856 resultados para CONSENSUS
Resumo:
The androgen receptor (AR) signaling pathway is a common therapeutic target for prostate cancer, because it is critical for the survival of both hormone-responsive and castrate-resistant tumor cells. Most of the detailed understanding that we have of AR transcriptional activation has been gained by studying classical target genes. For more than two decades, Kallikrein 3 (KLK3) (prostate-specific antigen) has been used as a prototypical AR target gene, because it is highly androgen responsive in prostate cancer cells. Three regions upstream of the KLK3 gene, including the distal enhancer, are known to contain consensus androgen-responsive elements required for AR-mediated transcriptional activation. Here, we show that KLK3 is one of a specific cluster of androgen-regulated genes at the centromeric end of the kallikrein locus with enhancers that evolved from the long terminal repeat (LTR) (LTR40a) of an endogenous retrovirus. Ligand-dependent recruitment of the AR to individual LTR-derived enhancers results in concurrent up-regulation of endogenous KLK2, KLK3, and KLKP1 expression in LNCaP prostate cancer cells. At the molecular level, a kallikrein-specific duplication within the LTR is required for maximal androgen responsiveness. Therefore, KLK3 represents a subset of target genes regulated by repetitive elements but is not typical of the whole spectrum of androgen-responsive transcripts. These data provide a novel and more detailed understanding of AR transcriptional activation and emphasize the importance of repetitive elements as functional regulatory units
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Control of biospecimen quality that is linked to processing is one of the goals of biospecimen science. Consensus is lacking, however, regarding optimal sample quality-control (QC) tools (ie, markers and assays). The aim of this review was to identify QC tools, both for fluid and solid-tissue samples, based on a comprehensive and critical literature review. The most readily applicable tools are those with a known threshold for the preanalytical variation and a known reference range for the QC analyte. Only a few meaningful markers were identified that meet these criteria, such as CD40L for assessing serum exposure at high temperatures and VEGF for assessing serum freeze-thawing. To fully assess biospecimen quality, multiple QC markers are needed. Here we present the most promising biospecimen QC tools that were identified.
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This paper explores grassroots leadership, an under-researched and often side-lined approach to leadership that operates outside of formal bureaucratic structures. The paper’s central purpose is the claim that an understanding of grassroots leadership and tactics used by grassroots leaders provides valuable insights for the study of school leadership. In this paper, we present and discuss an original model of grassroots leadership based on the argument that this under-researched area can further our understanding of school leadership. Drawing upon the limited literature in the field, we present a model consisting of two approaches to change (i.e. conflict and consensus) and two categories of change (i.e. reform and refinement) and then provide illustrations of how the model works in practice. We make the argument that the model has much merit for conceptualizing school leadership, and this is illustrated by applying the model to formal bureaucratic leadership within school contexts. Given the current climate in education where business and management language is pervasive within leadership-preparation programs, we argue that it is timely for university academics, who are responsible for preparing school leaders to consider broadening their approach by exposing school leaders to a variety of change-based strategies and tactics used by grassroots leaders.
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Discourses of public education reform, like that exemplified within the Queensland Government’s future vision document, Queensland State Education-2010 (QSE-2010), position schooling as a panacea to pervasive social instability and a means to achieve a new consensus. However, in unravelling the many conflicting statements that conjoin to form education policy and inform related literature (Ball, 1993), it becomes clear that education reform discourse is polyvalent (Foucault, 1977). Alongside visionary statements that speak of public education as a vehicle for social justice are the (re)visionary or those reflecting neoliberal individualism and a conservative politics. In this paper, it is argued that the latter coagulate to form strategic discursive practices which work to (re)secure dominant relations of power. Further, discussion of the characteristics needed by the “ideal” future citizen of Queensland reflect efforts to ‘tame change through the making of the child’ (Popkewitz, 2004, p.201). The casualties of this (re)vision and the refusal to investigate the pathologies of “traditional” schooling are the children who, for whatever reason, do not conform to the norm of the desired school child as an “ideal” citizen-in-the-making and who become relegated to alternative educational settings.
