894 resultados para Consensus building process


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Three experiments are reported which examine the effects of consensus information on majority and minority influence. In all experiments two levels of consensus difference were examined; large (82% versus 18%) and small (52% versus 48%). Experiment 1 showed that a majority source had more influence than a minority source, irrespective of consensus level. Experiment 2 examined the cause of this effect by presenting only the source label ('majority' versus 'minority'), only the consensus information (percentages) or both. The superior influence of the majority was again found when either (a) both source label and consensus information were given (replicating Experiment 1) and (b) only consensus information was given, but not when (c) only the source label was given. The results showed majority influence was due to the consensus information indicating more than 50% of the population supported that position. Experiment 3 also manipulated message quality (strong versus weak arguments) to identify whether systematic processing had occurred. Message quality only had an impact with the minority of 18%. These studies show that consensus information has different effects' for majority and minority influence. For majority influence, having over 50% support is sufficient to cause compliance while for a minority there are advantages to being numerically small, in terms of leading to detailed processing of its message. Copyright (C) 2002 John Wiley Sons, Ltd.

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Therapeutic drug monitoring of cyclosporin (CsA) has been established as part of the routine clinical treatment of patients following organ transplantation for more than 20 years, and based on contemporary knowledge, many consensus guidelines have been published to assist clinics and laboratories attain optimal strategies for patient care. This article addresses the newer directions in CsA monitoring, with particular reference to the Australasian situation that has evolved since the 1993 Australasian guideline (1). These changes have included the introduction of alternative assay methodologies, changed CsA formulation from Sandimmun to Neoral throughout Australasia, and alternatives to trough concentration (C0) monitoring, especially 2-hour concentration (C2) monitoring and associated validated dilution protocols to accurately quantitate the higher whole blood CsA concentrations. The revision was prepared following a recent survey of all Australasian CsA-monitoring laboratories (2) where discordant practices were evident.

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In Australian universities the discipline of Geography has been the pace-setter in forging cross-disciplinary links to create multidisciplinary departments and schools, well ahead of other disciplines in humanities, social sciences and sciences, and also to a greater extent than in comparable overseas university systems. Details on all cross-disciplinary links and on immediate outcomes have been obtained by surveys of all heads of departments/schools with undergraduate Geography programs. These programs have traced their own distinctive trajectories, with ramifying links to cognate fields of enquiry, achieved through mergers, transfers, internal initiatives and, more recently, faculty-wide restructuring to create supradisciplinary schools. Geography's `exceptionalism' has proved short-lived. Disciplinary flux is now extending more widely within Australian universities, driven by a variety of internal and external forces, including: intellectual questioning and new ways of constituting knowledge; technological change and the information revolution; the growth of instrumentalism and credentialism, and managerialism and entre-preneurial imperatives; reinforced by a powerful budgetary squeeze. Geographers are proving highly adaptive in pursuit of cross-disciplinary connections, offering analytical tools and selected disciplinary insights useful to non-geographers. However, this may be at cost to undergraduate programs focussing on Geography's intellectual core. Whereas formerly Geography had high reproductive capacity but low instrumental value it may now be in a phase of enhanced utility but perilously low reproductive capacity.

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In the last 7 years, a method has been developed to analyse building energy performance using computer simulation, in Brazil. The method combines analysis of building design plans and documentation, walk-through visits, electric and thermal measurements and the use of an energy simulation tool (DOE-2.1E code), The method was used to model more than 15 office buildings (more than 200 000 m(2)), located between 12.5degrees and 27.5degrees South latitude. The paper describes the basic methodology, with data for one building and presents additional results for other six cases. (C) 2002 Elsevier Science Ltd. All rights reserved.

