Consensus Research Articles

Follow-Up Survey for Conservatively Managed Ureteric Stones.

Introduction Currently, there are no agreed-upon investigations and follow-up guidelines for the conservative management of ureteric stones. This study used common themes identified in previous works to investigate whether there is a consensus amongst urology consultants in the United Kingdom. Methods This was a questionnaire-based survey study. An online questionnaire was disseminated nationally to urological consultants practicing in the United Kingdom to explore a range of common factors. The initial sample size was 81 UK-based urological consultants with an interest in endourology and stone surgery. Of the initial 81, 20 participants did not complete the survey and therefore the final sample size was 61. Descriptive analysis was used to analyze the data. Results Our survey found that the main factors influencing the follow-up of conservatively managed ureteric stones were stone size 98% (60), stone location 92% (56), and the degree of altered renal function 79% (48). Regardless of stone size, most participants chose to follow up at 2-4 weeks with asymptomatic patients requiring imaging with discrepancies about the modality. Regarding biochemical markers, most participants only repeated renal function tests if this was deranged on presentation. Calcium and uric acid levels were checked regularly. Diclofenac was the analgesia of choice 93% (55). Regarding the availability of acute ESWL services, over half (59%) were able to offer acute ESWL within the week. The majority offer services at least three or more lists per week. Conclusion Our results demonstrate that there is still no overarching consensus in the follow-up of conservatively managed ureteric stones.Several factors backed by high-level evidence are already consistent across the population of urology consultants and considered "best practice." However, before any all-encompassing national guidelines are formalized, further studies in the form of randomized control trials will be needed to yield high-level evidence.

Intraoperative application of three-dimensional printed guides in total hip arthroplasty: A systematic review.

Acetabular component positioning in total hip arthroplasty (THA) is of key importance to ensure satisfactory post-operative outcomes and to minimize the risk of complications. The majority of acetabular components are aligned freehand, without the use of navigation methods. Patient specific instruments (PSI) and three-dimensional (3D) printing of THA placement guides are increasingly used in primary THA to ensure optimal positioning. To summarize the literature on 3D printing in THA and how they improve acetabular component alignment. PubMed was used to identify and access scientific studies reporting on different 3D printing methods used in THA. Eight studies with 236 hips in 228 patients were included. The studies could be divided into two main categories; 3D printed models and 3D printed guides. 3D printing in THA helped improve preoperative cup size planning and post-operative Harris hip scores between intervention and control groups (P = 0.019, P = 0.009). Otherwise, outcome measures were heterogeneous and thus difficult to compare. The overarching consensus between the studies is that the use of 3D guidance tools can assist in improving THA cup positioning and reduce the need for revision THA and the associated costs. The implementation of 3D printing and PSI for primary THA can significantly improve the positioning accuracy of the acetabular cup component and reduce the number of complications caused by malpositioning.

Surgical Techniques for Lymphovenous Bypass: A Review

Background: Lymphedema is a progressive, debilitating disease that may affect up to 250 million individuals worldwide. Complex decongestive therapy (CDT) remains the first line of treatment for lymphedema, and surgical treatment currently has no formally established role. In recent years, lymphovenous bypass (LVB) has emerged as a potentially efficacious intervention to improve patients' objective and subjective measures of lymphedema. Despite this promise, there are few evidence-based recommendations to inform the adoption of the practice. Methods: A narrative review of the present literature on LVB was performed through a query of records using various combinations of Medical Subject Heading (MeSH) terms and keywords such as “lymphatic vessels,” “lymphedema,” “breast cancer lymphedema,” “surgical anastomosis,” “lymphovenous bypass,” “lymphovenous anastomosis.” The articles were assessed for 1) bibliometric characteristics, 2) preoperative evaluation, 2) operative techniques, 3) postoperative regimens, and 4) outcome measures. Results: The sixty-year evolution of LVB has transformed rapidly in response to technological advances in the last two decades. The geographically distributed investigation of these surgical innovations has prompted a fragmentation of LVB practice. As original research outpaces literature review, there needs to be more consistency in terminology, perioperative practices, and evaluation of outcomes of LVB, which challenge systematic analysis. The systematic reviews to date emphasize the ability of LVB to improve objective measures such as limb circumference. Still, the inconsistent use of subjective measures limits our appreciation of the collective improvement in patient-reported outcomes. Moreover, there are a limited number of accepted methods for patient selection, preoperative evaluation, and surgical planning, with many surgical techniques employed. Conclusion: The unifying principles and scientific evidence must be clarified to guide an overarching consensus before the widespread adoption of LVB. This article aims to synthesize recommendations and current institutional preferences concerning the research and clinical applications of LVB. The collaboration and continued refining of these practices will be necessary to establish the role of LVB in the treatment and prevention of lymphedema.

