Elicitation of expert prior opinion: application to the MYPAN trial in childhood polyarteritis nodosa.

Directory of Open Access Journals (Sweden)

Lisa V Hampson

Full Text Available Definitive sample sizes for clinical trials in rare diseases are usually infeasible. Bayesian methodology can be used to maximise what is learnt from clinical trials in these circumstances. We elicited expert prior opinion for a future Bayesian randomised controlled trial for a rare inflammatory paediatric disease, polyarteritis nodosa (MYPAN, Mycophenolate mofetil for polyarteritis nodosa.A Bayesian prior elicitation meeting was convened. Opinion was sought on the probability that a patient in the MYPAN trial treated with cyclophosphamide would achieve disease remission within 6-months, and on the relative efficacies of mycophenolate mofetil and cyclophosphamide. Expert opinion was combined with previously unseen data from a recently completed randomised controlled trial in ANCA associated vasculitis.A pan-European group of fifteen experts participated in the elicitation meeting. Consensus expert prior opinion was that the most likely rates of disease remission within 6 months on cyclophosphamide or mycophenolate mofetil were 74% and 71%, respectively. This prior opinion will now be taken forward and will be modified to formulate a Bayesian posterior opinion once the MYPAN trial data from 40 patients randomised 1:1 to either CYC or MMF become available.We suggest that the methodological template we propose could be applied to trial design for other rare diseases.

Using expert opinion to evaluate a habitat effectiveness model for elk in western Oregon and Washington.

Science.gov (United States)

Richard S. Holthausen; Michael J. Wisdom; John Pierce; Daniel K. Edwards; Mary M. Rowland

1994-01-01

We used expert opinion to evaluate the predictive reliability of a habitat effectiveness model for elk in western Oregon and Washington. Twenty-five experts in elk ecology were asked to rate habitat quality for 16 example landscapes. Rankings and ratings of 21 experts were significantly correlated with model output. Expert opinion and model predictions differed for 4...

Risk-Informed SSCs Categorization: Elicitation Method of Expert's Opinion

International Nuclear Information System (INIS)

Hwang, Mee Jeong; Yang, Joon Eon; Kim, Kil Yoo

2005-01-01

The regulations have been performing by deterministic way since nuclear power plants have been operating. However, some SSCs identified as safety-significance by deterministic way, were turned out to be low or non safety-significant and some SSCs identified as non-safety significance were turned out to be high safety-significant according to the results of PSA. Considering these risk insights, Regulatory Guide 1.174 and 10CFR50.69 were drawn up, and we can re-categorize the SSCs according to their safety significance. Therefore, a study and an interest about the risk-informed SSCs re-categorization and treatment has been continued. The objective of this regulatory initiative is to adjust the scope of equipment subject to special regulatory treatment to better focus licensee and regulatory attention and resources on equipment that has safety significance. Current most regulations define the plant equipment necessary to meet deterministic regulatory basis as 'safety-related.' This equipment is subject to special treatment regulations. Other plant equipment is categorized as 'non-safety related,' and is not subject to a select number of special treatment requirement or a subset of those requirement. However, risk information is not a magic tool making a decision but a supporting tool to categorize SSCs. This is because only small parts of a plant are modeled in PSA model. Thus, engineering and deterministic judgments are also used for risk-informed SSCs categorization, and expert opinion elicitation is very important for risk-informed SSCs categorization. Therefore, we need a rational method to elicit the expert's opinions, and in this study, we developed a systematic method for expert elicitation to categorize the nuclear power plants' SSCs. Current states for SSCs categorization of the USA and the existing methods for expert elicitation were surveyed and more systematic way eliciting the expert opinions and combining was developed. To validate the developed method

Survey of Expert Opinion on Intelligence: Causes of International Differences in Cognitive Ability Tests.

Science.gov (United States)

Rindermann, Heiner; Becker, David; Coyle, Thomas R

2016-01-01

Following Snyderman and Rothman (1987, 1988), we surveyed expert opinions on the current state of intelligence research. This report examines expert opinions on causes of international differences in student assessment and psychometric IQ test results. Experts were surveyed about the importance of culture, genes, education (quantity and quality), wealth, health, geography, climate, politics, modernization, sampling error, test knowledge, discrimination, test bias, and migration. The importance of these factors was evaluated for diverse countries, regions, and groups including Finland, East Asia, sub-Saharan Africa, Southern Europe, the Arabian-Muslim world, Latin America, Israel, Jews in the West, Roma (gypsies), and Muslim immigrants. Education was rated by N = 71 experts as the most important cause of international ability differences. Genes were rated as the second most relevant factor but also had the highest variability in ratings. Culture, health, wealth, modernization, and politics were the next most important factors, whereas other factors such as geography, climate, test bias, and sampling error were less important. The paper concludes with a discussion of limitations of the survey (e.g., response rates and validity of expert opinions).

Was the Conconi test validated by sporting success, expert opinion ...

African Journals Online (AJOL)

Was the Conconi test validated by sporting success, expert opinion or good science? ... Open Access DOWNLOAD FULL TEXT ... Despite scientific evidence to the contrary, a popular incremental field test for endurance athletes (Conconi Test) ...

Expert Opinion Is Necessary: Delphi Panel Methodology Facilitates a Scientific Approach to Consensus.

Science.gov (United States)

Hohmann, Erik; Brand, Jefferson C; Rossi, Michael J; Lubowitz, James H

2018-02-01

Our current trend and focus on evidence-based medicine is biased in favor of randomized controlled trials, which are ranked highest in the hierarchy of evidence while devaluing expert opinion, which is ranked lowest in the hierarchy. However, randomized controlled trials have weaknesses as well as strengths, and no research method is flawless. Moreover, stringent application of scientific research techniques, such as the Delphi Panel methodology, allows survey of experts in a high quality and scientific manner. Level V evidence (expert opinion) remains a necessary component in the armamentarium used to determine the answer to a clinical question. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Common problems in the elicitation and analysis of expert opinion affecting probabilistic safety assessments

Energy Technology Data Exchange (ETDEWEB)

Meyer, M.A.; Booker, J.M.

1990-01-01

Expert opinion is frequently used in probabilistic safety assessment (PSA), particularly in estimating low probability events. In this paper, we discuss some of the common problems encountered in eliciting and analyzing expert opinion data and offer solutions or recommendations. The problems are: that experts are not naturally Bayesian. People fail to update their existing information to account for new information as it becomes available, as would be predicted by the Bayesian philosophy; that experts cannot be fully calibrated. To calibrate experts, the feedback from the known quantities must be immediate, frequent, and specific to the task; that experts are limited in the number of things that they can mentally juggle at a time to 7 {plus minus} 2; that data gatherers and analysts can introduce bias by unintentionally causing an altering of the expert's thinking or answers; that the level of detail the data, or granularity, can affect the analyses; and the conditioning effect poses difficulties in gathering and analyzing of the expert data. The data that the expert gives can be conditioned on a variety of factors that can affect the analysis and the interpretation of the results. 31 refs.

Risk-Informed SSCs Categorization: Elicitation Method of Expert's Opinion

Energy Technology Data Exchange (ETDEWEB)

Hwang, Mee Jeong; Yang, Joon Eon; Kim, Kil Yoo

2005-01-15

The regulations have been performing by deterministic way since nuclear power plants have been operating. However, some SSCs identified as safety-significance by deterministic way, were turned out to be low or non safety-significant and some SSCs identified as non-safety significance were turned out to be high safety-significant according to the results of PSA. Considering these risk insights, Regulatory Guide 1.174 and 10CFR50.69 were drawn up, and we can re-categorize the SSCs according to their safety significance. Therefore, a study and an interest about the risk-informed SSCs re-categorization and treatment has been continued. The objective of this regulatory initiative is to adjust the scope of equipment subject to special regulatory treatment to better focus licensee and regulatory attention and resources on equipment that has safety significance. Current most regulations define the plant equipment necessary to meet deterministic regulatory basis as 'safety-related.' This equipment is subject to special treatment regulations. Other plant equipment is categorized as 'non-safety related,' and is not subject to a select number of special treatment requirement or a subset of those requirement. However, risk information is not a magic tool making a decision but a supporting tool to categorize SSCs. This is because only small parts of a plant are modeled in PSA model. Thus, engineering and deterministic judgments are also used for risk-informed SSCs categorization, and expert opinion elicitation is very important for risk-informed SSCs categorization. Therefore, we need a rational method to elicit the expert's opinions, and in this study, we developed a systematic method for expert elicitation to categorize the nuclear power plants' SSCs. Current states for SSCs categorization of the USA and the existing methods for expert elicitation were surveyed and more systematic way eliciting the expert opinions and combining was developed. To

Remarks on the assessment, representation, aggregation and utilization of expert opinion

International Nuclear Information System (INIS)

Fine, T.L.

1980-04-01

This report considers the relevance of recent ideas in the foundations of probability to the rational use of expert opinion in the design of a nuclear waste repository, and the assessment of its performance. The main probability concepts introduce are those of modal (probably A), comparative (A is at least as probable as B) and interval-valued (the lower probability of A is P(A) and the upper probability of A is P(anti A)) probabilities. We then outline an approach first using comparative probability to model the resuls of binary elicitation of an expert's opinions concerning repository uncertainties and then employing interval-valued probability to represent comparative probability in a computationally convenient form. We further consider the issue of aggregating or amalgamating the responses of several experts, and we emphasize the need to preserve some measure of the disagreements among the experts. The resulting aggregated interval-valued representation of the responses concerning the uncertainties surrounding the performance of a nuclear waste repository design can then be used to numerically assess this performance in a manner parallel to that of utility theory. Utility theory is the basis for statistical decision theory. Our recommendations can only be tentative, and research is recommended to gain some working experience with the results of the proposed decision-making process in the repostory design context

Development of the Paris Definition of Early Crohn's Disease for Disease-Modification Trials: Results of an International Expert Opinion Process

NARCIS (Netherlands)

Peyrin-Biroulet, Laurent; Billioud, Vincent; D'Haens, Geert; Panaccione, Remo; Feagan, Brian; Panés, Julian; Danese, Silvio; Schreiber, Stefan; Ogata, Haruhiko; Hibi, Toshifumi; Higgins, Peter D. R.; Beaugerie, Laurent; Chowers, Yehuda; Louis, Edouard; Steinwurz, Flávio; Reinisch, Walter; Rutgeerts, Paul; Colombel, Jean-Frédéric; Travis, Simon; Sandborn, William J.

2012-01-01

We report the findings and outputs of an international expert opinion process to develop a definition of early Crohn's disease (CD) that could be used in future disease-modification trials. Nineteen experts on inflammatory bowel diseases held an international expert opinion meeting to discuss and

Experts' opinion on the radioecology of the waste water of Esensham nuclear power plant

International Nuclear Information System (INIS)

Bliefert, M.; Marks, R.; Meier, A.; Wallenschus, M.

1978-01-01

Review of the legal steps taken in the dispute over the radiation burden due to the nuclear power plant. There are the experts Prof. Feld (official expert's opunion) with 0.0028 mrem/a and Prof. Bleck (plaintiff's expert's opinion) with 230 mrem/a. The different values obtained are attributed to transfer factors of Cs and to a manipulation of dose factors. (GL) [de

Risk perception: expert opinion versus public understanding

International Nuclear Information System (INIS)

Brown, Jennifer

1987-01-01

A research project looking at the public's attitudes towards the siting of radioactive waste depositories is reported. The risk perception studies seek to compare expert and lay understanding of risk. Adverse public reactions to risk can only be understood if it is known how people relate to risks in their everyday or working lives. Social trends and experiences are important, for example, the adverse public opinion on the siting of nuclear waste facilities. A number of elements have been identified as common to different risk areas such as chemicals, drugs, food or radioactive waste. These are the clashing of values, polarization of beliefs or clashes of interest. (UK)

SFPM opinion on the so-called 'transit' in vivo dosimetry in external radiotherapy

International Nuclear Information System (INIS)

Berger, Lucie; Dupuis, Pauline; Marchesi, Vincent; Boutry, Christine; Francois, Pascal; Crespin, Sylvain

2014-01-01

Written to the demand of the ASN to the SFPM (the French professional body in medical physics), this report states the opinion of these professionals regarding the use of the so-called 'transit' dosimetry for the control of the in vivo dose received during radiotherapy. After an overview of the use of in vivo dosimetry in medical practices, the authors outline the main benefits and drawbacks of point conventional detectors used for this dosimetry. They propose an overview of the state-of-the-art in transit in vivo dosimetry by briefly describing the different developed methodologies: the prediction-based methodology and the rear projection methodology. They also propose a literature review on transit in vivo dosimetry. Based on expert experience and on this review they give lists of technical benefits and drawbacks of techniques of in vivo dosimetry by EPID transit imagery. They finally indicate some commercially available technical solutions to transit in vivo dosimetry

Tropospheric ozone. Formation, properties, effects. Expert opinion; Ozon in der Troposphaere. Bildung, Eigenschaften, Wirkungen. Gutachten

Energy Technology Data Exchange (ETDEWEB)

Elstner, E.F. [Technische Univ. Muenchen (Germany). Lehrstuhl fuer Phytopathologie

1996-06-01

The formation and dispersion of tropospheric ozone are discussed only marginally in this expert opinion; the key interest is in the effects of ground level ozone on plants, animals, and humans. The expert opinion is based on an analysis of the available scientific publications. (orig./MG) [Deutsch] Das Gutachten nimmt nur am Rande die Problematik der Bildung und Ausbreitung von troposphaerischen Ozon auf; Im Mittelpunkt steht die Auseinandersetzung mit den Wirkungen des bodennahen Ozons auf Pflanze, Tier und Mensch. Das Gutachten basiert auf einer Analyse der zugaenglichen wissenschaftlichen Arbeiten. (orig./MG)

Oral contraception and menstrual bleeding during treatment of venous thromboembolism: Expert opinion versus current practice: Combined results of a systematic review, expert panel opinion and an international survey

NARCIS (Netherlands)

Klok, F. A.; Schreiber, K.; Stach, K.; Ageno, W.; Middeldorp, S.; Eichinger, S.; Delluc, A.; Blondon, M.; Ay, C.

2017-01-01

The optimal management of oral contraception and menstrual bleeding during treatment of venous thromboembolism (VTE) is largely unknown. We aimed to elicit expert opinion and compare that to current practice as assessed by a world-wide international web-based survey among physicians. 10

Methods for the elicitation and use of expert opinion in risk assessment: Phase 1, A critical evaluation and directions for future research

International Nuclear Information System (INIS)

Mosleh, A.; Bier, V.M.; Apostolakis, G.

1987-08-01

The purpose of this work is to critically review and evaluate the elicitation and use of expert opinion in probabilistic risk assessment (PRA) in light of the available empirical and theoretical results on expert opinion use. PRA practice is represented by five case studies selected to represent a variety of aspects of the problem: assessments of component failure rates and maintenance data; recent assessments of seismic hazard rates; assessments of containment phenomenology; assessments of human error rates; and accident precursor studies. The review has yielded mixed results. On the negative side, there appears to be little reliance on normative expertise in structuring the process of expert opinion elicitation and use; most applications instead rely primarily on the common sense of the experts involved in the analysis, which is not always an adequate guide. On the positive side, however, there is evidence that expert opinions can in fact be used well in practical settings. Suggestions are given for Phase II work to enhance the applicability and use of appropriate expert opinion methods

The opinion of experts in the assessment of reliability in nuclear power plant operation

International Nuclear Information System (INIS)

Akersten, P.A.; Wirstad, J.

1983-06-01

An inventory of methods used for quantifying of the opinion of experts for use in fault tree evaluations is presented. A number of different methods are evaluated and future research is recommended for three, namely 1. Saatys Analytical Hierarchy Process. 2. Embreys SLIM-method with variations. 3. Methods for feed-back from the expert group during evaluation.(authors)

Development of the Paris definition of early Crohn's disease for disease-modification trials: results of an international expert opinion process.

Science.gov (United States)

Peyrin-Biroulet, Laurent; Billioud, Vincent; D'Haens, Geert; Panaccione, Remo; Feagan, Brian; Panés, Julian; Danese, Silvio; Schreiber, Stefan; Ogata, Haruhiko; Hibi, Toshifumi; Higgins, Peter D R; Beaugerie, Laurent; Chowers, Yehuda; Louis, Edouard; Steinwurz, Flávio; Reinisch, Walter; Rutgeerts, Paul; Colombel, Jean-Frédéric; Travis, Simon; Sandborn, William J

2012-12-01

We report the findings and outputs of an international expert opinion process to develop a definition of early Crohn's disease (CD) that could be used in future disease-modification trials. Nineteen experts on inflammatory bowel diseases held an international expert opinion meeting to discuss and agree on a definition for early CD to be used in disease-modification trials. The process included literature searches for the relevant basic-science and clinical evidence. A published preliminary definition of early CD was used as the basis for development of a proposed definition that was discussed at the expert opinion meeting. The participants then derived a final definition, based on best current knowledge, that it is hoped will be of practical use in disease-modification trials in CD.

Classification of Word Levels with Usage Frequency, Expert Opinions and Machine Learning

Science.gov (United States)

Sohsah, Gihad N.; Ünal, Muhammed Esad; Güzey, Onur

2015-01-01

Educational applications for language teaching can utilize the language levels of words to target proficiency levels of students. This paper and the accompanying data provide a methodology for making educational standard-aligned language-level predictions for all English words. The methodology involves expert opinions on language levels and…

Can journalistic "false balance" distort public perception of consensus in expert opinion?

Science.gov (United States)

Koehler, Derek J

2016-03-01

Media critics have expressed concern that journalistic "false balance" can distort the public's perceptions of what ought to be noncontroversial subjects (e.g., climate change). I report several experiments testing the influence of presenting conflicting comments from 2 experts who disagree on an issue (balance condition) in addition to a complete count of the number of experts on a panel who favor either side. Compared with a control condition, who received only the complete count, participants in the balance condition gave ratings of the perceived agreement among the experts that did not discriminate as clearly between issues with and without strong expert consensus. Participants in the balance condition also perceived less agreement among the experts in general, and were less likely to think that there was enough agreement among experts on the high-consensus issues to guide government policy. Evidently, "false balance" can distort perceptions of expert opinion even when participants would seem to have all the information needed to correct for its influence. (c) 2016 APA, all rights reserved).

[Digitalisation of palmar pattern configurations. Practicability in the anthropologic-heredobiological expert opinion (author's transl)].

Science.gov (United States)

Berghaus, G; Baitsch, H

1980-01-01

A half-automatic technique for extracting characteristics from handprints is presented. Characteristics of the mainline system are defined from the co-ordinate aggregates. The practicability of the method in the anthropologic-heredobiological expert opinion is discussed.

The validation index: a new metric for validation of segmentation algorithms using two or more expert outlines with application to radiotherapy planning.

Science.gov (United States)

Juneja, Prabhjot; Evans, Philp M; Harris, Emma J

2013-08-01

Validation is required to ensure automated segmentation algorithms are suitable for radiotherapy target definition. In the absence of true segmentation, algorithmic segmentation is validated against expert outlining of the region of interest. Multiple experts are used to overcome inter-expert variability. Several approaches have been studied in the literature, but the most appropriate approach to combine the information from multiple expert outlines, to give a single metric for validation, is unclear. None consider a metric that can be tailored to case-specific requirements in radiotherapy planning. Validation index (VI), a new validation metric which uses experts' level of agreement was developed. A control parameter was introduced for the validation of segmentations required for different radiotherapy scenarios: for targets close to organs-at-risk and for difficult to discern targets, where large variation between experts is expected. VI was evaluated using two simulated idealized cases and data from two clinical studies. VI was compared with the commonly used Dice similarity coefficient (DSCpair - wise) and found to be more sensitive than the DSCpair - wise to the changes in agreement between experts. VI was shown to be adaptable to specific radiotherapy planning scenarios.

Using expert opinion surveys to rank threats to endangered species: a case study with sea turtles.

Science.gov (United States)

Donlan, C Josh; Wingfield, Dana K; Crowder, Larry B; Wilcox, Chris

2010-12-01

Little is known about how specific anthropogenic hazards affect the biology of organisms. Quantifying the effect of regional hazards is particularly challenging for species such as sea turtles because they are migratory, difficult to study, long lived, and face multiple anthropogenic threats. Expert elicitation, a technique used to synthesize opinions of experts while assessing uncertainty around those views, has been in use for several decades in the social science and risk assessment sectors. We conducted an internet-based survey to quantify expert opinion on the relative magnitude of anthropogenic hazards to sea turtle populations at the regional level. Fisheries bycatch and coastal development were most often ranked as the top hazards to sea turtle species in a geographic region. Nest predation and direct take followed as the second and third greatest threats, respectively. Survey results suggest most experts believe sea turtles are threatened by multiple factors, including substantial at-sea threats such as fisheries bycatch. Resources invested by the sea turtle community, however, appear biased toward terrestrial-based impacts. Results from the survey are useful for conservation planning because they provide estimates of relative impacts of hazards on sea turtles and a measure of consensus on the magnitude of those impacts among researchers and practitioners. Our survey results also revealed patterns of expert bias, which we controlled for in our analysis. Respondents with no experience with respect to a sea turtle species tended to rank hazards affecting that sea turtle species higher than respondents with experience. A more-striking pattern was with hazard-based expertise: the more experience a respondent had with a specific hazard, the higher the respondent scored the impact of that hazard on sea turtle populations. Bias-controlled expert opinion surveys focused on threatened species and their hazards can help guide and expedite species recovery plans. �

On Consistency Test Method of Expert Opinion in Ecological Security Assessment.

Science.gov (United States)

Gong, Zaiwu; Wang, Lihong

2017-09-04

To reflect the initiative design and initiative of human security management and safety warning, ecological safety assessment is of great value. In the comprehensive evaluation of regional ecological security with the participation of experts, the expert's individual judgment level, ability and the consistency of the expert's overall opinion will have a very important influence on the evaluation result. This paper studies the consistency measure and consensus measure based on the multiplicative and additive consistency property of fuzzy preference relation (FPR). We firstly propose the optimization methods to obtain the optimal multiplicative consistent and additively consistent FPRs of individual and group judgments, respectively. Then, we put forward a consistency measure by computing the distance between the original individual judgment and the optimal individual estimation, along with a consensus measure by computing the distance between the original collective judgment and the optimal collective estimation. In the end, we make a case study on ecological security for five cities. Result shows that the optimal FPRs are helpful in measuring the consistency degree of individual judgment and the consensus degree of collective judgment.

Evaluating Presence Data versus Expert Opinions to Assess Occurrence, Habitat Preferences and Landscape Permeability: A Case Study of Butterflies

Directory of Open Access Journals (Sweden)

Muhammad Arfan

2018-02-01

Full Text Available We explored how presence data and expert opinions performed with respect to identifying the ecological preferences and the spatial needs of six butterfly species in the Federal State of Saxony, Germany. We used presence records and a land-cover map. In parallel we used expert responses to evaluate the 40 land-cover types occurring in the map, in terms of both suitability and permeability for the six species. Presence data were translated into preferences through Ivlev’s electivity indices (IEI. Visual analysis of preference maps based on IEI showed a distinct pattern of suitable versus less suitable areas. Similarly, spatial analyses found that presence-points were closer to suitability areas based on IEI than those that were based on expert data. However, in case of mismatches between expert and presence-based evaluations, independent experts identified the expert evaluation as better and considered IEI outcomes as wrong. We found a medium to high correlation between land-cover class suitability and permeability based on expert opinions for all species. This indicates that expert evaluation of permeability is affiliated with habitat suitability. Integration of species-presence data and expert-knowledge about species could enhance our capabilities to understand and potentially map suitability while gathering information about suitability and permeability separately can improve species conservation planning.

Key considerations for preventing suicide in older adults: consensus opinions of an expert panel

DEFF Research Database (Denmark)

Erlangsen, Annette; Nordentoft, Merete; Conwell, Yeates

2011-01-01

BACKGROUND: The number of older adults is growing rapidly. This fact, combined with the high rates of suicide in later life, indicates that many more older adults will die by their own hands before rigorous trials can be conducted to fully understand the best approaches to prevent late life suicide....... AIMS: To disseminate key considerations for interventions addressing senior suicidal behavior. METHODS: An international expert panel has reviewed and discussed key considerations for interventions against suicide in older adults based on existing evidence, where available, and expert opinion. RESULTS...

Expert opinion on laparoscopic surgery for colorectal cancer parallels evidence from a cumulative meta-analysis of randomized controlled trials.

Directory of Open Access Journals (Sweden)

Guillaume Martel

Full Text Available This study sought to synthesize survival outcomes from trials of laparoscopic and open colorectal cancer surgery, and to determine whether expert acceptance of this technology in the literature has parallel cumulative survival evidence.A systematic review of randomized trials was conducted. The primary outcome was survival, and meta-analysis of time-to-event data was conducted. Expert opinion in the literature (published reviews, guidelines, and textbook chapters on the acceptability of laparoscopic colorectal cancer was graded using a 7-point scale. Pooled survival data were correlated in time with accumulating expert opinion scores.A total of 5,800 citations were screened. Of these, 39 publications pertaining to 23 individual trials were retained. As well, 414 reviews were included (28 guidelines, 30 textbook chapters, 20 systematic reviews, 336 narrative reviews. In total, 5,782 patients were randomized to laparoscopic (n = 3,031 and open (n = 2,751 colorectal surgery. Survival data were presented in 16 publications. Laparoscopic surgery was not inferior to open surgery in terms of overall survival (HR = 0.94, 95% CI 0.80, 1.09. Expert opinion in the literature pertaining to the oncologic acceptability of laparoscopic surgery for colon cancer correlated most closely with the publication of large RCTs in 2002-2004. Although increasingly accepted since 2006, laparoscopic surgery for rectal cancer remained controversial.Laparoscopic surgery for colon cancer is non-inferior to open surgery in terms of overall survival, and has been so since 2004. The majority expert opinion in the literature has considered these two techniques to be equivalent since 2002-2004. Laparoscopic surgery for rectal cancer has been increasingly accepted since 2006, but remains controversial. Knowledge translation efforts in this field appear to have paralleled the accumulation of clinical trial evidence.

Climate Change and Infectious Disease Risk in Western Europe: A Survey of Dutch Expert Opinion on Adaptation Responses and Actors.

Science.gov (United States)

Akin, Su-Mia; Martens, Pim; Huynen, Maud M T E

2015-08-18

There is growing evidence of climate change affecting infectious disease risk in Western Europe. The call for effective adaptation to this challenge becomes increasingly stronger. This paper presents the results of a survey exploring Dutch expert perspectives on adaptation responses to climate change impacts on infectious disease risk in Western Europe. Additionally, the survey explores the expert sample's prioritization of mitigation and adaptation, and expert views on the willingness and capacity of relevant actors to respond to climate change. An integrated view on the causation of infectious disease risk is employed, including multiple (climatic and non-climatic) factors. The results show that the experts consider some adaptation responses as relatively more cost-effective, like fostering interagency and community partnerships, or beneficial to health, such as outbreak investigation and response. Expert opinions converge and diverge for different adaptation responses. Regarding the prioritization of mitigation and adaptation responses expert perspectives converge towards a 50/50 budgetary allocation. The experts consider the national government/health authority as the most capable actor to respond to climate change-induced infectious disease risk. Divergence and consensus among expert opinions can influence adaptation policy processes. Further research is necessary to uncover prevailing expert perspectives and their roots, and compare these.

Interdisciplinary management of EGFR-inhibitor-induced skin reactions: a German expert opinion.

Science.gov (United States)

Potthoff, K; Hofheinz, R; Hassel, J C; Volkenandt, M; Lordick, F; Hartmann, J T; Karthaus, M; Riess, H; Lipp, H P; Hauschild, A; Trarbach, T; Wollenberg, A

2011-03-01

Anti-epidermal growth factor receptor treatment strategies, i.e. monoclonal antibodies such as cetuximab and panitumumab, or epidermal growth factor receptor (EGFR) small molecule tyrosine kinase inhibitors, such as erlotinib and gefitinib, have expanded the treatment options for different tumor types. Dermatologic toxic effects are the most common side-effects of EGFR inhibitor therapy. They can profoundly affect the patient's quality of life. The aim of this study was to provide interdisciplinary expert recommendations on how to treat patients with skin reactions undergoing anti-EGFR treatment. An expert panel from Germany with expertise in medical oncology, dermatology or clinical pharmacology was convened to develop expert recommendations based on published peer-reviewed literature. The expert recommendations for the state-of-the-art treatment of skin reactions induced by EGFR inhibitor therapy include recommendations for diagnostics and grading as well as grade-specific and stage-adapted treatment approaches and preventive measures. It was concluded that EGFR-inhibitor-related dermatologic reactions should always be treated combining basic care of the skin and a specific therapy adapted to stage and grade of skin reaction. For grade 2 and above, specific treatment recommendations for early- and later-stage skin reactions induced by EGFR-inhibitor therapy were proposed. This paper presents a German national expert opinion for the treatment of skin reactions in patients receiving EGFR inhibitor therapy.

Proposal for a structured computed tomography report in the evaluation of pancreatic neoplasms based on expert opinions

Energy Technology Data Exchange (ETDEWEB)

Lopes, Paulo Gustavo Maciel; Matsumoto, Carlos Alberto; Lobo, Edson José; D' Ippolito, Giuseppe, E-mail: pgmlopes87@gmail.com [Universidade Federal de São Paulo (EPM/UNIFESP), SP (Brazil). Escola de Medicina

2018-03-15

Objective: To create a structured computed tomography (CT) report for the systematic evaluation of pancreatic ductal adenocarcinoma (PDAC), based on the opinions of clinicians and surgeons. Materials And Methods: This was a prospective study in which we applied a 21-item questionnaire to experts in pancreatic diseases in order to create a model of a structured abdominal CT report. The questionnaire addressed the location and size of PDACs, as well as their effects on adjacent structures and on the vasculature, together with metastases. We used a Likert scale to determine which of those parameters should be included in the model. Results: A total of 18 experts (12 surgeons and 6 clinicians) from 9 institutions completed the questionnaire. All of the experts agreed that the following (if present) should be described in the CT report on a PDAC: the degree of enhancement; the diameter and location of the lesion; pancreatic duct obstruction; biliary dilatation; pancreatic atrophy; liver metastases; peritoneal nodules; ascites; lymph node enlargement; and invasion of adjacent structures. More than 80% of the experts agreed that the report should also describe the relationship between the PDAC and the surrounding vasculature. Conclusion: We have developed a template for a CT report on patients with PDAC, based on the opinions of experts involved in the treatment of such patients. (author)

Expert Opinions on Improving Femicide Data Collection across Europe: A Concept Mapping Study.

Directory of Open Access Journals (Sweden)

Carmen Vives-Cases

Full Text Available Femicide, defined as the killings of females by males because they are females, is becoming recognized worldwide as an important ongoing manifestation of gender inequality. Despite its high prevalence or widespread prevalence, only a few countries have specific registries about this issue. This study aims to assemble expert opinion regarding the strategies which might feasibly be employed to promote, develop and implement an integrated and differentiated femicide data collection system in Europe at both the national and international levels. Concept mapping methodology was followed, involving 28 experts from 16 countries in generating strategies, sorting and rating them with respect to relevance and feasibility. The experts involved were all members of the EU-Cost-Action on femicide, which is a scientific network of experts on femicide and violence against women across Europe. As a result, a conceptual map emerged, consisting of 69 strategies organized in 10 clusters, which fit into two domains: "Political action" and "Technical steps". There was consensus among participants regarding the high relevance of strategies to institutionalize national databases and raise public awareness through different stakeholders, while strategies to promote media involvement were identified as the most feasible. Differences in perceived priorities according to the level of human development index of the experts' countries were also observed.

Uncertainties in environmental impact assessments due to expert opinion. Case study. Radioactive waste in Slovenia

International Nuclear Information System (INIS)

Kontic, B.; Ravnik, M.

1998-01-01

A comprehensive study was done at the J. Stefan Institute in Ljubljana and the School of Environmental Sciences in Nova Gorica in relation to sources of uncertainties in long-term environmental impact assessment (EIA). Under the research two main components were examined: first, methodology of the preparation of an EIA, and second validity of an expert opinion. Following the findings of the research a survey was performed in relation to assessing acceptability of radioactive waste repository by the regulatory. The components of dose evaluation in different time frames were examined in terms of susceptibility to uncertainty. Uncertainty associated to human exposure in the far future is so large that dose and risk, as individual numerical indicators of safety, by our opinion, should not be used in compliance assessment for radioactive waste repository. On the other hand, results of the calculations on the amount and activity of low and intermediate level waste and the spent fuel from the Krsko NPP show that expert's understanding of the treated questions can be expressed in transparent way giving credible output of the models used.(author)

The effect of case-based discussion of topics with experts on learners' opinions: implications for spinal education and training.

Science.gov (United States)

Berjano, Pedro; Villafañe, Jorge Hugo; Vanacker, Gerard; Cecchinato, Riccardo; Ismael, Maryem; Gunzburg, Robert; Marruzzo, Daniele; Lamartina, Claudio

2017-10-01

This investigation aimed to examine the extent to which case-based discussion with experts could influence the audience's opinions on the treatment of patients during a continuing medical education event for spine surgeons. We conducted a prospective controlled crossover study of 90 surgeons. During a continuing medical education activity using case-based discussion, quiz questions were used which asked participants (attendants and faculty group) their opinions on the best choices about diagnosis and treatment in a number of cases. No answer was considered correct, but we evaluated the number of participants choosing each specific answer among a number of valid options. Quiz questions were collected with an automated response system at the entry and at the end of each case discussion. Change in participant's opinions was estimated from the change in the preferred answers between the entry and exit quizzes. Chi-square analysis was performed to determine significance. Sixty-two attendants out of eighty three (75%) and six faculties out of twelve (50%) responded to the survey. After the case discussion, 68.2% (p < 0.04, Chi-square test) of the attendants changed their opinion on the appropriate treatment. The faculty answers, however, showed no significant change in opinions regarding the identification of the appropriate treatment. On the basis of our results, case-based discussion driven by experts, as a form of teaching, has a measurable effect in terms of changes in the learners' opinions.