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Introduction QC and EQA are integral to good pathology laboratory practice. Medical Laboratory Science students undertake a project exploring internal QC and EQA procedures used in chemical pathology laboratories. Each student represents an individual lab and the class group represents the peer group of labs performing the same assay using the same method. Methods Using a manual BCG assay for serum albumin, normal and abnormal controls are run with a patient sample over 7 weeks. The QC results are assessed each week using calculated z-scores and both 2S & 3S control rules to determine whether a run is ‘in control’. At the end of the 7 weeks a completed LJ chart is assessed using the Westgard Multirules. Students investigate causes of error and the implications for both lab practice and patient care if runs are not ‘in control’. Twice in the 7 weeks two EQA samples (with target values unknown) are assayed alongside the weekly QC and patient samples. Results from each student are collated and form the basis of an EQA program. ALP are provided and students complete a Youden Plot, which is used to analyse the performance of each ‘lab’ and the method to identify bias. Students explore the concept of possible clinical implications of a biased method and address the actions that should be taken if a lab is not in consensus with the peer group. Conclusion This project is a model of ‘real world’ practice in which student demonstrate an understanding of the importance of QC procedures in a pathology laboratory, apply and interpret statistics and QC rules and charts, apply critical thinking and analytical skills to quality performance data to make recommendations for further practice and improve their technical competence and confidence.
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This research examines the entrepreneurship phenomenon, and the question: Why are some venture attempts more successful than others? This question is not a new one. Prior research has answered this by describing those that engage in nascent entrepreneurship. Yet, this approach yielded little consensus and offers little comfort for those newly considering venture creation (Gartner, 1988). Rather, this research considers the process of venture creation, by focusing on the actions of nascent entrepreneurs. However, the venture creation process is complex (Liao, Welsch, & Tan, 2005), and multi-dimensional (Davidsson, 2004). The process can vary in the amount of action engaged by the entrepreneur; the temporal dynamics of how action is enacted (Lichtenstein, Carter, Dooley, and Gartner 2007); or the sequence in which actions are undertaken. And little is known about whether any, or all three, of these dimensions matter. Further, there exists scant general knowledge about how the venture creation process influences venture creation outcomes (Gartner & Shaver, 2011). Therefore, this research conducts a systematic study of what entrepreneurs do as they create a new venture. The primary goal is to develop general principles so that advice may be offered on how to ‘proceed’, rather than how to ‘be’. Three integrated empirical studies were conducted that separately focus on each of the interrelated dimensions. The basis for this was a randomly sampled, longitudinal panel, of nascent ventures. Upon recruitment these ventures were in the process of being created, but yet to be established as new businesses. The ventures were tracked one year latter to follow up on outcomes. Accordingly, this research makes the following original contributions to knowledge. First, the findings suggest that all three of the dimensions play an important role: action, dynamics, and sequence. This implies that future research should take a multi-dimensional view of the venture creation process. Failing to do so can only result in a limited understanding of a complex phenomenon. Second, action is the fundamental means through which venture creation is achieved. Simply put, more active venture creation efforts are more likely more successful. Further, action is the medium which allows resource endowments their effect upon venture outcomes. Third, the dynamics of how venture creation plays out over time is also influential. Here, a process with a high rate of action which increases in intensity will more likely achieve positive outcomes. Forth, sequence analysis, suggests that the order in which actions are taken will also drive outcomes. Although venture creation generally flows in sequence from discovery toward exploitation (Shane & Venkataraman, 2000; Eckhardt & Shane, 2003; Shane, 2003), processes that actually proceed in this way are less likely to be realized. Instead, processes which specifically intertwine discovery and exploitation action together in symbiosis more likely achieve better outcomes (Sarasvathy, 2001; Baker, Miner, & Eesley, 2003). Further, an optimal venture creation order exists somewhere between these sequential and symbiotic process archetypes. A process which starts out as symbiotic discovery and exploitation, but switches to focus exclusively on exploitation later on is most likely to achieve venture creation. These sequence findings are unique, and suggest future integration between opposing theories for order in venture creation.
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Most teachers recognise the importance of mathematics teaching and learning in early years but there is not consensus on how and when this learning should occur. Young-Loveridge (cited in de Vries, Thomas, and Warren, 2010) suggests that quality early mathematical experiences are a key determinant to later achievement.
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Over the past several decades, policy has become increasingly global. In economics, for example, policy has followed the so-called Washington Consensus of privatization, liberalization, and deregulation. In education, global policy has included the proliferation of strategies including standardized testing, paraprofessional teachers, user fees, and privatization. There are many problems with these neoliberal policies. Foremost among them, is the havoc they wreak on the lives of so many children and adults. Poverty, inequality, and myriad associated problems have reached new heights in this neoliberal era. Moreover, these policies have been adopted uncritically and alternative policies have been ignored, which leads to our focus here.