Exploring Tannery Solid Wastes as a Source of Animal Feed

This review delves into the processing of tannery solid waste, emphasizing fleshings and chromium-tanned leather waste. This paper centers on fat recovery, chromium elimination, and protein preservation, aiming to make them apt for animal consumption. This paper also assesses the potential of introducing such recycled products to the global market. Drawing on the literature from the past two decades, sourced comprehensively from Scopus and Web of Science, 36 articles were selected because of their significant contributions from leather production powerhouses such as India and Brazil. Fleshings have shown immense potential as animal feed, and the extraction of tallow and collagen from rawhide trimmings yields up to 98% and 93%, respectively. Fermented tannery fleshings, notably with Enterococcus faecium HAB01, also demonstrate strong antioxidant capabilities. The overarching consensus emphasizes the need for rigorous purification when dealing with chromium-containing wastes, addressing concerns tied to Cr (III) and Cr (VI). Furthermore, raw tannery fleshings stand out as a sustainable, cost-effective, and globally marketable solution for animal feed production.

Exploring the policy space for public health in large-scale mining in Burkina Faso: A Q-methodology study

Large-scale resource extraction may lead to significant negative externalities on the environment, social well-being and public health. Negative environmental impacts of extractive projects are regularly considered through mandatory environmental impact assessments; however, public health impacts frequently remain unaddressed due to a lack of legal requirements, particularly in Africa where many resource extraction projects are being implemented. While policy instruments are available to mitigate negative externalities on public health - the most eminent being the Health Impact Assessment (HIA) - such instruments have not been widely established. We use Q-methodology to explore the policy space available to advance public health in large-scale mining projects in Burkina Faso. A Q-methodology study is purposeful as it allows to reveal common ground between government, private sector and civil society stakeholders on whose support successful policy initiatives depend. We identify two broader stakeholder perspectives that reveal an overarching consensus on the need to regulate health impacts of mining projects. Both perspectives reject industry self-regulation and broadly agree on introducing HIA as a regulatory instrument, but also point to different priorities and focal points among stakeholders. We develop a conceptual framework to map stakeholders’ shared and divergent policy preferences. The findings can help to initiate a policy dialogue on safeguarding public health in large-scale mining projects and may guide policymakers to implement public health policy reform.

Insights From an Expert Roundtable Discussion: Navigating Intermittent Catheterisation-Associated Complications

With a pre-specified aim of improving the standard of care of those living with intermittent catheter use, a roundtable discussion led by a panel of esteemed international experts convened in early 2023. The discussion provided valuable insights and recommendations regarding understanding the challenges associated with intermittent catheter use and catheter-associated complications (CAC). Key issues centred on the myriad of complications associated with intermittent catheterisation (IC), including urinary tract infections (UTI), discomfort, urethral trauma, haematuria, and their impact on patient-reported outcomes. The heterogeneity of patient groups included in IC research evidence, and discrepancies in current guidelines emerged as key concerns. The panel acknowledged the lack of consensus and clarity surrounding definitions and classification of several complications related to IC and the heterogenous range of reported outcome measures, highlighting the critical need for establishing unified definitions of IC-associated complications (ICAC), and better-defined patient groups in future research, in order to avoid these issues, and produce more definitive research conclusions. To promote clarity and consistency in terminology and clinical practice, the roundtable discussion proposed an overarching consensus definition for catheter-related complications of IC and associated endpoints, referring to these as “events that disrupt catheterisation.” The panel also considered the potential of education and innovative catheter technology as an effective means to address these common issues. Recognising the importance of education, the experts highlighted the need for new definitions and descriptions to improve clarity and consistency in clinical practice, and more research involving the array of complications associated with intermittent catheter use. Furthermore, the discussion shed light on advancements in catheter technology, exploring the potential contributions of emerging innovations, such as next-generation catheter technology like FeelClean™ Technology (Convatec, Paddington, London, UK), in minimising complications and enhancing patient outcomes.

The role of online symptom questionnaires to support the diagnosis of cow's milk allergy in children for healthcare professionals - A Delphi consensus study.

