Consensual Approach Research Articles

Biological Age Predictors: The Status Quo and Future Trends

There is no single universal biomarker yet to estimate overall health status and longevity prospects. Moreover, a consensual approach to the very concept of aging and the means of its assessment are yet to be developed. Markers of aging could facilitate effective health control, more accurate life expectancy estimates, and improved health and quality of life. Clinicians routinely use several indicators that could be biomarkers of aging. Duly validated in a large cohort, models based on a combination of these markers could provide a highly accurate assessment of biological age and the pace of aging. Biological aging is a complex characteristic of chronological age (usually), health-to-age concordance, and medically estimated life expectancy. This study is a review of the most promising techniques that could soon be used in routine clinical practice. Two main selection criteria were applied: a sufficient sample size and reliability based on validation. The selected biological age calculators were grouped according to the type of biomarker used: (1) standard clinical and laboratory markers; (2) molecular markers; and (3) epigenetic markers. The most accurate were the calculators, which factored in a variety of biomarkers. Despite their demonstrated effectiveness, most of them require further improvement and cannot yet be considered for use in standard clinical practice. To illustrate their clinical application, we reviewed their use during the COVID-19 pandemic.

Phenological growth stages and growing degree days of peach [Prunus persica (L.) Batsch] in sub‐temperate climatic zone of North‐Western Himalayan region using BBCH scale

AbstractIn this study, the phenological stages of peach have been described for the first time according to the BBCH scale (Biologische Bundesanstalt, Bundessortenamt and Chemische Industrie) and Baggiolini codes for five cultivars (Pratap, Tropic Snow, Tropic Beauty, Redhaven and July Elberta) in sub‐temperate region of India, which markedly differentiates vegetative and reproductive stages occurring in peach. The growing degree days (GDD) are the best indicators for monitoring the different phenological growth stages and were determined from dormancy breaking to fruit harvest when the cultivars reached maturity. Pratap, Tropic Snow and Tropic Beauty were identified as early‐season maturing with 814 ± 5.10, 996 ± 8.13 and 1004 ± 8.72 GDD, respectively. While, Redhaven was mid‐season cultivar with 1502 ± 16.17 GDD, and July Elberta was the late‐season cultivar with 1894 ± 6.00 GDD. Mid‐season cultivar Redhaven performed better in India's sub‐temperate region, accounting for higher yield (54.87 kg per tree), fruit length: diameter (1.11), TSS (12.26%) and total sugars content (10.26%). The description presented in the paper will act as a tool to provide a consensual unified approach for standardisation of phenological stages in peach and also for various cultural inputs and timely planning of harvesting. Moreover, the BBCH scale will act as a tool to assess the impact of climate change on crop phenology and to evaluate the adaptation of particular peach cultivars to different conditions.

Beyond the campaign‐style enforcement: A consensual approach to bridge the environmental policy implementation gap

AbstractExisting studies on environmental policy implementation in China have largely been focused on the inadequacy of environmental policy implementation at local levels and the adversarial campaign‐style enforcement used to remedy it, while overlooked other approaches to addressing environmental issues. We present a case in which a consensual approach was used to control water pollution and identify key factors contributing to the adoption and success of such an approach. The research unit is the process of water pollution control in Shandong Province from 2002 to 2011. During the case period, the pulp and paper industry (the leading polluting source) was regulated with gradually tightened water pollution discharge standards which were made and implemented in a consensual way, surface water quality was greatly improved, and the economic output of the regulated industry grew rapidly. Key factors contributing to the adoption and success of such an approach include the presence of a capable policy entrepreneur who played an important role in policy innovation, forging consensus building in policy making and facilitating consensual policy implementation; the deep and wide involvement of the regulated firms in the policy making process which allowed them to share know‐how and express preferences; and the strong political support from provincial higher‐ups which signaled strong political wills. The findings enrich our understanding of environmental policy enforcement in China by adding a set of internal factors to a literature pool focusing more on the the influence of such external factors as institutional incentiveson policy processes and outcomes.