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The purpose of this article is to grade research evidence supporting exercise-based interventions for persons with early-stage dementias and to report the recommendations of a consensus panel. The search produced 11 data based articles testing the effects of exercise interventions on a variety of outcomes. The body of evidence to support exercise interventions in the prevention and treatment of Alzheimer’s disease is growing and has potential as a treatment modality following translational studies in recreation therapy and other fields.
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Background: Nurse practitioner education and practice has been guided by generic competency standards in Australia since 2006. Development of specialist competencies has been less structured and there are no formal standards to guide education and continuing professional development for specialty fields. There is limited international research and no Australian research into development of specialist nurse practitioner competencies. This pilot study aimed to test data collection methods, tools and processes in preparation for a larger national study to investigate specialist competency standards for emergency nurse practitioners. Research into specialist emergency nurse practitioner competencies has not been conducted in Australia. Methods: Mixed methods research was conducted with a sample of experienced emergency nurse practitioners. Deductive analysis of data from a focus group workshop informed development of a draft specialty competency framework. The framework was subsequently subjected to systematic scrutiny for consensus validation through a two round Delphi Study. Results: The Delphi study first round had a 100% response rate; the second round 75% response rate. The scoring for all items in both rounds was above the 80% cut off mark with the lowest mean score being 4.1 (82%) from the first round. Conclusion: The authors collaborated with emergency nurse practitioners to produce preliminary data on the formation of specialty competencies as a first step in developing an Australian framework.
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Good daylighting design in buildings not only provides a comfortable luminous environment, but also delivers energy savings and comfortable and healthy environments for building occupants. Yet, there is still no consensus on how to assess what constitutes good daylighting design. Currently amongst building performance guidelines, Daylighting factors (DF) or minimum illuminance values are the standard; however, previous research has shown the shortcomings of these metrics. New computer software for daylighting analysis contains new more advanced metrics for daylighting (Climate Base Daylight Metrics-CBDM). Yet, these tools (new metrics or simulation tools) are not currently understood by architects and are not used within architectural firms in Australia. A survey of architectural firms in Brisbane showed the most relevant tools used by industry. The purpose of this paper is to assess and compare these computer simulation tools and new tools available architects and designers for daylighting. The tools are assessed in terms of their ease of use (e.g. previous knowledge required, complexity of geometry input, etc.), efficiency (e.g. speed, render capabilities, etc.) and outcomes (e.g. presentation of results, etc. The study shows tools that are most accessible for architects, are those that import a wide variety of files, or can be integrated into the current 3d modelling software or package. These software’s need to be able to calculate for point in times simulations, and annual analysis. There is a current need in these software solutions for an open source program able to read raw data (in the form of spreadsheets) and show that graphically within a 3D medium. Currently, development into plug-in based software’s are trying to solve this need through third party analysis, however some of these packages are heavily reliant and their host program. These programs however which allow dynamic daylighting simulation, which will make it easier to calculate accurate daylighting no matter which modelling platform the designer uses, while producing more tangible analysis today, without the need to process raw data.
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QUT Bachelor of Radiation Therapy students progress from first visiting a radiation therapy department to graduation and progression into the NPDP over a span of three years. Although there are clear guidelines as to expected competency level post-NPDP, there is still a variety of perceived levels prior to this. Staff and students feedback both suggest that different centres and within centres different staff have differing opinions of these levels. Indeed, many staff members object to the use of the word “competency” for a pre-NPODP undergraduate, preferring the term “achievement”. While it is acknowledged that students progress at different rates, it is vitally important for equity that staff expectations of students at different academic levels are identical. Provision of guidelines for different stages of progression are essential for equitable assessment and most assessments, including the NRTAT are complemented by statements to enable level to be determined. For the University-specific competency assessments some level of consensus between clinical staff is required, especially where students are placed at a large number of different placement sites. Aims The main aim of this initial study is to gauge staff opinions of levels of student progression in order to judge cross-centres consistency. A secondary objective is to evaluate the degree of correlation between staff seniority and perception of student levels. Informal feedback suggests that staff at or just post NPDP level have a different perception of student competency expectations than more senior staff. If these perceptions change with level it will make agreement of guidelines statements more challenging. Study Methods A standard evaluation questionnaire was provided to RT staff participating in ongoing updates to clinical assessment. As part of curriculum development staff were asked to provide anonymous and optional answers to further questions in order to audit current practice. This involved assigning level of student progression to different statements relating to tasks or competencies. After data collation, scores were assigned to level and totals used to rank statements according to perceived student level. Descriptive statistical analysis was used to identify which statements were easier to assign to student level and which were more ambiguous. Further sub-analysis was performed for each category of staff seniority to judge differences in perception. Strength of correlation between seniority and expectation was calculated to confirm or contradict the informal feedback. Results By collating different staff perceptions of competencies for different student levels commonly agreed statements can be used to define achievement level. This presentation outlines the results of the audit including statements that most staff perceived as relevant to a specific student group and statements that staff found to be harder to attribute. Strength of correlation between staff perception and seniority will be outlined where statistically significant.