Cow's milk allergy (CMA) is one of the most common food allergies world-wide. The emergence of online CMA symptom questionnaires, aimed at parents and/or healthcare professionals (HCP), may raise awareness about the possible diagnosis of CMA, but also increases the risk for overdiagnosis leading to unnecessary dietary restriction impacting on growth and nutrition. This publication sets out to establish the availability of these CMA symptom questionnaires and critically assesses the development and validity. Thirteen HCP working in the field of CMA, from different countries, were recruited to participate. A combination of a Pubmed and CINAHL literature and online review using the Google search engine in English language was used. Symptoms in the questionnaires were assessed, using the European Academy for Allergy and Clinical Immunology guidelines for food allergy. Following the assessment of both the questionnaires and literature, the authors followed the modified Delphi approach to generate consensus statements. Six hundred and fifty-one publications were identified, of which 29 were suitable for inclusion, with 26 being associated with the Cow's Milk-Related Symptoms Score. The online search yielded 10 available questionnaires: 7/10 were sponsored by formula milk companies and 7/10 were aimed at parents and three at HCP. Following the assessment of data, 19 statements were generated in two rounds of anonymous voting reaching 100% agreement. Online CMA questionnaires, available to parents and HCP's, are varied in symptoms, and most were not validated. The overarching consensus generated from authors is that these questionnaires should not be used without the involvement of HCP.

Nominal group technique to establish the core components of home-based rehabilitation for survivors of stroke with severe disability

In the UK, over 20% of patients leaving hospital after a stroke will be severely disabled. Despite this, limited clinical guidance is available to teams tasked with providing support for...

The Mechanics of Consensus: Nonterritorial Cultural Autonomy and the Russian State

AbstractRussia’s institutions on nonterritorial cultural autonomy (NTCA) can be broadly situated within the country’s political community, in the sense that they—for the most part—recognize the government’s rules of engagement and its role as decision maker, leading to overarching consensus and pursuit of shared objectives. At the same time, they remain at the periphery of the political community. This article outlines the reasons for NTCA institutions’ peripherality and limited influence upon Russia’s minority policies. Such reasons are linked to external factors—Russia’s undemocratic political system—but also to conditions intrinsic to NTCA institutions themselves—forms of passivity and (non)participation, and blurred boundaries between NTCA institutions and state actors. The interaction of such factors generates the noted prevailing consensus between NTCA institutions and the Russian state. Interview data further reveal that representatives of NTCA institutions are far from monolithic: the said external and internal factors affect them in different ways, resulting in variations in forms of consensus and cooperation with state actors. This, in turn, allows for multiple interpretative frameworks of state–civil society coexistence in the sphere of Russia’s diversity management.

Azadirachtin acting as a hazardous compound to induce multiple detrimental effects in Drosophila melanogaster

Azadirachtin, a tetranortriterpenoid botanical insecticide, has varied sub-lethal effects against many insect pests, including antifeedant, repellent, and growth regulatory. Despite extensive studies of the mechanisms that underline these physiological effects, little attention has been given to multiple toxic effects of azadirachtin under a coherent concentration, and there is no definitive overarching consensus on its toxicity. Here, we investigated multiple sub-lethal effects induced by 4 mg L−1 of azadirachtin, which did not elicit antifeedant behavior in Drosophila melanogaster, on metrics of longevity, development, compound eyes and reproduction. Exposure to <20 mg L−1 azadirachtin did not induce mortality, and 4 mg L−1 of azadirachtin could shorten lifespan, expression of detoxification genes and activities of related detoxification enzymes were higher. The lower activity of chitinase and higher content of chitin in fruit fly exposed to 4 mg L−1 azadirachtin could be important in developmental inhibition effects, and ovarian abnormalities and lower fecundity could have resulted from azadirachtin-mediated influences on juvenile hormone and ecdysone that disrupted the endocrine system. Caspase-3, head involution defective and reaper-dependent apoptosis genes may have been responsible for compound eye abnormalities in flies exposed to azadirachtin. Our findings provide important insights to the potential mechanisms of sub-lethal effects of azadirachtin.