Impacts of nested forward validation techniques on machine learning and regression waste disposal time series models

Dataset partitioning and validation techniques are required in all artificial neural network based waste models. However, there is currently no consensual approach on the validation techniques. This study examines the effects of three time series nested forward validation techniques (rolling origin - RO, rolling window - RW, and growing window - GW) on total municipal waste disposal estimates using recurrent neural network (RNN) models, and benchmarks model performance with respect to multiple linear regression (MLR) models. Validation selection techniques appear important to waste disposal time series model construction and evaluation. Sample size is found as an important factor on model accuracy for both RNN and MLR models. Better performance in Trial RW4 is observed, probably due to a more consistent testing set in 2019. Overall, the MAPE of the waste disposal models ranging from 10.4% to 12.7%. Both GW and RO validation techniques appear appropriate for RNN waste models. However, MLR waste models are more sensitive to the dataset characteristics, and RO validation technique appears more suitable to MLR models. It is found that data characteristics are more important than training period duration. It is recommended data set normality and skewness be examined for waste disposal modeling.

It’s your world too, you can do what you want”: the role of subcultural activism in Stop The City protests (1983-1984) and its implications for political protest in Britain’

ABSTRACT This article explores the role of subcultural activism in the Stop the City Protests (STC), 1983-1984. It shows how protestors broke with the consensual approach of overarching political organisations, chiefly the Campaign for Nuclear Disarmament (CND), using direct action tactics to shut down the City of London, which was emerging as a strategic centre for globalised capitalism. STC is shown to be on a continuum with the radicalism of the preceding decades, with bands, including Crass and Poison Girls bridging the gap to anarcho-punk. This article innovates by combining official evidence, in the form of police briefing notes, with ‘ground-up’ activist materials and fanzines, to evaluate the approach and ideology of the protestors and the police, thereby tracing the increasingly intolerant policing methods that were adopted during key political battles of the 1980s, including The Miners’ Strike and The Battle of the Beanfield. Questioning the extent to which Thatcherism was the hegemonic project of the 1980s, it demonstrates how STC was at odds with the contemporaneous corporatisation of political activism, and thereby provided a model for the road protests and Reclaim the Streets movement of the 1990s, and fed into the anti-globalisation and environmental movements of the 21st century.

The Experiences of Counselors-in-Training in A Semester-Long Ecotherapy Course: A Qualitative Study

ABSTRACT A growing body of research examines the impact of the natural world on mental health and well-being. The purpose of this study was to analyze experiences of counselors-in-training (CITs) in a semester-long ecotherapy course. CITs were exposed to theoretical constructs and interventions used to conceptualize clients and conduct therapy within an ecotherapy framework. Consensual qualitative research approach was used to explore how CITs understand and make meaning of the course content, as well as how participants integrated the concepts of ecotherapy into their counselor identity and clinical experiences. Results of the data analyzed produced the following domains: benefits, intent to take the class, class experiences, impact of the pandemic, class cohesion, and relationship to the natural world. Intrapersonal benefits and the effects of nature were two of the most prevalent themes detected.

Qualitative Purpose Profiles of Chinese Student Teachers.

Teachers are well positioned to help students cultivate their purpose in life, which is an asset that is associated with optimal development. Teachers must also have a grasp on their own sense of purpose, especially during times of intense social pressure and change, when the capability to sustain and support worthy aims may impart personal resilience and contribute to the social good. To train educators who have this capability, it is therefore vital for teacher education programs to in turn understand their own students’ individualized purpose statuses. Using a qualitative person-centered approach, the current study identified purpose profiles of teacher education candidates in China as part of a larger multinational study. Three hundred and thirty-one participants wrote answers to questions about the content and fulfillment of their purpose in life, and statements were reliably coded for how specifically the respondents referenced their purpose, and for whether their purpose aimed to benefit others. A consensual qualitative research approach then identified four purpose profiles: beyond-the-self purpose, self-oriented life goal, daydreamer and purposeless. The meaning of these profiles and their significance for cultivating purpose among China’s teachers are discussed.

The Limits of Power Concentration and Expert Knowledge in Emergency Management: Spain’s Government Response during the First Phase of the Covid-19 Pandemic

ABSTRACT Focusing on the central government’s response to the Covid-19 crisis during the first wave in Spain, the article analyses the executive’s strategy of power concentration, and the factors that shape its implementation. We sketch how the crisis erupted, the main measures and strategies adopted by the national executive, the role of the experts, and the interaction with other political actors and institutions. We also explore the second phase and how the political reaction evolved towards a more consensual approach. Paradoxically, the consequences for the political actors were apparently less harmful than expected, since the governments did not lose political support, and the electorate continued to support the policy measures adopted to mitigate the pandemic.