Extracranial radiotherapy in stereotaxic conditions

International Nuclear Information System (INIS)

Noel, Georges; Moty-Monnereau, Celine; Meyer, Aurelia; David, Pauline; Pages, Frederique; Muller, Felix; Lee-Robin, Sun Hae; David, Denis Jean

2006-12-01

This document reports a literature survey and the discussion of an expert group with the objective to assess the use of extracranial radiotherapy devices in stereotaxic conditions. After a brief overview of the technological context, the authors proposes a technical description of radiotherapy in stereotaxic conditions, of the CyberKnife, of others radiotherapy techniques in stereotaxic conditions for extracranial indications, and of alternate techniques. They give an overview of concerned pathologies: skeleton, hepatic, bronchopulmonary, pancreas, prostate, kidney, and paediatric tumours. They describe the present care condition in France in terms of classification of medial acts, and of patient homogeneous groups. They provide the identification of this practice in foreign nomenclature. In the next part, they report the assessment, first through a critical analysis of published data and information in terms of act feasibility, efficiency and safety, of act role in the therapeutic strategy, of conditions of execution, and of impact on public health, and secondly through a statement of opinion of the working group in terms of terminology, indications, safety, and conditions of execution

Expert opinion on landslide susceptibility elicted by probabilistic inversion from scenario rankings

Science.gov (United States)

Lee, Katy; Dashwood, Claire; Lark, Murray

2016-04-01

For many natural hazards the opinion of experts, with experience in assessing susceptibility under different circumstances, is a valuable source of information on which to base risk assessments. This is particularly important where incomplete process understanding, and limited data, limit the scope to predict susceptibility by mechanistic or statistical modelling. The expert has a tacit model of a system, based on their understanding of processes and their field experience. This model may vary in quality, depending on the experience of the expert. There is considerable interest in how one may elicit expert understanding by a process which is transparent and robust, to provide a basis for decision support. One approach is to provide experts with a set of scenarios, and then to ask them to rank small overlapping subsets of these with respect to susceptibility. Methods of probabilistic inversion have been used to compute susceptibility scores for each scenario, implicit in the expert ranking. It is also possible to model these scores as functions of measurable properties of the scenarios. This approach has been used to assess susceptibility of animal populations to invasive diseases, to assess risk to vulnerable marine environments and to assess the risk in hypothetical novel technologies for food production. We will present the results of a study in which a group of geologists with varying degrees of expertise in assessing landslide hazards were asked to rank sets of hypothetical simplified scenarios with respect to land slide susceptibility. We examine the consistency of their rankings and the importance of different properties of the scenarios in the tacit susceptibility model that their rankings implied. Our results suggest that this is a promising approach to the problem of how experts can communicate their tacit model of uncertain systems to those who want to make use of their expertise.

Risk perception: expert opinion versus public understanding. [Of radioactive waste repositories

Energy Technology Data Exchange (ETDEWEB)

Brown, J

1987-02-01

A research project looking at the public's attitudes towards the siting of radioactive waste depositories is reported. The risk perception studies seek to compare expert and lay understanding of risk. Adverse public reactions to risk can only be understood if it is known how people relate to risks in their everyday or working lives. Social trends and experiences are important, for example, the adverse public opinion on the siting of nuclear waste facilities. A number of elements have been identified as common to different risk areas such as chemicals, drugs, food or radioactive waste. These are the clashing of values, polarization of beliefs or clashes of interest.

Expert-Opinion Elicitation for the Risk Analysis of Design-Improvement Alternatives to the Lindy Claiborne Boggs Lock and Dam

National Research Council Canada - National Science Library

Ayyub, Bilal M

2002-01-01

This report documents the expert-opinion elicitation performed to meet risk analysis needs of the lower lock approach sediment management improvement alternatives to the Lindy Claiborne Boggs Lock and Dam...

The IRSN 2008 barometer. The opinion on risks and security of the French population. Global results

International Nuclear Information System (INIS)

2008-01-01

This report presents and comments the results of a survey during which a sample of the French population has been questioned on their current concerns (about the society, about the environment, about quantitative criteria of risk management and about the image of science), on their opinion of scientific expertise (who should control a risky installation, the role and image of experts, the access to expertise files, the perception of pluralist structures), the opinion on 31 risk situations (risks to which French people feel exposed, confidence in authorities, truth of information on hazards, hierarchy of the 31 situations), the opinion on the nuclear activity and industry (the nuclear risk, the credibility and expertise of interveners), incidents which occurred in 2007, the demand of information on the nuclear risk), and on their opinion about radiotherapy accidents in France

[A retrospective study of expert opinions of a psychosomatic-psychotherapeutic university hospital for public and private customers over a period of 12 years].

Science.gov (United States)

Uhlenbrock, Judith; Hinrichs, Jens; Heuft, Gereon

2017-09-01

A retrospective study of expert opinions of a psychosomatic-psychotherapeutic university hospital for public and private customers over a period of 12 years Objectives: Both the public and the legislative have developed an increasingly critical awareness for the fact that expert witnesses need to be independent. In contrast, to date there have been few studies concerning the quantity and the results of psychosomatic-psychotherapeutic expert opinions for public and private clients. In a retrospective study design, 285 expert opinions of a psychosomatic-psychotherapeutic university hospital stemming from consecutive, unselected random sampling over a 12-year time period (1990-2011) were analyzed using a predefined list of criteria. Besides client data, the study also noted the type and the objectives of the expertise, the sociodemographic data of the subjects, the biographic data of the subjects, the size of records, the particular psychopathological findings including conflict and structural diagnostics via the Operationalized Psychodynamic Diagnostics (OPD-2, Research Group 2006), syndromic diagnostics according to ICD-10 (WHO) including the related Impairment Scale Score (ISS, Schepank 1995), and the Global Assessment of Functioning-Scale (GAF, Heuft 2016). 54% of the subjects were men. All subjects were 46 years old at the time of examination; on average symptomatology had existed for 7 years, which made assessment of causality difficult. Most assignments referred to the effects of diseases or accidents in private contexts, followed by pension reports. Among the expert opinions related to possible implications of acts of violence, 95% were women. In 43.2% (n = 123) of the cases, the assessment had occurred in the context of legal action. In 65 cases at least one party had requested a supplemental written report during further procedure. In 17.8% (n = 22) of the cases sought by the courts, the expert witness was requested by at least one party to present the

Does expert opinion match the operational definition of the Lupus Low Disease Activity State (LLDAS)? A case-based construct validity study.

Science.gov (United States)

Golder, Vera; Huq, Molla; Franklyn, Kate; Calderone, Alicia; Lateef, Aisha; Lau, Chak Sing; Lee, Alfred Lok Hang; Navarra, Sandra Teresa V; Godfrey, Timothy; Oon, Shereen; Hoi, Alberta Yik Bun; Morand, Eric Francis; Nikpour, Mandana

2017-06-01

To evaluate the construct validity of the Lupus Low Disease Activity State (LLDAS), a treatment target in systemic lupus erythematosus (SLE). Fifty SLE case summaries based on real patients were prepared and assessed independently for meeting the operational definition of LLDAS. Fifty international rheumatologists with expertise in SLE, but with no prior involvement in the LLDAS project, responded to a survey in which they were asked to categorize the disease activity state of each case as remission, low, moderate, or high. Agreement between expert opinion and LLDAS was assessed using Cohen's kappa. Overall agreement between expert opinion and the operational definition of LLDAS was 77.96% (95% CI: 76.34-79.58%), with a Cohen's kappa of 0.57 (95% CI: 0.55-0.61). Of the cases (22 of 50) that fulfilled the operational definition of LLDAS, only 5.34% (59 of 22 × 50) of responses classified the cases as moderate/high activity. Of the cases that did not fulfill the operational definition of LLDAS (28 of 50), 35.14% (492 of 28 × 50) of responses classified the cases as remission/low activity. Common reasons for discordance were assignment to remission/low activity of cases with higher corticosteroid doses than defined in LLDAS (prednisolone ≤ 7.5mg) or with SLEDAI-2K >4 due to serological activity (high anti-dsDNA antibody and/or low complement). LLDAS has good construct validity with high overall agreement between the operational definition of LLDAS and expert opinion. Discordance of results suggests that the operational definition of LLDAS is more stringent than expert opinion at defining a low disease activity state. Copyright © 2017 Elsevier Inc. All rights reserved.

Expert opinion on detecting and treating depression in palliative care: A Delphi study

Directory of Open Access Journals (Sweden)

Hotopf Matthew

2011-05-01

Full Text Available Abstract Background There is a dearth of data regarding the optimal method of detecting and treating depression in palliative care. This study applied the Delphi method to evaluate expert opinion on choice of screening tool, choice of antidepressant and choice of psychological therapy. The aim was to inform the development of best practice recommendations for the European Palliative Care Research Collaborative clinical practice guideline on managing depression in palliative care. Methods 18 members of an international, multi-professional expert group completed a structured questionnaire in two rounds, rating their agreement with proposed items on a scale from 0-10 and annotating with additional comments. The median and range were calculated to give a statistical average of the experts' ratings. Results There was contention regarding the benefits of screening, with 'routine informal asking' (median 8.5 (0-10 rated more highly than formal screening tools such as the Hospital Anxiety and Depression Scale (median 7.0 (1-10. Mirtazapine (median 9 (7-10 and citalopram (median 9 (5-10 were the considered the best choice of antidepressant and cognitive behavioural therapy (median 9.0 (3-10 the best choice of psychological therapy. Conclusions The range of expert ratings was broad, indicating discordance in the views of experts. Direct comparative data from randomised controlled trials are needed to strengthen the evidence-base and achieve clarity on how best to detect and treat depression in this setting.

Perspectives of tax reforms in Croatia: expert opinion survey

Directory of Open Access Journals (Sweden)

Hrvoje Šimović

2014-12-01

Full Text Available In order to shape tax reform it is necessary objectively to assess the current stateof-the-art of and of the outlook for the tax system. After having reviewed all previous reforms in the light of the consumption-based (interest-adjusted concept of direct taxation, which was almost systematically implemented in Croatia in 1994, we present the results of a broad expert opinion survey about the Croatian tax system. The most interesting results suggest the maintenance/(reintroduction of different tax incentives and reduced VAT rates, rejection of a flat tax as well as decrease of tax brackets, an increase in alcohol and tobacco duties, the introduction of a financial activities tax, a further shift from income to consumption, a decrease of the tax share in GDP and a belief in the behavioral responsiveness of tax decreases/exemptions, as well as a firm commitment to the principle of equity. The last three economic views/values are important predictors of other tax attitudes.

Radiotherapy in the curative treatment of breast cancer: current status and future trends. An opinion sample of radiation oncologists active in breast cancer research

International Nuclear Information System (INIS)

Kurtz, J.M.

1994-01-01

A questionnaire regarding the current practice of breast cancer radiotherapy and possible future trends in this field was filled out by 13 radiation oncologists active in breast cancer research. In the opinion of this small group, radiotherapy is presently included in the initial treatment of the large majority of early breast cancers, particularly in the framework of breast-conserving therapy, which is currently used in >50% of these patients. Indications for post-mastectomy irradiation vary greatly among respondents, as do attitudes toward the potentially negative aspects of adjuvant radiotherapy. Most respondents feel that their future practices will be significantly influenced by an increase in screen-detected cancers, the aging of the population, the increasing influence of medical oncologists, participation in clinical trials, and increased patient participation in treatment decisions. An increase is foreseen in the use of breast-conserving approaches, radiotherapy, and systemic therapies, and a decrease in the use of both total mastectomy and axillary dissection. Most respondents feel that there will be a modest decrease in the percentage of conservatively operated patients receiving radiotherapy. A future role is seen for neo-adjuvant chemotherapy, at least in well-defined subgroups, increasing the number of patients offered breast-conserving approaches. Most respondents expect that irradiation of lymph nodal areas will gain new credibility and be used more often. No majority opinion could be elicited regarding ways of improving the therapeutic ratio in breast cancer radiotherapy. (author)

Identifying deficiencies in national and foreign medical team responses through expert opinion surveys: implications for education and training.

Science.gov (United States)

Djalali, Ahmadreza; Ingrassia, Pier Luigi; Corte, Francesco Della; Foletti, Marco; Gallardo, Alba Ripoll; Ragazzoni, Luca; Kaptan, Kubilay; Lupescu, Olivera; Arculeo, Chris; von Arnim, Gotz; Friedl, Tom; Ashkenazi, Michael; Heselmann, Deike; Hreckovski, Boris; Khorram-Manesh, Amir; Khorrram-Manesh, Amir; Komadina, Radko; Lechner, Kostanze; Patru, Cristina; Burkle, Frederick M; Fisher, Philipp

2014-08-01

Unacceptable practices in the delivery of international medical assistance are reported after every major international disaster; this raises concerns about the clinical competence and practice of some foreign medical teams (FMTs). The aim of this study is to explore and analyze the opinions of disaster management experts about potential deficiencies in the art and science of national and FMTs during disasters and the impact these opinions might have on competency-based education and training. This qualitative study was performed in 2013. A questionnaire-based evaluation of experts' opinions and experiences in responding to disasters was conducted. The selection of the experts was done using the purposeful sampling method, and the sample size was considered by data saturation. Content analysis was used to explore the implications of the data. This study shows that there is a lack of competency-based training for disaster responders. Developing and performing standardized training courses is influenced by shortcomings in budget, expertise, and standards. There is a lack of both coordination and integration among teams and their activities during disasters. The participants of this study emphasized problems concerning access to relevant resources during disasters. The major findings of this study suggest that teams often are not competent during the response phase because of education and training deficiencies. Foreign medical teams and medically related nongovernmental organizations (NGOs) do not always provide expected capabilities and services. Failures in leadership and in coordination among teams are also a problem. All deficiencies need to be applied to competency-based curricula.

Running retraining to treat lower limb injuries: a mixed-methods study of current evidence synthesised with expert opinion.

Science.gov (United States)

Barton, C J; Bonanno, D R; Carr, J; Neal, B S; Malliaras, P; Franklyn-Miller, A; Menz, H B

2016-05-01

Running-related injuries are highly prevalent. Synthesise published evidence with international expert opinion on the use of running retraining when treating lower limb injuries. Mixed methods. A systematic review of clinical and biomechanical findings related to running retraining interventions were synthesised and combined with semistructured interviews with 16 international experts covering clinical reasoning related to the implementation of running retraining. Limited evidence supports the effectiveness of transition from rearfoot to forefoot or midfoot strike and increase step rate or altering proximal mechanics in individuals with anterior exertional lower leg pain; and visual and verbal feedback to reduce hip adduction in females with patellofemoral pain. Despite the paucity of clinical evidence, experts recommended running retraining for: iliotibial band syndrome; plantar fasciopathy (fasciitis); Achilles, patellar, proximal hamstring and gluteal tendinopathy; calf pain; and medial tibial stress syndrome. Tailoring approaches to each injury and individual was recommended to optimise outcomes. Substantial evidence exists for the immediate biomechanical effects of running retraining interventions (46 studies), including evaluation of step rate and strike pattern manipulation, strategies to alter proximal kinematics and cues to reduce impact loading variables. Our synthesis of published evidence related to clinical outcomes and biomechanical effects with expert opinion indicates running retraining warrants consideration in the treatment of lower limb injuries in clinical practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

[Deontology of the medical expert].

Science.gov (United States)

Raszeja, S

1995-09-01

The authority of prosecuting organ to choose the expert, set his task and verify the following opinion is defined. The qualities of the medical expert and his duties are described, referring to: -his expertise; -his morality; -his ability to issue an independent (objective) opinion. Detailed rules, which can be ascribed to a specific medical expert's deontological code, are listed and explained.

SU-F-T-244: Radiotherapy Risk Estimation Based On Expert Group Survey

International Nuclear Information System (INIS)

Koo, J; Yoon, M; Chung, W; Chung, M; Kim, D

2016-01-01

Purpose: To evaluate the reliability of RPN (Risk Priority Number) decided by expert group and to provide preliminary data for adapting FMEA in Korea. Methods: 1163 Incidents reported in ROSIS for 11 years were used as a real data to be compared with, and were categorized into 146 items. The questionnaire was composed of the 146 items and respondents had to valuate ‘occurrence (O)’, ‘severity (S)’, ‘detectability (D)’ of each item on a scale from 1 to 10 according to the proposed AAPM TG-100 rating scales. 19 medical physicists from 19 different organizations in Korea had participated in the survey. Because the number of ROSIS items was not evenly spread enough to be classified into 10 grades, 1–5 scale was chosen instead of 1–10 and survey result was also fit to 5 grades to compare. Results: The average O,S,D were 1.77, 3.50, 2.13, respectively and the item which had the highest RPN(32) was ‘patient movement during treatment’ in the survey. When comparing items ranked in the top 10 of each survey(O) and ROSIS database, two items were duplicated and ‘Simulation’ and ’Treatment’ were the most frequently ranked RT process in top 10 of survey and ROSIS each. The Chronbach α of each RT process were ranged from 0.74 to 0.99 and p-value was <0.001. When comparing O*D, the average difference was 1.4. Conclusion: This work indicates the deviation between actual risk and expectation. Considering that the respondents were Korean and ROSIS is mainly composed of incidents happened in European countries and some of the top 10 items of ROSIS cannot be applied in radiotherapy procedure in Korea, the deviation could have been came from procedural difference. Moreover, if expert group was consisted of experts from various parts, expectation might have been more accurate. Therefore, further research on radiotherapy risk estimation is needed.

SU-F-T-244: Radiotherapy Risk Estimation Based On Expert Group Survey

Energy Technology Data Exchange (ETDEWEB)

Koo, J; Yoon, M [Korea University, Seoul (Korea, Republic of); Chung, W; Chung, M; Kim, D [Kyung Hee University Hospital at Gangdong, Gangdong-gu, Seoul (Korea, Republic of)

2016-06-15

Purpose: To evaluate the reliability of RPN (Risk Priority Number) decided by expert group and to provide preliminary data for adapting FMEA in Korea. Methods: 1163 Incidents reported in ROSIS for 11 years were used as a real data to be compared with, and were categorized into 146 items. The questionnaire was composed of the 146 items and respondents had to valuate ‘occurrence (O)’, ‘severity (S)’, ‘detectability (D)’ of each item on a scale from 1 to 10 according to the proposed AAPM TG-100 rating scales. 19 medical physicists from 19 different organizations in Korea had participated in the survey. Because the number of ROSIS items was not evenly spread enough to be classified into 10 grades, 1–5 scale was chosen instead of 1–10 and survey result was also fit to 5 grades to compare. Results: The average O,S,D were 1.77, 3.50, 2.13, respectively and the item which had the highest RPN(32) was ‘patient movement during treatment’ in the survey. When comparing items ranked in the top 10 of each survey(O) and ROSIS database, two items were duplicated and ‘Simulation’ and ’Treatment’ were the most frequently ranked RT process in top 10 of survey and ROSIS each. The Chronbach α of each RT process were ranged from 0.74 to 0.99 and p-value was <0.001. When comparing O*D, the average difference was 1.4. Conclusion: This work indicates the deviation between actual risk and expectation. Considering that the respondents were Korean and ROSIS is mainly composed of incidents happened in European countries and some of the top 10 items of ROSIS cannot be applied in radiotherapy procedure in Korea, the deviation could have been came from procedural difference. Moreover, if expert group was consisted of experts from various parts, expectation might have been more accurate. Therefore, further research on radiotherapy risk estimation is needed.

Problems arising in connection with the commissioning of experts in conflict-oriented implementation of nuclear law. The legal status of expert opinions in administrative procedures under the Atomic Energy Act

International Nuclear Information System (INIS)

Fiebig, T.H.

1995-01-01

Court decisions available so far do not primarily consider the problems linked to the commissioning of an expert and his mandate, as well as the legal status of the commissioning of an expert as an administrative act which might be legally contestable. Thus there are at present no court decisions that would create legal certainty in matters of the act of commissioning a nuclear expert opinion. The current legal situation is such that an independent order for commissioning of an expert opinion in compliance with section 19 III AtG (Atomic Energy Act), which in general is given in response to the refusal of the facility operator to do so, can be independently contested on the basis of section 44 a, sentence 2 VwGO (Rules of Administrative Courts). The current practice of conflict-oriented, or nuclear power phase-out-oriented, implementation of the nuclear law poses a threat to our constitutional state and to our democracy. The supply of energy as a common good is of essential importance and thus deserves fair and objective treatment free of emotions, including the matter of nuclear energy. In cases of nuclear licensing procedures meeting with impedimental treatment by a Land government favouring the nuclear power phase-out, this treatment however not fitting into the Land governments' overall political line, there is reason to call upon the Federal Government to take action for clarifying the situation. (orig./HP) [de

Forensic medicine experts' opinion on medico-legal autopsies in hospital deaths: a questionnaire survey.

Science.gov (United States)

D'Souza, Deepak Herald; Pant, Sadip; Menezes, Ritesh George

2013-10-01

Medico-legal autopsy is conducted routinely in some countries and selectively in others in hospital deaths. This study was conducted to evaluate the views of the forensic medicine experts regarding this matter. A questionnaire pro forma was sent to sixty-five forensic medicine experts practicing in different medical institutions all around India. Designations and experiences of the participants were noted by requests in the same questionnaire. Their specific experience in conducting medico-legal autopsy in hospital deaths was also requested for. Responses were charted in frequency distribution tables and analyzed using SPSS, version 17.0. One-third of the participants felt that a medico-legal autopsy was necessary in all the hospital death cases as defined in the present study. Ten percent of the participants opined that a medico-legal autopsy was unnecessary in hospital deaths. The majority of the experts mentioned finding the cause of death, followed by finding the manner of death and collecting the evidentiary materials, as the reasons for medico-legal autopsy in hospital deaths. Twenty percent of the participants felt that internal findings at autopsy poorly matched with the case records. All the experts agreed that external autopsy findings matched with the hospital case records. Nearly two-third of the participants felt that it was difficult in some cases to interpret the autopsy findings without case records from the hospital where the deceased was treated. Our findings suggest that the exercise of carrying out medico-legal autopsy routinely in every hospital death as evident in the Indian framework is often unnecessary as per the experts' opinion. Autopsy findings in hospital deaths often correlate with hospital case records.

Expert Opinion Analysis on Renewable Hydrogen Storage Systems Potential in Europe

Directory of Open Access Journals (Sweden)

Davide Astiaso Garcia

2016-11-01

Full Text Available Among the several typologies of storage technologies, mainly on different physical principles (mechanical, electrical and chemical, hydrogen produced by power to gas (P2G from renewable energy sources complies with chemical storage principle and is based on the conversion of electrical energy into chemical energy by means of the electrolysis of water which does not produce any toxic or climate-relevant emission. This paper aims to pinpoint the potential uses of renewable hydrogen storage systems in Europe, analysing current and potential locations, regulatory framework, governments’ outlooks, economic issues, and available renewable energy amounts. The expert opinion survey, already used in many research articles on different topics including energy, has been selected as an effective method to produce realistic results. The obtained results highlight strategies and actions to optimize the storage of hydrogen produced by renewables to face varying electricity demand and generation-driven fluctuations reducing the negative effects of the increasing share of renewables in the energy mix of European Countries.

Informing decision making in agricultural greenhouse gas mitigation policy: A Best–Worst Scaling survey of expert and farmer opinion in the sheep industry

International Nuclear Information System (INIS)

Jones, A.K.; Jones, D.L.; Edwards-Jones, G.; Cross, P.

2013-01-01

Highlights: ► Effectiveness and practicality of greenhouse gas mitigation measures are assessed. ► Best–Worst Scaling surveys are used to elicit expert and sheep farmer opinion. ► Effective and practical measures are priority candidates for policy inclusion. ► Support mechanisms may be needed to deliver effective, low practicality measures. ► Variation in farmers’ perceptions of practicality holds implications for policy delivery. -- Abstract: Policy decision making for agricultural greenhouse gas mitigation is hindered by scientific uncertainty regarding the effectiveness of mitigation measures. Successful on-farm adoption of measures is contingent upon farmer perception of the relative practicality of implementing the measure and associated incentives and advice. In the absence of a comprehensive evidence base we utilised Best–Worst Scaling, a discrete choice survey method, to elicit expert and farmer opinion on the relative effectiveness and practicality of mitigation measures to reduce greenhouse gas emissions from sheep production systems. The method enabled individual mitigation measures to be ranked on a ratio scale of effectiveness (expert opinion) and practicality (farmer opinion). Six measures were identified as possessing the combined qualities of effectiveness and practicality and are considered priority candidates for policy promotion. The overall preferred measure was the use of legumes in pasture reseed mixes. Estimation and analysis of the distribution of individual respondent scores revealed heterogeneity in farmers’ perceptions of practicality, suggesting that flexible policies are required to enable farmers to select mitigation measures most suited to their farm type and locality. Practical measures with below average effectiveness may be widely adopted with limited regulation, incentivisation or advice, whilst some highly effective measures with lower practicality are likely to present greater obstacles to adoption

[Adolescent arsonists--psychodynamics, family dynamics and attempt at framing a typology based on 40 expert opinions].

Science.gov (United States)

Klosinski, G; Bertsch, S L

2001-02-01

Psychiatric, psychological and medical data of 40 adolescent firesetters are obtained from a retrospective analysis of expert opinions which have been drawn up by the Department of Child and Adolescent Psychiatry in Tübingen over a period of 16 years (1981-1997). This analysis mainly focusses on the patients' physical and psychosexual development, their social integration and competence and their family dynamics. It further concentrates on the psychic situation at the time of the offense, the reasons and motives given for firesetting (by the patient and by the expert) and specific psychological test results. According to the results three different characteristic groups can be found: 1st a group of offenders who have set fires to their parents' house, 2nd firesetters being member of the firebrigade, and 3rd an unspecific inhomogeneous group of firesetters.

Expert judgment for nuclear energy

International Nuclear Information System (INIS)

Choi, Young Sung; Lee, Sun Ho; Lee, Byong Whi

2000-01-01

Public perception on nuclear energy is much influenced by subjective impressions mostly formed through sensational and dramatic news of mass media or anti-nuclear groups. However, nuclear experts, those who have more relevant knowledge and information about nuclear energy, may have reasonable opinion based on scientific facts or inferences. Thus their opinion and consensus should be examined and taken into account during the process of nuclear energy policy formulation. For the purpose of eliciting experts' opinion, the web-based on-line survey system (eBOSS) was developed. Using the survey system, experts' views on nuclear energy were tallied, analyzed and compared with the public's. Based on the survey results, the paper suggests some recommendations about the future direction of the public information program in Korea

Medico-legal and legal-penal aspects of expert opinions and adjudication in cases of intoxications with intoxicating agents and ethanol-like intoxicants

Directory of Open Access Journals (Sweden)

Monika Ćwiklińska

2015-08-01

Full Text Available Introduction: The available legal regulations in Poland do not define the concentration thresholds enabling to differentiate between the states of “after-use” versus “under the influence” of a drug, as it is in the case of alcohol. The aim of the study was to analyse jurisdiction in cases regarding the evaluation of the effects of intoxicating agents and ethanol-like intoxicants and to identify ambiguities and gaps in the applicable regulations leading to problems in preparing expert opinions. Material and methods: The material included the opinions of experts in the field of toxicology and forensic medicine made by the Department of Forensic Medicine in Lublin in the years 2009–2011 and records obtained in the process of inquiry from the regional prosecutor’s offices and courts in 52 cases. Results : Amongst 52 cases in which the ordered toxicology examinations demonstrated the presence of intoxicating agents in drivers’ blood (tetrahydrocannabinols in 39 and amphetamine in 21 cases in 2 cases petty offence proceedings were instituted (Art. 87 of the Petty Offence Code although high concentrations of xenobiotics indicated the state of being “under the influence” of a narcotic drug (Art. 178a of the Penal Code. Three cases were discontinued despite expert opinions that the drivers were at least in the after-narcotic use state. In only 3 cases were witnesses asked to provide testimony about the circumstances of the driver’s conduct. Conclusions : The analysis has demonstrated that judicial bodies expect forensic expertise based exclusively on toxicological examination results; when expert findings are inconclusive, they only administer litigations opportunistically applying the principle of the presumption of innocence understood literally. Considering the above, threshold values of “use” and “influence” of the most commonly detected drugs should be urgently determined.

Ustekinumab in the management of Crohn's disease: Expert opinion.

Science.gov (United States)

Armuzzi, Alessandro; Ardizzone, Sandro; Biancone, Livia; Castiglione, Fabiana; Danese, Silvio; Gionchetti, Paolo; Orlando, Ambrogio; Rizzello, Fernando; Scribano, Maria Lia; Vecchi, Maurizio; Daperno, Marco

2018-03-11

This expert-opinion paper reviews available evidence for the use of ustekinumab, a human interleukin 12/23 monoclonal antibody, in the treatment of Crohn's disease and discusses its potential role in the current treatment scenario for the condition. Ustekinumab appears to be associated with rapid and sustained clinical effect, as reported from the clinical research program, with additional support for potential mucosal healing. These characteristics are paralleled by a favorable safety profile, lack of immunogenicity and the presence of systemic anti-inflammatory activity. Importantly, ustekinumab requires only one single intravenous administration, while subsequent dosing is administered subcutaneously, with potential advantages for home-based therapy. Lastly, the dosage of ustekinumab is flexible. On the basis of the evidence, ustekinumab has a role in patients with primary failure or secondary loss of response to anti-tumor necrosis factor agents, as well as in those who have adverse events on front-line biologics or are reinitiating therapy after a treatment holiday. Current evidence suggests that ustekinumab may be particularly suitable in patients who present extra-intestinal manifestations of the disease or are at risk of infections. Ustekinumab may also be considered in the first-line setting, especially in frail patients, in young subjects or in those who have concomitant immune-mediated diseases. Copyright © 2018 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Right of residence under Article 20 TFEU of the Primary Carer of a Minor Union Citizen: Summary of an expert opinion on issues arising from the pending case of Chavez-Vilchez and others (C-133/15)

NARCIS (Netherlands)

Dziedzic, Lukasz; Davies, Gareth; De Lange, Janneke; Biersteker, Anouk; Navia-Rodriguez, Lorena

2015-01-01

This is an English language summary of an extensive Dutch expert opinion concerning a pending ECJ case of wide relevance - a follow up to Ruiz Zambrano and Dereci which explores some of the more complex and realistic scenarios which may arise. That expert opinion provides a legal analysis of the

False confessions, expert testimony, and admissibility.

Science.gov (United States)

Watson, Clarence; Weiss, Kenneth J; Pouncey, Claire

2010-01-01

The confession of a criminal defendant serves as a prosecutor's most compelling piece of evidence during trial. Courts must preserve a defendant's constitutional right to a fair trial while upholding the judicial interests of presenting competent and reliable evidence to the jury. When a defendant seeks to challenge the validity of that confession through expert testimony, the prosecution often contests the admissibility of the expert's opinion. Depending on the content and methodology of the expert's opinion, testimony addressing the phenomenon of false confessions may or may not be admissible. This article outlines the scientific and epistemological bases of expert testimony on false confession, notes the obstacles facing its admissibility, and provides guidance to the expert in formulating opinions that will reach the judge or jury. We review the 2006 New Jersey Superior Court decision in State of New Jersey v. George King to illustrate what is involved in the admissibility of false-confession testimony and use the case as a starting point in developing a best-practice approach to working in this area.

Cost estimation: An expert-opinion approach. [cost analysis of research projects using the Delphi method (forecasting)

Science.gov (United States)

Buffalano, C.; Fogleman, S.; Gielecki, M.

1976-01-01

A methodology is outlined which can be used to estimate the costs of research and development projects. The approach uses the Delphi technique a method developed by the Rand Corporation for systematically eliciting and evaluating group judgments in an objective manner. The use of the Delphi allows for the integration of expert opinion into the cost-estimating process in a consistent and rigorous fashion. This approach can also signal potential cost-problem areas. This result can be a useful tool in planning additional cost analysis or in estimating contingency funds. A Monte Carlo approach is also examined.

Probability encoding of hydrologic parameters for basalt. Elicitation of expert opinions from a panel of five consulting hydrologists

International Nuclear Information System (INIS)

Runchal, A.K.; Merkhofer, M.W.; Olmsted, E.; Davis, J.D.

1984-11-01

The Columbia River basalts underlying the Hanford Site in Washington State are being considered as a possible location for a geologic repository for high-level nuclear waste. To investigate the feasibility of a repository at this site, the hydrologic parameters of the site must be evaluated. Among hydrologic parameters of particular interest are the effective porosity of the Cohassett basalt flow top and flow interior and the vertical-to-horizontal hydraulic conductivity, or anisotropy ratio, of the Cohassett basalt flow interior. The Cohassett basalt flow is the prime candidate horizon for repository studies. Site-specific data for these hydrologic parameters are currently inadequate for the purpose of preliminary assessment of candidate repository performance. To obtain credible, auditable, and independently derived estimates of the specified hydrologic parameters, a panel of five nationally recognized hydrologists was assembled. Their expert judgments were quantified during two rounds of Delphi process by means of a probability encoding method developed to estimate the probability distributions of the selected hydrologic variables. The results indicate significant differences of expert opinion for cumulative probabilities of less than 10% and greater than 90%, but relatively close agreement in the middle ranges of values. The principal causes of the diversity of opinion are believed to be the lack of site-specific data and the absence of a single, widely accepted, conceptual or theoretical basis for analyzing these variables

Expert opinion in the management of aqueous Deficient Dry Eye Disease (DED).

Science.gov (United States)

Sy, Aileen; O'Brien, Kieran S; Liu, Margaret P; Cuddapah, Puja A; Acharya, Nisha R; Lietman, Thomas M; Rose-Nussbaumer, Jennifer

2015-10-13

Dry eye disease (DED) affects millions of people worldwide. There are a variety of new treatments beyond traditional therapies such as preservative free artificial tears. Here, we conduct a survey to identify the most common treatments used among specialists and assess their interest in newer therapies. An international survey was distributed to dry eye researchers and expert practitioners via an internet survey. The survey data collected were analyzed with descriptive statistics. One hundred and fifteen respondents completed the survey; of these, 66 % were cornea specialists. The most commonly prescribed topical treatments included cyclosporine A (CSA) 0.05 % (71/104, 68 %), fluorometholone (FML) 0.1 % (59/99, 60 %), loteprednol etabonate 0.5 % (50/99, 51 %), and autologous serum eye drops (ASD; 48/97, 49 %). The most commonly prescribed non-topical medications included essential fatty acid supplements (72/104, 69 %), low-dose doxycycline (oral; 61/100, 61 %), and flaxseed supplements (32/96, 33 %) as well as punctal plugs (76/102, 75 %). Respondents reported treatment with topical corticosteroids for 2 to 8 weeks (46/86, 53 %), followed by less than 2 weeks (24/86, 28 %) and with topical CSA between 2 to 8 weeks (45/85, 53 %) followed by 2 to 6 months (24/85, 28 %). The top three signs and symptoms reported to indicate treatment response were, in order, fluorescein staining of the cornea, reduction in foreign body sensation, and reduction in burning sensation. This survey offers insight into current expert opinion in the treatment of DED. The results of this survey are hypothesis generating and will aid in the design of future clinical studies.