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Although Basin and Range style extension affected several areas of western Mexico since the Late Eocene, extension in the Gulf of California region (the Gulf Extensional Province GEP) is thought to have started as subduction waned and ended at ~14 12.5 Ma. A general consensus also exists in considering the mid Miocene Comondú group as a suprasubduction volcanic arc. Our new integration of the geology of the south east Gulf region, backed by 43 new Ar Ar and U Pb mineral ages and geochemical studies, document a widespread phase of extension in the southern GEP between latest Oligocene and Early Miocene that subsequently focused in the region of the future Gulf in the Middle Miocene. Upper Oligocene to Lower Miocene rocks across the southern Sierra Madre Occidental (SMO)(northern Nayarit and southern Sinaloa) were affected by major ~N S to NNW striking normal faults prior to ~21 Ma. Then, between ~21 and 11 Ma, a system of NNW-SSE high angle extensional faults continued extending the southwestern side of the SMO. Rhyolitic domes, shallow intrusive bodies, and lesser basalts were emplaced along this extensional belt at 20-17 Ma. In northern Sinaloa, large grabens were floored by huge dome complexes at ~21-17 Ma and filled by continental sediments with interlayered basalts dated at 15-14 Ma, a setting and timing very similar to Sonora. Early to Middle Miocene volcanism, including the largely volcaniclastic Comondú strata in Baja California Sur, was thus emplaced in rift basins and was likely associated to decompression melting of upper mantle (inducing crustal partial melting) rather than to fluxing by fluids from the young subducting plate. Along the Nayarit and Sinaloa coast, flatlying basaltic lava flows dated at 11-10 Ma are exposed just above the present sea level. Here, crustal thickness is almost half that in the unextended core of the SMO, implying significant lithosphere stretching before ~11 Ma. Our study shows that rifting began much earlier than Late Miocene and provided a fundamental control on the style and composition of volcanism from at least 30 Ma. We envision a sustained period of lithospheric stretching and magmatism during which the pace and breadth of extension changed at ~20-18 Ma to be narrower and likely more rapid, and again at ~12.5 Ma, when the kinematics of rifting became more oblique.
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Background: Antibiotic overuse is influenced by several factors that can only be measured using a valid and reliable psychosocial measurement instrument. This study aims to establish translation and early stage validation of an instrument recently developed by this research team to measure factors influencing the overuse of antibiotics in children with upper respiratory tract infections in Saudi Arabia. Method: The content evaluation panel was composed of area experts approached using the Delphi Technique. Experts were provided with the questionnaires iteratively, on a three-round basis until consensus on the relevance of items was reached independently. Translation was achieved by adapting Brislin’s model of translation. Results: After going through the iterative process with the experts, consensus was reached to 58 items (including demographics). Experts also pointed out some issues related to ambiguity and redundancy in some items. A final Arabic version was produced from the translation process. Conclusion: This study produced preliminary validation of the developed instrument from the experts’ contributions. Then, the instrument was translated from English to Arabic. The instrument will undergo further validation steps in the future, such as construct validity.
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Voltage rise is one of the main factors which limits the capacity of Low Voltage (LV) network to accommodate more Renewable Energy (RE) sources. This paper proposes a robust and effective approach to coordinate customers’ resources and manage voltage rise in residential LV networks. PV is considered as the customer RE source. The suggested coordination approach in this paper includes both localized control strategy, based on local measurement, and distributed control strategy based on consensus algorithm. This approach can completely avoid maximum permissible voltage limit violation. A typical residential LV network is used as the case study where the simulated results are shown to verify the effectiveness of the proposed approach.