Past, present, and future of basin and petroleum system modeling

Basin and petroleum system modeling (BPSM) has had increasing impact on industry decisions related to exploration and new venture opportunities over the last decade. Basin and petroleum system modeling technology, usability, and user group size have grown as a result of its capacity to reduce exploration risk. Based on current statistics, improvements in BPSM have significant potential to reduce future well failures, particularly when caused by lack of petroleum charge. To bring BPSM practitioners from academia and industry together, an AAPG Hedberg Research Conference was organized to discuss the latest developments and issues in this field. A survey was conducted during the conference in Santa Barbara, California (April 2016), and this paper summarizes the results. A key takeaway was an overarching consensus throughout the BPSM community that improved understanding of hydrocarbon migration and more flexible workflows are necessary to better assess charge and migration risk in exploration and new ventures. In addition, BPSM is increasingly used to predict pore pressure and porosity at field scales, which opens new opportunities to integrate BPSM workflows with other technologies, such as seismic rock property analysis and reservoir quality modeling. In this paper, we discuss these and other issues that arose from in-depth discussion and an online survey.

Re-totalizing Culture

With the growth of concern over diminishing cultural diversity, homogenization, and the preservation of tangible patrimony, UNESCO has increasingly assumed a lead position in devising new legislative instruments – programs, proclamations, conventions, and treaties – for the safeguard and regulation of cultural heritage. This cultural policy has been re-directed in the last two decades by a newly emergent and confident cosmopolitan political bloc that has attempted to reverse the organization’s Occidental bias by extending the protection it gives to tangible heritage to include intangible cultural expressions. This new political interest coincides with wider demands for the re-totalization of both aspects of culture aimed at encouraging the institutional use of vernacular interpretations in place of typological and externally imposed classifications. While these movements share a common interest in the decolonization of institutional culture, there is no overarching consensus on the means by which authority over interpretation can be returned to and exercised by originating communities and practitioners. To support its relatively new cultural mandate, UNESCO has revised its definitions of culture. These re-articulations – largely appropriated from specific anthropological discourses – expand the concept of culture to include its tangible and intangible manifestations, and provide a legitimating moral and intellectual authority to promote its wider acceptability. This essay represents a modest attempt to define and trace the influence of part of the rhetoric generated by globalized institutional cultures on museum practice and to raise questions on the current choices museums have been called to make.

Pending Matters

Pending Matters David William Foster (bio) Necessarily—and, indeed, almost as an imperative—one takes advantage of writing a note such as this to promote an intellectual agenda. Our selection process for these essays on film has been an interesting and rather anomalous one, since we each examined a range of possible contributions, without knowing what the overall pool of topics might be beyond just those each of us saw individually. This made it difficult for any one of us to favor a particular range of submissions—that is, to nudge the selection process towards any one individual’s intellectual agenda. Of course, I might have favored the essays I did see that matched that agenda, but the process was complex and anonymous enough for me to have been of little influence in that regard. As a consequence, I recognize that the final list of essays accepted was highly aleatory, even if it was designed to result in an overarching consensus as regards a selection of the very best, no matter how they distributed themselves thematically or intellectually. Ours is a conjunctive organization, Spanish and Portuguese, and it is possible to debate what the implications of that conjunction are. For those of us working in Brazilian studies (and I am fully aware of the way in which I am an unabashed interloper, not having been fully trained as a Brazilianist and counting myself primarily as an Argentinist), the conjunction here has served always to mark a fundamental disjunction: one was either a Hispanist or one was a Luso-Brazilianist. Hispanists and Brazilianists were brought together in the same organization for geohistorical reasons, but not because their research agendas overlapped, and it has been, with few exceptions, only in recent years that doctoral students—at least in research extensive universities where Portuguese is likely to be taught—are emerging with a solid grounding in both areas, or, at least, with a decent familiarity across the conjunction. Integrated projects, of the sort envisioned by the Beyond Tordesillas initiative, still are quite lacking, although one is confident that they will eventually prosper. It is, therefore, with regret that I note the lack of a substantial set of essays on Brazilian film in our final roster: only one deals with Brazil. I do not know what Brazilian film submissions were examined and, in the end, rejected, although I am willing to be firmly convinced that rejections were for reasons of critical deficiency and not out of any desire to slight Brazil (or Portugal)! While the Portuguese film industry remains modest (especially in comparison to Spain), there can be no doubting the vigor of film in Brazil. And unlike Mexico, where it is difficult to view a Mexican film in general because commercial and art house bookings favor a heavy preponderance of foreign films (e.g., US films in the former case), almost any Cineplex in Brazil’s major cities includes national titles. To be sure, the Brazilian film industry is uniquely different—but, then, so are the Argentine, the Mexican, the Cuban ones—and glitzy commercial productions (very much as part of a continuum with the television industry; the so-called O Globo network phenomenon) figure prominently, and these are not usually likely to attract serious critical analyses except within a sociology of culture context. Although Mexico has a certain amount [End Page 385] of such titles—mostly recently, something like Pedro Pablo Ibarra’s A la mala (2015)—they have largely faded into the background in Argentina, with the very vigorous putatively serious filmmaking now coming out of that country, and, of course, they have not existed in Cuba since the Revolution. But serious filmmaking is thriving in Brazil, and it merits the same level of interpretive scrutiny as the Hispanic materials that rose to the top of our complex selection process. Another gap in our final inventory—and here, I can legitimately claim a position of disciplinary centrality—concerns queer filmmaking. I don’t mean just films in which theme and characters are manifestly queer-centered, but rather, the application of queer film theory to the entire corpus: I am much more interested in a queer analysis of the Mexican legendary...