Development of a Descriptive Profile and References for the Assessment of Taste and Mouthfeel Descriptors of Protected Designation of Origin Wines.

Producers of PDO (Protected Designation of Origin) wines must submit to the EU authorities’ technical specifications that include the specific sensory description of each product typology, to be subsequently checked by the competent authority in each country. Unfortunately, there is no consensual and standardized approach for the development of sensory control methods for PDO wines. The aim of this work was to develop a sensory profile for the taste and mouthfeel descriptors that allows the characterization of wines from 11 existing PDOs in Catalonia (Spain), and with the purpose of advancing the process of harmonization of the official sensory analysis of wines. This paper includes the selection process of tasters, the procedure used for the definition and grouping of descriptors, and the development of references for the selected attributes. The use of this analytical tool should allow PDO/PGI product certification and control authorities to verify compliance with their specifications (descriptive and quantitative) based on objectively evaluated results.

A future multipolar world

AbstractThe contemporary geopolitical world is unipolar, with the US (aided by its Western allies) attempting to impose a specific ideological polity on the rest of the world. The analysis developed in this paper is that such an absolutist political approach is dangerous to the peaceful stability of the world order and fails to appreciate the dynamic, interleaved layering across economic, trade, monetary, security, and politico‐cultural functionality. These interactions are structuring the establishment of a limited number of supra‐regions, interacting functionally, within and across the wide geographical areas concerned. This strengthening tendency should be seen as a positive evolutionary strategy that may lead to a multipolar world order that can be effective in achieving a constructive and consensual approach to the peaceful resolution of global conflicts, while allowing essential politico‐cultural diversity. This approach and its implications for UN reform are explored.

Reading Wiredu, by Barry Hallen

<i>Reading Wiredu</i>, by Barry Hallen

Cannabis Use During Pregnancy: A Qualitative Analysis of Online Information Sharing About Safety

The number of cannabis users is increasing worldwide and includes women, who may or may not make decisions about use before and during pregnancy depending on information received about safety. We investigated online information sharing about cannabis use during pregnancy. A consensual qualitative research approach was used to evaluate online discussions about cannabis use. Six thematic domains emerged: General Support, Advice/Directives, Personal Opinion/Experiences, Warnings, Judgment, and Comparisons of Use. Results showed that online posts regarding the safety of cannabis are often incorrect, unhelpful, and/or inconsistent. Understanding women’s concerns and information sharing is an important part of providing healthcare and ensuring the best possible outcomes for mother and baby.

What’s Your Laughter Doing There? A Taxonomy of the Pragmatic Functions of Laughter

Laughter is a crucial signal for communication and managing interactions. Until now no consensual approach has emerged for classifying laughter. We propose a new framework for laughter analysis and classification, based on the pivotal assumption that laughter has propositional content. We propose an annotation scheme to classify the pragmatic functions of laughter taking into account the form, the laughable, the social, situational, and linguistic context. We apply the framework and taxonomy proposed in a multilingual corpus study (French, Mandarin Chinese, and English), involving a variety of situational contexts. Our results give rise to novel generalizations about the range of meanings laughter exhibits, the placement of the laughable, and how placement and arousal relate to the functions of laughter. We have tested and refuted the validity of the commonly accepted assumption that laughter directly follows its laughable. In the concluding section, we discuss the implications our work has for spoken dialogue systems. We stress that laughter integration in spoken dialogue systems is not only crucial for emotional and affective computing aspects, but also for aspects related to natural language understanding and pragmatic reasoning. We formulate the emergent computational challenges for incorporating laughter in spoken dialogue systems.