Dramatically Polarized Opinion on the Role of Brachytherapy Boost in Management of High-risk Prostate Cancer: A Survey of North American Genitourinary Expert Radiation Oncologists.

Science.gov (United States)

McClelland, Shearwood; Sandler, Kiri A; Degnin, Catherine; Chen, Yiyi; Mitin, Timur

2018-06-01

Three randomized clinical trials have established brachytherapy (BT) boost in combination with external beam radiation therapy (EBRT) and androgen deprivation therapy (ADT) as superior to definitive EBRT and ADT alone in terms of biochemical control (but not overall survival) at the expense of increased toxicity in men with high-risk (HR) prostate cancer (PCa). The current view regarding these 2 treatment algorithms among North American genitourinary (GU) experts is not known. A survey was distributed to 88 practicing North American GU physicians serving on decision-making committees of cooperative group research organizations. Questions pertained to opinions regarding BT as monotherapy for low-risk PCa and BT boost for HR PCa. Responders were asked to self-identify as BT experts versus non-experts. Treatment recommendations were correlated with practice patterns using the Fisher exact test. Forty-two radiation oncologists completed the survey, of whom 23 (55%) recommend EBRT and ADT alone and 19 (45%) recommend addition of BT boost. Twenty-five participants (60%) identified themselves as BT experts. Nearly 90% of those recommending BT boost were BT experts versus approximately 10% of non-BT experts (P < .001). Responders who recommended BT monotherapy as first-choice treatment for low-risk PCa were more likely to recommend BT boost for HR PCa (P < .0001). There is a dramatic polarization in opinions regarding incorporation of BT boost into EBRT + ADT therapy for patients with HR PCa among North American GU radiation oncology experts, who serve on decision-making committees and influence the national treatment guidelines and future clinical trials. Those who identify themselves as BT experts are significantly more likely to recommend BT boost. These findings are likely to influence the national guidelines and implementation of BT boost in current and future North American PCa clinical studies. Copyright © 2018 Elsevier Inc. All rights reserved.

Defining landscape resistance values in least-cost connectivity models for the invasive grey squirrel: a comparison of approaches using expert-opinion and habitat suitability modelling.

Science.gov (United States)

Stevenson-Holt, Claire D; Watts, Kevin; Bellamy, Chloe C; Nevin, Owen T; Ramsey, Andrew D

2014-01-01

Least-cost models are widely used to study the functional connectivity of habitat within a varied landscape matrix. A critical step in the process is identifying resistance values for each land cover based upon the facilitating or impeding impact on species movement. Ideally resistance values would be parameterised with empirical data, but due to a shortage of such information, expert-opinion is often used. However, the use of expert-opinion is seen as subjective, human-centric and unreliable. This study derived resistance values from grey squirrel habitat suitability models (HSM) in order to compare the utility and validity of this approach with more traditional, expert-led methods. Models were built and tested with MaxEnt, using squirrel presence records and a categorical land cover map for Cumbria, UK. Predictions on the likelihood of squirrel occurrence within each land cover type were inverted, providing resistance values which were used to parameterise a least-cost model. The resulting habitat networks were measured and compared to those derived from a least-cost model built with previously collated information from experts. The expert-derived and HSM-inferred least-cost networks differ in precision. The HSM-informed networks were smaller and more fragmented because of the higher resistance values attributed to most habitats. These results are discussed in relation to the applicability of both approaches for conservation and management objectives, providing guidance to researchers and practitioners attempting to apply and interpret a least-cost approach to mapping ecological networks.

Defining landscape resistance values in least-cost connectivity models for the invasive grey squirrel: a comparison of approaches using expert-opinion and habitat suitability modelling.

Directory of Open Access Journals (Sweden)

Claire D Stevenson-Holt

Full Text Available Least-cost models are widely used to study the functional connectivity of habitat within a varied landscape matrix. A critical step in the process is identifying resistance values for each land cover based upon the facilitating or impeding impact on species movement. Ideally resistance values would be parameterised with empirical data, but due to a shortage of such information, expert-opinion is often used. However, the use of expert-opinion is seen as subjective, human-centric and unreliable. This study derived resistance values from grey squirrel habitat suitability models (HSM in order to compare the utility and validity of this approach with more traditional, expert-led methods. Models were built and tested with MaxEnt, using squirrel presence records and a categorical land cover map for Cumbria, UK. Predictions on the likelihood of squirrel occurrence within each land cover type were inverted, providing resistance values which were used to parameterise a least-cost model. The resulting habitat networks were measured and compared to those derived from a least-cost model built with previously collated information from experts. The expert-derived and HSM-inferred least-cost networks differ in precision. The HSM-informed networks were smaller and more fragmented because of the higher resistance values attributed to most habitats. These results are discussed in relation to the applicability of both approaches for conservation and management objectives, providing guidance to researchers and practitioners attempting to apply and interpret a least-cost approach to mapping ecological networks.

The rehabilitation of children and adolescents with severe or medically complicated obesity: an ISPED expert opinion document.

Science.gov (United States)

Grugni, Graziano; Licenziati, Maria Rosaria; Valerio, Giuliana; Crinò, Antonino; Maffeis, Claudio; Tanas, Rita; Morino, Giuseppe Stefano

2017-03-01

Severe/medically complicated obesity in childhood, and particularly in adolescence, is a real disability that requires an intensive and continuous approach which should follow the procedures and schedule of rehabilitation medicine. Given the lack of a specific document focusing on children and adolescents, the Childhood Obesity Study Group set out to explore the available evidence for the treatment of severe or medically complicated obesity and to set standards tailored to the specific context of the Italian Health Service. Through a series of meetings and electronic communications, the writing committee (selected from members of the Study Group) selected the key issues, explored the literature and produced a draft document which was submitted to the other experts until the final synthesis was approved by the group. In brief, the following issues were involved: (1) definition and epidemiology; (2) identification of common goals designed to regain functional competence and limit the progression of metabolic and psychological complications; (3) a multi-professional team approach; (4) the care setting. This paper is an expert opinion document on the rehabilitation of severe and medically complicated obesity in children and adolescents produced by experts belonging to the Childhood Obesity Study Group of the Italian Society for Pediatric Endocrinology and Diabetology (ISPED).

Building legitimacy by criticising the pharmaceutical industry: a qualitative study among prescribers and local opinion leaders.

Science.gov (United States)

Pittet, Anne-Laure; Saraga, Michael; Stiefel, Friedrich

2015-01-01

The literature has described opinion leaders not only as marketing tools of the pharmaceutical industry, but also as educators promoting good clinical practice. This qualitative study addresses the distinction between the opinion-leader-as-marketing-tool and the opinion-leader-as-educator, as it is revealed in the discourses of physicians and experts, focusing on the prescription of antidepressants. We explore the relational dynamic between physicians, opinion leaders and the pharmaceutical industry in an area of French-speaking Switzerland. Qualitative content analysis of 24 semistructured interviews with physicians and local experts in psychopharmacology, complemented by direct observation of educational events led by the experts, which were all sponsored by various pharmaceutical companies. Both physicians and experts were critical of the pharmaceutical industry and its use of opinion leaders. Local experts, in contrast, were perceived by the physicians as critical of the industry and, therefore, as a legitimate source of information. Local experts did not consider themselves opinion leaders and argued that they remained intellectually independent from the industry. Field observations confirmed that local experts criticised the industry at continuing medical education events. Local experts were vocal critics of the industry, which nevertheless sponsor their continuing education. This critical attitude enhanced their credibility in the eyes of the prescribing physicians. We discuss how the experts, despite their critical attitude, might still be beneficial to the industry's interests.

Palliative Radiotherapy for Bone Metastases: An ASTRO Evidence-Based Guideline

International Nuclear Information System (INIS)

Lutz, Stephen; Berk, Lawrence; Chang, Eric; Chow, Edward; Hahn, Carol; Hoskin, Peter; Howell, David; Konski, Andre; Kachnic, Lisa; Lo, Simon; Sahgal, Arjun; Silverman, Larry; Gunten, Charles von; Mendel, Ehud; Vassil, Andrew; Bruner, Deborah Watkins; Hartsell, William

2011-01-01

Purpose: To present guidance for patients and physicians regarding the use of radiotherapy in the treatment of bone metastases according to current published evidence and complemented by expert opinion. Methods and Materials: A systematic search of the National Library of Medicine's PubMed database between 1998 and 2009 yielded 4,287 candidate original research articles potentially applicable to radiotherapy for bone metastases. A Task Force composed of all authors synthesized the published evidence and reached a consensus regarding the recommendations contained herein. Results: The Task Force concluded that external beam radiotherapy continues to be the mainstay for the treatment of pain and/or prevention of the morbidity caused by bone metastases. Various fractionation schedules can provide significant palliation of symptoms and/or prevent the morbidity of bone metastases. The evidence for the safety and efficacy of repeat treatment to previously irradiated areas of peripheral bone metastases for pain was derived from both prospective studies and retrospective data, and it can be safe and effective. The use of stereotactic body radiotherapy holds theoretical promise in the treatment of new or recurrent spine lesions, although the Task Force recommended that its use be limited to highly selected patients and preferably within a prospective trial. Surgical decompression and postoperative radiotherapy is recommended for spinal cord compression or spinal instability in highly selected patients with sufficient performance status and life expectancy. The use of bisphosphonates, radionuclides, vertebroplasty, and kyphoplasty for the treatment or prevention of cancer-related symptoms does not obviate the need for external beam radiotherapy in appropriate patients. Conclusions: Radiotherapy is a successful and time efficient method by which to palliate pain and/or prevent the morbidity of bone metastases. This Guideline reviews the available data to define its proper use

The radiotherapy affects the cognitive processes; La radiotherapie affecte la cognition

Energy Technology Data Exchange (ETDEWEB)

Anon

2009-10-15

Researchers from the medical center of the free university of Amsterdam report that the radiotherapy can hinder the cognitive functions of patients affected by cerebral tumors treated after a surgery. Even low dose radiation could contribute in their opinion, to the progressive cognitive decline of patients suffering of low grade gliomas, the most commune cerebral tumor. To get these conclusions, 65 patients, whom half of them received a radiotherapy, had a neurological and psychological evaluation twelve years after their treatment. Results: 53% of patients treated by radiotherapy present disorders of attention, memory, execution and speed of information treatment against 27% of these ones that received an only surgery. The researchers conclude to the necessity to take into account this risk in the choice of treatment, or even to avoid radiotherapy in this precise case. (N.C.)

Accepted standards on how to give a Medical Research Presentation: a systematic review of expert opinion papers

Directory of Open Access Journals (Sweden)

Blome, Christine

2017-02-01

Full Text Available Background: This systematic review aimed to extract recommendations from expert opinion articles on how to give a medical research presentation on a scientific conference and to determine whether the experts agree on what makes an effective or poor presentation. Methods: Presentation-related terms were searched within article titles listed in PubMed, restricting the search to English-language articles published from January 1975 to July 2015. Recommendations were extracted from the articles, grouped by content, and analyzed for frequency. Ninety-one articles were included. Among 679 different recommendations, 29 were given in more than 20% of articles each. The five most frequent recommendations were to keep slides simple, adjust the talk to the audience, rehearse, not read the talk from slides or a manuscript, and make eye contact. Results: No article gave advice that was the complete opposite of the 29 most frequent recommendations with the exception of whether a light or dark background should be used for slides. Conclusions: Researchers should comply with these widely accepted standards to be perceived as effective presenters.

Accepted standards on how to give a Medical Research Presentation: a systematic review of expert opinion papers.

Science.gov (United States)

Blome, Christine; Sondermann, Hanno; Augustin, Matthias

2017-01-01

Background: This systematic review aimed to extract recommendations from expert opinion articles on how to give a medical research presentation on a scientific conference and to determine whether the experts agree on what makes an effective or poor presentation. Methods: Presentation-related terms were searched within article titles listed in PubMed, restricting the search to English-language articles published from January 1975 to July 2015. Recommendations were extracted from the articles, grouped by content, and analyzed for frequency. Ninety-one articles were included. Among 679 different recommendations, 29 were given in more than 20% of articles each. The five most frequent recommendations were to keep slides simple, adjust the talk to the audience, rehearse, not read the talk from slides or a manuscript, and make eye contact. Results: No article gave advice that was the complete opposite of the 29 most frequent recommendations with the exception of whether a light or dark background should be used for slides. Conclusions: Researchers should comply with these widely accepted standards to be perceived as effective presenters.

Assessing the probability of introduction and spread of avian influenza (AI) virus in commercial Australian poultry operations using an expert opinion elicitation.

Science.gov (United States)

Singh, Mini; Toribio, Jenny-Ann; Scott, Angela Bullanday; Groves, Peter; Barnes, Belinda; Glass, Kathryn; Moloney, Barbara; Black, Amanda; Hernandez-Jover, Marta

2018-01-01

The objective of this study was to elicit experts' opinions and gather estimates on the perceived probability of introduction and spread of avian influenza (AI) virus in the Australian broiler and layer industry. Using a modified Delphi method and a 4-step elicitation process, 11 experts were asked to give initial individual estimates for the various pathways and practices in the presented scenarios using a questionnaire. Following this, a workshop was conducted to present group averages of estimates and discussion was facilitated to obtain final individual estimates. For each question, estimates for all experts were combined using a discrete distribution, with weights allocated representing the level of expertise. Indirect contact with wild birds either via a contaminated water source or fomites was considered the most likely pathway of introduction of low pathogenic avian influenza (LPAI) on poultry farms. Presence of a water body near the poultry farm was considered a potential pathway for introduction only when the operation type was free range and the water body was within 500m distance from the shed. The probability that LPAI will mutate to highly pathogenic avian influenza (HPAI) was considered to be higher in layer farms. Shared personnel, equipment and aerosol dispersion were the most likely pathways of shed to shed spread of the virus. For LPAI and HPAI spread from farm to farm, shared pick-up trucks for broiler and shared egg trays and egg pallets for layer farms were considered the most likely pathways. Findings from this study provide an insight on most influential practices on the introduction and spread of AI virus among commercial poultry farms in Australia, as elicited from opinions of experts. These findings will be used to support parameterization of a modelling study assessing the risk of AI introduction and spread among commercial poultry farms in Australia.

Expert opinion on climatic change

International Nuclear Information System (INIS)

Nordhaus, W.D.

1994-01-01

This paper discusses the results of an indepth interview survey of experts, both social and natural scientists, about estimates of the economic impact of potential greenhouse warming. The range of estimate impacts was enormous as was the difference between disciplines, particularly mainstream economists and natural scientists. The nineteen survey participants and their affiliations are listed. The general areas discussed in the paper include the following: survey development; estimation of subjective probabilities; description of different scenarios presented; discussion of pertinent answers and general trends in answers including influence of point of view; magnitude of problem; ecosystems; secondary effects; ability to adapt; regional distribution of impacts; nonmarket effects; limits to understanding. 7 figs

Experts opinion on the use of normative data for functional capacity evaluation in occupational and rehabilitation medicine and disability claims.

Science.gov (United States)

Soer, Remko; Reneman, Michiel F; Frings-Dresen, Monique H W; Kuijer, P Paul; Kuijer, P Paul F M

2014-12-01

Application of normative values for functional capacity evaluation (FCE) is controversial for the assessment of clients for work ability. The objective of this study was to study when clinicians and researchers consider normative values of FCE useful or of no use for their purposes. A focus group meeting was organized among 43 FCE experts working in insurance, occupational and/or rehabilitation medicine from eight countries during the first international FCE research meeting on October 25th, 2012 in the Netherlands. Participants were asked to rate to which degree they agree or disagree with a statement concerning their position toward normative values for FCE on a 10 cm VAS ranging from 0 (completely disagree) to 100 (completely agree) at T0 and T1. Arguments for aspects that are useful and of no use for normative values were systematically collected during the meeting and afterwards independently clustered by two researchers in higher order topics. Baseline opinion of participants on their position toward normative values was 49 ± 29 points. After the meeting, mean VAS was 55 ± 23 (p = 0.07), indicating that participants did not significantly change their opinion toward normative values. Based on arguments provided by the experts, seven higher order topics were constructed namely 'Comparison with job demands or treatment goals'; 'Comparison with co-workers physical ability'; 'Sincerity of effort'; 'Validity for work ability and return to work'; 'Experience of referrer with assessment method'; 'Clinimetrics compared to alternative assessment methods or reference values'; and 'Ease of use for clinician and stakeholders'. Although experts state useful aspects for the use of normative values of FCE for these assessments, it may also lead to over-interpretation of results, leading to dualistic statements concerning work ability, with potential harmful consequences for work ability of patients.

Current opinions on radiotherapy of pediatric central nervous system tumors

International Nuclear Information System (INIS)

Chojnacka, M.; Skowronska-Gardas, A.

2006-01-01

Primary central nervous system (CNS) neoplasms are the most frequent solid tumors in childhood accounting for 20% of all pediatric malignancies. Despite developments in neurosurgery, radiotherapy and chemotherapy, a significant proportion of these patients suffer progressive disease. A good treatment management strategy should consider not only survival but also the quality of life of the child. Irradiation is ann essential part of the management of the majority of CNS tumors. During then last decade, there significant advances in the technology of planning and delivery of radiation treatment. These new radiotherapy techniques such as conformal, intensity modulated photon beam and stereotactic methods allow a high homogenous dose to the tumor region with minimal doses to normal tissue. This is particularly important in children with localized low-grade tumors, whose prognosis of long-term survival is often excellent and should be accompanied by smallest risk of treatment toxicity. For small tumors fractionated radiotherapy stereotactic radiotherapy using multiple fixed non-coplanar beams is an appropriate treatment. Modification of craniospinal technique, lowering of the total craniospinal dose with adjuvant chemotherapy, new radiotherapy modalities to treat the posterior fossa may be employed to possibly decrease the late rectifies of radiation therapy. For malignant glioma and brain stem tumors we need new approaches, as chemo sensitization, angiogenesis inhibitors and gene therapies. These new methods in therapy of pediatric brain tumors and our experience in treatment of children with medulloblastoma, low-grade astrocytoma, craniopharyngioma and brain stem tumors are presented. We summarize therapeutic aspects of most childhood brain tumors. (author)

An expert system for uranium exploration

International Nuclear Information System (INIS)

Chhipa, V.K.; Sengupta, M.

1989-01-01

Artificial intelligence is an emerging technology in the field of computer application. Expert systems have been developed to imitate human intelligence and reasoning process. Expert systems have much scope of application in the decision making process in mineral exploration as such decisions are highly subjective and expert opinions are very helpful. This paper presents a small expert system to analyze the reasoning process in exploring for uranium deposits in sandstone

Intensity modulated conformal radiotherapy

International Nuclear Information System (INIS)

Noel, Georges; Moty-Monnereau, Celine; Meyer, Aurelia; David, Pauline; Pages, Frederique; Muller, Felix; Lee-Robin, Sun Hae; David, Denis Jean

2006-12-01

This publication reports the assessment of intensity-modulated conformal radiotherapy (IMCR). This assessment is based on a literature survey which focussed on indications, efficiency and safety on the short term, on the risk of radio-induced cancer on the long term, on the role in the therapeutic strategy, on the conditions of execution, on the impact on morbidity-mortality and life quality, on the impact on the health system and on public health policies and program. This assessment is also based on the opinion of a group of experts regarding the technical benefit of IMCR, its indications depending on the cancer type, safety in terms of radio-induced cancers, and conditions of execution. Before this assessment, the report thus indicates indications for which the use of IMCR can be considered as sufficient or not determined. It also proposes a technical description of IMCR and helical tomo-therapy, discusses the use of this technique for various pathologies or tumours, analyses the present situation of care in France, and comments the identification of this technique in foreign classifications

Experts reviews of the multidisciplinary consensus conference colon and rectal cancer 2012: science, opinions and experiences from the experts of surgery.

Science.gov (United States)

van de Velde, C J H; Boelens, P G; Tanis, P J; Espin, E; Mroczkowski, P; Naredi, P; Pahlman, L; Ortiz, H; Rutten, H J; Breugom, A J; Smith, J J; Wibe, A; Wiggers, T; Valentini, V

2014-04-01

The first multidisciplinary consensus conference on colon and rectal cancer was held in December 2012, achieving a majority of consensus for diagnostic and treatment decisions using the Delphi Method. This article will give a critical appraisal of the topics discussed during the meeting and in the consensus document by well-known leaders in surgery that were involved in this multidisciplinary consensus process. Scientific evidence, experience and opinions are collected to support multidisciplinary teams (MDT) with arguments for medical decision-making in diagnosis, staging and treatment strategies for patients with colon or rectal cancer. Surgery is the cornerstone of curative treatment for colon and rectal cancer. Standardizing treatment is an effective instrument to improve outcome of multidisciplinary cancer care for patients with colon and rectal cancer. In this article, a review of the following focuses; Perioperative care, age and colorectal surgery, obstructive colorectal cancer, stenting, surgical anatomical considerations, total mesorectal excision (TME) surgery and training, surgical considerations for locally advanced rectal cancer (LARC) and local recurrent rectal cancer (LRRC), surgery in stage IV colorectal cancer, definitions of quality of surgery, transanal endoscopic microsurgery (TEM), laparoscopic colon and rectal surgery, preoperative radiotherapy and chemoradiotherapy, and how about functional outcome after surgery? Copyright © 2013 Elsevier Ltd. All rights reserved.

Efficacy of post-operative radiotherapy in the treatment of breast cancer

Energy Technology Data Exchange (ETDEWEB)

Api, P; Corcione, S; Magnoni, G

1985-01-01

A clinical evaluation regarding the efficacy of post-operative radiotherapy in 294 patients with breast cancer is presented. In the author's opinion post-operative radiotherapy is fundamental in the treatment of this tumor. 21 refs.

Heterodoxy, iconoclasm and spuriousness: the limits of novel expert evidence.

Science.gov (United States)

Freckelton, Ian

2007-12-01

A difficult issue arises for courts' decision-making at common law and under statutory evidentiary regimes when expert opinions are significantly unorthodox, iconoclastic or methodologically flawed. This editorial analyses the relevant evidentiary principles and the Australian jurisprudence on the subject, giving particular attention to the decisions of the South Australian Supreme Court in R v Parenzee [2007] SASC 143 and R v Parenzee [2007] SASC 316 in which expert opinions about the existence, identifiability and transmissibility of HIV and its relationship to AIDS adduced on behalf of the defence in a criminal trial were found to be seriously wanting. A variety of factors indicative of low probative value in expert opinions are distilled.

Comprehensive embryo testing. Experts' opinions regarding future directions: an expert panel study on comprehensive embryo testing.

Science.gov (United States)

Hens, Kristien; Dondorp, Wybo J; Geraedts, Joep P M; de Wert, Guido M

2013-05-01

What do scientists in the field of preimplantation genetic diagnosis (PGD) and preimplantation genetic screening (PGS) consider to be the future direction of comprehensive embryo testing? Although there are many biological and technical limitations, as well as uncertainties regarding the meaning of genetic variation, comprehensive embryo testing will impact the IVF/PGD practice and a timely ethical reflection is needed. Comprehensive testing using microarrays is currently being introduced in the context of PGD and PGS, and it is to be expected that whole-genome sequencing will also follow. Current ethical and empirical sociological research on embryo testing focuses on PGD as it is practiced now. However, empirical research and systematic reflection regarding the impact of comprehensive techniques for embryo testing is missing. In order to understand the potential of this technology and to be able to adequately foresee its implications, we held an expert panel with seven pioneers in PGD. We conducted an expert panel in October 2011 with seven PGD pioneers from Belgium, The Netherlands, Germany and the UK. Participants expected the use of comprehensive techniques in the context of PGD. However, the introduction of these techniques in embryo testing requires timely ethical reflection as it involves a shift from choosing an embryo without a particular genetic disease (i.e. PGD) or most likely to result in a successful pregnancy (i.e. PGS) to choosing the best embryo based on a much wider set of criteria. Such ethical reflection should take account of current technical and biological limitations and also of current uncertainties with regard to the meaning of genetic variance. However, ethicists should also not be afraid to look into the future. There was a general agreement that embryo testing will be increasingly preceded by comprehensive preconception screening, thus enabling smart combinations of genetic testing. The group was composed of seven participants from

Expert Opinion on the Perceived Effectiveness and Importance of On-Farm Biosecurity Measures for Cattle and Swine Farms in Switzerland.

Directory of Open Access Journals (Sweden)

Karin Kuster

Full Text Available Biosecurity is crucial for safeguarding livestock from infectious diseases. Despite the plethora of biosecurity recommendations, published scientific evidence on the effectiveness of individual biosecurity measures is limited. The objective of this study was to assess the perception of Swiss experts about the effectiveness and importance of individual on-farm biosecurity measures for cattle and swine farms (31 and 30 measures, respectively. Using a modified Delphi method, 16 Swiss livestock disease specialists (8 for each species were interviewed. The experts were asked to rank biosecurity measures that were written on cards, by allocating a score from 0 (lowest to 5 (highest. Experts ranked biosecurity measures based on their importance related to Swiss legislation, feasibility, as well as the effort required for implementation and the benefit of each biosecurity measure. The experts also ranked biosecurity measures based on their effectiveness in preventing an infectious agent from entering and spreading on a farm, solely based on transmission characteristics of specific pathogens. The pathogens considered by cattle experts were those causing Bluetongue (BT, Bovine Viral Diarrhea (BVD, Foot and Mouth Disease (FMD and Infectious Bovine Rhinotracheitis (IBR. Swine experts expressed their opinion on the pathogens causing African Swine Fever (ASF, Enzootic Pneumonia (EP, Porcine Reproductive and Respiratory Syndrome (PRRS, as well as FMD. For cattle farms, biosecurity measures that improve disease awareness of farmers were ranked as both most important and most effective. For swine farms, the most important and effective measures identified were those related to animal movements. Among all single measures evaluated, education of farmers was perceived by the experts to be the most important and effective for protecting both Swiss cattle and swine farms from disease. The findings of this study provide an important basis for recommendation to farmers

Expert Opinion on the Perceived Effectiveness and Importance of On-Farm Biosecurity Measures for Cattle and Swine Farms in Switzerland

Science.gov (United States)

Kuster, Karin; Cousin, Marie-Eve; Jemmi, Thomas; Schüpbach-Regula, Gertraud; Magouras, Ioannis

2015-01-01

Biosecurity is crucial for safeguarding livestock from infectious diseases. Despite the plethora of biosecurity recommendations, published scientific evidence on the effectiveness of individual biosecurity measures is limited. The objective of this study was to assess the perception of Swiss experts about the effectiveness and importance of individual on-farm biosecurity measures for cattle and swine farms (31 and 30 measures, respectively). Using a modified Delphi method, 16 Swiss livestock disease specialists (8 for each species) were interviewed. The experts were asked to rank biosecurity measures that were written on cards, by allocating a score from 0 (lowest) to 5 (highest). Experts ranked biosecurity measures based on their importance related to Swiss legislation, feasibility, as well as the effort required for implementation and the benefit of each biosecurity measure. The experts also ranked biosecurity measures based on their effectiveness in preventing an infectious agent from entering and spreading on a farm, solely based on transmission characteristics of specific pathogens. The pathogens considered by cattle experts were those causing Bluetongue (BT), Bovine Viral Diarrhea (BVD), Foot and Mouth Disease (FMD) and Infectious Bovine Rhinotracheitis (IBR). Swine experts expressed their opinion on the pathogens causing African Swine Fever (ASF), Enzootic Pneumonia (EP), Porcine Reproductive and Respiratory Syndrome (PRRS), as well as FMD. For cattle farms, biosecurity measures that improve disease awareness of farmers were ranked as both most important and most effective. For swine farms, the most important and effective measures identified were those related to animal movements. Among all single measures evaluated, education of farmers was perceived by the experts to be the most important and effective for protecting both Swiss cattle and swine farms from disease. The findings of this study provide an important basis for recommendation to farmers and

Comparison of expert and nonexpert swimmers' opinions about the value, potency, and activity of four standard swimming strokes and underwater undulatory swimming.

Science.gov (United States)

Collard, L; Oboeuf, A

2009-04-01

Underwater undulatory swimming (UUS) is often perceived to be a nonessential aspect of aquatic propulsion. Given their solid theoretical and practical training in swimming, physical education students should be capable of judging the true value of the "fifth stroke," since it appears to be the most efficient technique in high level, competitive swimming. To compare opinions and connotations associated with the stroke and the four official strokes (butterfly, backstroke, breaststroke, and crawl), 198 students (32 of whom were expert swimmers; M age = 20.6 yr., SD = 1.2), were surveyed using the semantic differential of Osgood, Suci, and Tannenbaum. Although answers of expert and nonexpert swimmers differed significantly (p stroke was less attractive, less powerful, and less rapid than the four surface strokes (d = 2.88 for the expert swimmers). Putting one arm in front of the other and repeating the sequence still remains the most solidly held representation of "the right way" to swim. However, the high observed standard deviations for the underwater undulatory stimulus (SD > or = 1.1 with SD max = 3 for the expert swimmers) attests to the view being less strongly held by swimming specialists.

Expert panel on additional cross subsidisation. Considering arguments and providing expert opinion

International Nuclear Information System (INIS)

Faber, J.; Nelissen, D.; Lowe, S.; Mason, A.

2007-10-01

In the period end 2005 till September 2006 MVA London in cooperation with SEO Amsterdam was commissioned by the Dutch Ministry of Transport to perform an analysis of the economic and competition effects of the different proposals from the European Commission to include aviation in the European Emission Trading System (ETS). Roughly at the same time CE Delft was commissioned to study the overall impacts of this inclusion for the European Commission. Both studies considered the possibility that inclusion of aviation in the ETS could lead to the distortion of competition between airlines through cross-subsidisation. The studies concluded differently on additional possibilities for cross-subsidisation. As a result, both parties have different views on the possible distortion of the competitive market on routes where EU-based carriers compete directly with carriers based outside the EU. CE Delft concluded that 'none of the policy options considered in this study will significantly damage the competitive position of EU airlines relative to non-EU airlines'. In contrast, MVA and SEO (2006) concluded that 'effective cross-subsidisation by non-EU carriers in the Departing EU scope of the ETS appears to be more probable than cross-subsidisation by EU network carriers in the Intra-EU scope of the ETS'. In July 2007, the Dutch Ministry of Transport, DGTL commissioned CE Delft, MVA and SEO to study the causes for their different opinions and to see whether a further investigation could shed more light on the likelihood of additional cross-subsidisation. Formally, the aim of the work currently carried out is: (1) To determine whether it is possible to assess the impacts on the competitive market between EU based carriers and non-EU based carriers based on sound economic reasoning and analysis of empirical data; and, if so, (2) to determine whether the inclusion of aviation in ETS as proposed by the European Commission will offer non-EU airlines the opportunity to increase their

Ethical Issues in Expert Opinions and Testimony.

Science.gov (United States)

Weed, Roger O.

2000-01-01

This article provides an overview of ethical issues in private for-profit practice, with particular focus on expert testimony, using examples from a sample of claims filed with the National Association of Rehabilitation Professionals in the Private Sector and malpractice insurance companies. Complaints most frequently involve issues related to…

Veterinary Expert Opinion on Potential Drivers and Opportunities for Changing Antimicrobial Usage Practices in Livestock in Denmark, Portugal, and Switzerland

Directory of Open Access Journals (Sweden)

Luís P. Carmo

2018-03-01

Full Text Available Reducing antimicrobial use (AMU in livestock is requested by Public Health authorities. Ideally, this should be achieved without jeopardizing production output or animal health and welfare. Thus, efficient measures must be identified and developed to target drivers of AMU. Veterinarians play a central role in the identification and implementation of such efficient interventions. Sixty-seven veterinarians with expertise in livestock production in Denmark, Portugal, and Switzerland participated in an expert opinion study aimed at investigating experiences and opinions of veterinarians about the driving forces and practices related to AMU in the main livestock sectors (broiler, dairy cattle, fattening/veal calf, and pig industry of the aforementioned countries. Opinions on potential factors influencing the choice of antimicrobials and opportunities to reduce AMU were collected. Antibiograms are seldom used, mainly due to the time lag between testing and obtaining the results. The perceived percentage of treatment failures varied between countries and livestock sectors; however, little changes were reported over time (2005−2015. The animal health problems of each livestock sector most frequently leading to AMU did not vary substantially between countries. Mandatory official interventions (i.e., binding measures applied by national or international authorities were highlighted as having the biggest impact on AMU. There was a variation in the experts’ opinion regarding feasibility and impact of interventions both between countries and livestock sectors. Nevertheless, improved biosecurity and education of veterinarians frequently received high scores. Most veterinarians believed that AMU can be reduced. The median potential reduction estimates varied from 1% in Swiss broilers to 50% in Portuguese broilers and veal/fattening calves in all countries. We hypothesize that the differences in views could be related to disease epidemiology, animal

Historical baselines of coral cover on tropical reefs as estimated by expert opinion

Directory of Open Access Journals (Sweden)

Tyler D. Eddy

2018-01-01

Full Text Available Coral reefs are important habitats that represent global marine biodiversity hotspots and provide important benefits to people in many tropical regions. However, coral reefs are becoming increasingly threatened by climate change, overfishing, habitat destruction, and pollution. Historical baselines of coral cover are important to understand how much coral cover has been lost, e.g., to avoid the ‘shifting baseline syndrome’. There are few quantitative observations of coral reef cover prior to the industrial revolution, and therefore baselines of coral reef cover are difficult to estimate. Here, we use expert and ocean-user opinion surveys to estimate baselines of global coral reef cover. The overall mean estimated baseline coral cover was 59% (±19% standard deviation, compared to an average of 58% (±18% standard deviation estimated by professional scientists. We did not find evidence of the shifting baseline syndrome, whereby respondents who first observed coral reefs more recently report lower estimates of baseline coral cover. These estimates of historical coral reef baseline cover are important for scientists, policy makers, and managers to understand the extent to which coral reefs have become depleted and to set appropriate recovery targets.

Historical baselines of coral cover on tropical reefs as estimated by expert opinion.

Science.gov (United States)

Eddy, Tyler D; Cheung, William W L; Bruno, John F

2018-01-01

Coral reefs are important habitats that represent global marine biodiversity hotspots and provide important benefits to people in many tropical regions. However, coral reefs are becoming increasingly threatened by climate change, overfishing, habitat destruction, and pollution. Historical baselines of coral cover are important to understand how much coral cover has been lost, e.g., to avoid the 'shifting baseline syndrome'. There are few quantitative observations of coral reef cover prior to the industrial revolution, and therefore baselines of coral reef cover are difficult to estimate. Here, we use expert and ocean-user opinion surveys to estimate baselines of global coral reef cover. The overall mean estimated baseline coral cover was 59% (±19% standard deviation), compared to an average of 58% (±18% standard deviation) estimated by professional scientists. We did not find evidence of the shifting baseline syndrome, whereby respondents who first observed coral reefs more recently report lower estimates of baseline coral cover. These estimates of historical coral reef baseline cover are important for scientists, policy makers, and managers to understand the extent to which coral reefs have become depleted and to set appropriate recovery targets.