Current Trajectories of Democracy – Diagnosis, Implications, Proposals

type="graphical" xml:id="gpol12219-abs-0001"> There is agreement across the various contributions to the special issue that the state of democratic systems has deteriorated – not only in Europe but also in the United States. Of course, attention must be paid to the different contexts, reasons and the degrees to which democracies are experiences a period of unease. There is also agreement as to the necessity of national democracies - and the EU as a supranational political actor - to re-think current practices and to allow for a new democratic ethos that gives greater room for contestation.

Assessing the Role of European Attitudes in Cross-National Research

How does Eastern Europe contribute to the debate over EU’s democratic deficit from an electoral perspective? Does Eastern Europe challenge our theoretical understanding of what motivates European citizens to participate and express their opinions in European Parliamentary elections? While there is no overarching consensus in the academic community regarding these questions, this essay aims to illustrate how a deeper understanding of one post-communist case and a bottom-up perspective on attitudes and political behavior in one locale, Romania, allowed the researcher to delve deeper into the taken-for-granted dynamics that European citizens from the South, East, and West engage in when voting in European Parliamentary elections. The approach of “ethnographic sensibility” mentioned in the workshop’s discussions and illustrated in several contributions to this volume (see e.g. Kubik 2013; Knott 2015) constitutes then a useful starting point in deconstructing conventional knowledge. Moreover, during the process of moving up the ladder of generality and building inferences from one case study to a region, Eastern Europe still shares enough characteristics to deserve its own dummy variable, so to speak, in large- N continent-wide analyses covering the 2004 and 2009 European Parliamentary (EP) elections. Yet, as Joshua Tucker (2015) mentions in his contribution, it is unclear whether the historical legacies discussed at the workshop and further elaborated on by Grigore Pop-Eleches (2015) will continue to play a role in a priori distinguishing Eastern Europeans’ political attitudes and behaviors from other EU citizens in the South or West in future EP elections.

Improving Clinical Outcomes Among Hemodialysis Patients: A Proposal for a “Volume First” Approach From the Chief Medical Officers of US Dialysis Providers

Addressing fluid intake and volume control requires alignment and coordination of patients, providers, dialysis facilities, and payers, potentially necessitating a "Volume First" approach. This article reports the consensus opinions achieved at the March 2013 symposium of the Chief Medical Officers of 14 of the largest dialysis providers in the United States. These opinions are based on broad experience among participants, but often reinforced by only observational and frequently retrospective studies, highlighting the lack of high-quality clinical trials in nephrology. Given the high morbidity and mortality rates among dialysis patients and the absence of sufficient trial data to guide most aspects of hemodialysis therapy, participants believed that immediate attempts to improve care based on quality improvement initiatives, physiologic principles, and clinical experiences are warranted until such time as rigorous clinical trial data become available. The following overarching consensus opinions emerged. (1) Extracellular fluid status should be a component of sufficient dialysis, such that approaching normalization of extracellular fluid volume should be a primary goal of dialysis care. (2) Fluid removal should be gradual and dialysis treatment duration should not routinely be less than 4 hours without justification based on individual patient factors. (3) Intradialytic sodium loading should be avoided by incorporating dialysate sodium concentrations set routinely in the range of 134-138 mEq/L, avoidance of routine use of sodium modeling, and avoidance of hypertonic saline solution. (4) Dietary counseling should emphasize sodium avoidance.

Impact of thyroid nodule size on prevalence and post-test probability of malignancy: a systematic review.