Intrahospital Protocol for the Management of COVID-19 Disease in Adults

The COVID-19 pandemic is currently responsible for over 526 million infections and over 6.3 million deaths. As a new disease, the number of papers on the subject is extensive, motivating considerable heterogeneity in its approach. Despite some medicines having sound evidence of benefit, new interventions and strategies continue to be proposed, and some still lack scientific evidence, which hinders a uniform and consensual approach. This article aims to standardize healthcare to adult patients with moderate-to-critical COVID-19, from the emergency department to hospitalization, either in a general ward or in level 2 or level 3 intensive care units, based on the best and most updated scientific evidence available. This protocol presents recommendations for the stratification of adult patients with COVID-19 disease, adequate workup at admission and during hospitalization, inpatient treatment criteria, general treatment measures, pharmacological treatment, management of complications such as organizing pneumonia and bacterial superinfection, thromboprophylaxis, special considerations on pregnancy and breastfeeding and possible future therapies.

Educators' Perceptions of Characteristics That Define Athletic Training Student Competence: A Report From the Association for Athletic Training Education Research Network

Context As health professions education continues to transition toward competency-based education, it is essential that educators have an in-depth understanding of student competence and how it is achieved. However, little is known concerning the perceptions of educators regarding student competence in athletic training. Objective To explore athletic training educators' perceptions of student competence. Design Cross-sectional. Setting Online survey with open-ended questions. Patients or Other Participants In total, 368 of 1577 athletic training educators accessed the survey (23.3% access rate); 327 were included in data analysis because they indicated they served as an athletic training educator at the time of data collection and completed at least 1 open-ended question. Respondents represented athletic training programs in 47 states, and their average age was 41.5 ± 9.4 years. Main Outcome Measure(s) We used a 10-item survey, including 5 demographic items and 5 open-ended questions to collect data. Descriptive statistics were used to characterize the demographic variables, while responses to the open-ended questions were coded by a 3-person team following the consensual qualitative research approach. To enhance trustworthiness, an external auditor confirmed the accuracy of the findings following the structured, 4-phase data analysis progression. Results Our findings revealed that educators described the meaning of student competence in a variety of ways that ranged between lower-level cognitive learning, midlevel cognitive learning, and high-level cognitive learning. Educators further characterized student competence as being time based or student or skill based or both. Finally, educators perceived that student competence is achieved when a student is ready to practice autonomously yet shared conflicting views on the similarities or differences between student competence and student readiness. Conclusions The views and perceptions of student competence varied among athletic training educators. To progress toward competency-based education, our findings highlight the need to establish consensus regarding student competence among educators in athletic training education.

Collegiate Athletic Trainers' Experiences Implementing Return-to-Sport Policies and Procedures During COVID-19: A Qualitative Research Study.

Athletic trainers (ATs) were critical personnel in the development of policies and procedures for the safe return to campus and resumption of sport during the 2020-2021 academic year. Policies focused on preventing the potential spread of COVID-19, as well as screening, testing, and management of cases; however, which aspects of implementation were successful or more challenging was unknown. To identify successes and challenges in the implementation of return-to-sport policies and procedures during the 2020-2021 academic year amid the COVID-19 pandemic. Qualitative study. National Collegiate Athletic Association Divisions I, II, and III. A total of 27 ATs (9 women [33.3%], mean age = 48.5 ± 9.8 years, years of experience = 25.0 ± 10.5) who were in positions of leadership or who were actively involved in developing and then implementing COVID-19 return-to-sport policies and procedures completed Zoom interviews. Semistructured Zoom interviews were audio and video recorded and later transcribed. The data were analyzed by a team of 4 experienced researchers using the consensual qualitative research approach. Field notes, intercoder reliability, and multiple-analyst triangulation were used to establish data credibility. Emerging themes were implementation of public health interventions, interprofessional collaboration, and advancing the profession of athletic training. Participants described establishing and strengthening collaborations with other health care professionals as well as key stakeholders on campus as a positive outcome of the pandemic, but variations in policies among institutions and states made policy communication and enforcement more challenging. The ATs played a pivotal role in policy development, communication, and enforcement. Overall, participants took pride in serving as health care leaders for their universities and opening the eyes of colleagues to the breadth of their athletic training skill sets.