A probabilistic risk assessment for field radiography based on expert judgment and opinion

International Nuclear Information System (INIS)

Jang, Han-Ki; Ryu, Hyung-Joon; Kim, Ji-Young; Lee, Jai-Ki; Cho, Kun-Woo

2011-01-01

A probabilistic approach was applied to assess radiation risk associated with the field radiography using gamma sources. The Delphi method based on the expert judgments and opinions was used in the process of characterization of parameters affecting risk, which are inevitably subject to large uncertainties. A mathematical approach applying the Bayesian inferences was employed for data processing to improve the Delphi results. This process consists of three phases: (1) setting prior distributions, (2) constructing the likelihood functions and (3) deriving the posterior distributions based on the likelihood functions. The approach for characterizing input parameters using the Bayesian inference is provided for improved risk estimates without intentional rejection of part of the data, which demonstrated utility of Bayesian updating of distributions of uncertain input parameters in PRA (Probabilistic Risk Assessment). The data analysis portion for PRA in field radiography is addressed for estimates of the parameters used to determine the frequencies and consequences of the various events modeled. In this study, radiological risks for the worker and the public member in the vicinity of the work place are estimated for field radiography system in Korea based on two-dimensional Monte Carlo Analysis (2D MCA). (author)

Quantification of informed opinion

International Nuclear Information System (INIS)

Rasmuson, D.M.

1985-01-01

The objective of this session, Quantification of Informed Opinion, is to provide the statistician with a better understanding of this important area. The NRC uses informed opinion, sometimes called engineering judgment or subjective judgment, in many areas. Sometimes informed opinion is the only source of information that exists, especially in phenomenological areas, such as steam explosions, where experiments are costly and phenomena are very difficult to measure. There are many degrees of informed opinion. These vary from the weatherman who makes predictions concerning relatively high probability events with a large data base to the phenomenological expert who must use his intuition tempered with basic knowledge and little or no measured data to predict the behavior of events with a low probability of occurrence. The first paper in this session provides the reader with an overview of the subject area. The second paper provides some aspects that must be considered in the collection of informed opinion to improve the quality of the information. The final paper contains an example of the use of informed opinion in the area of seismic hazard characterization. These papers should be useful to researchers and statisticians who need to collect and use informed opinion in their work

Treatment Guidelines for Preoperative Radiation Therapy for Retroperitoneal Sarcoma: Preliminary Consensus of an International Expert Panel

Energy Technology Data Exchange (ETDEWEB)

Baldini, Elizabeth H., E-mail: ebaldini@partners.org [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, Massachusetts (United States); Wang, Dian [Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois (United States); Haas, Rick L.M. [Department of Radiotherapy, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Catton, Charles N. [Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Indelicato, Daniel J. [Department of Radiation Oncology, University of Florida Medical Center, Jacksonville, Florida (United States); Kirsch, David G. [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Roberge, David [Department of Radiation Oncology, Centre Hospitalier de l' Université de Montreal, Montreal, Quebec (Canada); Salerno, Kilian [Department of Radiation Oncology, Roswell Park Cancer Institute, Buffalo, New York (United States); Deville, Curtiland [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins Sidney Kimmel Cancer Center, Washington, DC (United States); Guadagnolo, B. Ashleigh [Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas (United States); O' Sullivan, Brian [Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Petersen, Ivy A. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Le Pechoux, Cecile [Department of Radiotherapy, Institut Gustave-Roussy, Villejuif (France); Abrams, Ross A. [Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois (United States); DeLaney, Thomas F. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

2015-07-01

Purpose: Evidence for external beam radiation therapy (RT) as part of treatment for retroperitoneal sarcoma (RPS) is limited. Preoperative RT is the subject of a current randomized trial, but the results will not be available for many years. In the meantime, many practitioners use preoperative RT for RPS, and although this approach is used in practice, there are no radiation treatment guidelines. An international expert panel was convened to develop consensus treatment guidelines for preoperative RT for RPS. Methods and Materials: An expert panel of 15 academic radiation oncologists who specialize in the treatment of sarcoma was assembled. A systematic review of reports related to RT for RPS, RT for extremity sarcoma, and RT-related toxicities for organs at risk was performed. Due to the paucity of high-quality published data on the subject of RT for RPS, consensus recommendations were based largely on expert opinion derived from clinical experience and extrapolation of relevant published reports. It is intended that these clinical practice guidelines be updated as pertinent data become available. Results: Treatment guidelines for preoperative RT for RPS are presented. Conclusions: An international panel of radiation oncologists who specialize in sarcoma reached consensus guidelines for preoperative RT for RPS. Many of the recommendations are based on expert opinion because of the absence of higher level evidence and, thus, are best regarded as preliminary. We emphasize that the role of preoperative RT for RPS has not been proven, and we await data from the European Organization for Research and Treatment of Cancer (EORTC) study of preoperative radiotherapy plus surgery versus surgery alone for patients with RPS. Further data are also anticipated pertaining to normal tissue dose constraints, particularly for bowel tolerance. Nonetheless, as we await these data, the guidelines herein can be used to establish treatment uniformity to aid future assessments of efficacy

Environmental policy. 2000 environmental expert opinion of the Council of Experimental Experts

International Nuclear Information System (INIS)

2000-05-01

The reorientation of energy policy is a key issue. The Council of Environmental Experts considers the further use of atomic energy to be irresponsible and recommends a new orientation. Recommendations are made on ecology-centered taxation. Critical comments are made in the context of conservation of nature, where many species of plants and animals still continue to be endangered. The conservation programme of the Federal government, which also comprises a system of large, interconnected biotopes on 10% of Germany's total surface, is approved, and the potential contribution of sustainable agricultural and forestry policy is discussed in a separate chapter. Further subjects discussed are recycling and waste management, protection of water and soil, air pollution abatement, health protection and genetic engineering. The environmental aspects of Eastern European states becoming EC members are gone into in particular. The network of Europen Environmental Councils, for which the German Council of Environmental Experts currently acts as a coordinator, makes intensive efforts to improve environmental counselling in these states [de

Quantitative and qualitative analysis of the expert and non-expert opinion in fire risk in buildings

International Nuclear Information System (INIS)

Hanea, D.M.; Jagtman, H.M.; Alphen, L.L.M.M. van; Ale, B.J.M.

2010-01-01

Expert judgment procedure is a method very often used in the area of risk assessments of complex systems or processes to fill in quantitative data. Although it has been proved to be a very reliable source of information when no other data are available, the choice of experts is always questioned. When the available data are limited, the seed questions cover only partially the domains of expertise, which may cause problems. Expertise is assessed not covering the full object of study but only those topics for which seed questions can be formulated. The commonly used quantitative analysis of an expert judgment exercise is combined with a qualitative analysis. The latter adds more insights to the relation between the assessor's field and statistical knowledge and their performance in an expert judgment. In addition the qualitative analysis identifies different types of seed questions. Three groups of assessors with different levels of statistical and domain knowledge are studied. The quantitative analysis shows no differences between field experts and non-experts and no differences between having advanced statistical knowledge or not. The qualitative analysis supports these findings. In addition it is found that especially technical questions are answered with larger intervals. Precaution is required when using seed questions for which the real value can be calculated, which was the case for one of the seed questions.

Perception of risks by opinion leaders 2011

International Nuclear Information System (INIS)

2011-01-01

The authors report a survey made just after the Fukushima accident on a panel of opinion leaders (belonging to political, economical or media sector) in order to compare their perception of risks with that of the public. The questions addressed the perception of risks, the role of scientific experts, the usefulness and breaks on the diffusion of expertise results, the perception of pluralist bodies, and the Fukushima accident. The answers are analysed and discussed with respect to fifteen hazardous situations, to their opinion of expertise, and to their opinion on safety audit and information

Specific aspects of radiotherapy of malignant tumors in childhood

International Nuclear Information System (INIS)

Bek, V.; Abrahamova, J.

1987-01-01

Based on the experience with radiotherapy of malignant tumors in 1839 children treated at the Oncological Clinic in Prague from 1946 to 1985, the conclusion is arrived at that some specific aspects of radiotherapy of tumors in children, such as kinetics and biological features are so important that it can be considered a special sub-discipline of clinical radiotherapy. An opinion is expressed about the application of irradiation in non-malignant affections in children. (author). 2 figs., 4 tabs., 25 refs

Precision in Setting Cancer Prevention Priorities: Synthesis of Data, Literature, and Expert Opinion.

Science.gov (United States)

Girschik, Jennifer; Miller, Laura Jean; Addiscott, Tony; Daube, Mike; Katris, Paul; Ransom, David; Slevin, Terry; Threlfall, Tim; Weeramanthri, Tarun Stephen

2017-01-01

Cancer will continue to be a leading cause of ill health and death unless we can capitalize on the potential for 30-40% of these cancers to be prevented. In this light, cancer prevention represents an enormous opportunity for public health, potentially saving much of the pain, anguish, and cost associated with treating cancer. However, there is a challenge for governments, and the wider community, in prioritizing cancer prevention activities, especially given increasing financial constraints. This paper describes a method for identifying cancer prevention priorities. This method synthesizes detailed cancer statistics, expert opinion, and the published literature for the priority setting process. The process contains four steps: assessing the impact of cancer types; identifying cancers with the greatest impact; considering opportunities for prevention; and combining information on impact and preventability. The strength of our approach is that it is straightforward, transparent and reproducible for other settings. Applying this method in Western Australia produced a priority list of seven adult cancers which were identified as having not only the biggest impact on the community but also the best opportunities for prevention. Work conducted in an additional project phase went on to present data on these priority cancers to a public consultation and develop an agenda for action in cancer prevention.

From expert witness to defendant: abolition of expert witness protection and its implications.

Science.gov (United States)

Mendelson, Danuta

2012-12-01

In Jones v Kaney [2011] 2 AC 398, the United Kingdom Supreme Court held that in England and Wales (but not in Scotland), clients can sue expert witnesses in negligence and/or contract for work performed under their retainer, whether in civil or criminal trials. The duties of expert witnesses in England are regulated by the Civil Procedure Rules and Protocols; the former also regulate the conduct of cases involving expert opinions. The legal context that led to the litigation is examined in the light of these rules, in particular, the nature of the allegations against Dr Kaney, a psychologist retained to provide psychiatric opinion. Jones v Kaney, as a decision of the United Kingdom Supreme Court, is not a binding precedent in Australia. However, unlike statutory enactments, common law judgments are retrospective in their operation, which means that health care practitioners who follow a generally accepted practice today may still be sued for damages by their patients or clients in the future. By definition, the future, including the refusal by the Australian High Court to follow Kaney's abolition of expert witnesses' immunity from suit for breach of duty to their clients, cannot be predicted with certainty. Consequently, health care practitioners in Australia and other countries should be aware of the case, its jurisprudential and practical ramifications.

Intensity-modulated conformal radiotherapy in the anal canal cancer. Report of technological assessment. Updating of the 2006 report

International Nuclear Information System (INIS)

2015-07-01

As intensity-modulated conformal radiotherapy (IMCR) has already been technologically assessed in 2006 with a positive opinion for some treatments and a negative one for others, and as this technique displays some interesting properties for the treatment of pelvic cancers (optimisation of dose distribution, preservation of sane tissues, reduction of secondary effects during irradiation), this report proposes an assessment of clinical safety and efficiency of IMCR in the treatment of an anal canal cancer. After a discussion of generalities, of histological and epidemiological data, and of knowledge regarding treatment and follow-up of this cancer, the report presents the IMCR technique, some regulatory aspects, and its applications to the considered cancer. The methodology adopted for this assessment is then presented. Based on various studies and clinical results, the IMCR clinical safety and efficiency in the treatment of the anal canal cancer are discussed and assessed. Recommendations produced by different medical professional bodies are reported. Opinion of experts and a synthesis of stakeholders are then proposed

29 CFR 18.701 - Opinion testimony by lay witnesses.

Science.gov (United States)

2010-07-01

... 29 Labor 1 2010-07-01 2010-07-01 true Opinion testimony by lay witnesses. 18.701 Section 18.701 Labor Office of the Secretary of Labor RULES OF PRACTICE AND PROCEDURE FOR ADMINISTRATIVE HEARINGS... Opinion testimony by lay witnesses. If the witness is not testifying as an expert, the witness' testimony...

Environment and health. Realistic risk assessment. Special expert opinion; Umwelt und Gesundheit. Risiken richtig einschaetzen. Sondergutachten

Energy Technology Data Exchange (ETDEWEB)

NONE

1999-12-01

In this special expert opinion, the Environmental Council discusses the problem of how to assess the risk of environment-induced health hazards. In many cases, there is a discrepancy between scientific risk assessment and subjective risk perception of the exposed population in this context. The Environmental Council suggests that communication between all parties concerned should be improved by target-finding models and also proposes an integrative risk assessment procedure. It is particularly important to identify and characterize vulnerable groups by scientific methods. [German] In seinem Sondergutachten Umwelt und Gesundheit - Risiken richtig einschaetzen greift der Umweltrat die Problematik von Risikoabschaetzungen umweltbedingter Gesundheitsbeeintraechtigungen auf. In diesem Zusammenhang ist vielfach eine Diskrepanz zwischen wissenschaftlicher Risikoabschaetzung und der subjektiven Risikowahrnehmung seitens der Betroffenen festzustellen. Der Umweltrat verweist zur Verbesserung der Kommunikation zwischen den beteiligten Gruppen auf entsprechende Modelle zur Zielfindung und schlaegt einen integrativen Ansatz zur Risikobewertung vor. Von besonderer Bedeutung bei der Bewertung von umweltbedingten Gesundheitsbeeintraechtigungen ist die wissenschaftlich begruendete Identifizierung und Charakterisierung von empfindlichen Gruppen (vulnerablen Gruppen). (orig.)

Assimilation of public opinions in nuclear decision-making using risk perception

International Nuclear Information System (INIS)

Sohn, K.Y.; Yang, J.W.; Kang, C.S.

2001-01-01

A method of assimilating public opinions in the decision-making process has been developed in this study. The proposed method will resolve the major shortcomings of existing decision-making models, which are deficient in, or missing public participation during the process. In the nuclear-related decision-making process, a particular concern of the public is nuclear safety, which is numerically characterized by risk. In reality, it is the risk that each individual perceives that is very important. Hence, the public perception of risk has been employed as a key decision-making element in representing public opinions. To quantify the public perception of risk, the psychometric model is used. Psychological risk dimensions are first assessed using factor analysis and a set of factors is identified for optimized computation. Expert opinions formulated by a group of selected professionals and experts are then aggregated with the public opinions. To gather public and expert opinions, separate polls were conducted in this study. In the aggregation, the analytic hierarchy process (AHP) and multi-attribute utility analysis (MAUA) were employed, and for uncertainty analysis, a fuzzy set based approach was adopted. This method has been applied to analyze six options for spent fuel management in Korea for a case study. As expected, the results of the case study show that public risk perception is an important element in nuclear-related decision-making processes

Expert Opinions on Nutrition Issues in Clinical Dentistry.

Science.gov (United States)

Palmer, Carole A.; And Others

1990-01-01

A survey of 79 experts in dental nutrition sought consensus on the appropriate scope of nutrition in clinical dentistry. Results support the need for greater attention to nutrition issues in dental schools and better models for nutrition interventions in dental practice. (Author/MSE)

The radiotherapy affects the cognitive processes

International Nuclear Information System (INIS)

Anon.

2009-01-01

Researchers from the medical center of the free university of Amsterdam report that the radiotherapy can hinder the cognitive functions of patients affected by cerebral tumors treated after a surgery. Even low dose radiation could contribute in their opinion, to the progressive cognitive decline of patients suffering of low grade gliomas, the most commune cerebral tumor. To get these conclusions, 65 patients, whom half of them received a radiotherapy, had a neurological and psychological evaluation twelve years after their treatment. Results: 53% of patients treated by radiotherapy present disorders of attention, memory, execution and speed of information treatment against 27% of these ones that received an only surgery. The researchers conclude to the necessity to take into account this risk in the choice of treatment, or even to avoid radiotherapy in this precise case. (N.C.)

Medicine authentication technology as a counterfeit medicine-detection tool: a Delphi method study to establish expert opinion on manual medicine authentication technology in secondary care.

Science.gov (United States)

Naughton, Bernard; Roberts, Lindsey; Dopson, Sue; Brindley, David; Chapman, Stephen

2017-05-06

This study aims to establish expert opinion and potential improvements for the Falsified Medicines Directive mandated medicines authentication technology. A two-round Delphi method study using an online questionnaire. Large National Health Service (NHS) foundation trust teaching hospital. Secondary care pharmacists and accredited checking technicians. Seven-point rating scale answers which reached a consensus of 70-80% with a standard deviation (SD) of <1.0. Likert scale questions which reached a consensus of 70-80%, a SD of <1.0 and classified as important according to study criteria. Consensus expert opinion has described database cross-checking technology as quick and user friendly and suggested the inclusion of an audio signal to further support the detection of counterfeit medicines in secondary care (70% consensus, 0.9 SD); other important consensus with a SD of <1.0 included reviewing the colour and information in warning pop up screens to ensure they were not mistaken for the 'already dispensed here' pop up, encouraging the dispenser/checker to act on the warnings and making it mandatory to complete an 'action taken' documentation process to improve the quarantine of potentially counterfeit, expired or recalled medicines. This paper informs key opinion leaders and decision makers as to the positives and negatives of medicines authentication technology from an operator's perspective and suggests the adjustments which may be required to improve operator compliance and the detection of counterfeit medicines in the secondary care sector. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Hip arthroscopy protocol: expert opinions on post-operative weight bearing and return to sports guidelines.

Science.gov (United States)

Rath, Ehud; Sharfman, Zachary T; Paret, Matan; Amar, Eyal; Drexler, Michael; Bonin, Nicolas

2017-01-01

The objectives of this study are to survey the weight-bearing limitation practices and delay for returning to running and impact sports of high volume hip arthroscopy orthopedic surgeons. The study was designed in the form of expert survey questionnaire. Evidence-based data are scares regarding hip arthroscopy post-operative weight-bearing protocols. An international cross-sectional anonymous Internet survey of 26 high-volume hip arthroscopy specialized surgeons was conducted to report their weight-bearing limitations and rehabilitation protocols after various arthroscopic hip procedures. The International Society of Hip Arthroscopy invited this study. The results were examined in the context of supporting literature to inform the studies suggestions. Four surgeons always allow immediate weight bearing and five never offer immediate weight bearing. Seventeen surgeons provide weight bearing depending on the procedures performed: 17 surgeons allowed immediate weight bearing after labral resection, 10 after labral repair and 8 after labral reconstruction. Sixteen surgeons allow immediate weight bearing after psoas tenotomy. Twenty-one respondents restrict weight bearing after microfracture procedures for 3-8 weeks post-operatively. Return to running and impact sports were shorter for labral procedures and bony procedures and longer for cartilaginous and capsular procedures. Marked variability exists in the post-operative weight-bearing practices of hip arthroscopy surgeons. This study suggests that most surgeons allow immediate weight bearing as tolerated after labral resection, acetabular osteoplasty, chondroplasty and psoas tenotomy. For cartilage defect procedures, 6 weeks or more non-weight bearing is suggested depending on the area of the defect and lateral central edge angle. Delayed return to sports activities is suggested after microfracture procedures. The level of evidence was Level V expert opinions.

School Construction Management: Expert Administrators Speak.

Science.gov (United States)

Fickes, Michael

2001-01-01

Presents expert opinion on school construction management communication concerning educational needs, obtaining consensus among diverse groups, and envisioning what schools must offer in the future. Why furniture issues are also important is highlighted. (GR)

Design and Shielding of Radiotherapy Treatment Facilities; IPEM Report 75, 2nd Edition

Science.gov (United States)

Horton, Patrick; Eaton, David

2017-07-01

Design and Shielding of Radiotherapy Treatment Facilities provides readers with a single point of reference for protection advice to the construction and modification of radiotherapy facilities. The book assembles a faculty of national and international experts on all modalities including megavoltage and kilovoltage photons, brachytherapy and high-energy particles, and on conventional and Monte Carlo shielding calculations. This book is a comprehensive reference for qualified experts and radiation-shielding designers in radiation physics and also useful to anyone involved in the design of radiotherapy facilities.

The effect of popular exemplars and expert account base-rate information on perceived public opinion

NARCIS (Netherlands)

Lefevere, J.; Walgrave, S.; de Swert, K.

2012-01-01

How people perceive public opinion is important because it affects their willingness to express themselves. This paper investigates whether two different portrayals of public opinion in the TV news affect people’s perception of public opinion. We use an experimental design in which roughly one

Scratching the surface of tomorrow's diagnostics: the Editor-in-Chief's opinion at the 15th year of Expert Review of Molecular Diagnostics.

Science.gov (United States)

Lorincz, Attila; Raison, Claire

2015-01-01

Interview with Attila Lorincz by Claire Raison (Commissioning Editor) To mark the beginning of the 15th year of Expert Review of Molecular Diagnostics, the journal's Editor-in-Chief shares his expert knowledge on translational diagnostics, his opinion on recent controversies and his predictions for molecular diagnostics in 2015 and beyond. Attila Lorincz received his doctorate from Trinity College, Dublin, Republic of Ireland, and went on to become a research fellow at the University of California, Santa Barbara, CA, USA. During Professor Lorincz's research on human papillomavirus (HPV), he found several important and novel carcinogenic HPV types and pioneered the use of HPV DNA testing for clinical diagnostics. In 1988, Professor Lorincz's team produced the first HPV test to be FDA-approved for patients and in 2003, for general population cervical precancer screening. Now Professor of Molecular Epidemiology at the Centre for Cancer Prevention, Queen Mary University of London, UK, he and his team are furthering translational research into DNA methylation assays for cancer risk prediction.

[Medical data security in medico-legal opinioning].

Science.gov (United States)

Susło, Robert; Swiatek, Barbara

2005-01-01

Medical data security can be approached in medico-legal opinioning in three main situations: security of medical data, on which the opinion should be based, opinioning itself and whether the medical data security was properly ensured and ensuring medical data security during medico-legal opinion giving. The importance of medical data security, during collecting, processing and storing, as well in medical as in legal institutions, is of major importance for the possibility of providing a proper medico-legal opinion. Theoretically speeking, it is possible to give a proper medico-legal opinion using incorrect data, but the possibility is low. When the expert is given improper, unreadable, incomplete or even bogus in part or in the whole medical data it is extremely possible, that he fails in giving his opinion. The term "medical data" was defined and subsequently there was a brief review of medical data storing methods made and specific threats bound with them, based on modern literature. The authors also pointed out possible methods of preventing the threats. They listed Polish as well as international regulations and laws concerning the problem, accenting the importance of preserving medical data for the purposes of medico-legal opinioning.

Experts' Views Regarding the Conceptualization of Narcissism.

Science.gov (United States)

Ackerman, Robert A; Hands, Aaron J; Donnellan, M Brent; Hopwood, Christopher J; Witt, Edward A

2017-06-01

There is debate over the definition of narcissism across social/personality and clinical psychology. The current article aims to quantify the level of disagreement by measuring experts' opinions concerning the attributes most central to narcissism. Accordingly, we developed a comprehensive list of attributes associated with narcissism and had 49 self-identified experts (among them 17 women, 23 psychologists from clinical psychology and 22 from social/personality psychology) rate these characteristics and provide their opinions on several issues related to the conceptualization of narcissism. Experts generally believe that the grandiose features of narcissism are more central than the vulnerable features. However, differences between clinical and social/personality psychologists were evident, especially regarding the relevance of self-esteem. Given the results, we suggest that researchers specify the kind of narcissism being assessed in a given study and consider using assessments of the full range of narcissistic features in future research to provide a more comprehensive perspective on the construct.

Probability encoding of hydrologic parameters for basalt. Elicitation of expert opinions from a panel of three basalt waste isolation project staff hydrologists

International Nuclear Information System (INIS)

Runchal, A.K.; Merkhofer, M.W.; Olmsted, E.; Davis, J.D.

1984-11-01

The present study implemented a probability encoding method to estimate the probability distributions of selected hydrologic variables for the Cohassett basalt flow top and flow interior, and the anisotropy ratio of the interior of the Cohassett basalt flow beneath the Hanford Site. Site-speciic data for these hydrologic parameters are currently inadequate for the purpose of preliminary assessment of candidate repository performance. However, this information is required to complete preliminary performance assessment studies. Rockwell chose a probability encoding method developed by SRI International to generate credible and auditable estimates of the probability distributions of effective porosity and hydraulic conductivity anisotropy. The results indicate significant differences of opinion among the experts. This was especially true of the values of the effective porosity of the Cohassett basalt flow interior for which estimates differ by more than five orders of magnitude. The experts are in greater agreement about the values of effective porosity of the Cohassett basalt flow top; their estimates for this variable are generally within one to two orders of magnitiude of each other. For anisotropy ratio, the expert estimates are generally within two or three orders of magnitude of each other. Based on this study, the Rockwell hydrologists estimate the effective porosity of the Cohassett basalt flow top to be generally higher than do the independent experts. For the effective porosity of the Cohassett basalt flow top, the estimates of the Rockwell hydrologists indicate a smaller uncertainty than do the estimates of the independent experts. On the other hand, for the effective porosity and anisotropy ratio of the Cohassett basalt flow interior, the estimates of the Rockwell hydrologists indicate a larger uncertainty than do the estimates of the independent experts

[Professionalization of Legal Dental Experts in Germany: Results of Studies on Structured Focus Groups].

Science.gov (United States)

Brauer, H U; Walther, W; Dick, M

2018-04-01

Legal expert opinions are a crucial instrument of professional self-control in medicine. To give impulses for further development, focus groups were initiated to reflect upon the perspective of legal dental experts. 5 focus group discussions on the topic "Professionalization of legal dental experts" were conducted. A total of 32 experienced legal dental experts participated in the discussions. The results were evaluated by qualitative content analysis. A catalogue of 68 ideas was generated for improvement and divided into 15 categories. Among these were periodic quality circles, interprofessional exchange, supervision of novices and periodic feedback for legal dental experts and dentists. Self-reflection can be included as an instrument for quality improvement of legal dental expert opinions. © Georg Thieme Verlag KG Stuttgart · New York.

Bayesian network models for error detection in radiotherapy plans

International Nuclear Information System (INIS)

Kalet, Alan M; Ford, Eric C; Phillips, Mark H; Gennari, John H

2015-01-01

The purpose of this study is to design and develop a probabilistic network for detecting errors in radiotherapy plans for use at the time of initial plan verification. Our group has initiated a multi-pronged approach to reduce these errors. We report on our development of Bayesian models of radiotherapy plans. Bayesian networks consist of joint probability distributions that define the probability of one event, given some set of other known information. Using the networks, we find the probability of obtaining certain radiotherapy parameters, given a set of initial clinical information. A low probability in a propagated network then corresponds to potential errors to be flagged for investigation. To build our networks we first interviewed medical physicists and other domain experts to identify the relevant radiotherapy concepts and their associated interdependencies and to construct a network topology. Next, to populate the network’s conditional probability tables, we used the Hugin Expert software to learn parameter distributions from a subset of de-identified data derived from a radiation oncology based clinical information database system. These data represent 4990 unique prescription cases over a 5 year period. Under test case scenarios with approximately 1.5% introduced error rates, network performance produced areas under the ROC curve of 0.88, 0.98, and 0.89 for the lung, brain and female breast cancer error detection networks, respectively. Comparison of the brain network to human experts performance (AUC of 0.90 ± 0.01) shows the Bayes network model performs better than domain experts under the same test conditions. Our results demonstrate the feasibility and effectiveness of comprehensive probabilistic models as part of decision support systems for improved detection of errors in initial radiotherapy plan verification procedures. (paper)

Lay Evaluation of Financial Experts: The Action Advice Effect and Confirmation Bias.

Science.gov (United States)

Zaleskiewicz, Tomasz; Gasiorowska, Agata; Stasiuk, Katarzyna; Maksymiuk, Renata; Bar-Tal, Yoram

2016-01-01

The goal of this experimental project was to investigate lay peoples' perceptions of epistemic authority (EA) in the field of finance. EA is defined as the extent to which a source of information is treated as evidence for judgments independently of its objective expertise and based on subjective beliefs. Previous research suggested that EA evaluations are biased and that lay people tend to ascribe higher EA to experts who advise action (in the case of medical experts) or confirm clients' expectations (in the case of politicians). However, there has been no research into biases in lay evaluations of financial experts and this project is aimed to fill this gap. Experiment 1 showed that lay people tended to ascribe greater authority to financial consultants who gave more active advice to clients considering taking out a mortgage. Experiment 2 confirmed the action advice effect found in Experiment 1. However, the outcomes of Experiments 2 and - particularly - 3 suggested that this bias might also be due to clients' desire to confirm their own opinions. Experiment 2 showed that the action advice effect was moderated by clients' own opinions on taking loans. Lay people ascribed the greatest EA to the advisor in the scenario in which he advised taking action and where this coincided with the client's positive opinion on the advisability of taking out a loan. In Experiment 3 only participants with a positive opinion on the financial product ascribed greater authority to experts who recommended it; participants whose opinion was negative tended to rate consultants who advised rejecting the product more highly. To conclude, these three experiments revealed that lay people ascribe higher EA to financial consultants who advise action rather than maintenance of the status quo , but this effect is limited by confirmation bias: when the client's a priori opinion is salient, greater authority is ascribed to experts whose advice confirms it. In this sense, results presented in the

Evidence - based pharmacological treatment of atopic dermatitis: An expert opinion and new expectations

Directory of Open Access Journals (Sweden)

Arnold P Oranje

2014-01-01

Full Text Available Atopic dermatitis (AD is one of the most common skin diseases with a complex multifactorial background. The clinical presentation, the aggravating factors and the complications vary according to the age of the patients. Most cases, approximately 60-80%, present for the 1 st time before the age of 12 months. Adult-onset AD has been observed as a special variant. Pruritus is the worst sign of AD, which also often indicates an exacerbation and is considered to be the most annoying symptom of AD. Treatment is preferably started based on the severity of AD. In only 10% of the cases, AD is so severe that systemic treatment is necessary. Systemic treatment including topical wet-wrap treatment is indicated in the worst and recalcitrant cases of AD. Systemic treatment of AD is discussed with regards to the evidence-based efficacy and safety aspects. I prefer wet-wraps as a crisis intervention in severe childhood cases, whereas UV and systemic treatments are the choices in patients older than 10 years. Probiotics are not useful in the treatment. If they have any effect at all it may only be in food-allergic children with AD. Finally, anti-histamines are not effective against pruritus in AD. They are only effective against urticarial flares and in cases with food-allergy. This article consists of an expert opinion on evidence-based pharmacological treatment of AD, but it is not a systemic review.

The place of conformal radiotherapy in the routine work: national investigation of SFRO members'opinion

International Nuclear Information System (INIS)

Lagrange, J.L.; Lipinski, F.

2001-01-01

National French investigation of the using of conformal radiotherapy in routine work, has been made in 2001, in 180 radiotherapeutic centers. Eighty responses have been obtained and analyzed. Conformal radiotherapy is used in 88% and virtual simulation in 60% of these centers. There is a heterogeneity in the equipment of these institutions, most of them have one or two machines. The accelerator equipment differs, and the availability of multi-leaf collimators and electronic portal imaging is limited. Actually only eleven centers have IMRT, eight have projects to install. Only six centers have CT-scans, used mainly for simulation. In 75% of centers conformal radiotherapy have been used in the treatment of CNS-tumors, head and neck cancers, prostate, and non-small cell lung carcinoma. If there are more equipment and human facilities to use conformal radiotherapy, this treatment can be proposed to patients with breast cancer, rectal and gynecological tumors. According 90% of responses, all prostatic cancers need conformal radiotherapy. The analysis of routine use of conformal radiotherapy in France shows an important heterogeneity but it seems that there is an agreement with objectives of this treatment. (authors)

Investigation of anxiety about radiotherapy and development of the Categorical Anxiety Scale about Radiotherapy

International Nuclear Information System (INIS)

Shimotsu, Sakie; Karasawa, Kumiko; Ito, Kana; Saito, Anne-yuko I; Kawase, Eri; Imasato, Sakae; Matsuki, Hideyuki; Horikawa, Naoshi

2006-01-01

There are many patients with anxiety for radiotherapy though it is one of most important treatments for cancer, to which attention has not been fully paid. Authors investigated this anxiety to classify and quantitatively evaluate the problems. Firstly they asked 48 patients with various cancers about the concrete anxiety items related with radiotherapy, and the items were examined by the expert doctor of consultation-liaison psychiatry and of radiology to make up questions of 25 items about radiotherapy. Then those questions together with Hospital Anxiety and Depression Scale (HAD) were asked to in-(52 subjects) and out-(133) patients (106 males and 79 females of the mean age 62.58 years) to classify anxiety and to see the reliability and validity of items included. Factor analysis of the results revealed that three kinds of anxiety, i.e., adverse effects of radiation, environments at irradiation and effect of radiotherapy, were significant. Based on this, authors arranged the Categorical Anxiety Scale about Radiotherapy composed from 17 items, of which reliability and validity in contents and in parallelism with HAD had been assured. (T.I.)

Factors influencing continuing professional development : A Delphi study among nursing experts

NARCIS (Netherlands)

Brekelmans, G.B.; Poell, R.F.; van Wijk, K.

2013-01-01

Purpose The aim of this paper is to present an inventory of expert opinions on the factors that influence the participation of registered nurses in continuing professional development (CPD) activities. Design/methodology/approach A Delphi study was conducted among 38 Dutch experts (nursing

Effects of CO{sub 2} sanitation program for buildings 2008. Expert opinion; Effekte des CO{sub 2}-Gebaeudesanierungsprogramms 2008. Gutachten

Energy Technology Data Exchange (ETDEWEB)

Clausnitzer, Klaus-Dieter; Gabriel, Juergen; Eilmes, Sabine [Bremer Energie-Institut, Bremen (Germany); Diefenbach, Nikolaus; Loga, Tobias [Institut Wohnen und Umwelt GmbH, Darmstadt (Germany); Wosniok, Werner [Bremen Univ. (Germany). Inst. fuer Statistik

2008-07-01

The climate protection, the securing of the power supply as well as the enabling of payable energy costs belong to the central tasks to the policy. In the year 2006, the working group consisting of the Bremen Energie Institute (Bremen, Federal Republic of Energy), Institute Wohnen und Umwelt GmbH (Darmstadt, Federal Republic of Germany) and the Institute for Statistics of the University of Bremen (Bremen, Federal Republic of Germany) was ordered to develop a model for the estimation of the positive effects of the CO{sub 2} sanitation program for buildings according to the reduction of CO{sub 2}, conservation of final energy, employment, progress in modernization and saving of heating cost. In the expert opinion under consideration, the influences are stated for the case of loan and grant for the year 2008.