Large thyroid nodules may be associated with higher risk of malignancy and less-accurate fine-needle aspiration (FNA) results, but there is currently no overarching consensus. We therefore tested two null hypotheses: 1) thyroid nodule size >3 to 4 cm is not associated with a higher baseline prevalence of malignancy (i.e., the associated pretest probability is the same, regardless of size), and 2) thyroid nodule size >3 to 4 cm is not associated with worse diagnostic accuracy (i.e., the associated sensitivity, false-negative rate, and post-test probability of malignancy is not affected by nodule diameter). Computerized searches of PubMed, Embase, and The Cochrane Library through July 2013 were performed, supplemented with manual searches. A priori criteria were defined to determine inclusion and exclusion of studies. Searches and data extraction were performed by independent reviewers and focused on FNA histopathologic findings and their relationship to nodule size, study design, and potential confounders. Criterion-meeting studies (n = 15) included a total of 13,180 participants. The preponderance of prospective comparative studies showed a statistically significantly higher prevalence of malignancy in large nodules. Although data are mixed, evidence from the best-reported studies suggests sensitivity, false-negative rates, and frequency of true negatives among benign FNA results are worse in large nodules. Large nodules have a higher pretest probability of malignancy. Data from larger studies suggest reduced FNA diagnostic accuracy in nodules >3 to 4 cm in diameter. Surgery represents a reasonable clinical option for nodules >3 cm.

‘New Water Architecture’: an integrated water management model

An integrated framework for the management of water in England and Wales is proposed that optimises the organisation of service infrastructure, customers and stakeholders to derive optimal social, economic and environmental health. ‘New Water Architecture’ recognises the intrinsic links between water stakeholders, and between water and other essential resources, particularly food, energy and biodiversity. A systems-based approach strengthens integration of physical infrastructure, controlling institutions, and the overarching society consensus. Consideration is also given to future pressures with resilience to climate change strengthened by initiatives that slow water passage across the landscape. Implementation of the framework requires coordinated water policy across traditionally discrete resource sectors. This need is investigated alongside specific initiatives related to system management, abstraction licensing and pricing. Capital investment should be targeted towards ‘low-regret’ infrastructure argued to be high flow storage, aquifer storage and recovery, sustainable drainage systems and water transfers. These examples deliver multiple benefits and can be further optimised if existing networks, particularly inland waterways, are revitalised to enable regional integration of water sources.

Charlotte Wilson, the “Woman Question”, and the Meanings of Anarchist Socialism in Late Victorian Radicalism

SummaryRecent literature on radical movements in the late nineteenth and early twentieth centuries has re-cast this period as a key stage of contemporary globalization, one in which ideological formulations and radical alliances were fluid and did not fall neatly into the categories traditionally assigned by political history. The following analysis of Charlotte Wilson's anarchist political ideas and activism in late Victorian Britain is an intervention in this new historiography that both supports the thesis of global ideological heterogeneity and supplements it by revealing the challenge to sexual hierarchy that coursed through many of these radical cross-currents. The unexpected alliances Wilson formed in pursuit of her understanding of anarchist socialism underscore the protean nature of radical politics but also show an over-arching consensus that united these disparate groups, a common vision of the socialist future in which the fundamental but oppositional values of self and society would merge. This consensus arguably allowed Wilson's gendered definition of anarchism to adapt to new terms as she and other socialist women pursued their radical vision as activists in the pre-war women's movement.

Professional Philosophy: Inside the Delivery of Sport Psychology Service at Team Denmark

Professional Philosophy: Inside the Delivery of Sport Psychology Service at Team Denmark The field of applied psychology has developed rapidly in Europe in the past four decades. In Denmark, the sports psychology profession has been characterized by a diversity of approaches with little overarching consensus on the professional philosophy and interventions strategies among consultants in the field. In 2008, Team Denmark established a sport psychology team with the aim to enhance the quality and consistency of applied sport psychology services. The team began their work by creating a professional philosophy. This paper describes the rationale, content, and implications of this philosophy, including: (a) basic beliefs and values; (b) theories of intervention and behaviour change; (c) objectives of the sport psychology intervention, (d) the content and focus of the interventions, and (e) sport psychological services and methods. High quality service requires coherence across all five levels of the philosophy. Implications of introducing the professional philosophy include a more unified service delivery across Denmark and the fact that sport psychology services are demanded more than ever in Danish elite sport.