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The aim of this study was to assess the variation between neuropathologists in the diagnosis of common dementia syndromes when multiple published protocols are applied. Fourteen out of 18 Australian neuropathologists participated in diagnosing 20 cases (16 cases of dementia, 4 age-matched controls) using consensus diagnostic methods. Diagnostic criteria, clinical synopses and slides from multiple brain regions were sent to participants who were asked for case diagnoses. Diagnostic sensitivity, specificity, predictive value, accuracy and variability were determined using percentage agreement and kappa statistics. Using CERAD criteria, there was a high inter-rater agreement for cases with probable and definite Alzheimer's disease but low agreement for cases with possible Alzheimer's disease. Braak staging and the application of criteria for dementia with Lewy bodies also resulted in high inter-rater agreement. There was poor agreement for the diagnosis of frontotemporal dementia and for identifying small vessel disease. Participants rarely diagnosed more than one disease in any case. To improve efficiency when applying multiple diagnostic criteria, several simplifications were proposed and tested on 5 of the original 210 cases. Inter-rater reliability for the diagnosis of Alzheimer's disease and dementia with Lewy bodies significantly improved. Further development of simple and accurate methods to identify small vessel lesions and diagnose frontotemporal dementia is warranted.

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A technique based on laser light diffraction is shown to be successful in collecting on-line experimental data. Time series of floc size distributions (FSD) under different shear rates (G) and calcium additions were collected. The steady state mass mean diameter decreased with increasing shear rate G and increased when calcium additions exceeded 8 mg/l. A so-called population balance model (PBM) was used to describe the experimental data, This kind of model describes both aggregation and breakage through birth and death terms. A discretised PBM was used since analytical solutions of the integro-partial differential equations are non-existing. Despite the complexity of the model, only 2 parameters need to be estimated: the aggregation rate and the breakage rate. The model seems, however, to lack flexibility. Also, the description of the floc size distribution (FSD) in time is not accurate.

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Complete biological nutrient removal (BNR) in a single tank, sequencing batch reactor (SBR) process, is demonstrated here at full-scale on a typical domestic wastewater. The unique feature of the UniFed process is the introduction of the influent into the settled sludge blanket during the settling and decant periods of the SBR operation. This achieves suitable conditions for denitrification and anaerobic phosphate release which is critical to successful biological phosphorus removal, It also achieves a selector effect, which helps in generating a compact, well settling biomass in the reactor. The results of this demonstration show that it is possible to achieve well over 90% removal of GOD, nitrogen and phosphorus in such a process. Effluent quality achieved over a six-month operating period directly after commissioning was: 29 mg/l GOD, 0.5 mg/l NH4-N, 1.5 mg/l NOx-N and 1.5 mg/l PO4-P (50%-iles of daily samples). During an 8-day, intensive sampling period, the effluent BOD5 was

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Background/Aims: The role of cytokines in hepatic injury has been examined for many liver diseases however little is known of the cytokine involvement in haemochromatosis. The aim of the current study was to examine the hepatic gene expression of potential proinflammatory and profibrogenic cytokines in haemochromatosis. Methods: Interferon-gamma, interleukin-10, transforming growth factor-beta(1) and tumor necrosis factor-alpha mRNA expression was assessed in liver tissue from 20 haemochromatosis patients, eight controls and eight chronic hepatitis C patients. To assess the immunophenotype of the inflammatory infiltrate in haemochromatosis, liver sections were subjected to immunohistochemistry using markers for macrophages (CD68, HAM56, MAC387) or T cells (CD3 and CD45RO). Results: Interferon-gamma mRNA was increased in both haemochromatosis (0.29+/-0.08%, P=0.01) and hepatitis C patients (1.02+/-0.32%, P=0.03) compared to controls (0.04+/-0.01%). Interleukin-10 mRNA was significantly decreased in both haemochromatosis and hepatitis C patients (0.01+/-0.003%, P=0.008 and 0.03+/-0.015%, P=0.02, respectively) compared to controls (0.12+/-0.01%). CD3 positive T-cell number was significantly correlated with increasing hepatic iron concentration (r=0.56, P=0.03). Conclusions: This study has demonstrated a distinct pattern of cytokine gene expression in haemochromatosis, which resembles that of inflammatory conditions such as chronic hepatitis C. These factors may play a role in the development of iron-induced hepatic fibrosis in haemochromatosis. (C) 2003 European Association for the Study of the Liver. Published by Elsevier Science B.V. All rights reserved.