Concept of expert system for modal split in transportation planning

Directory of Open Access Journals (Sweden)

Popović Maja M.

2006-01-01

Full Text Available The objective of this paper is to develop a concept of expert system based on the survey of experts' opinions and their experience concerning relations in modal split, on the basis of parameters of transport system demand and transport supply, defined through PT travel time and city size, i.e. mean trip length. This expert system could be of use both to experts and less experienced planners who could apply the knowledge contained in this expert system for further improvement, on operational as well as on strategic level.

The use of expert opinion for estimation of component unavailability

International Nuclear Information System (INIS)

Jordan Cizelj, R.; Kljenak, I.

1998-01-01

When evaluating system safety with Probabilistic Safety Assessment (PSA), data of component reliability are necessary input data. Despite a significant effort which has been devoted to the collection and processing of reliability data during the last ten years, the quality of data available is still not satisfactory. In the present paper, a method for a suitable failure rate estimation with the help of expert judgement of maintenance people is proposed. Expert judgement about component state is combined with information gathered from a classical reliability database. With the proposed method, generic data are adapted to specific components with combination of probability and fuzzy logic theory.(author)

MERS-CoV at the Animal-Human interface: inputs on exposure pathways from an Expert-Opinion elicitation

Directory of Open Access Journals (Sweden)

Anna Funk

2016-10-01

Full Text Available Nearly four years after the first report of the emergence of Middle-East respiratory syndrome Coronavirus (MERS-CoV and nearly 1800 human cases later, the ecology of MERS-CoV, its epidemiology, and risk factors of MERS-CoV transmission between camels are poorly understood. Knowledge about the pathways and mechanisms of transmission from animals to humans is limited; as of yet, transmission risks have not been quantified. Moreover the divergent sanitary situations and exposures to animals among populations in the Arabian Peninsula, where human primary cases appear to dominate, vs. other regions in the Middle East and Africa, with no reported human clinical cases and where the virus has been detected only in dromedaries, represents huge scientific and health challenges. Here, we have used expert opinion elicitation in order to obtain ideas on relative importance of MERS-CoV risk factors and estimates of transmission risks from various types of contact between humans and dromedaries. Fourteen (14 experts with diverse and extensive experience in MERS-CoV relevant fields were enrolled and completed an online questionnaire that examined pathways based on several scenarios e.g. camels-camels, camels-human, bats/other species to camels/humans and the role of diverse biological substances (milk, urine etc. and potential fomites.Experts believed that dromedary camels play the largest role in MERS-CoV infection of other dromedaries; however, they also indicated a significant influence of the season (i.e. calving or weaning periods on transmission risk. All experts thought that MERS-CoV infected dromedaries and asymptomatic humans play the most important role in infection of humans, with bats and other species presenting a possible, but yet undefined, risk. Direct and indirect contact of humans with dromedary camels were identified as the most risky types of contact, when compared to consumption of various camel products, with estimated 'most

In search of an integral conceptual definition of frailty: opinions of experts.

Science.gov (United States)

Gobbens, Robbert J J; Luijkx, Katrien G; Wijnen-Sponselee, Maria Th; Schols, Jos M G A

2010-06-01

There are many different conceptual definitions of frailty in circulation. Most of these definitions focus mainly on physical problems affecting older people. Only a few also draw attention to other domains of human functioning such as the psychological domain. The authors of this article fear that this could lead to fragmentation of care for frail older people. The aim is to develop an integral conceptual definition of frailty that starts from the premise of a holistic view of the person. To achieve this, a literature search was carried out. Thereafter a group of experts (N=20) were consulted, both verbally during 2 expert meetings and via a written questionnaire. These experts were asked which existing conceptual definition of frailty places most stress on the integral functioning of older people. The experts expressed a clear preference for one of the conceptual definitions. The result of the literature search and the consultation with the experts led to a new integral conceptual definition of frailty. The conceptual definition is intended to offer a framework for an operational definition of frailty for identifying frail older people. Copyright 2010 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.

Lay Evaluation of Financial Experts: The Action Advice Effect and Confirmation Bias

Directory of Open Access Journals (Sweden)

Tomasz Zaleskiewicz

2016-09-01

Full Text Available The goal of this experimental project was to investigate lay peoples’ perceptions of epistemic authority (EA in the field of finance. EA is defined as the extent to which a source of information is treated as evidence for judgments independently of its objective expertise and based on subjective beliefs. Previous research suggested that EA evaluations are biased and that lay people tend to ascribe higher EA to experts who advise action (in the case of medical experts or confirm clients’ expectations (in the case of politicians. However, there has been no research into biases in lay evaluations of financial experts and this project is aimed to fill this gap. Experiment 1 showed that lay people tended to ascribe greater authority to financial consultants who gave more active advice to clients considering taking out a mortgage. Experiment 2 confirmed the action advice effect found in Experiment 1. However, the outcomes of Experiments 2 and – particularly – 3 suggested that this bias might also be due to clients’ desire to confirm their own opinions. Experiment 2 showed that the action advice effect was moderated by clients’ own opinions on taking loans. Lay people ascribed the greatest EA to the advisor in the scenario in which he advised taking action and where this coincided with the client’s positive opinion on the advisability of taking out a loan. In Experiment 3 only participants with a positive opinion on the financial product ascribed greater authority to experts who recommended it; participants whose opinion was negative tended to rate consultants who advised rejecting the product more highly. To conclude, these three experiments revealed that lay people ascribe higher EA to financial consultants who advise action rather than maintenance of the status quo, but this effect is limited by confirmation bias: when the client’s a priori opinion is salient, greater authority is ascribed to experts whose advice confirms it. In this

Challenges of radiotherapy: report on the 4D treatment planning workshop 2013

NARCIS (Netherlands)

Knopf, Antje; Nill, Simeon; Yohannes, Indra; Graeff, Christian; Dowdell, Stephen; Kurz, Christopher; Sonke, Jan-Jakob; Biegun, Aleksandra K; Lang, Stephanie; McClelland, Jamie R.; Champion, Benjamin; Fast, Martin; Wölfelschneider, Jens; Gianoli, Chiara; Rucinski, Antoni; Baroni, Guido; Richter, Christian; van de Water, Steven; Grassberger, Clemens; Weber, Damien; Poulsen, Per; Shimizu, Shinichi; Bert, Christoph

2014-01-01

This report, compiled by experts on the treatment of mobile targets with advanced radiotherapy, summarizes the main conclusions and innovations achieved during the 4D treatment planning workshop 2013. This annual workshop focuses on research aiming to advance 4D radiotherapy treatments, including

Expert opinion on risks to the long-term viability of residential recycled water schemes: An Australian study.

Science.gov (United States)

West, Camilla; Kenway, Steven; Hassall, Maureen; Yuan, Zhiguo

2017-09-01

The water sector needs to make efficient and prudent investment decisions by carefully considering the long-term viability of water infrastructure projects. To support the assessment and planning of residential recycled water schemes in Australia, we have sought to clarify scheme objectives and to further define the array of critical risks that can impact the long-term viability of schemes. Building on historical information, we conducted a national survey which elicited responses from 88 Australian expert practitioners, of which 64% have over 10 years of industry experience and 42% have experience with more than five residential recycled water schemes. On the basis of expert opinion, residential recycled water schemes are considered to be highly relevant for diversifying and improving water supply security, reducing wastewater effluent discharge and pollutant load to waterways and contributing to sustainable urban development. At present however, the inability to demonstrate an incontestable business case is posing a significant risk to the long-term viability of residential recycled water schemes. Political, regulatory, organisational and financial factors were also rated as critical risks, in addition to community risk perception and fall in demand. The survey results shed further light on the regulatory environment of residential recycled water schemes, with regulatory participants rating the level and impact of risk factors higher than other survey participants in most cases. The research outcomes provide a comprehensive understanding of the critical risks to the long-term viability of residential recycled water schemes, thereby enabling the specification of targeted risk management measures at the assessment and planning stage of a scheme. Copyright © 2017 Elsevier Ltd. All rights reserved.

Nuclear expert web mining system: monitoring and analysis of nuclear acceptance by information retrieval and opinion extraction on the Internet

Energy Technology Data Exchange (ETDEWEB)

Reis, Thiago; Barroso, Antonio C.O.; Imakuma, Kengo, E-mail: thiagoreis@usp.b, E-mail: barroso@ipen.b, E-mail: kimakuma@ipen.b [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

2011-07-01

This paper presents a research initiative that aims to collect nuclear related information and to analyze opinionated texts by mining the hypertextual data environment and social networks web sites on the Internet. Different from previous approaches that employed traditional statistical techniques, it is being proposed a novel Web Mining approach, built using the concept of Expert Systems, for massive and autonomous data collection and analysis. The initial step has been accomplished, resulting in a framework design that is able to gradually encompass a set of evolving techniques, methods, and theories in such a way that this work will build a platform upon which new researches can be performed more easily by just substituting modules or plugging in new ones. Upon completion it is expected that this research will contribute to the understanding of the population views on nuclear technology and its acceptance. (author)

Nuclear expert web mining system: monitoring and analysis of nuclear acceptance by information retrieval and opinion extraction on the Internet

International Nuclear Information System (INIS)

Reis, Thiago; Barroso, Antonio C.O.; Imakuma, Kengo

2011-01-01

This paper presents a research initiative that aims to collect nuclear related information and to analyze opinionated texts by mining the hypertextual data environment and social networks web sites on the Internet. Different from previous approaches that employed traditional statistical techniques, it is being proposed a novel Web Mining approach, built using the concept of Expert Systems, for massive and autonomous data collection and analysis. The initial step has been accomplished, resulting in a framework design that is able to gradually encompass a set of evolving techniques, methods, and theories in such a way that this work will build a platform upon which new researches can be performed more easily by just substituting modules or plugging in new ones. Upon completion it is expected that this research will contribute to the understanding of the population views on nuclear technology and its acceptance. (author)

Development of an Index for the Assessment of Welfare of Finishing Pigs from Farm to Slaughter based on Expert Opinion

DEFF Research Database (Denmark)

Brandt, Pia; Rousing, Tine; Herskin, Mette S

2017-01-01

by aggregating 25 primarily animal-based measurements based on 38 experts opinion on inter-measurement and inter-stage weights. AWIs were calculated on animal level as the weighted sums of prevalence of the measurements, and were calculated for each of the six stages: pick-up pen, loading, transport, unloading......, lairage and race (AWIStage) and across the stages (AWIOverall). The AWIs were tested in 5 farms including a total of 45 fattening pigs delivered to two Danish abattoirs. Possible inter-relations between the AWI and heart rate measurements were examined. For each welfare measurement within stage......, this work has suggested a potential model for the aggregation of animal welfare measurements into animal welfare indexes for slaughter pigs on the day of slaughter. Further validation may allow simple comparison of the level of welfare between lorries, days, abattoirs etc. and may be used for future...

Radiotherapy - an effective treatment for vaginal verrucous carcinoma

International Nuclear Information System (INIS)

Reinecke, L.; Thornley, A.L.

1993-01-01

Vaginal carcinoma makes up 1%-2% of all gynaecological tumours. Verrucous carcinoma of the vagina is even more rare -only 16 cases are reported in the scientific literature. A case of a complete regression after 60 Gy fractionated radiotherapy by a tumour 12 cm 3 in size is reported. Most authors are of the opinion that radiotherapy causes anaplastic transformation of verrucous carcinoma. The minority view, that anaplastic transformation does not occur, is correct and is supported by our clinical and radiological data. The conflicting literature on vaginal verrucous carcinoma (VVC) is reviewed with reference to verrucous carcinoma at other sites. (Author)

Defining Sustainable Universities Following Public Opinion Formation Process

Science.gov (United States)

Zaptcioglu Celikdemir, Deniz; Gunay, Gonca; Katrinli, Alev; Penbek Alpbaz, Sebnem

2017-01-01

Purpose: The purpose of this paper is to define the sustainable university in Turkey, by considering perspectives of various stakeholders such as experts, intellectual, public, political parties and media using public opinion formation analysis. The paper aims to re-define the "sustainable university" with all dimensions including…

Expert Opinion on Three Phage Therapy Related Topics: Bacterial Phage Resistance, Phage Training and Prophages in Bacterial Production Strains

Directory of Open Access Journals (Sweden)

Christine Rohde

2018-04-01

Full Text Available Phage therapy is increasingly put forward as a “new” potential tool in the fight against antibiotic resistant infections. During the “Centennial Celebration of Bacteriophage Research” conference in Tbilisi, Georgia on 26–29 June 2017, an international group of phage researchers committed to elaborate an expert opinion on three contentious phage therapy related issues that are hampering clinical progress in the field of phage therapy. This paper explores and discusses bacterial phage resistance, phage training and the presence of prophages in bacterial production strains while reviewing relevant research findings and experiences. Our purpose is to inform phage therapy stakeholders such as policy makers, officials of the competent authorities for medicines, phage researchers and phage producers, and members of the pharmaceutical industry. This brief also points out potential avenues for future phage therapy research and development as it specifically addresses those overarching questions that currently call for attention whenever phages go into purification processes for application.

[Principles of radiotherapy of non-small cell lung cancer].

Science.gov (United States)

Esik, Olga; Horváth, Akos; Bajcsay, András; Hideghéty, Katalin; Agócs, László; Pikó, Béla; Lengyel, Zsolt; Petrányi, Agota; Pisch, Julianna

2002-01-01

The long-term survival probability for Hungarian lung cancer patients is 10% worse than the best results published in the most highly developed countries (the mean 5-year survival probability in Hungary is 5%, in contrast with the 15% survival probability in the USA). On the basis of the international recommendations and personal experience, an attempt was made to formulate the guidelines for radiotherapy as one of the fundamental non-small cell lung cancer (NSCLC) treatment modalities for national use. An expert panel was set up comprising physicians from 6 radiotherapeutic centers (the National Institute of Oncology / Semmelweis University, Budapest; the Beth Israel Medical Center, New York; the University of Kaposvár; the University of Essen; the University of Debrecen; and the County Hospital of Gyula). Experts in two important medical fields closely related to radiotherapy (surgery and diagnostic imaging) were also engaged in the elaboration of the manuscript. Discussion of the most important principles of the radiotherapy and an overview of the prognostic factors was followed by a critical analysis of the protocols applied in the radiotherapy of Hungarian NSCLC patients during recent decades. The new guidelines suggested for the radiotherapy of NSCLC are presented separately for the postoperative period, marginally resectable tumors, and the aggressive or non-aggressive radiotherapy of inoperable tumors. Detailed accounts are given of the techniques of external irradiation and brachytherapy, and of the acute and late radiation-induced damage of normal tissues. The authors believe that this document may be instrumental in improving the survival index of Hungarian NSCLC patients in the near future.

Radiotherapy of invasive breast cancer: French national guidelines

International Nuclear Information System (INIS)

Besnard, S.; Mazeau-Woynar, V.; Verdoni, L.; Cutuli, B.; Fourquet, A.; Giard, S.; Hennequin, C.; Leblanc-Onfroy, M.

2012-01-01

The French National Cancer Institute (INCa) and Societe francaise de senologie et pathologie mammaire (SFSPM), in collaboration with a multidisciplinary experts group, have published the French national clinical practice guidelines on a selection of 11 currently debated questions regarding the management of invasive breast cancer. Those guidelines are based on a comprehensive analysis of the current published evidence dealing with those issues, secondly reviewed by 100 reviewers. Radiotherapy was concerned by five of the 11 questions: indications for the boost after whole gland irradiation; hypo-fractionated radiotherapy; partial breast irradiation; indications for mammary internal nodes irradiation, and indications of radiotherapy after neo-adjuvant chemotherapy. (authors)

Evaluation of food provision and nutrition support at the London 2012 Olympic Games: the opinion of sports nutrition experts.

Science.gov (United States)

Pelly, Fiona; Meyer, Nanna L; Pearce, Jeni; Burkhart, Sarah J; Burke, Louise M

2014-12-01

The aim of this study was to evaluate the food provision and nutrition support at the London 2012 Olympic (OG) and Paralympic Games (PG) from the perspective of sports nutrition experts attending the event. Participants (n = 15) were asked to complete an online survey and rate on a Likert scale menu qualities, food safety, sustainability practices, nutrition labeling, and provision for cultural needs, dietary regimes and specific situations. Open-ended responses were incorporated to explore expert opinion and areas for improvement. Participants rated their overall experience of the food provision as 7.6 out of 10 (range 5 to 10), with the majority (n = 11) rating it greater than 7. The variety, accessibility, presentation, temperature, and freshness of menu items rated as average to good. A below average rating was received for recovery food and beverages, provision of food for traveling to other venues, taking suitable snacks out of the dining hall and provision of food at other venues. However, the variety and accessibility of choices for Ramadan, and provision of post-competition food were rated highly. A number of comments were received about the lack of gluten free and lower energy/fat items. The inclusion of allergens on nutrition labeling was considered more important than nutrient content. While dietetic review of the menu in advance of the OG and PG is clearly a valuable process that has resulted in improvements in the food supply, there are still areas that need to be addressed that are currently not implemented during the event.

Guide for External Beam Radiotherapy. Procedures 2007

International Nuclear Information System (INIS)

Ardiet, Jean-Michel; Bourhis, Jean; Eschwege, Francois; Gerard, Jean-Pierre; Martin, Philippe; Mazeron, Jean-Jacques; Barillot, Isabelle; Bey, Pierre; Cosset, Jean-Marc; Thomas, Olivier; Bolla, Michel; Bourguignon, Michel; Godet, Jean-Luc; Krembel, David; Valero, Marc; Bara, Christine; Beauvais-March, Helene; Derreumaux, Sylvie; Vidal, Jean-Pierre; Drouard, Jean; Sarrazin, Thierry; Lindecker-Cournil, Valerie; Robin, Sun Hee Lee; Thevenet, Nicolas; Depenweiller, Christian; Le Tallec, Philippe; Ortholan, Cecile; Aimone, Nicole; Baldeschi, Carine; Cantelli, Andree; Estivalet, Stephane; Le Prince, Cyrille; QUERO, Laurent; Costa, Andre; Gerard, Jean-Pierre; Ardiet, Jean-Michel; Bensadoun, Rene-Jean; Bourhis, Jean; Calais, Gilles; Lartigau, Eric; Ginot, Aurelie; Girard, Nicolas; Mornex, Francoise; Bolla, Michel; Chauvet, Bruno; Maingon, Philippe; Martin, Etienne; Azria, David; Gerard, Jean-Pierre; Grehange, Gilles; Hennequin, Christophe; Peiffert, Didier; Toledano, Alain; Belkacemi, Yazid; Courdi, Adel; Belliere, Aurelie; Peignaux, Karine; Mahe, Marc; Bondiau, Pierre-Yves; Kantor, Guy; Lepechoux, Cecile; Carrie, Christian; Claude, Line

2007-01-01

In order to optimize quality and security in the delivery of radiation treatment, the French SFRO (Societe francaise de radiotherapie oncologique) is publishing a Guide for Radiotherapy. This guide is realized according to the HAS (Haute Autorite de sante) methodology of 'structured experts consensus'. This document is made of two parts: a general description of external beam radiation therapy and chapters describing the technical procedures of the main tumors to be irradiated (24). For each procedure, a special attention is given to dose constraints in the organs at risk. This guide will be regularly updated

Mental illness and legal fitness (competence) to stand trial in New York State: expert opinion and criminal defendants' psychiatric symptoms.

Science.gov (United States)

Lee, Eugene; Rosner, Richard; Harmon, Ronnie

2014-07-01

Fitness to Stand Trial is a critical concept in the adjudication of justice-involved persons. A retrospective study was conducted to examine criminal defendants' specific psychiatric symptoms and those symptoms' associations with expert opinions on Competence to Stand Trial. One hundred charts were reviewed: 50 Cases (opined as Not Fit) were compared against 50 Controls (opined as Fit) with respect to ratings on the Brief Psychiatric Rating Scale (BPRS). A significance level of 0.001 was selected a priori. Statistically significant differences were found in seven of the eighteen BPRS symptom constructs (with the highest differences in Conceptual Disorganization and Unusual Thought Content) and two of the four BPRS higher-order syndrome factors (Thinking Disorder and Hostile-Suspiciousness). Consistent with previous reports, psychotic symptoms are found in this study to be inversely associated with Fitness. Validity, reliability, and limitations of this study, as well as directions for future research, are discussed herein. © 2014 American Academy of Forensic Sciences.

Survey of Opinions on the Primacy of "g" and Social Consequences of Ability Testing: A Comparison of Expert and Non-Expert Views

Science.gov (United States)

Reeve, Charlie L.; Charles, Jennifer E.

2008-01-01

The current study examines the views of experts in the science of mental abilities about the primacy and uniqueness of "g" and the social implications of ability testing, and compares their responses to the views of a group of non-expert psychologists. Results indicate expert consensus that "g" is an important, non-trivial determinant (or at least…

Adaptation and validation of the REGEN expert system for the Central Appalachians

Science.gov (United States)

Lance A. Vickers; Thomas R. Fox; David L. Loftis; David A. Boucugnani

2011-01-01

REGEN is an expert system that predicts future species composition at the onset of stem exclusion using preharvest stand conditions. To extend coverage into hardwood stands of the Central Appalachians, we developed REGEN knowledge bases for four site qualities (xeric, subxeric, submesic, mesic) based on relevant literature and expert opinion. Data were collected from...

[Giving medico-legal opinions in cases with suspicion of medical mistake.part 1. between medicine and justice.

Science.gov (United States)

Chowaniec, Czesław; Chowaniec, Małgorzata; Wilk, Mateusz

2017-01-01

Creating medico-legal opinion is a sophisticated investigative, analytical, decision-making and creative process. Forensic medicine specialist in cooperation with clinical medicine consultants, on the basis of evidence analysis, which was gathered during procedures and contained in the acts has to create an objective and essential opinion. This opinion is a vital, very important and irreplaceable proof in every case. Judicial body consults with forensic medicine specialist or specialists if there are circumstances for settlement of which there is a need of classified informations - art. 193 of Penalty Code. Forensic medicine specialists face many difficulties which may have effect on quality, positiveness of opinion, compliance with the deadline, increasing expectancy of judicial body or sides. It is very difficult to find clinical specialists which except their clinical knowledge have basic knowledge about law, the role and duties of an court expert. In this article we discuss creating-opinion problems, role and position of court expert in confrontation with expectations of judicial body and the Justice with particular emphasis on medical mistakes and assessment of medical proceedings. We show the complexity of creating of medical opinions, especially these institutional.

Report on radiotherapy organization in Ile-de-France

International Nuclear Information System (INIS)

Aoun, Andre; Nizri, Daniel; Chivot, Francois-Xavier

2011-07-01

Based on meetings with a large number of professional and experts, this report aimed at providing a view on the radiotherapy activity in all health establishments and independent laboratories, at analysing its organisation with respect to population needs, at proposing an answer on the short term to difficulties met by this care in some parts of different districts of Ile-de-France, and at bearing a specific attention to the issue of necessary collaborations in order to meet planning objectives. A first part analyses the treatment offer and actual health care for radiotherapy in the region: supply mapping (in terms of centres, medical and technical personnel), and analysis of patient flows in 2009 and 2010. It outlines challenges and formulates recommendations for an offer reorganisation by analysing the present access to radiotherapy offer, and by discussing a desirable offer in radiotherapy

Radioecological experts' opinions on waste water of Esensham nuclear power plant. Final report of a part of the project: Pollution at the place of work and in the Lower Weser industrialized region

International Nuclear Information System (INIS)

Bliefert, M.; Marks, R.; Meier, A.; Wallenschus, M.

1978-01-01

In December 1977, there was a public hearing by the Oldenburg administrative court where, among others, evidence was heard on whether the experts' opinions on the discharge of liquid radioactive waste into the river Weser, for which licence has already been granted, contain some major errors so that the licences already granted would have to be revoked. This part of the long and tedious administrative lawsuit is reported. (orig.) [de

Assessing the impact of climate change on vector-borne viruses in the EU through the elicitation of expert opinion.

Science.gov (United States)

Gale, P; Brouwer, A; Ramnial, V; Kelly, L; Kosmider, R; Fooks, A R; Snary, E L

2010-02-01

Expert opinion was elicited to undertake a qualitative risk assessment to estimate the current and future risks to the European Union (EU) from five vector-borne viruses listed by the World Organization for Animal Health. It was predicted that climate change will increase the risk of incursions of African horse sickness virus (AHSV), Crimean-Congo haemorrhagic fever virus (CCHFV) and Rift Valley fever virus (RVFV) into the EU from other parts of the world, with African swine fever virus (ASFV) and West Nile virus (WNV) being less affected. Currently the predicted risks of incursion were lowest for RVFV and highest for ASFV. Risks of incursion were considered for six routes of entry (namely vectors, livestock, meat products, wildlife, pets and people). Climate change was predicted to increase the risk of incursion from entry of vectors for all five viruses to some degree, the strongest effects being predicted for AHSV, CCHFV and WNV. This work will facilitate identification of appropriate risk management options in relation to adaptations to climate change.

Quality indicators in radiotherapy

International Nuclear Information System (INIS)

Cionini, Luca; Gardani, Gianstefano; Gabriele, Pietro; Magri, Secondo; Morosini, Pier Luigi; Rosi, Antonella; Viti, Vincenza

2007-01-01

Background and purpose: There is a widespread and increasing tendency to develop hospital performance indicators in the field of accreditation/certification systems and quality benchmarking. A study has been undertaken to develop a set of performance indicators for a typical radiotherapy Centre and to evaluate their ability to provide a continuous quality improvement. Materials and methods: A working group consisting of radiation oncologists, medical physicists and radiation technologists under the coordination of experts in health technology assessment has elaborated a set of general indicators able to monitor performances and the quality level of a typical radiotherapy Centre. The work has been carried out through four steps: a preliminary set of indicators was selected; data on these indicators were collected in a number of Italian radiotherapy Centres and medical physics Services; problems in collection and analysis of data were discussed; a final set of indicators was developed. Results: A final set of 13 indicators is here presented. They concern general structural and/or operational features, health physics activities and accuracy and technical complexity of the treatment. Conclusions: The indicators tested in a few Italian Centres of radiotherapy and medical physics Services are now ready to be utilized by a larger community

Opinions and statements of the experts who studied the framework conditions of abandonment of nuclear power - presented by the OeTV Executive Board (Public Services and Transport Workers' Union)

International Nuclear Information System (INIS)

1987-10-01

This second volume contains five annexes to the first volume, presenting in Annex 1 data, facts, tables and comments on the following topics: Electricity demand and supplies; possibilities of reducing electricity demand; alternative energy sources for electricity generation to replace the nuclear energy source; electricity imports; the costs arising from abandonment of nuclear power; environmental burdens and hazards of a power industry with or without nuclear energy. Annex 2 presents terms and definitions, and the remaining three annexes contain literature lists of the expert opinions. (HSCH) [de

Social influence and the collective dynamics of opinion formation.

Science.gov (United States)

Moussaïd, Mehdi; Kämmer, Juliane E; Analytis, Pantelis P; Neth, Hansjörg

2013-01-01

Social influence is the process by which individuals adapt their opinion, revise their beliefs, or change their behavior as a result of social interactions with other people. In our strongly interconnected society, social influence plays a prominent role in many self-organized phenomena such as herding in cultural markets, the spread of ideas and innovations, and the amplification of fears during epidemics. Yet, the mechanisms of opinion formation remain poorly understood, and existing physics-based models lack systematic empirical validation. Here, we report two controlled experiments showing how participants answering factual questions revise their initial judgments after being exposed to the opinion and confidence level of others. Based on the observation of 59 experimental subjects exposed to peer-opinion for 15 different items, we draw an influence map that describes the strength of peer influence during interactions. A simple process model derived from our observations demonstrates how opinions in a group of interacting people can converge or split over repeated interactions. In particular, we identify two major attractors of opinion: (i) the expert effect, induced by the presence of a highly confident individual in the group, and (ii) the majority effect, caused by the presence of a critical mass of laypeople sharing similar opinions. Additional simulations reveal the existence of a tipping point at which one attractor will dominate over the other, driving collective opinion in a given direction. These findings have implications for understanding the mechanisms of public opinion formation and managing conflicting situations in which self-confident and better informed minorities challenge the views of a large uninformed majority.

Key attributes of expert NRL referees.

Science.gov (United States)

Morris, Gavin; O'Connor, Donna

2017-05-01

Experiential knowledge of elite National Rugby League (NRL) referees was investigated to determine the key attributes contributing to expert officiating performance. Fourteen current first-grade NRL referees were asked to identify the key attributes they believed contributed to their expert refereeing performance. The modified Delphi method involved a 3-round process of an initial semi-structured interview followed by 2 questionnaires to reach consensus of opinion. The data revealed 25 attributes that were rated as most important that underpin expert NRL refereeing performance. Results illustrate the significance of the cognitive category, with the top 6 ranked attributes all cognitive skills. Of these, the referees ranked decision-making accuracy as the most important attribute, followed by reading the game, communication, game understanding, game management and knowledge of the rules. Player rapport, positioning and teamwork were the top ranked game skill attributes underpinning performance excellence. Expert referees also highlighted a number of psychological attributes (e.g., concentration, composure and mental toughness) that were significant to performance. There were only 2 physiological attributes (fitness, aerobic endurance) that were identified as significant to elite officiating performance. In summary, expert consensus was attained which successfully provided a hierarchy of the most significant attributes of expert NRL refereeing performance.

On the "general acceptance" of eyewitness testimony research. A new survey of the experts.

Science.gov (United States)

Kassin, S M; Tubb, V A; Hosch, H M; Memon, A

2001-05-01

In light of recent advances, this study updated a prior survey of eyewitness experts (S. M. Kassin, P. C. Ellsworth, & V. L. Smith, 1989). Sixty-four psychologists were asked about their courtroom experiences and opinions on 30 eyewitness phenomena. By an agreement rate of at least 80%, there was a strong consensus that the following phenomena are sufficiently reliable to present in court: the wording of questions, lineup instructions, confidence malleability, mug-shot-induced bias, postevent information, child witness suggestibility, attitudes and expectations, hypnotic suggestibility, alcoholic intoxication, the crossrace bias, weapon focus, the accuracy-confidence correlation, the forgetting curve, exposure time, presentation format, and unconscious transference. Results also indicate that these experts set high standards before agreeing to testify. Despite limitations, these results should help to shape expert testimony so that it more accurately represents opinions in the scientific community.

The definition and diagnosis of cold hypersensitivity in the hands and feet: Finding from the experts survey.

Science.gov (United States)

Bae, Kwang-Ho; Jeong, Young-Seok; Go, Ho-Yeon; Sun, Seung-Ho; Kim, Tae-Hoon; Jung, Ki-Yong; Song, Yun-Kyung; Ko, Seong-Gyu; Choi, You-Kyung; Park, Jong-Hyeong; Lee, Siwoo; Lee, Youngseop; Jeon, Chan-Yong

2018-03-01

Cold hypersensitivity in the hands and feet (CHHF) is a symptom patients usually feel cold in their hands and feet, but not dealt with a disease in western medicine. However, it is often appealed by patients at a clinic of Korean medicine (KM), considered to be a sort of key diagnostic indicator, and actively treated by physicians. Nevertheless, there is no standardized diagnostic definition for CHHF. Therefore, we surveyed KM experts' opinions to address the clinical definition, diagnostic criteria, and other relevant things on CHHF. We developed a survey to assess the definition, diagnosis, causes, and accompanying symptoms on CHHF. 31 experts who work at specialized university hospitals affiliated with KM hospitals consented to participation. Experts responded to survey questions by selecting multiple-choice answers or stating their opinions. Vast majority of experts (83.8%) agreed with our definition on CHHF ("a feeling of cold as a symptom; that one's hands or feet become colder than those of average people in temperatures that are not normally perceived as cold"). 77.4% of experts considered subjective symptoms on CHHF were more important than medical instrument results. Constitution or genetic factors (87.1%) and stress (64.5%) were the most common causes reported for CHHF. This study offers an expert consensus regarding the themes, opinions, and experiences of practitioners with CHHF. Our results underscore the need for standardized definitions and diagnostic criteria for CHHF.

Expert Opinion in SR 97 and the SKI/SSI Joint Review of SR 97

Energy Technology Data Exchange (ETDEWEB)

Hora, Stephen

2002-09-01

The role of sensitivity and uncertainty analyses for radioactive waste disposal assessments is reviewed. The report covers a description of the these concepts were applied in the authorities' review of the safety report SR 97. With regard to the use of expert knowledge, the most significant weakness of SR 97 is absence of any standards, procedures, and even definitions for expert judgment. This situation needs to be dealt with by SKB in the near future as it denigrates the portions of the study that are well done. In developing expert judgment processes, SSI should ensure that SKB creates procedures that guarantee traceability and transparency. This will become very important as the repository system matures and receives greater public scrutiny. Both in the area of scenario creation and expert judgement, there are processes that have gained international acceptance. It would be in the best interest of SKB, and the public, to adhere these accepted approaches.

Expert Opinion in SR 97 and the SKI/SSI Joint Review of SR 97

International Nuclear Information System (INIS)

Hora, Stephen

2002-09-01

The role of sensitivity and uncertainty analyses for radioactive waste disposal assessments is reviewed. The report covers a description of the these concepts were applied in the authorities' review of the safety report SR 97. With regard to the use of expert knowledge, the most significant weakness of SR 97 is absence of any standards, procedures, and even definitions for expert judgment. This situation needs to be dealt with by SKB in the near future as it denigrates the portions of the study that are well done. In developing expert judgment processes, SSI should ensure that SKB creates procedures that guarantee traceability and transparency. This will become very important as the repository system matures and receives greater public scrutiny. Both in the area of scenario creation and expert judgement, there are processes that have gained international acceptance. It would be in the best interest of SKB, and the public, to adhere these accepted approaches

Conformal radiotherapy: a glossary

International Nuclear Information System (INIS)

Dubray, B.; Giraud, P.; Beaudre, A.