“Law Does Not Come Down From Heaven”: Youth Legal Socialisation Approaches in Chinese Textbooks of the Xi Jinping Era

Schools constitute key sites for legal socialisation, the process whereby youth develop their relationship with the law. Yet, what does legal socialisation entail in the context of an authoritarian party-state such as China? The article examines this question by analysing Chinese citizenship education textbooks of the Xi era. The study finds that China's current textbooks contain elements associated with both a coercive and a consensual approach to legal education. Nonetheless, it is the consensual orientation that receives greater stress, as the books highlight the positive benefits of legal compliance and endorse the idea that youth should advance beyond the external supervisory stage to the self-discipline level of legal consciousness. Reflecting the attempt of the Chinese Communist Party leadership to draw on legality as a key source of legitimacy, this approach is nonetheless undermined by the propagandist tone of the textbooks and their ambiguous messages regarding citizens’ ability to challenge China's existing laws.

Heat and cold waves in mainland Spain: Origins, characteristics, and trends

Heat and cold waves are extreme temperature events with a high potential of causing negative impacts on human health, and natural and socioeconomic systems, depending on their duration and intensity. There is, however, no consensual approach to address their definition, which is critical to set priority action areas to prevent such risks. Mainland Spain experiences heat and cold waves every year with important impacts especially in the most populated areas with mild or transition climates. Here we used a high-resolution (5 × 5 km) gridded daily temperature dataset and employed a combination of threshold exceedances of maximum and minimum temperature in the same day to identify heat and cold wave events over 75 years (1940–2014). We further examined the duration and the seasonal/annual intensities to detect potential spatial and temporal patterns. Additionally, we used the days within the most widespread events to perform a synoptic classification to categorise the atmospheric conditions leading to high-risk situations. Our results show a similar historical duration of heat and cold waves (4–5 days) and a much higher seasonal intensity of cold ones (double than heat waves). We find a tipping point in the early 1980s from which heat waves became more frequent, longer, and more intense than cold waves. Finally, we discern between 9 historical weather types with a dominance of southern advections driving heat waves and cold continental north-northeast air masses causing cold waves. Understanding the patterns and trends of heat and cold waves, as well as the mechanisms of their genesis is key to assist in risk management in mainland Spain, especially in the context of a warming climate scenario.

A role for metformin in the treatment of Dupuytren disease?

Dupuytren disease (DD) is a hand-localized fibrotic disorder characterized by a scar-like, collagen-rich cord. Treatment usually comprises surgical removal of the cord, but is associated with a high relapse rate, in some cases requiring finger amputation. There is currently no consensual medical approach for treating DD. Numerous preclinical studies have highlighted antifibrotic properties of metformin, and the aim of this study was to assess a potential antifibrotic role of metformin in DD. Fibroblasts from DD cords (DF) and phenotypically normal palmar fascia (PF) were extracted from surgical specimens and cultured. The fibrotic status of DF and PF was compared at baseline, and under profibrotic (TGF-β stimulation) and antifibrotic (metformin stimulation) conditions, using quantitative RT-PCR, western blot, immunocytochemistry, and a functional fibroblast contraction assay. At baseline, DF showed higher levels of fibrotic markers and contraction capacity compared with PF. Both types of fibroblasts responded to TGF-β stimulation. Treatment of DF and PF with metformin did not affect basal levels of fibrotic markers and contraction but largely prevented their induction by TGF-β. In conclusion, our data show that metformin inhibits TGF-β-induced expression of fibrotic markers and contraction in hand-derived fibroblasts. This supports the case for a clinical trial to assess the repurposing of metformin as an adjuvant to surgery, to prevent, reduce, or delay recurrence in at-risk DD patients.

The Sword of King Solomon.

Conjoined twin pregnancies are one of the greatest dilemmas we face in healthcare practice. Thanks to scientific knowledge and evolution, technology and the higher level of wealth in our society, conjoined twins have a chance to survive, albeit with the risk of major consequences on their lifespan and quality of life. Particularly, in the case of newborns with extreme prematurity or congenital malformations, special care must be taken in the use of treatments that offer little to no benefit. This is especially the case with procedures and techniques of unproven efficacy that could create unfounded expectations and hopes in parents and health professionals. It is within this conceptual framework that the author presents a case submitted to a bioethics committee at a pediatric hospital in a Latin American metropolis and analyzes the ethical challenges posed to the treating team and the consensual approach determined by the team.