1999-01-01

Most of the concepts and terms related to conformal radiotherapy were produced by English-speaking authors and eventually validated by international groups of experts, whose working language was also English. Therefore, a significant part of this literature is poorly accessible to the French-speaking radiation oncology community. The present paper gathers the 'official' definitions already published in French, along with propositions for the remaining terms which should be submitted to a more formal and representative validation process. (author)

What information should patients be given before radiotherapy?

International Nuclear Information System (INIS)

Bergerot, Ph.

2009-01-01

Following a number of accidents at radiotherapy units, at Epinal and Toulouse hospitals in particular, and the problems encountered in the summer 2008, mainly caused by a shortage of radiation physicians and probably due to legislation that bears little relation to reality, a national radiotherapy monitoring committee was set up on 15 December 2008 in the presence of Roselyne Bachelot-Narquin, France's Minister for Health and Sport. A first progress report was submitted to the Minister in May 2009. Twelve members sit on this national monitoring committee, including a CISS representative and a person that has received radiotherapy treatment. This demonstrates the seriousness and the commitment required of users on this issue. Radiotherapy, one of the main treatments for cancer, is a loco-regional treatment that uses radiation capable of destroying cancer cells. It can be used on its own, or before, during or after another treatment method (surgery or a medical treatment such as chemotherapy, for example). The decision to treat a patient by means of radiotherapy is based on the opinions of health care professionals discussed at a multidisciplinary team meeting, the minutes of which are sent to the various doctors involved. The radiotherapy treatment prescribed (the technique, total radiation dose, length of the treatment, number of sessions, etc.) is adapted to the individual situation of each patient. It is designed to be as effective as possible in light of the tumour pathology, while protecting neighbouring organs as far as is possible. (author)

Human reliability in high dose rate afterloading radiotherapy based on FMECA

International Nuclear Information System (INIS)

Deng Jun; Fan Yaohua; Yue Baorong; Wei Kedao; Ren Fuli

2012-01-01

Objective: To put forward reasonable and feasible recommendations against the procedure with relative high risk during the high dose rate (HDR) afterloading radiotherapy, so as to enhance its clinical application safety, through studying the human reliability in the process of carrying out the HDR afterloading radiotherapy. Methods: Basic data were collected by on-site investigation and process analysis as well as expert evaluation. Failure mode, effect and criticality analysis (FMECA) employed to study the human reliability in the execution of HDR afterloading radiotherapy. Results: The FMECA model of human reliability for HDR afterloading radiotherapy was established, through which 25 procedures with relative high risk index were found,accounting for 14.1% of total 177 procedures. Conclusions: FMECA method in human reliability study for HDR afterloading radiotherapy is feasible. The countermeasures are put forward to reduce the human error, so as to provide important basis for enhancing clinical application safety of HDR afterloading radiotherapy. (authors)

Ask the experts how to treat individuals with spatial neglect: a survey study.

Science.gov (United States)

Chen, Peii; Pitteri, Marco; Gillen, Glen; Ayyala, Harsha

2017-07-11

Spatial neglect (SN) impedes rehabilitation success and leaves long-term consequences. We asked experts to provide their opinions in addressing SN by scenario (ideal vs. reality) and by recovery phase (earliest, acute, subacute, and chronic). Experts were individuals who have assessed or treated patients with SN clinically. This study was conducted using an anonymous survey on the Internet with 189 responders over 3 months. Located in 23 different countries, 127 experts of seven disciplines were included (occupational therapy, physical therapy, nursing, speech and language pathology or therapy, neurology, physical medicine and rehabilitation, and psychology or neuropsychology). Comparing the two scenarios, more treatments were selected in the ideal than in the reality scenario for all recovery phases except for the chronic phase. In both scenarios, (1) more treatments were selected in acute and subacute phases than in earliest or chronic phases, (2) less experienced experts selected diverse treatment options more often, and (3) highly experienced experts were more likely to provide their reasons of treatment selection, suggestions of treatment delivery methods, and other insights. Finally, 83.7% reported obstacles in treating SN. Experts' treatment selections are consistent with current evidence and practice guidelines. Recognizing the limitation of evidence, their opinions may help generate ideas in various topics (e.g., dosing, integrative intervention, and treatment implementation) to be examined in future studies. Implications for Rehabilitation Clinicians with experience in treating people with spatial neglect (i.e., experts as defined in the present study) recognized the limitation of evidence but nonetheless suggested specific treatments by recovery phase. In both the reality and ideal scenarios, experts included visual scanning, active limb activation, and sustained attention training in the top-five selections. Prism adaptation was in the top

Basic foundations of phthisiology professionalization in the assessment of experts

Directory of Open Access Journals (Sweden)

Alenin P.N.

2016-12-01

Full Text Available The aim of the work is to study the conditions and stereotypes that determine the process of professionalization in the field of phthisiology. The main factors have been analyzed that characterize the situation of ТВ as a public health sphere in Russia. Material and Methods. Applying qualitative research strategy — semi-structured expert interviews. The basis of the study is the expert opinion of practitioners in the field of ТВ: ТВ service specialists of Saratov Region (Regional Clinical ТВ Dispensary in Saratov and lecturers of the department of Phthisiopulmonology of Saratov State Medical University n.a. V. I. Razumovsky (n=10. Results. The article presents research materials, aimed at identifying the specifics of the basic foundations of national ТВ professionalization. The main factors of vocational choice include a personal interest in the profession, value preferences, information availability, safety and the risk of occupational diseases, the contingent of patients. Conclusion. On the basis of expert opinion the influence of endogenous and exogenous factors to assess ТВ status of the professional medical community, as well as students — physicians in the context of their future professional socialization have been described.

Expert opinions on carbon dioxide capture and storage-A framing of uncertainties and possibilities

International Nuclear Information System (INIS)

Hansson, Anders; Bryngelsson, Marten

2009-01-01

There are many uncertainties and knowledge gaps regarding the development of carbon dioxide capture and storage (CCS)-e.g., when it comes to costs, life-cycle effects, storage capacity and permanence. In spite of these uncertainties and barriers, the CCS research community is generally very optimistic regarding CCS' development. The discrepancy between the uncertainties and the optimism is the point of departure in this study, which is based on interviews with 24 CCS experts. The aim is to analyse experts' framings of CCS with focus on two key aspects: (i) the function and potential of CCS and (ii) uncertainties. The optimism among the CCS experts is tentatively explained. The interpretative flexibility of CCS is claimed to be an essential explanation for the optimism. CCS is promoted from a wide variety of perspectives, e.g., solidarity and peace, bridge to a sustainable energy system, sustaining the modern lifestyle and compatibility with the fossil fuel lock-in. Awareness of the uncertainties and potential over-optimism is warranted within policy and decision making as they often rely on scientific forecasts and experts' judgements.

Expert opinions on carbon dioxide capture and storage-A framing of uncertainties and possibilities

Energy Technology Data Exchange (ETDEWEB)

Hansson, Anders [Linkoeping University, Department of Technology and Social Change, SE-58183 Linkoeping (Sweden); Linkoeping University, Centre for Climate Science and Policy Research, SE-60174 Norrkoeping (Sweden); Bryngelsson, Marten [KTH, School of Chemical Sciences, Teknikringen 50, SE-10044 Stockholm (Sweden)], E-mail: mrtn@kth.se

2009-06-15

There are many uncertainties and knowledge gaps regarding the development of carbon dioxide capture and storage (CCS)-e.g., when it comes to costs, life-cycle effects, storage capacity and permanence. In spite of these uncertainties and barriers, the CCS research community is generally very optimistic regarding CCS' development. The discrepancy between the uncertainties and the optimism is the point of departure in this study, which is based on interviews with 24 CCS experts. The aim is to analyse experts' framings of CCS with focus on two key aspects: (i) the function and potential of CCS and (ii) uncertainties. The optimism among the CCS experts is tentatively explained. The interpretative flexibility of CCS is claimed to be an essential explanation for the optimism. CCS is promoted from a wide variety of perspectives, e.g., solidarity and peace, bridge to a sustainable energy system, sustaining the modern lifestyle and compatibility with the fossil fuel lock-in. Awareness of the uncertainties and potential over-optimism is warranted within policy and decision making as they often rely on scientific forecasts and experts' judgements.

Sources of correlation between experts: Empirical results from two extremes

International Nuclear Information System (INIS)

Meyer, M.A.; Booker, J.M.

1987-04-01

Through two studies, this report seeks to identify the sources of correlation, or dependence, between experts' estimates. Expert estimates are relied upon as sources of data whenever experimental data is lacking, such as in risk analyses and reliability assessments. Correlation between experts is a problem in the elicitation and subsequent use of subjective estimates. Until now, there have been no data confirming sources of correlation, although the experts' background is commonly speculated to be one. Two different populations of experts were administered questions in their areas of expertise. Data on their professional backgrounds and means of solving the questions were elicited using techniques from educational psychology and ethnography. The results from both studies indicate that the way in which an expert solves the problem is the major source of correlation. The experts' background can not be shown to be an important source of correlation nor to influence his choice of method for problem solution. From these results, some recommendations are given for the elicitation and use of expert opinion

The role of radiotherapy in the treatment of tumors of the paranasal sinuses

International Nuclear Information System (INIS)

Thiel, H.J.

1989-01-01

A multidisciplinary treatment conception is necessary for carcinomas of the paranasal sinuses. It is difficult to obtain complete recovery by surgery alone. Therefore radiotherapy plays an important role: it shall destroy malignant cells which could not be eliminated by surgery. The optimum succession of operation and irradiation is still a subject of controversial discussion, although preoperative irradiation is preferred by the majority. Intraarterial chemotherapy has also been combined with surgery and radiotherapy, but no unanimous opinion has yet been built with respect to the efficiency of this method. Astonishing results have been achieved with recently developed conceptions of a 'trimodal combined therapy' consisting of reduction surgery, radiotherapy, limited intraarterial and mostly topic application of 5-fluorouracil, and special care to the operation cavity during several weeks. These conceptions should be investigated by means of prospective multicentric studies. Primary lymph kode metastases are treated by functional or radical neck dissection with subsequent postoperative irradiation in case of severe invasion, especially if a capsular perforation with infiltration of perinodular tissue is histologically demonstrated. Opinions are divided about prophylactic irradiation of the clinically negative neck aiming at a destruction of subclinical metastases. Many authors recommend to take a wait-and-see attitude. In case of certain risk factors an irradiation could possibly be discussed. (orig./MG) [de

On-site visits to radiotherapy centres: Medical physics procedures. Quality Assurance Team for Radiation Oncology (QUATRO)

International Nuclear Information System (INIS)

2007-03-01

The IAEA has a long standing history of providing support and assistance for radiotherapy dosimetry audits in Member States, for educating and training radiotherapy professionals, and for reviewing the radiotherapy process in a variety of situations. Since 1969, and in collaboration with the World Health Organization (WHO), the IAEA has implemented a dosimetry audit service using mailed thermoluminescent dosimeters (TLD) to verify the calibration of radiotherapy beams in hospitals in Member States. The IAEA/WHO TLD service aims at improving the accuracy and consistency of clinical radiotherapy dosimetry worldwide. Detailed follow-up procedures have been implemented for correcting incorrect beam calibrations. When necessary, on-site visits by IAEA experts in radiotherapy physics are organized to identify and rectify dosimetry problems in hospitals. The IAEA has also been requested to organize expert missions in response to problems found during the radiation treatment planning process. Assessment of the doses received by affected patients and a medical assessment were undertaken when appropriate. Although vital for the radiotherapy process, accurate beam dosimetry and treatment planning alone cannot guarantee the successful treatment of a patient. The quality assurance (QA) of the entire radiotherapy process has to be taken into account. Hence, a new approach has been developed and named 'Quality Assurance Team for Radiation Oncology (QUATRO)'. The principal aim of QUATRO is to review the radiotherapy process, including the organization, infrastructure, clinical and medical physics aspects of the radiotherapy services. It also includes reviewing the hospital's professional competence, with a view to quality improvement. The QUATRO methodology is described in the IAEA publication Comprehensive Audits of Radiotherapy Practices: A Tool for Quality Improvement. QUATRO, in addition, offers assistance in the resolution of suspected or actual dose misadministrations (over

Expert opinions on carbon dioxide capture and storage. A framing of uncertainties and possibilities

Energy Technology Data Exchange (ETDEWEB)

Hansson, Anders [Linkoeping University, Department of Technology and Social Change, SE-58183 Linkoeping (Sweden); Bryngelsson, Maarten [KTH, School of Chemical Sciences, Teknikringen 50, SE-10044 Stockholm (Sweden)

2009-06-15

There are many uncertainties and knowledge gaps regarding the development of carbon dioxide capture and storage (CCS) - e.g., when it comes to costs, life-cycle effects, storage capacity and permanence. In spite of these uncertainties and barriers, the CCS research community is generally very optimistic regarding CCS' development. The discrepancy between the uncertainties and the optimism is the point of departure in this study, which is based on interviews with 24 CCS experts. The aim is to analyse experts' framings of CCS with focus on two key aspects: (1) the function and potential of CCS and (2) uncertainties. The optimism among the CCS experts is tentatively explained. The interpretative flexibility of CCS is claimed to be an essential explanation for the optimism. CCS is promoted from a wide variety of perspectives, e.g., solidarity and peace, bridge to a sustainable energy system, sustaining the modern lifestyle and compatibility with the fossil fuel lock-in. Awareness of the uncertainties and potential over-optimism is warranted within policy and decision making as they often rely on scientific forecasts and experts' judgements. (author)

Preliminary statement concerning the expert opinion and other documents relating to the Wackersdorf fuel reprocessing plant, laid open between June 18 and July 15, 1985 by the Bavarian Ministry of State for Regional Development and Environmental Affairs

International Nuclear Information System (INIS)

1985-01-01

The conclusion drawn in the statement is that the expert opinions and documents available do not justify the granting of a first partial licence for the erection of the fuel reprocessing plant. Such a first partial licence would include the site approval, the outline design approval, and part-construction permits, in this case for instance for the fuel element receiving store. The site approval would be a premature decision according to this statement, as some decisive expert opinions (on meteorological, hydrological, and radioecological site conditions) are not yet completed. The documents available for evaluation of the design concept are said to have been insufficient in many regards, so that all the authors can state at the present time is that 'there may be technically feasible solutions by now'. This is judged to be an insufficient basis for an outline design approval in accordance with the Atomic Energy Act. The reasons brought forward against licensing the fuel element receiving store are similar. For lack of appropriate documents, the authors of the statement found themselves unable to assess the safety of a major component, the fuel element storage tank. (orig./HSCH) [de

Train medical physicist-urgent need for advanced radiotherapy

International Nuclear Information System (INIS)

Hareyama, Masato; Teshima, Teruki; Yamamoto, Tokihiro; Haga, Akihiro; Nakagawa, Keiichi; Uesaka, Mitsuru

2008-01-01

A Japanese advanced charged particle therapy for cancer that places fewer physical burdens on patients is leading the world and stereotactic radiotherapy and intensity-modulated radiotherapy (IMRT) have been implemented also as a high precision radiotherapy. For the further advancement and dissemination of the therapy, training and qualification of medical physicists has become more needed. Cancer professional train course plan has been performed at many universities in Japan partly to train medical physicists. This special issue consists of seven relevant articles from experts of academia. Medical physicists have been qualified by the Japan Radiological Society, but should have national qualification such as to carry out the R and D of therapy equipment. This has been supported by many academia such as the Japanese Society for Therapeutic Radiology and Oncology (JASTRO) but not by the Japan Association of Radiological Technologists (JART). (T. Tanaka)

Expert Judgement Assessment & SCENT Ontological Analysis

Directory of Open Access Journals (Sweden)

NICHERSU Iulian

2018-05-01

Full Text Available This study aims to provide insights in the starting point of the Horizon 2020 ECfunded project SCENT (Smart Toolbox for Εngaging Citizens into a People-Centric Observation Web Citizen Observatory (CO in terms of existing infrastructure, existing monitoring systems and some discussion on the existing legal and administrative framework that relate to flood monitoring and management in the area of Danube Delta. The methodology used in this approach is based on expert judgement and ontological analysis, using the information collected from the identified end-users of the SCENT toolbox. In this type of analysis the stages of flood monitoring and management that the experts are involved in are detailed. This is done through an Expert Judgement Assessment analysis. The latter is complemented by a set of Key Performance Indicators that the stakeholders have assessed and/or proposed for the evaluation of the SCENT demonstrations, for the impact of the project and finally for SCENT toolbox performance and usefulness. The second part of the study presents an analysis that attempts to map the interactions between different organizations and components of the existing monitoring systems in the Danube Delta case study. Expert Judgement (EJ allows to gain information from specialists in a specific field through a consultation process with one or more experts that have experience in similar and complementary topics. Expert judgment, expert estimates, or expert opinion are all terms that refer to the contents of the problem; estimates, outcomes, predictions, uncertainties, and their corresponding assumptions and conditions are all examples of expert judgment. Expert Judgement is affected by the process used to gather it. On the other hand, the ontological analysis comes to complete this study, by organizing and presenting the connections behind the flood management and land use systems in the three phases of the flood event.

An Investigation of Marketing via Mobile Devices - Attitudes of Croatian Marketing Experts

OpenAIRE

Dobrinić, Damir; Dvorski, Stjepan; Bosilj, Neven

2008-01-01

Marketing activities supported by mobile devices offer great opportunities for direct communication with consumers without the barriers of time, place, location and other. This article explores opinions and expectations Croatian marketing experts have towards use of m-advertising and other available advertising media, where we take the perspective of marketing experts to predict the future of m-marketing and m-advertising in Croatia. The paper also discusses the relevance of m-advertising and...

Assessment of the severity of asthma by an expert system. Description and evaluation.

Science.gov (United States)

Redier, H; Daures, J P; Michel, C; Proudhon, H; Vervloet, D; Charpin, D; Marsac, J; Dusser, D; Brambilla, C; Wallaert, B

1995-02-01

Asthmaexpert, an expert system (ES), was produced at the special request of several clinicians in order to better understand the medical decisions made clinical experts in managing an asthmatic patient. We describe and evaluate this knowledge base, focusing mainly on assessment of the severity of asthma. After compiling data from a patient, Asthmaexpert assesses the severity of the disease and identifies the trigger factors involved, suggests any further investigations that may be required, and offers a treatment strategy. Implemented with Nexpert and Hypercard, it runs on a MacIntosh personal computer. The validation stage involved eight clinical experts who provided 20 case report forms (CRF) with their conclusions about management of asthma. The CRF were then programmed into the ES, which provided its own conclusions about the same subjects. Afterward, all the experts evaluated the conclusions given by ES or by their colleagues in a double-blind manner. One hundred twenty-seven CRF were available. The reliability of the experts' opinions was good, with a substantial consensus between them when assessing severity scores (kappa = 0.27 to 0.54). There was no difference in concordance of opinions on severity scores either between the experts who designed the system and ES or between the other experts and ES (weighted kappa = 0.72 and 0.69, respectively). Experts judged that the severity scores given by ES were as good as those proposed by their colleagues, and that the overall conclusions given by ES were as good as or better than those given by their colleagues. The conclusions drawn by ES were given a good rating.(ABSTRACT TRUNCATED AT 250 WORDS)

Expert opinion

DEFF Research Database (Denmark)

Ferrer, Marta; Boccon-Gibod, Isabelle; Gonçalo, Margarida

2017-01-01

Omalizumab (a recombinant, humanized anti-immunoglobulin-E antibody) has been shown in three pivotal Phase III trials (ASTERIA I, II and GLACIAL) and real-world studies to be effective and well-tolerated for the treatment of chronic spontaneous urticaria (CSU), and is the only licensed third......-line treatment for CSU. However, the definition of response to omalizumab treatment often differs between clinical trials, real-world studies, and daily practice of individual physicians globally. As such, a consensus definition of "complete", "partial" and "non-response" to omalizumab is required in order...... into a patient's disease burden and its changes during treatment. A potential omalizumab treatment approach based on speed and pattern of response at 1-3 and 3-6 months is suggested. In cases where there is no response during the first 1-3 months, physicians should consider reassessing the original CSU diagnosis...

Expert views on societal responses to different applications of nanotechnology: a comparative analysis of experts in countries with different economic and regulatory environments

Energy Technology Data Exchange (ETDEWEB)

Gupta, Nidhi, E-mail: guptanidhi12@gmail.com; Fischer, Arnout R. H., E-mail: arnout.fischer@wur.nl [Wageningen University, Marketing and Consumer Behaviour Group (Netherlands); George, Saji, E-mail: saji_george@nyp.gov.sg [Nanyang Polytechnic, Centre for Sustainable Nanotechnology, School of Chemical and Life Sciences (Singapore); Frewer, Lynn J., E-mail: lynn.frewer@newcastle.ac.uk [Newcastle University, School of Agriculture, Food and Rural Development (United Kingdom)

2013-08-15

The introduction of different applications of nanotechnology will be informed by expert views regarding which (types of) application will be most societally acceptable. Previous research in Northern Europe has indicated that experts believe that various factors will be influential, predominant among these being public perceptions of benefit, need and consumer concern about contact with nanomaterials. These factors are thought by experts to differentiate societal acceptance and rejection of nanotechnology applications. This research utilises a larger sample of experts (N = 67) drawn from Northern America, Europe, Australasia, India and Singapore to examine differences in expert opinion regarding societal acceptance of different applications of nanotechnology within different technological environments, consumer cultures and regulatory regimes. Perceived risk and consumer concerns regarding contact with nano-particles are thought by all experts to drive rejection, and perceived benefits to influence acceptance, independent of country. Encapsulation and delivery of nutrients in food was thought to be the most likely to raise societal concerns, while targeted drug delivery was thought most likely to be accepted. Lack of differentiation between countries suggests that expert views regarding social acceptance may be homogenous, independent of local contextual factors.

Expert views on societal responses to different applications of nanotechnology: a comparative analysis of experts in countries with different economic and regulatory environments

International Nuclear Information System (INIS)

Gupta, Nidhi; Fischer, Arnout R. H.; George, Saji; Frewer, Lynn J.

2013-01-01

The introduction of different applications of nanotechnology will be informed by expert views regarding which (types of) application will be most societally acceptable. Previous research in Northern Europe has indicated that experts believe that various factors will be influential, predominant among these being public perceptions of benefit, need and consumer concern about contact with nanomaterials. These factors are thought by experts to differentiate societal acceptance and rejection of nanotechnology applications. This research utilises a larger sample of experts (N = 67) drawn from Northern America, Europe, Australasia, India and Singapore to examine differences in expert opinion regarding societal acceptance of different applications of nanotechnology within different technological environments, consumer cultures and regulatory regimes. Perceived risk and consumer concerns regarding contact with nano-particles are thought by all experts to drive rejection, and perceived benefits to influence acceptance, independent of country. Encapsulation and delivery of nutrients in food was thought to be the most likely to raise societal concerns, while targeted drug delivery was thought most likely to be accepted. Lack of differentiation between countries suggests that expert views regarding social acceptance may be homogenous, independent of local contextual factors

Opinions and statements of the experts who studied the framework conditions of abandonment of nuclear power - presented by the commission set in by the OeTV Executive Board (Public Services and Transport Workers' Union)

International Nuclear Information System (INIS)

1987-10-01

The publication consists of two volumes and explains the position and opinions of the OeTV Executive Board concerning abandonment of nuclear power. The first volume presents the Executive Board's statement given in September 1987: Nuclear power should be abandoned, and it can be done; energy policy has to take a new line, concentrating on energy conservation, enhanced use of coal for electricity generation, enhanced use of renewable energy sources; stepwise shutdown of nuclear power stations. The first volume also presents the documents and experience forming the basis of the Union's position, namely the expert opinions on this issue, and an information visit to Sweden together with a report of Sweden's Minister of Industry on effects of the Chernobyl reactor accident. The development of the Union's point of view of energy policy since the year 1976. (HSCH) [de

Treatment of severe psoriasis in children: recommendations of an Italian expert group.

Science.gov (United States)

Fortina, Anna Belloni; Bardazzi, Federico; Berti, Samantha; Carnevale, Claudia; Di Lernia, Vito; El Hachem, Maya; Neri, Iria; Gelmetti, Carlo Mario; Lora, Viviana; Mazzatenta, Carlo; Milioto, Mirella; Moretta, Gaia; Patrizi, Annalisa; Peris, Ketty; Villani, Alberto

2017-10-01

This article provides comprehensive recommendations for the systemic treatment of severe pediatric psoriasis based on evidence obtained from a systematic review of the literature and the consensus opinion of expert dermatologists and pediatricians. For each systemic treatment, the grade of recommendation (A, B, C) based on the treatment's approval by the European Medicines Agency for childhood psoriasis and the experts' opinions is discussed. The grade of recommendation for narrow-band-ultraviolet B phototherapy, cyclosporine, and retinoids is C, while that for methotrexate is C/B. The use of adalimumab, etanercept, and ustekinumab has a grade A recommendation. No conventional systemic treatments are approved for pediatric psoriasis. Adalimumab is approved by the European Medicines Agency as a first-line treatment for severe chronic plaque psoriasis in children (≥ 4 years old) and adolescents. Etanercept and ustekinumab are approved as second-line therapy in children ≥ 6 and ≥ 12 years, respectively. A treatment algorithm as well as practical tools (i.e., tabular summaries of differential diagnoses, treatment mechanism of actions, dosing regimens, control parameters) are provided to assist in therapeutic reasoning and decision-making for individual patients. These treatment recommendations are endorsed by major Italian Pediatric and Dermatology Societies. What is Known: • Guidelines for the treatment of severe pediatric psoriasis are lacking and most traditional systemic treatments are not approved for use in young patients. Although there has been decades of experience with some of the traditional agents such as phototherapy, acitretin, and cyclosporine in children, there are no RCTs on their pediatric use while RCTs investigating new biologic agents have been performed. What is New: • In this manuscript, an Italian multidisciplinary team of experts focused on treatment recommendations for severe forms of psoriasis in children based on an up

Updated clinical indications for transcatheter aortic valve implantation in patients with severe aortic stenosis: expert opinion of the Italian Society of Cardiology and GISE.

Science.gov (United States)

Indolfi, Ciro; Bartorelli, Antonio L; Berti, Sergio; Golino, Paolo; Esposito, Giovanni; Musumeci, Giuseppe; Petronio, Sonia; Tamburino, Corrado; Tarantini, Giuseppe; Ussia, Gianpaolo; Vassanelli, Corrado; Spaccarotella, Carmen; Violini, Roberto; Mercuro, Giuseppe; Romeo, Francesco

2018-05-01

: The introduction of percutaneous treatment of severe aortic stenosis with transcatheter aortic valve implantation (TAVI) remains one of the greatest achievements of interventional cardiology. In fact, TAVI emerged as a better option than either medical therapy or balloon aortic valvuloplasty for patients who cannot undergo surgical aortic valve replacement (SAVR) or are at high surgical risk. Recently, increased operator experience and improved device systems have led to a worldwide trend toward the extension of TAVI to low-risk or intermediate-risk patients. In this expert opinion paper, we first discuss the basic pathophysiology of aortic stenosis in different settings then the key results of recent clinical investigations on TAVI in intermediate-risk aortic stenosis patients are summarized. Particular emphasis is placed on the results of the nordic aortic valve intervention, placement of aortic transcatheter valves (PARTNER) 2 and Surgical Replacement and Transcatheter Aortic Valve Implantation Randomized trials. The PARTNER 2 was the first large randomized trial that evaluated the outcome of TAVI in patients at intermediate risk. The PARTNER 2 data demonstrated that TAVI is a feasible and reasonable alternative to surgery in intermediate-risk patients (Society of Thoracic Surgeons 4-8%), especially if they are elderly or frail. There was a significant interaction between TAVI approach and mortality, with transfemoral TAVI showing superiority over SAVR. Moreover, we examine the complementary results of the recently concluded Surgical Replacement and Transcatheter Aortic Valve Implantation trial. This prospective randomized trial demonstrated that TAVI is comparable with surgery (primary end point 12.6% in the TAVI group vs. 14.0% in the SAVR group) in severe aortic stenosis patients deemed to be at intermediate risk. We review the most relevant clinical evidence deriving from nonrandomized studies and meta-analyses. Altogether, clinical outcome available data

Interest of Supportive and Barrier Protective Skin Care Products in the Daily Prevention and Treatment of Cutaneous Toxicity During Radiotherapy for Breast Cancer

Directory of Open Access Journals (Sweden)

Antoine Berger

2018-01-01

Full Text Available Purpose: As many as 50% of patients with cancer develop acute skin reactions to some degree with radiotherapy. Proactive skin care is often recommended to minimise these skin reactions and maintain the integrity of the epidermal barrier; nevertheless, no consensual guidelines are systematically used. This multicentre, observational, prospective study evaluated the tolerability and benefit of supportive and barrier protective skin care products in preventing radiotherapy-induced skin reactions in 253 women initiating radiotherapy (exclusive or adjuvant for breast cancer. Methods: Patients received a kit of 5 commercially available skin care products before the first radiotherapy treatment. The following variables were assessed: cutaneous adverse events, investigator-assessed skin reactions (oedema, erythema, dryness, desquamation before and after radiotherapy course, investigator, and patient opinion on products benefit. Results were analysed by frequency of product use (heavy versus low. Results: Average age was 60 years (range: 34-85. Over 92% of patients reported good to excellent tolerance on irradiated skin for each product. During the 6-week radiotherapy period, we observed that heavy product users had less skin reactions than the low users, particularly within 10 days of radiotherapy initiation (8% versus 18%; p  = .031. Positive physician’s opinion on product use was more frequent for high (66.6% versus low (32% users. Patient-assessed patient benefit index was generally >1, indicating relevant treatment benefit, with a tendency for better benefit in high versus low users. Conclusions: These results support recommendations to use skin care products to minimise the impact of secondary cutaneous reactions with radiotherapy cancer treatment.

Interest of Supportive and Barrier Protective Skin Care Products in the Daily Prevention and Treatment of Cutaneous Toxicity During Radiotherapy for Breast Cancer.

Science.gov (United States)

Berger, Antoine; Regueiro, Carlos; Hijal, Tarek; Pasquier, David; De La Fuente, Cristina; Le Tinier, Florence; Coche-Dequeant, Bernard; Lartigau, Eric; Moyal, Dominique; Seité, Sophie; Bensadoun, René-Jean

2018-01-01

As many as 50% of patients with cancer develop acute skin reactions to some degree with radiotherapy. Proactive skin care is often recommended to minimise these skin reactions and maintain the integrity of the epidermal barrier; nevertheless, no consensual guidelines are systematically used. This multicentre, observational, prospective study evaluated the tolerability and benefit of supportive and barrier protective skin care products in preventing radiotherapy-induced skin reactions in 253 women initiating radiotherapy (exclusive or adjuvant) for breast cancer. Patients received a kit of 5 commercially available skin care products before the first radiotherapy treatment. The following variables were assessed: cutaneous adverse events, investigator-assessed skin reactions (oedema, erythema, dryness, desquamation) before and after radiotherapy course, investigator, and patient opinion on products benefit. Results were analysed by frequency of product use (heavy versus low). Average age was 60 years (range: 34-85). Over 92% of patients reported good to excellent tolerance on irradiated skin for each product. During the 6-week radiotherapy period, we observed that heavy product users had less skin reactions than the low users, particularly within 10 days of radiotherapy initiation (8% versus 18%; p  = .031). Positive physician's opinion on product use was more frequent for high (66.6%) versus low (32%) users. Patient-assessed patient benefit index was generally >1, indicating relevant treatment benefit, with a tendency for better benefit in high versus low users. These results support recommendations to use skin care products to minimise the impact of secondary cutaneous reactions with radiotherapy cancer treatment.

The tissue injury and repair in cancer radiotherapy

International Nuclear Information System (INIS)

Matsuzawa, Taiju

1975-01-01

One of the difficulties in cancer radiotherapy arises from the fact that the tissue tolerance dose is much smaller than the tumor lethal dose. In our opinion the former depends upon the tolerance of the endothelial cell of the blood vessel in the normal tissue. In this introduction, a new concept regarding the estimation of tissue radiosensitivity was described, and the possible significance of the mode of radiation injury and the repair capability of normal tissue in the cancer radiotheraphy was discussed. (author)

Long-term effects of megavoltage radiotherapy in acromegaly

International Nuclear Information System (INIS)

Lam, K.S.L.; Wang, C.; Ma, J.T.C.; Yeung, R.T.T.; Choi, P.

1989-01-01

The progress of 41 Chinese patients with acromegaly treated with megavoltage radiotherapy was reviewed after a mean follow-up of 4.5 (one-ten) years. Nine received prior surgery. Radiotherapy was delivered by a 3-field technique to a total of 4000-5000 cGy in 25 fractions. By life table analysis successful treatment of growth hormone (GH) hypersecretion, as defined by a mean GH concentration of ≤ 10 mu/L, could be expected in 6, 11, 26, 64 and 67% of the patients after one, two, five, eight and ten years respectively. Median intervals before achieving a mean GH level of ≤ 10 Mu/L were 6.6 and 8.6 years following radiotherapy with the higher (4500-5000 cGy) and lower (4000 cGy) doses respectively, suggesting a tendency towards earlier response following radiotherapy with the higher dose. The prevalence of acquired hypopituitarism in patients followed up for over five years was 40% for gonadotrophins, 30% for TSH and 20% for ACTH deficiency respectively. In the majority of patients, acquired hypopituitarism was not apparent within five years after radiotherapy. No mortality or major side effects were noted following radiotherapy. In 34 patients on longterm bromocriptine treatment, mean GH concentrations were normalised in 26.5% of patients. We conclude that with judicious selection of patients and use of adjunctive medical therapy, megavoltage radiotherapy remains a safe and satisfactory form of treatment for acromegaly especially if expert transphenoidal surgery is not readily available. 19 refs., 3 figs., 2 tabs

Estimating distribution and connectivity of recolonizing American marten in the northeastern United States using expert elicitation techniques

Science.gov (United States)

Aylward, C.M.; Murdoch, J.D.; Donovan, Therese M.; Kilpatrick, C.W.; Bernier, C.; Katz, J.

2018-01-01

The American marten Martes americana is a species of conservation concern in the northeastern United States due to widespread declines from over‐harvesting and habitat loss. Little information exists on current marten distribution and how landscape characteristics shape patterns of occupancy across the region, which could help develop effective recovery strategies. The rarity of marten and lack of historical distribution records are also problematic for region‐wide conservation planning. Expert opinion can provide a source of information for estimating species–landscape relationships and is especially useful when empirical data are sparse. We created a survey to elicit expert opinion and build a model that describes marten occupancy in the northeastern United States as a function of landscape conditions. We elicited opinions from 18 marten experts that included wildlife managers, trappers and researchers. Each expert estimated occupancy probability at 30 sites in their geographic region of expertise. We, then, fit the response data with a set of 58 models that incorporated the effects of covariates related to forest characteristics, climate, anthropogenic impacts and competition at two spatial scales (1.5 and 5 km radii), and used model selection techniques to determine the best model in the set. Three top models had strong empirical support, which we model averaged based on AIC weights. The final model included effects of five covariates at the 5‐km scale: percent canopy cover (positive), percent spruce‐fir land cover (positive), winter temperature (negative), elevation (positive) and road density (negative). A receiver operating characteristic curve indicated that the model performed well based on recent occurrence records. We mapped distribution across the region and used circuit theory to estimate movement corridors between isolated core populations. The results demonstrate the effectiveness of expert‐opinion data at modeling occupancy for rare

Part of an observatory of opinions on risks

International Nuclear Information System (INIS)

Brenot, J.

1999-01-01

An observatory of opinions about risks constitutes the frame in which can be developed exchanges between research workers, engineers, experts, persons in charge of authorities and societies managers for who the way whom the public takes into account the risks constitutes an element of the management, the decision or the communication. The Institute of Protection and Nuclear Safety (I.P.S.N.) has, with the passing of the years, build a such observatory whom activities are developed according to several directions. (N.C.)

User Information Needs for Environmental Opinion-forming and Decision-making in Link-enriched Video

NARCIS (Netherlands)

A.C. Palumbo; L. Hardman (Lynda)

2013-01-01

htmlabstractLink-enriched video can support users in informative processes of environmental opinion-forming and decision-making. To enable this, we need to specify the information that should be captured in an annotation schema for describing the video. We conducted expert interviews to elicit

Use of fuzzy set theory in the aggregation of expert judgments

International Nuclear Information System (INIS)

Moon, Joo Hyun; Kang, Chang Sun

1999-01-01

It is sometimes impossible to make a correct decision in a certain engineering task without the help from professional expert judgments. Even though there are different expert opinions available, however, they should be appropriately aggregated to a useful form for making an acceptable engineering decision. This paper proposes a technique which utilizes the fuzzy set theory in the aggregation of expert judgments. In the technique, two main key concepts are employed: linguistic variables and fuzzy numbers. Linguistic variables first represent the relative importance of evaluation criteria under consideration and the degree of confidence on each expert perceived by the decision maker, and then are replaced by suitable triangular fuzzy numbers for arithmetic manipulation. As a benchmark problem, the pressure increment in the containment of Sequoyah nuclear power plant due to reactor vessel breach was estimated to verify and validate the proposed technique

Expert consensus for multi-modality imaging evaluation of cardiovascular complications of radiotherapy in adults

DEFF Research Database (Denmark)

Lancellotti, Patrizio; Nkomo, Vuyisile T; Badano, Luigi P

2013-01-01

. A comprehensive review of potential cardiac complications related to radiotherapy is warranted. An evidence-based review of several imaging approaches used to detect, evaluate, and monitor RIHD is discussed. Recommendations for the early identification and monitoring of cardiovascular complications...

Multimedia educational services in stereotactic radiotherapy

International Nuclear Information System (INIS)

Bazioglou, M.; Theodorou, K.; Kappas, C.

1999-01-01

The computer-based learning methods in medicine have been well established as stand-alone learning systems. Recently, these systems were enriched with the use of telematics technology to provide distance learning capabilities. Stereotactic radiotherapy is more of the most representative advanced radiotherapy techniques. Due to the multidisciplinary character of the technique and the rapid evolution of technology implemented, the demands in training have increased. The potential of interactive multimedia and Internet technologies for the achievement of distance learning capabilities in this domain are investigated. The realization of a computer-based educational program in stereotactic radiotherapy in a multimedia format is a new application in the computer-aided distance learning field. The system is built according to a client and server architecture, based on the Internet infrastructure, and composed of server nodes. The impact of the system may be described in terms of: time and transportation costs saving, flexibility in training (scheduling, rate and subject selection), online communication and interaction with experts, cost effective access to material (delivery or access by a large number of users and revision of the material by avoiding and database development. (authors)

2002/03 public opinion survey 'Nuclear Energy - the Present and the Future'

International Nuclear Information System (INIS)

Trontl, K.; Gergeta, K.

2003-01-01

During the years 2000 and 2002 the Croatian Nuclear Society Young Generation Network carried out public opinion surveys among student population of around 650 individuals age 18-20. The results of the surveys suggested the necessity of a more active involvement of nuclear experts in high school education. Croatian Young Generation Network decided to prepare brochures on different subjects concerning nuclear energy and distribute them to high school students, primarily third and fourth graders. To be able to evaluate the influence of distributed materials, fresh reference data are needed. Therefore, a traditional public opinion survey 'Nuclear Energy - the Present and the Future' has been carried out among faculty student population. (author)

A Web-Based Rice Plant Expert System Using Rule-Based Reasoning

Directory of Open Access Journals (Sweden)

Anton Setiawan Honggowibowo

2009-12-01

Full Text Available Rice plants can be attacked by various kinds of diseases which are possible to be determined from their symptoms. However, it is to recognize that to find out the exact type of disease, an agricultural expert’s opinion is needed, meanwhile the numbers of agricultural experts are limited and there are too many problems to be solved at the same time. This makes a system with a capability as an expert is required. This system must contain the knowledge of the diseases and symptom of rice plants as an agricultural expert has to have. This research designs a web-based expert system using rule-based reasoning. The rule are modified from the method of forward chaining inference and backward chaining in order to to help farmers in the rice plant disease diagnosis. The web-based rice plants disease diagnosis expert system has the advantages to access and use easily. With web-based features inside, it is expected that the farmer can accesse the expert system everywhere to overcome the problem to diagnose rice diseases.

Experts' consensus on use of electronic cigarettes: a Delphi survey from Switzerland.

Science.gov (United States)

Blaser, Jeremie; Cornuz, Jacques

2015-04-15

In some countries, nicotine-containing electronic cigarettes (e-cigarettes) are considered a consumer product without specific regulations. In others (eg, Switzerland), the sale of e-cigarettes containing nicotine is forbidden, despite the eagerness of many smokers to obtain them. As scientific data about efficacy and long-term safety of these products are scarce, tobacco control experts are divided on how to regulate them. In order to gain consensus among experts to provide recommendations to health authorities, we performed a national consensus study. We used a Delphi method with electronic questionnaires to bring together the opinion of Swiss experts on e-cigarettes. 40 Swiss experts from across the country. We measured the degree of consensus between experts on recommendations regarding regulation, sale, use of and general opinion about e-cigarettes containing nicotine. New recommendations and statements were added following the experts' answers and comments. There was consensus that e-cigarettes containing nicotine should be made available, but only under specific conditions. Sale should be restricted to adults, using quality standards, a maximum level of nicotine and with an accompanying list of authorised ingredients. Advertisement should be restricted and use in public places should be forbidden. These recommendations encompass three principles: (1) the reality principle, as the product is already on the market; (2) the prevention principle, as e-cigarettes provide an alternative to tobacco for actual smokers, and (3) the precautionary principle, to protect minors and non-smokers, since long-term effects are not yet known. Swiss authorities should design specific regulations to sell nicotine-containing e-cigarettes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Deriving the probability of a linear opinion pooling method being superior to a set of alternatives

International Nuclear Information System (INIS)

Bolger, Donnacha; Houlding, Brett

2017-01-01

Linear opinion pools are a common method for combining a set of distinct opinions into a single succinct opinion, often to be used in a decision making task. In this paper we consider a method, termed the Plug-in approach, for determining the weights to be assigned in this linear pool, in a manner that can be deemed as rational in some sense, while incorporating multiple forms of learning over time into its process. The environment that we consider is one in which every source in the pool is herself a decision maker (DM), in contrast to the more common setting in which expert judgments are amalgamated for use by a single DM. We discuss a simulation study that was conducted to show the merits of our technique, and demonstrate how theoretical probabilistic arguments can be used to exactly quantify the probability of this technique being superior (in terms of a probability density metric) to a set of alternatives. Illustrations are given of simulated proportions converging to these true probabilities in a range of commonly used distributional cases. - Highlights: • A novel context for combination of expert opinion is provided. • A dynamic reliability assessment method is stated, justified by properties and a data study. • The theoretical grounding underlying the data-driven justification is explored. • We conclude with areas for expansion and further relevant research.

Quality and safety in radiotherapy

CERN Document Server

Pawlicki, Todd

2010-01-01

The first text to focus solely on quality and safety in radiotherapy, this work encompasses not only traditional, more technically oriented, quality assurance activities, but also general approaches of quality and safety. It includes contributions from experts both inside and outside the field to present a global view. The task of assuring quality is no longer viewed solely as a technical, equipment-dependent endeavor. Instead, it is now recognized as depending on both the processes and the people delivering the service. Divided into seven broad categories, the text covers: Quality Management

Monitoring and control of microbioreactors: An expert opinion on development needs

DEFF Research Database (Denmark)

Gernaey, Krist; Baganz, Frank; Franco-Lara, Ezequiel

2012-01-01

This perspective article is based on an expert panel review on microbioreactor applications in biochemical and biomedical engineering that was organized by the M3C (measurement, monitoring, modelling and control) Working Group of the European Section of Biochemical Engineering Science (ESBES......) in the European Federation of Biotechnology (EFB). The aim of the panel was to provide an updated view on the present status of the subject and to identify critical needs and issues for furthering the successful development of microbioreactor monitoring and control. This will benefit future bioprocess development...

OpinionFlow: Visual Analysis of Opinion Diffusion on Social Media.

Science.gov (United States)

Wu, Yingcai; Liu, Shixia; Yan, Kai; Liu, Mengchen; Wu, Fangzhao

2014-12-01

It is important for many different applications such as government and business intelligence to analyze and explore the diffusion of public opinions on social media. However, the rapid propagation and great diversity of public opinions on social media pose great challenges to effective analysis of opinion diffusion. In this paper, we introduce a visual analysis system called OpinionFlow to empower analysts to detect opinion propagation patterns and glean insights. Inspired by the information diffusion model and the theory of selective exposure, we develop an opinion diffusion model to approximate opinion propagation among Twitter users. Accordingly, we design an opinion flow visualization that combines a Sankey graph with a tailored density map in one view to visually convey diffusion of opinions among many users. A stacked tree is used to allow analysts to select topics of interest at different levels. The stacked tree is synchronized with the opinion flow visualization to help users examine and compare diffusion patterns across topics. Experiments and case studies on Twitter data demonstrate the effectiveness and usability of OpinionFlow.

Application of radiotherapy for hepatocellular carcinoma in current clinical practice guidelines

Energy Technology Data Exchange (ETDEWEB)

Rim, Chai Hong; Seong, Jin Sil [Dept. of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (Korea, Republic of)

2016-09-15

In oncologic practice, treatment guidelines provide appropriate treatment strategies based on evidence. Currently, many guidelines are used, including those of the European Association for the Study of the Liver and European Organization for Research and Treatment of Cancer (EASL-EORTC), National Comprehensive Cancer Network (NCCN), Asia-Pacific Primary Liver Cancer Expert (APPLE), and Korean Liver Cancer Study Group and National Cancer Centre (KLCSG-NCC). Although radiotherapy is commonly used in clinical practice, some guidelines do not accept it as a standard treatment modality. In this review, we will investigate the clinical practice guidelines currently used, and discuss the application of radiotherapy.

Application of radiotherapy for hepatocellular carcinoma in current clinical practice guidelines

International Nuclear Information System (INIS)

Rim, Chai Hong; Seong, Jin Sil

2016-01-01

In oncologic practice, treatment guidelines provide appropriate treatment strategies based on evidence. Currently, many guidelines are used, including those of the European Association for the Study of the Liver and European Organization for Research and Treatment of Cancer (EASL-EORTC), National Comprehensive Cancer Network (NCCN), Asia-Pacific Primary Liver Cancer Expert (APPLE), and Korean Liver Cancer Study Group and National Cancer Centre (KLCSG-NCC). Although radiotherapy is commonly used in clinical practice, some guidelines do not accept it as a standard treatment modality. In this review, we will investigate the clinical practice guidelines currently used, and discuss the application of radiotherapy

Analysis of quality control protocol implementation of equipment in radiotherapy services

International Nuclear Information System (INIS)

Calcina, Carmen S. Guzman; Lima, Luciana P. de; Rubo, Rodrigo A.; Ferraz, Eduardo; Almeida, Adelaide de

2000-01-01

Considering the importance of the Quality Assurance in the radiotherapy services, there was an interest to make tests' evaluation for a Quality Control for the cobalt equipment, linear accelerator and simulator as a classification and comparison. The work proposed is a suggestion that can serve as tool for medical physicists that are starting to work in the radiotherapy area and for the most experts. The discussions were made by the gathering of local tests and official protocols, resulting in a minimum protocol as a suggestion for a routine work, emphasizing the periodicity and level of tolerance of each one of the tests. (author)

Risk perceptions starting to shift? U.S. citizens are forming opinions about nanotechnology

International Nuclear Information System (INIS)

Priest, Susanna; Greenhalgh, Ted; Kramer, Victoria

2010-01-01

This article presents early results from an opinion formation study based on a 76-member panel of U.S. citizens, with comparison data from a group of 177 nanotechnology experts. While initially similar to the expert group in terms of their perceptions of the risks, benefits, and need for regulation characterizing several forms of nanotechnology, the first follow-up survey indicates that the panel is beginning to diverge from the experts, particularly with respect to perceptions of the levels of various 'societal' risks that nanotechnology might present. The data suggest that responding to public concerns may involve more than attention to physical risks in areas such as health and environment; concerns about other forms of risk actually appear more salient.

Towards a Fuzzy Expert System on Toxicological Data Quality Assessment.

Science.gov (United States)

Yang, Longzhi; Neagu, Daniel; Cronin, Mark T D; Hewitt, Mark; Enoch, Steven J; Madden, Judith C; Przybylak, Katarzyna

2013-01-01

Quality assessment (QA) requires high levels of domain-specific experience and knowledge. QA tasks for toxicological data are usually performed by human experts manually, although a number of quality evaluation schemes have been proposed in the literature. For instance, the most widely utilised Klimisch scheme1 defines four data quality categories in order to tag data instances with respect to their qualities; ToxRTool2 is an extension of the Klimisch approach aiming to increase the transparency and harmonisation of the approach. Note that the processes of QA in many other areas have been automatised by employing expert systems. Briefly, an expert system is a computer program that uses a knowledge base built upon human expertise, and an inference engine that mimics the reasoning processes of human experts to infer new statements from incoming data. In particular, expert systems have been extended to deal with the uncertainty of information by representing uncertain information (such as linguistic terms) as fuzzy sets under the framework of fuzzy set theory and performing inferences upon fuzzy sets according to fuzzy arithmetic. This paper presents an experimental fuzzy expert system for toxicological data QA which is developed on the basis of the Klimisch approach and the ToxRTool in an effort to illustrate the power of expert systems to toxicologists, and to examine if fuzzy expert systems are a viable solution for QA of toxicological data. Such direction still faces great difficulties due to the well-known common challenge of toxicological data QA that "five toxicologists may have six opinions". In the meantime, this challenge may offer an opportunity for expert systems because the construction and refinement of the knowledge base could be a converging process of different opinions which is of significant importance for regulatory policy making under the regulation of REACH, though a consensus may never be reached. Also, in order to facilitate the implementation

Towards an ICF core set for ADHD: a worldwide expert survey on ability and disability

OpenAIRE

de Schipper, Elles; Mahdi, Soheil; Coghill, David; de Vries, Petrus J.; Gau, Susan Shur-Fen; Granlund, Mats; Holtmann, Martin; Karande, Sunil; Levy, Florence; Almodayfer, Omar; Rohde, Luis; Tannock, Rosemary; B?lte, Sven

2015-01-01

This is the second in a series of four empirical studies designed to develop International Classification of Functioning, Disability and Health (ICF and Children and Youth version, ICF-CY) core sets for attention deficit hyperactivity disorder (ADHD). The objective of this stage was to gather the opinions from international experts on which ability and disability concepts were considered relevant to functioning in ADHD. An email-based survey was carried out amongst international experts in AD...

THE GHOST IN THE MACHINE? THE VALUE OF EXPERT ADVICE IN THE PRODUCTION OF EVIDENCE-BASED GUIDANCE: A MIXED METHODS STUDY OF THE NICE INTERVENTIONAL PROCEDURES PROGRAMME.

Science.gov (United States)

Oyebode, Oyinlola; Patrick, Hannah; Walker, Alexander; Campbell, Bruce; Powell, John

2016-01-01

The aim of this study was to determine the aspects of expert advice that decision makers find most useful in the development of evidence-based guidance and to identify the characteristics of experts providing the most useful advice. First, semi-structured interviews were conducted with seventeen members of the Interventional Procedures Advisory Committee of the UK's National Institute of Health and Care Excellence. Interviews examined the usefulness of expert advice during guidance development. Transcripts were analyzed inductively to identify themes. Second, data were extracted from 211 experts' questionnaires for forty-one consecutive procedures. Usefulness of advice was scored using an index developed through the qualitative work. Associations between usefulness score and characteristics of the expert advisor were investigated using univariate and multivariate analyses. Expert opinion was seen as a valued complement to empirical evidence, providing context and tacit knowledge unavailable in published literature, but helpful for interpreting it. Interviewees also valued advice on the training and experience required to perform a procedure, on patient selection criteria and the place of a procedure within a clinical management pathway. Limitations of bias in expert opinion were widely acknowledged and skepticism expressed regarding the anecdotal nature of advice on safety or efficacy outcomes. Quantitative analysis demonstrated that the most useful advice was given by clinical experts with direct personal experience of the procedure, particularly research experience. Evidence-based guidance production is often characterized as a rational, pipeline process. This ignores the valuable role that expert opinion plays in guidance development, complementing and supporting the interpretation of empirical data.

Second-opinion interpretations of gynecologic oncologic MRI examinations by sub-specialized radiologists influence patient care

International Nuclear Information System (INIS)

Lakhman, Yulia; Vargas, Hebert Alberto; Sosa, Ramon E.; Hricak, Hedvig; Sala, Evis; D'Anastasi, Melvin; Micco, Maura; Scelzo, Chiara; Nougaret, Stephanie; Chi, Dennis S.; Abu-Rustum, Nadeem R.

2016-01-01

To determine if second-opinion review of gynaecologic oncologic (GynOnc) magnetic resonance imaging (MRI) by sub-specialized radiologists impacts patient care. 469 second-opinion MRI interpretations rendered by GynOnc radiologists were retrospectively compared to the initial outside reports. Two gynaecologic surgeons, blinded to the reports' origins, reviewed all cases with discrepancies between initial and second-opinion MRI reports and recorded whether these discrepancies would have led to a change in patient management defined as a change in treatment approach, counselling, or referral. Histopathology or minimum 6-month imaging follow-up were used to establish the diagnosis. Second-opinion review of GynOnc MRIs would theoretically have affected management in 94/469 (20 %) and 101/469 (21.5 %) patients for surgeons 1 and 2, respectively. Specifically, second-opinion review would have theoretically altered treatment approach in 71/469 (15.1 %) and 60/469 (12.8 %) patients for surgeons 1 and 2, respectively. According to surgeons 1 and 2, these treatment changes would have prevented unnecessary surgery in 35 (7.5 %) and 31 (6.6 %) patients, respectively, and changed surgical procedure type/extent in 19 (4.1 %) and 12 (2.5 %) patients, respectively. Second-opinion interpretations were correct in 103 (83 %) of 124 cases with clinically relevant discrepancies between initial and second-opinion reports. Expert second-opinion review of GynOnc MRI influences patient care. (orig.)

The IRSN 2010 barometer. The opinion on risks and security of the French population. Global results

International Nuclear Information System (INIS)

2010-01-01

This report presents and comments the results of a survey during which a sample of the French population has been questioned on their current concerns (about the society, about the environment, about the image of science), on their opinion on scientific expertise (who should control a risky installation, the role and image of experts, the access to expertise files, the perception of pluralist structures), the opinion on 32 risk situations (risks to which French people feel exposed, confidence in authorities, truth of information on hazards, hierarchy of the 32 situations), the opinion on the nuclear activity and industry (the nuclear risk, the credibility and expertise of interveners, incidents which occurred in 2008, the demand of information on the nuclear risk)

The IRSN 2009 barometer. The opinion on risks and security of the French population. Global results

International Nuclear Information System (INIS)

2009-01-01

This report presents and comments the results of a survey during which a sample of the French population has been questioned on their current concerns (about the society, about the environment, about the image of science), on their opinion on scientific expertise (who should control a risky installation, the role and image of experts, the access to expertise files, the perception of pluralist structures), the opinion on 31 risk situations (risks to which French people feel exposed, confidence in authorities, truth of information on hazards, hierarchy of the 31 situations), the opinion on the nuclear activity and industry (the nuclear risk, the credibility and expertise of interveners, incidents which occurred in 2008, the demand of information on the nuclear risk)

New horizons with PET/CT in high-tech radiotherapy planning

International Nuclear Information System (INIS)

Hadjieva, T.

2009-01-01

Full text:The precise delineation of exposed volumes in the high-tech radiotherapy is a major problem. The malignoma imaging was revolutionized by PET. PET became one of the routine imaging methods in developed countries in Europe and USA. PET with 18-FDG, combined with structural and topographic representation of images by CT, currently provides the most reliable information about the location and spread of tumor. Three dimensional radiotherapy planning is a challenge in today's practice and requires the most accurate visualization of the tumor, with its functional characteristics (proliferation activity, hypoxic cells, apoptosis, neoangiogenesis) and surrounding radiosensitive normal tissue and organs. The collected information about the main indications for radiotherapy planning using PET / CT in head and neck cancers , small cell lung carcinoma and some malignant lymphomas has been discussed. The problem of false positive and false negative findings has been also considered. The protocol for 18-FDG PET / CT conducting according to the agreed consensus of the IAEA expert meeting held in 2006 is presented

Alleged child sexual abuse : The expert witness and the court

OpenAIRE

Gumpert, Clara Hellner

2001-01-01

Background During the past decades, the evaluation of alleged sexual abuse has manifested itself as a major challenge for professionals working within the field of child maltreatment. A new role for psychologists and psychiatrists has been to give expert opinions regarding the credibility and reliability of child witnesses in legal proceedings. Although some aspects of evaluating suspected sexual abuse cases are close to traditional clinical work, other aspects necessitate ...

Factors influencing societal response of nanotechnology : an expert stakeholder analysis

OpenAIRE

Gupta, N.; Fischer, A.R.H.; Lans, van der, I.A.; Frewer, L.J.

2012-01-01

Nanotechnology can be described as an emerging technology and, as has been the case with other emerging technologies such as genetic modification, different socio-psychological factors will potentially influence societal responses to its development and application. These factors will play an important role in how nanotechnology is developed and commercialised. This article aims to identify expert opinion on factors influencing societal response to applications of nanotechnology. Structured i...

Factors influencing societal response of nanotechnology: an expert stakeholder analysis

OpenAIRE

Gupta, Nidhi; Fischer, Arnout R. H.; van der Lans, Ivo A.; Frewer, Lynn J.

2012-01-01

Nanotechnology can be described as an emerging technology and, as has been the case with other emerging technologies such as genetic modification, different socio-psychological factors will potentially influence societal responses to its development and application. These factors will play an important role in how nanotechnology is developed and commercialised. This article aims to identify expert opinion on factors influencing societal response to applications of nanotechnology. Structured i...

Application of expert elicitation techniques in human reliability, assessment

International Nuclear Information System (INIS)

Sanyasi Rao, V.V.S.; Saraf, R.K.; Ghosh, A.K.; Kushwaha, H.S.

2006-01-01

Expert elicitation techniques are being used, in the area of technological forecasting, in estimating data needed for analysis when it is either difficult to arrive at the data by experimental means or when it is quite involved to plan and conduct the experiment. In this study, expert elicitation techniques are applied to the evaluation of the frequencies of the various accident sequences that can result from the initiating event (IE) 'High Pressure Process Water (HPPW) system failure' in typical Indian Pressurised Heavy Water Reactor (IPHWR) of the older generation. The Operating Procedure under Emergency Conditions (OPEC) for this IE involves human actions according to a pre-defined procedure. The Human Error Probabilities for all these human actions are obtained using expert elicitation techniques. These techniques aim at eliciting the opinion of the experts in the area of interest with regard to the issue in question. The uncertainty is analysed by employing the measure of dissonance and the most probable range of human error probabilities are arrived at by maximizing this measure. These values are combined using the same procedures mentioned above to yield a distribution representing the uncertainty associated with the predictions. (author)

Structured expert elicitation about Listeria monocytogenes cross-contamination in the environment of retail deli operations in the United States.

Science.gov (United States)

Hoelzer, Karin; Oliver, Haley F; Kohl, Larry R; Hollingsworth, Jill; Wells, Martin T; Wiedmann, Martin

2012-07-01

Listeria monocytogenes is among the foodborne pathogens with the highest death toll in the United States. Ready-to-eat foods contaminated at retail are an important source of infection. Environmental sites in retail deli operations can be contaminated. However, commonly contaminated sites are unlikely to come into direct contact with food and the public health relevance of environmental contamination has remained unclear. To identify environmental sites that may pose a considerable cross-contamination risk, to elucidate potential transmission pathways, and to identify knowledge gaps, we performed a structured expert elicitation of 41 experts from state regulatory agencies and the food retail industry with practical experience in retail deli operations. Following the "Delphi" method, the elicitation was performed in three consecutive steps: questionnaire, review and discussion of results, second questionnaire. Hands and gloves were identified as important potential contamination sources. However, bacterial transfers to and from hands or gloves represented a major data gap. Experts agreed about transfer probabilities from cutting boards, scales, deli cases, and deli preparation sinks to product, and about transfer probabilities from floor drains, walk-in cooler floors, and knife racks to food contact surfaces. Comparison of experts' opinions to observational data revealed a tendency among experts with certain demographic characteristics and professional opinions to overestimate prevalence. Experts' votes clearly clustered into separate groups not defined by place of employment, even though industry experts may have been somewhat overrepresented in one cluster. Overall, our study demonstrates the value and caveats of expert elicitation to identify data gaps and prioritize research efforts. © 2011 Society for Risk Analysis.

Identifying the Essential Elements of Effective Science Communication: What Do the Experts Say?

Science.gov (United States)

Bray, Belinda; France, Bev; Gilbert, John K.

2012-01-01

Experts in science communication were asked to identify the essential elements of a science communication course for post-graduate students. A Delphi methodology provided a framework for a research design that accessed their opinions and allowed them to contribute to, reflect on and identify 10 essential elements. There was a high level of…

DEGRO practical guidelines. Radiotherapy of breast cancer I. Radiotherapy following breast conserving therapy for invasive breast cancer

International Nuclear Information System (INIS)

Sedlmayer, F.

2013-01-01

Background and purpose: The aim of the present paper is to update the practical guidelines for postoperative adjuvant radiotherapy of breast cancer published in 2007 by the breast cancer expert panel of the German Society for Radiooncology (Deutsche Gesellschaft fuer Radioonkologie, DEGRO). The present recommendations are based on a revision of the German interdisciplinary S-3 guidelines published in July 2012. Methods: A comprehensive survey of the literature concerning radiotherapy following breast conserving therapy (BCT) was performed using the search terms 'breast cancer', 'radiotherapy', and 'breast conserving therapy'. Data from lately published meta-analyses, recent randomized trials, and guidelines of international breast cancer societies, yielding new aspects compared to 2007, provided the basis for defining recommendations according to the criteria of evidence-based medicine. In addition to the more general statements of the DKG (Deutsche Krebsgesellschaft), this paper addresses indications, target definition, dosage, and technique of radiotherapy of the breast after conservative surgery for invasive breast cancer. Results: Among numerous reports on the effect of radiotherapy during BCT published since the last recommendations, the recent EBCTCG report builds the largest meta-analysis so far available. In a 15 year follow-up on 10,801 patients, whole breast irradiation (WBI) halves the average annual rate of disease recurrence (RR 0.52, 0.48-0.56) and reduces the annual breast cancer death rate by about one sixth (RR 0.82, 0.75-0.90), with a similar proportional, but different absolute benefit in prognostic subgroups (EBCTCG 2011). Furthermore, there is growing evidence that risk-adapted dose augmentation strategies to the tumor bed as well as the implementation of high precision RT techniques (e.g., intraoperative radiotherapy) contribute substantially to a further reduction of local relapse rates. A main focus of ongoing research lies in partial breast

The necessity of repeated assessment of imaging studies contained in medical records in medico-legal opinions

Directory of Open Access Journals (Sweden)

Aleksandra Borowska-Solonynko

2014-12-01

Full Text Available The paper presents two case reports of living victims, in which imaging studies of the chest conducted at a medical facility were an essential part of the medico-legal opinion. The first case was that of a young male hospitalized due to CT evidence of bilateral rib fractions, who claimed to have been assaulted by police officers. The other case was that of a six week old baby hospitalized due to chest X-ray evidence of right hand side rib fractions. The chest X-ray was performed due to one bruise found on the baby’s forehead and two small bruises on the back, which gave rise to suspicions of child abuse. In both cases, expert witnesses in radiology definitively excluded the presence of any fractures. These cases indicate that a new assessment of imaging studies contained in medical records is needed. Expert opinions based solely on the description of imaging studies may result in grave consequences.

Expert Elicitation Methods in Quantifying the Consequences of Acoustic Disturbance from Offshore Renewable Energy Developments.

Science.gov (United States)

Donovan, Carl; Harwood, John; King, Stephanie; Booth, Cormac; Caneco, Bruno; Walker, Cameron

2016-01-01

There are many developments for offshore renewable energy around the United Kingdom whose installation typically produces large amounts of far-reaching noise, potentially disturbing many marine mammals. The potential to affect the favorable conservation status of many species means extensive environmental impact assessment requirements for the licensing of such installation activities. Quantification of such complex risk problems is difficult and much of the key information is not readily available. Expert elicitation methods can be employed in such pressing cases. We describe the methodology used in an expert elicitation study conducted in the United Kingdom for combining expert opinions based on statistical distributions and copula-like methods.

What defines an Expert? - Uncertainty in the interpretation of seismic data

Science.gov (United States)

Bond, C. E.

2008-12-01

Studies focusing on the elicitation of information from experts are concentrated primarily in economics and world markets, medical practice and expert witness testimonies. Expert elicitation theory has been applied in the natural sciences, most notably in the prediction of fluid flow in hydrological studies. In the geological sciences expert elicitation has been limited to theoretical analysis with studies focusing on the elicitation element, gaining expert opinion rather than necessarily understanding the basis behind the expert view. In these cases experts are defined in a traditional sense, based for example on: standing in the field, no. of years of experience, no. of peer reviewed publications, the experts position in a company hierarchy or academia. Here traditional indicators of expertise have been compared for significance on affective seismic interpretation. Polytomous regression analysis has been used to assess the relative significance of length and type of experience on the outcome of a seismic interpretation exercise. Following the initial analysis the techniques used by participants to interpret the seismic image were added as additional variables to the analysis. Specific technical skills and techniques were found to be more important for the affective geological interpretation of seismic data than the traditional indicators of expertise. The results of a seismic interpretation exercise, the techniques used to interpret the seismic and the participant's prior experience have been combined and analysed to answer the question - who is and what defines an expert?

CLINICAL PATHWAYS IN 17 EUROPEAN UNION COUNTRIES: A SURVEY OF EXPERT OPINIONS

Directory of Open Access Journals (Sweden)

Don Hindle

2004-11-01

Full Text Available Background. The main focus of the survey is on the extent to which clinical pathways are being used, and whether it might provide a basis for improved service planning and consequently strategic asset planning in health care.Methods. In the first stage, our aim was to make contact with one agency in each country (the primary agency below that would be able to provide contacts within that country with a mix of experts from each of the following types of agencies: Health sector government regulator, Health care purchasing (insurance agencies, Senior clinical managers in hospitals, Senior clinical managers in non-hospital care provider agencies (eg, home care, or primary medical care, Health professional societies (preferably medical and nursing, Accreditation or audit agencies, Consumer associations and Public or private agencies concerned with health facilities development. Definitions of these agencies and other terms were attached to the questionnaire itself. We would then ask the primary agency to choose the experts that were most likely to be aware of clinical pathway use. The persons thus contacted would then be asked to complete the questionnaire and send it back to the researchers. The aim was not to attempt to establish a random sample, but rather to target well-informed people.Results. 51 completed questionnaires were provided by largely self-selected experts from 17 EU countries. Respondents reported that pathways are important and becoming increasingly widely used (although the rate of progress is highly variable, the main constraints to their use are a cultural aversion among doctors and little encouragement from external parties, and there is growing recognition that multi-setting pathways have the greatest potential value.Conclusions. More needs to be done to achieve a common understanding of the ideas of pathways, strategic asset planning, and the interrelationships. Systems problems need systems solutions. In the case of clinical

Nuclear energy and public opinion: arousal of a myth

International Nuclear Information System (INIS)

Agrafiotis, D.; Delarminat, E.; Morlat, G.; Pages, J.P.

1977-01-01

In order to explain why an individual or the public opinion is in favour or against the peaceful uses of nuclear energy, one should not only consider the dimension of the involved risk, as radiation protection and safety experts will often do. Many other dimensions should be considered all the more as the nuclear problem is gaining importance on a national level, becoming the topic of the day in press and other media and the subject of 'definite' position from political parties and social groups. An investigation carried out within the Protection Division of the French Atomic Energy Commission (C.E.A.) has made it possible to specify the socio-cultural dimensions at the origin of the attitudes taken on the nuclear problem in France. The nuclear topic was therefore compared with other present topics interesting public opinion; this comparison was made possible by means of an attitude survey covering various social groups. A model of social perception was thus developed [fr

Bridge between public perception and expert assessment of nuclear safety

International Nuclear Information System (INIS)

1987-09-01

Preparation of the brief consisted of a comprehensive review of literature, selective interviews of available representative parties, and categorization of the spectrum of opinions. Analysis of the information thus obtained included identification of reconcilable and irreconcilable differences among the opinions and indication of possible ways to bridge some of the differences. Opinions were generally found to be best categorized as the pro, neutral, and contra opinions associated with experts and the public. The primary issues separating the opposing groups appear to be the following: 1) the required input for probabilistic risk analysis of accidents; 2) the evaluation of what constitutes an acceptable risk; 3) the evaluation of potential long-term consequences; 4) the general need for nuclear energy; and 5) the long-term risk to public health. Among the above issues, potential for reconciliation was found only for the first two, while the latter issues, because of the relatively short history of the industry and paucity of knowledge on relevant factors, were found difficult to reconcile without expansion of our present knowledge and data base. Reconciliation, generally, was proposed through augmentation of communication among the opposing groups through the availability of appropriate fora and development of a general spirit of good intention for a common cause: mankind's ultimate well-being

Radiotherapy facilities: Master planning and concept design considerations

Energy Technology Data Exchange (ETDEWEB)

NONE

2014-08-15

This publication provides guidelines on how to plan a radiotherapy facility in terms of the strategic master planning process including the legal, technical and infrastructure requirements. It outlines a risk assessment methodology, a typical project work plan and describes the professional expertise required for the implementation of such a project. Generic templates for a block design are suggested, which include possibilities for future expansion. These templates can be overlaid onto the designated site such that the most efficient workflow between the main functional areas can be ensured. A sample checklist is attached to act as a guideline for project management and to indicate the critical stages in the process where technical expert assistance may be needed. The publication is aimed at professionals and administrators involved in infrastructure development, planning and facility management, as well as engineers, building contractors and radiotherapy professionals.

Radiotherapy facilities: Master planning and concept design considerations

International Nuclear Information System (INIS)

2014-01-01

This publication provides guidelines on how to plan a radiotherapy facility in terms of the strategic master planning process including the legal, technical and infrastructure requirements. It outlines a risk assessment methodology, a typical project work plan and describes the professional expertise required for the implementation of such a project. Generic templates for a block design are suggested, which include possibilities for future expansion. These templates can be overlaid onto the designated site such that the most efficient workflow between the main functional areas can be ensured. A sample checklist is attached to act as a guideline for project management and to indicate the critical stages in the process where technical expert assistance may be needed. The publication is aimed at professionals and administrators involved in infrastructure development, planning and facility management, as well as engineers, building contractors and radiotherapy professionals

Proof of causation through expert opinion evidence in low-level radiation cases

International Nuclear Information System (INIS)

Heideck, R.E.

1985-01-01

Tort law requires that the injured person prove that the injury was caused by a particular exposure to radiation for which the defendant is responsible. Heideck shows how expert evidence helps the court or jury resolve this question. The author analyzes a recent effort to bridge the gap between the legal requirement of proof of causation in individual cases and the conclusions that derive from group statistics. Some scientists argue that this approach is more technically sound than traditional tort law because it attempts to develop a probability of causation in individual cases

Best practice strategies to safeguard drug prescribing and drug administration: an anthology of expert views and opinions.

Science.gov (United States)

Seidling, Hanna M; Stützle, Marion; Hoppe-Tichy, Torsten; Allenet, Benoît; Bedouch, Pierrick; Bonnabry, Pascal; Coleman, Jamie J; Fernandez-Llimos, Fernando; Lovis, Christian; Rei, Maria Jose; Störzinger, Dominic; Taylor, Lenka A; Pontefract, Sarah K; van den Bemt, Patricia M L A; van der Sijs, Heleen; Haefeli, Walter E

2016-04-01

While evidence on implementation of medication safety strategies is increasing, reasons for selecting and relinquishing distinct strategies and details on implementation are typically not shared in published literature. We aimed to collect and structure expert information resulting from implementing medication safety strategies to provide advice for decision-makers. Medication safety experts with clinical expertise from thirteen hospitals throughout twelve European and North American countries shared their experience in workshop meetings, on-site-visits and remote structured interviews. We performed an expert-based, in-depth assessment of implementation of best-practice strategies to improve drug prescribing and drug administration. Workflow, variability and recommended medication safety strategies in drug prescribing and drug administration processes. According to the experts, institutions chose strategies that targeted process steps known to be particularly error-prone in the respective setting. Often, the selection was channeled by local constraints such as the e-health equipment and critically modulated by national context factors. In our study, the experts favored electronic prescribing with clinical decision support and medication reconciliation as most promising interventions. They agreed that self-assessment and introduction of medication safety boards were crucial to satisfy the setting-specific differences and foster successful implementation. While general evidence for implementation of strategies to improve medication safety exists, successful selection and adaptation of a distinct strategy requires a thorough knowledge of the institute-specific constraints and an ongoing monitoring and adjustment of the implemented measures.

Chinese academic experts' assessment for forest bio-energy development in China

International Nuclear Information System (INIS)

Qu Mei; Ahponen, Pirkkoliisa; Tahvanainen, Liisa; Pelkonen, Paavo

2010-01-01

The aim of this study was to assess the current situation of the forest bio-energy development in China. This assessment is based on opinions of Chinese academic experts. Key drivers and uncertainties regarding the implementation, and the strategies for the future practices in the development of forest bio-energy were investigated. In addition, the purpose of this study was also to determine whether there is a consensus among the experts concerning forest bio-energy and if this consensus agrees with policy-makers in China. A thorough assessment was conducted using a two-round Delphi survey of sixty-one bio-energy experts in China. The results revealed the advantages, potential problems, and the experts' recommendations for the future development. Furthermore, the experts agreed that the Chinese government plays a dominant role in the development process of forest bio-energy in the country. The experts recognized that the process of developing forest bio-energy is a challenging task both domestically and globally. At the same time they also highlighted the potential benefits of developing forest bio-energy in China during the next ten years. The outcomes of this study could be used to give advice to policy-makers and to support the implementation of the future forest bio-energy policies in China.

Factors influencing societal response of nanotechnology: an expert stakeholder analysis

International Nuclear Information System (INIS)

Gupta, Nidhi; Fischer, Arnout R. H.; Lans, Ivo A. van der; Frewer, Lynn J.

2012-01-01

Nanotechnology can be described as an emerging technology and, as has been the case with other emerging technologies such as genetic modification, different socio-psychological factors will potentially influence societal responses to its development and application. These factors will play an important role in how nanotechnology is developed and commercialised. This article aims to identify expert opinion on factors influencing societal response to applications of nanotechnology. Structured interviews with experts on nanotechnology from North West Europe were conducted using repertory grid methodology in conjunction with generalized Procrustes analysis to examine the psychological constructs underlying societal uptake of 15 key applications of nanotechnology drawn from different areas (e.g. medicine, agriculture and environment, chemical, food, military, sports, and cosmetics). Based on expert judgement, the main factors influencing societal response to different applications of nanotechnology will be the extent to which applications are perceived to be beneficial, useful, and necessary, and how 'real' and physically close to the end-user these applications are perceived to be by the public.

Factors influencing societal response of nanotechnology: an expert stakeholder analysis

Science.gov (United States)

Gupta, Nidhi; Fischer, Arnout R. H.; van der Lans, Ivo A.; Frewer, Lynn J.

2012-05-01

Nanotechnology can be described as an emerging technology and, as has been the case with other emerging technologies such as genetic modification, different socio-psychological factors will potentially influence societal responses to its development and application. These factors will play an important role in how nanotechnology is developed and commercialised. This article aims to identify expert opinion on factors influencing societal response to applications of nanotechnology. Structured interviews with experts on nanotechnology from North West Europe were conducted using repertory grid methodology in conjunction with generalized Procrustes analysis to examine the psychological constructs underlying societal uptake of 15 key applications of nanotechnology drawn from different areas (e.g. medicine, agriculture and environment, chemical, food, military, sports, and cosmetics). Based on expert judgement, the main factors influencing societal response to different applications of nanotechnology will be the extent to which applications are perceived to be beneficial, useful, and necessary, and how 'real' and physically close to the end-user these applications are perceived to be by the public.

Expert assessment of the current state of the energy management system in the company

Science.gov (United States)

Minnullina, Anna; Abdrazakov, Rais

2017-10-01

The authors’ expert assessment of the current state of the energy management system in the company is proposed in the article. The experts are invited to assess the status of the energy management system in the following categories: energy policy, organizational structure, training, motivation, control, communication, investment, and energy consumption culture. For the purposes of interpretation of the results of the expert evaluation obtained, a gradation based on a possible range of values is proposed. The expert evaluation allows representing the status of the energy management system in general and at each of its individual levels, which makes it possible to identify the problem areas more accurately. To confirm the applied nature of the proposed methodology, the authors assessed the opinions of 8 experts, employed by the road construction company of the Tyumen Region and related in one way or another to the process of energy consumption in the company due to the nature of their activities.

DEGRO practical guidelines for radiotherapy of breast cancer I. Breast-conserving therapy

International Nuclear Information System (INIS)

Sautter-Bihl, M.L.; Budach, W.; Dunst, J.; Feyer, P.; Haase, W.; Harms, W.; Sedlmayer, F.; Souchon, R.; Wenz, F.; Sauer, R.

2007-01-01

Background: The present paper is an update of the practical guidelines for radiotherapy of breast cancer published in 2006 by the breast cancer expert panel of the German Society of Radiation Oncology (DEGRO). These recommendations have been elaborated on the basis of the S3 guidelines of the German Cancer Society that were revised in March 2007 by an interdisciplinary panel. Methods: The DEGRO expert panel performed a comprehensive survey of the literature, comprising lately published meta-analyses, data from recent randomized trials and guidelines of international breast cancer societies, referring to the criteria of evidence-based medicine. In addition to the more general statements of the German Cancer Society, this paper emphasizes specific radiotherapeutic aspects. It is focused on radiotherapy after breast-conserving surgery. Technique, targeting, and dose are described in detail. Results: Postoperative radiotherapy significantly reduces rates of local recurrence. The more pronounced the achieved reduction is, the more substantially it translates into improved survival. Four prevented local recurrences result in one avoided breast cancer death. This effect is independent of age. An additional boost provides a further absolute risk reduction for local recurrence irrespective of age. Women > 50 years have a hazard ratio of 0.59 in favor of the boost. For DCIS, local recurrence was 2.4% per patient year even in a subgroup with favorable prognostic factors leading to premature closure of the respective study due to ethical reasons. For partial-breast irradiation as a sole method of radiotherapy, results are not yet mature enough to allow definite conclusions. Conclusion: After breast-conserving surgery, whole-breast irradiation remains the gold standard of treatment. The indication for boost irradiation should no longer be restricted to women ≤ 50 years. Partial-breast irradiation is still an experimental treatment and therefore discouraged outside controlled

Involvement of experts in nuclear licensing and supervisory procedures who are known for their critical attitude towards nuclear technology

International Nuclear Information System (INIS)

Schirp, W.

1996-01-01

The article discusses legal and procedural aspects in the context of expert opinions demanded by the supervisory and licensing authorities of nuclear power plants, and the role and activities of experts known for their critical approach to nuclear electricity generation. The aspects addressed are: Reasons to break the dominance of ''established'' experts who in general are members of the TUeV organisations (technical control boards), reasons for challenging motions such as suspicion of prejudice or insufficient expertise, order by the supervisory authority to take a ''dual approach'' and involve two experts for a task, as well as the relevant administrative and legal procedures. (orig./CB) [de

Who are the opinion leaders? The physicians, pharmacists, patients, and direct-to-consumer prescription drug advertising.

Science.gov (United States)

Lee, Annisa Lai

2010-09-01

A popular perception holds that physicians prescribe requested drugs to patients influenced by mass mediated direct-to-consumer prescription drug advertising. The phenomenon poses a serious challenge to the two-step flow model, which emphasizes the influence of opinion leaders on their followers and their legitimating power over the informing power of the mass media. This study investigates a 2002 Food and Drug Administration (FDA) survey and finds that patients searching for drug information through mass and hybrid media in newspapers and magazines' small print, the Internet, and toll-free numbers are more likely to seek information through interpersonal communication channels like health care providers. Patients using small print, toll-free numbers, one's own physician, and other physicians are associated with influencing their physicians with various drug-requesting behaviors. But physicians only prescribe requested drugs to patients who are influenced by other health care providers, such as pharmacists and other physicians, not the mass media. The influence of expert opinion leaders of drugs is so strong that the patients even would switch from their own unyielding physicians who do not prescribe drugs as advised by the pharmacists. Physicians and patients all are influenced more by other expert opinion leaders of drugs than by the mass media and therefore still uphold the basic tenet of the two-step model.

DEGRO practical guidelines: radiotherapy of breast cancer II. Radiotherapy of non-invasive neoplasia of the breast

International Nuclear Information System (INIS)

Souchon, R.; Sautter-Bihl, M.L.; Sedlmayer, F.; Budach, W.; Dunst, J.; Feyer, P.; Fietkau, R.; Sauer, R.; Harms, W.; Wenz, F.; Haase, W.

2014-01-01

To complement and update the 2007 practice guidelines of the breast cancer expert panel of the German Society of Radiation Oncology (DEGRO) for radiotherapy (RT) of breast cancer. Owing to its growing clinical relevance, in the current version, a separate paper is dedicated to non-invasive proliferating epithelial neoplasia of the breast. In addition to the more general statements of the German interdisciplinary S3 guidelines, this paper is especially focused on indication and technique of RT in addition to breast conserving surgery. The DEGRO expert panel performed a comprehensive survey of the literature comprising recently published data from clinical controlled trials, systematic reviews as well as meta-analyses, referring to the criteria of evidence-based medicine yielding new aspects compared to 2005 and 2007. The literature search encompassed the period 2008 to September 2012 using databases of PubMed and Guidelines International Network (G-I-N). Search terms were ''non invasive breast cancer'', ''ductal carcinoma in situ, ''dcis'', ''borderline breast lesions'', ''lobular neoplasia'', ''radiotherapy'' and ''radiation therapy''. In addition to the more general statements of the German interdisciplinary S3 guidelines, this paper is especially focused on indications of RT and decision making of non-invasive neoplasia of the breast after surgery, especially ductal carcinoma in situ. Among different non-invasive neoplasia of the breast only the subgroup of pure ductal carcinoma in situ (DCIS; synonym ductal intraepithelial neoplasia, DIN) is considered for further recurrence risk reduction treatment modalities after complete excision of DCIS, particularly RT following breast conserving surgery (BCS), in order to avoid a mastectomy. About half of recurrences are invasive cancers. Up to 50?% of all recurrences require salvage mastectomy. Randomized clinical trials and a huge number of mostly observational studies have unanimously demonstrated that RT significantly

A Belief Rule-Based Expert System to Assess Bronchiolitis Suspicion from Signs and Symptoms Under Uncertainty

DEFF Research Database (Denmark)

Karim, Rezuan; Hossain, Mohammad Shahadat; Khalid, Md. Saifuddin

2017-01-01

developed generic belief rule-based inference methodology by using evidential reasoning (RIMER) acts as the inference engine of this BRBES while belief rule base as the knowledge representation schema. The knowledge base of the system is constructed by using real patient data and expert opinion from...

Radiotherapy Learning in Medical Undergraduate Courses.

Science.gov (United States)

de la Peña, L; Garcia-Linares, A

2016-12-01

Approximately 60 % of all cancer patients receive radiotherapy as a component of their treatment. Radiation Oncology concepts, specifically, are not formally introduced to students in most traditional school curricula until their clinical rotations or may only be included as an optional elective during the core clinical clerkships. The aim of this study is to determine whether the teaching of Radiation Oncology by radiation oncologists, in the third year, in block diagnostic and therapeutic procedures, is helpful for student training and changes their attitude towards the specialty. We administered a pre-test and post-test examination of the concepts in general radiation oncology, radiation physics, radiobiology, breast cancer and their opinion to the third year medical students. The 10-question, multiple choice tests were administered before starting the lessons and when they finished the course. Of the 130 third year students, 95 (73.07 %) participated in the pre-test and post-test analysis. For the entire cohort, improvement was seen in all questions except one regarding physics. A statistically significant improvement (p < 0.005) was seen in the question regarding the aspects of general radiotherapy, radiobiology, acute and after-effects of radiation and the management of early-stage breast cancer. With an adequate methodology, third year students can learn aspects of Radiation Oncology.

The IRSN 2012 barometer. The opinion on risks and security of the French population. Global results

International Nuclear Information System (INIS)

El Jammal, Marie-Helene; Rollinger, Francois; Mur, Emmanuelle

2012-01-01

This report presents and comments the results of a survey during which a sample of the French population has been questioned on their current concerns (what is the most concerning issue in the present society and in the environment, science within concerns), on their opinion on scientific expertise (who should control a risky installation, the role and image of experts, the access to expertise files, the perception of pluralist structures), on their opinion on 33 risk situations (risks to which French people feel exposed, confidence in authorities to protect them, truth of information on hazards, hierarchy of the 33 situations), on their opinion on the nuclear activity and industry (the nuclear risk, the credibility and expertise of interveners), and on the Fukushima accident (perception of the accident, quality of information, expectations on the assessment of nuclear power stations)

Ethical acceptability of research on human-animal chimeric embryos: summary of opinions by the Japanese Expert Panel on Bioethics.

Science.gov (United States)

Mizuno, Hiroshi; Akutsu, Hidenori; Kato, Kazuto

2015-01-01

Human-animal chimeric embryos are embryos obtained by introducing human cells into a non-human animal embryo. It is envisaged that the application of human-animal chimeric embryos may make possible many useful research projects including producing three-dimensional human organs in animals and verification of the pluripotency of human ES cells or iPS cells in vivo. The use of human-animal chimeric embryos, however, raises several ethical and moral concerns. The most fundamental one is that human-animal chimeric embryos possess the potential to develop into organisms containing human-derived tissue, which may lead to infringing upon the identity of the human species, and thus impairing human dignity. The Japanese Expert Panel on Bioethics in the Cabinet Office carefully considered the scientific significance and ethical acceptability of the issue and released its "Opinions regarding the handling of research using human-animal chimeric embryos". The Panel proposed a framework of case-by-case review, and suggested that the following points must be carefully reviewed from the perspective of ethical acceptability: (a) Types of animal embryos and types of animals receiving embryo transfers, particularly in dealing with non-human primates; (b) Types of human cells and organs intended for production, particularly in dealing with human nerve or germ cells; and (c) Extent of the period required for post-transfer studies. The scientific knowledge that can be gained from transfer into an animal uterus and from the production of an individual must be clarified to avoid unnecessary generation of chimeric animals. The time is ripe for the scientific community and governments to start discussing the ethical issues for establishing a global consensus.

Cardiovascular effects after low-dose exposure and radiotherapy: what research is needed?

Energy Technology Data Exchange (ETDEWEB)

Wondergem, Jan [International Atomic Energy Agency, Applied Radiation Biology and Radiotherapy Section, Division of Human Health, Department of Nuclear Sciences and Applications, Vienna (Austria); Boerma, Marjan [University of Arkansas for Medical Sciences, Division of Radiation Health, Department of Pharmaceutical Sciences, Little Rock, AR (United States); Kodama, Kazunori [Radiation Effects Research Foundation, Hiroshima (Japan); Stewart, Fiona A. [Netherlands Cancer Institute, Biological Stress Response (H3), Amsterdam (Netherlands); Trott, Klaus R.

2013-11-15

The authors of this report met at the Head Quarter of the International Atomic Energy Agency (IAEA) in Vienna, Austria, on 2-4 July 2012, for intensive discussions of an abundance of original publications on new epidemiological studies on cardiovascular effects after low-dose exposure and radiotherapy and radiobiological experiments as well as several comprehensive reviews that were published since the previous meeting by experts sponsored by the IAEA in June 2006. The data necessitated a re-evaluation of the situation with special emphasis on the consequences current experimental and clinical data may have for clinical oncology/radiotherapy and radiobiological research. The authors jointly arrived at the conclusions and recommendations presented here. (orig.)

Cardiovascular effects after low-dose exposure and radiotherapy: what research is needed?

International Nuclear Information System (INIS)

Wondergem, Jan; Boerma, Marjan; Kodama, Kazunori; Stewart, Fiona A.; Trott, Klaus R.

2013-01-01

The authors of this report met at the Head Quarter of the International Atomic Energy Agency (IAEA) in Vienna, Austria, on 2-4 July 2012, for intensive discussions of an abundance of original publications on new epidemiological studies on cardiovascular effects after low-dose exposure and radiotherapy and radiobiological experiments as well as several comprehensive reviews that were published since the previous meeting by experts sponsored by the IAEA in June 2006. The data necessitated a re-evaluation of the situation with special emphasis on the consequences current experimental and clinical data may have for clinical oncology/radiotherapy and radiobiological research. The authors jointly arrived at the conclusions and recommendations presented here. (orig.)

Essential elements of an early intervention service for psychosis: the opinions of expert clinicians

Directory of Open Access Journals (Sweden)

Lewis Shôn

2004-07-01

Full Text Available Abstract Background Early intervention teams attempt to improve outcome in schizophrenia through earlier detection and the provision of phase-specific treatments. Whilst the number of early intervention teams is growing, there is a lack of clarity over their essential structural and functional elements. Methods A 'Delphi' exercise was carried out to identify how far there was consensus on the essential elements of early intervention teams in a group of 21 UK expert clinicians. Using published guidelines, an initial list was constructed containing 151 elements from ten categories of team structure and function. Results Overall there was expert consensus on the importance of 136 (90% of these elements. Of the items on which there was consensus, 106 (70.2% were rated essential, meaning that in their absence the functioning of the team would be severely impaired. Conclusion This degree of consensus over essential elements suggests that it is reasonable to define a model for UK early intervention teams, from which a measure of fidelity could be derived.

Patriotic Education of Youth in Russia: Problems, Opinions, Expert Review

Directory of Open Access Journals (Sweden)

Жанна Васильевна Пузанова

2017-12-01

Full Text Available Patriotism is designated as a national idea in Russia; nowadays the questions the relevance of patriotic education of the most reactive of social groups - young people - is especially acute. Round table in the format of focus groups with 20 experts working with young people, among them - professors, teachers, veterans, employees public authorities to work with youth was held on the 27th of May 2016 on the basis of the museum-panorama “Battle of Stalingrad” in Volgograd, with the assistance of the Peoples’ Friendship University of Russia. During the two-hour round table were discussed issues of civil and patriotic education of youth, including the theme - “Ultrapatriotizm-Patriotism-pseudo-patriotism” (ratio of the concepts, their similarities and differences, manifestations in modern Russian society among young people, “Today's youth and moral conflicts” (spiritually-moral development of today's youth, its values, “infantilism - the scourge of modern youth?” (problem of infantilism as a barrier in the way of civic and patriotic education, “Does extremist views attractive for young people?” (the attitude of youth to extremism and terrorism, effective countermeasures of youth involvement in extremist groups.

Public perceptions and preferences regarding large scale implementation of six CO2 capture and storage technologies. Well-informed and well-considered opinions versus uninformed pseudo-opinions of the Dutch public

International Nuclear Information System (INIS)

De Best-Waldhober, M.; Daamen, D.

2006-03-01

Three research projects were carried out within the framework of the programme 'Sustainable use of fossil fuels'. Two research projects focussed on technical aspects of advanced fossil fuel options with CO2 capture and storage (CCS). The focus of the third project was on studying informed opinions of the general public regarding advanced fossil fuel options. This study has investigated the choices the general public would make after having received and evaluated expert information on the consequences pertaining to these choices. The method to collect these informed preferences is called the Information-Choice Questionnaire (ICQ). By comparing informed public preferences, obtained through administration of the ICQ, with current public opinions and preferences regarding fossil fuel options, collected in a more conventional survey, the outcomes of this project can indicate what options would be considered acceptable given sufficient knowledge, and how much and in what respect the current situation deviates from this possible future situation. Answering these questions constitutes the main goal of this project. This report describes the development and deployment of the Information-Choice Questionnaire on advanced fossil fuel options. It furthermore describes the parallel deployment of a more traditional questionnaire without expert information and a second measure of this more traditional questionnaire. This report encompasses all parts of the project 'Informed opinions of the general public as a tool for policy measures regarding advanced fossil fuel options'. This report will explain the ICQ methodology and its usefulness for this project. Furthermore, the development of the current ICQ, the method of the ICQ and of the more traditional questionnaires, and the results thereof, are described.

Radiotherapy

International Nuclear Information System (INIS)

Prosnitz, L.R.; Kapp, D.S.; Weissberg, J.B.

1983-01-01

This review highlights developments over the past decade in radiotherapy and attempts to summarize the state of the art in the management of the major diseases in which radiotherapy has a meaningful role. The equipment, radiobiology of radiotherapy and carcinoma of the lung, breast and intestines are highlighted

Factors influencing societal response of nanotechnology: an expert stakeholder analysis

Energy Technology Data Exchange (ETDEWEB)

Gupta, Nidhi, E-mail: nidhi.gupta@wur.nl; Fischer, Arnout R. H., E-mail: arnout.fischer@wur.nl; Lans, Ivo A. van der, E-mail: Ivo.vanderLans@wur.nl [Wageningen University, Marketing and Consumer Behaviour Group (Netherlands); Frewer, Lynn J., E-mail: lynn.frewer@newcastle.ac.uk [Newcastle University, School of Agriculture, Food and Rural Development (United Kingdom)

2012-05-15

Nanotechnology can be described as an emerging technology and, as has been the case with other emerging technologies such as genetic modification, different socio-psychological factors will potentially influence societal responses to its development and application. These factors will play an important role in how nanotechnology is developed and commercialised. This article aims to identify expert opinion on factors influencing societal response to applications of nanotechnology. Structured interviews with experts on nanotechnology from North West Europe were conducted using repertory grid methodology in conjunction with generalized Procrustes analysis to examine the psychological constructs underlying societal uptake of 15 key applications of nanotechnology drawn from different areas (e.g. medicine, agriculture and environment, chemical, food, military, sports, and cosmetics). Based on expert judgement, the main factors influencing societal response to different applications of nanotechnology will be the extent to which applications are perceived to be beneficial, useful, and necessary, and how 'real' and physically close to the end-user these applications are perceived to be by the public.

An expert display system and nuclear power plant control rooms

International Nuclear Information System (INIS)

Beltracchi, L.

1988-01-01

An expert display system controls automatically the display of segments on a cathode ray tube's screen to form an image of plant operations. The image consists of an icon of: 1) the process (heat engine cycle), 2) plant control systems, and 3) safety systems. A set of data-driven, forward-chaining computer stored rules control the display of segments. As plant operation changes, measured plant data are processed through the rules, and the results control the deletion and addition of segments to the display format. The icon contains information needed by control rooms operators to monitor plant operations. One example of an expert display is illustrated for the operator's task of monitoring leakage from a safety valve in a steam line of a boiling water reactor (BWR). In another example, the use of an expert display to monitor plant operations during pre-trip, trip, and post-trip operations is discussed as a universal display. The viewpoints and opinions expressed herein are the author's personal ones, and they are not to be interpreted as Nuclear Regulatory Commission criteria, requirements, or guidelines

The role of the article 31 experts group in harmonising the standards for radiation protection in the European Union

International Nuclear Information System (INIS)

Govaerts, P.

2002-01-01

Article 2 of the Euratom (European Atomic Energy Community) treaty requires the establishment of uniform safety standards to be implemented by each member state: Article 2, b: In order to perform its task the community shall establish uniform safety standards to protect the health of workers and of the general public and ensure that they are applied. The scope of those standards is defined by Article 30 and relates to doses compatible with adequate safety; levels of exposure and contamination; the fundamental principles governing the health surveillance of workers. Article 31 stipulates the decision making process with respect to those standards. Article 31: The basic standards shall be worked out by the Commission after it has obtained the opinion of a group of persons appointed by the Scientific and Technical Committee from among scientific experts, and in particular public health experts, in the Member States. The Commission shall obtain the opinion of the Economic and Social Committee on these basic standards. After consulting the Assembly the Council shall, on a proposal from the Commission, which shall forward to it the opinions from these Committees, establish the basic safety standards; the Council shall act by a qualified majority

Continental mapping of groundwater dependent ecosystems: A methodological framework to integrate diverse data and expert opinion

Directory of Open Access Journals (Sweden)

Tanya M. Doody

2017-04-01

New hydrological insights: It was identified that 34% of Australia’s landscape potentially contains GDEs of which 5% are classified with a high GDE potential. In addition, new continental scale insights into landscape processes where provided by the derivation and integration of remote sensing products using MODIS and Landsat. These products identify landscapes which are ‘wetter’ or ‘greener’ than surrounding areas, indicating these landscapes are accessing additional water, such as groundwater, supplementary to rainfall. The method reported also demonstrates the importance of expert knowledge, obtained through literature and expert elicitation, in order to provide a conceptual understanding of regional ecohydrological processes to develop rules of GDE dependency that would guide the extrapolation of known GDEs.

Leader's opinion priority bounded confidence model for network opinion evolution

Science.gov (United States)

Zhu, Meixia; Xie, Guangqiang

2017-08-01

Aiming at the weight of trust someone given to participate in the interaction in Hegselmann-Krause's type consensus model is the same and virtual social networks among individuals with different level of education, personal influence, etc. For differences between agents, a novelty bounded confidence model was proposed with leader's opinion considered priority. Interaction neighbors can be divided into two kinds. The first kind is made up of "opinion leaders" group, another kind is made up of ordinary people. For different groups to give different weights of trust. We also analyzed the related characteristics of the new model under the symmetrical bounded confidence parameters and combined with the classical HK model were analyzed. Simulation experiment results show that no matter the network size and initial view is subject to uniform distribution or discrete distribution. We can control the "opinion-leader" good change the number of views and values, and even improve the convergence speed. Experiment also found that the choice of "opinion leaders" is not the more the better, the model well explain how the "opinion leader" in the process of the evolution of the public opinion play the role of the leader.

Put yourself in their shoes … the vulnerability of children and their families when attending for radiotherapy treatment: The role of the specialist paediatric radiotherapy radiographer

International Nuclear Information System (INIS)

Woodman, Helen

2013-01-01

Childhood cancer is rare; only 1 in 600 children under the age of 15 years develop a cancer. The treatment of childhood cancers is usually a multimodality approach and can involve surgery, chemotherapy and radiotherapy. Radiotherapy is used in the management of tumours of the central nervous system, solid tumours, leukaemia's and Hodgkin's Lymphoma in the paediatric setting. Paediatric patients make up just 1% of the workload in radiotherapy departments, therefore they tend to be very adult orientated environments and treating children can be complex and challenging for staff. As healthcare professionals we must acknowledge the vulnerability of children and their families when they are coming for radiotherapy treatment. The role of the specialist paediatric radiographer has evolved to work alongside the children and their families to alleviate some of the families and staff anxieties, acting as an advocate, a key point of contact and resource. The very nature of radiotherapy treatment means parents will be separated from their children whilst the treatment is delivered. As radiographers we must ensure we put ourselves in their shoes and acknowledge how difficult this is for children and their parents. The key to every interaction with families is excellent communication and this is not just between professionals, the children and families but also between colleagues to ensure care is co-ordinated. Radiographers working with paediatric patients must have refined communication skills, be able to build rapports, offer support and comfort to children and their parents to ensure they receive the best possible care that is tailored to the individual families holistic needs. The specialist paediatric radiotherapy radiographer is in a unique position to deliver this expert care and support

Universal Health Coverage in Francophone Sub-Saharan Africa: Assessment of Global Health Experts' Confidence in Policy Options.

Science.gov (United States)

Paul, Elisabeth; Fecher, Fabienne; Meloni, Remo; van Lerberghe, Wim

2018-05-29

Many countries rely on standard recipes for accelerating progress toward universal health coverage (UHC). With limited generalizable empirical evidence, expert confidence and consensus plays a major role in shaping country policy choices. This article presents an exploratory attempt conducted between April and September 2016 to measure confidence and consensus among a panel of global health experts in terms of the effectiveness and feasibility of a number of policy options commonly proposed for achieving UHC in low- and middle-income countries, such as fee exemptions for certain groups of people, ring-fenced domestic health budgets, and public-private partnerships. To ensure a relative homogeneity of contexts, we focused on French-speaking sub-Saharan Africa. We initially used the Delphi method to arrive at expert consensus, but since no consensus emerged after 2 rounds, we adjusted our approach to a statistical analysis of the results from our questionnaire by measuring the degree of consensus on each policy option through 100 (signifying total consensus) minus the size of the interquartile range of the individual scores. Seventeen global health experts from various backgrounds, but with at least 20 years' experience in the broad region, participated in the 2 rounds of the study. The results provide an initial "mapping" of the opinions of a group of experts and suggest interesting lessons. For the 18 policy options proposed, consensus emerged only on strengthening the supply of quality primary health care services (judged as being effective with a confidence score of 79 and consensus score of 90), and on fee exemptions for the poorest (judged as being fairly easy to implement with a confidence score of 66 and consensus score of 85). For none of the 18 common policy options was there consensus on both potential effectiveness and feasibility, with very diverging opinions concerning 5 policy options. The lack of confidence and consensus within the panel seems to

Radiotherapy

Directory of Open Access Journals (Sweden)

Rema Jyothirmayi

1999-01-01

Full Text Available Purpose. Conservative treatment in the form of limited surgery and post-operative radiotherapy is controversial in hand and foot sarcomas, both due to poor radiation tolerance of the palm and sole, and due to technical difficulties in achieving adequate margins.This paper describes the local control and survival of 41 patients with soft tissue sarcoma of the hand or foot treated with conservative surgery and radiotherapy. The acute and late toxicity of megavoltage radiotherapy to the hand and foot are described. The technical issues and details of treatment delivery are discussed. The factors influencing local control after radiotherapy are analysed.

Radiotherapy Facilities: Master Planning and Concept Design Considerations (Russian Edition)

International Nuclear Information System (INIS)

2015-01-01

This publication provides guidelines on how to plan a radiotherapy facility in terms of the strategic master planning process including the legal, technical and infrastructure requirements. It outlines a risk assessment methodology and a typical project work plan, and describes the professional expertise required for the implementation of such a project. Generic templates for a block design are suggested, which include possibilities for future expansion. These templates can be overlaid onto the designated site such that the most efficient workflow between the main functional areas can be ensured. A sample checklist is attached to act as a guideline for project management and to indicate the critical stages in the process where technical expert assistance may be needed. The publication is aimed at professionals and administrators involved in infrastructure development, planning and facility management, as well as engineers, building contractors and radiotherapy professionals

The experience of a local partnership with experts

International Nuclear Information System (INIS)

Draulans, H.

2004-01-01

STOLA is an abbreviation for Structured Study group for Low-level short-lived radioactive waste, with all the actors of our small community of Dessel. You may know: social culture and economic factors of course all play a role in radioactive waste management and we work together with the experts of ONDRAF/NIRAS. But I am sure that was explained to you sufficiently yesterday and I can skip all that. 70 000 m 3 of low-level radioactive waste can be disposed of in our area and that only under certain safety conditions for humans and the environment. Of course one of the conditions is also that it has an added value for our municipality. In the past four years, I have participated in the activities of STOLA in Dessel and also led them. In that period, I met many, many experts, I spoke to them; I also really listened to them and together we worked on this disposal process. I will give you my personal opinion on that contact with those experts. Although I am going to be one in a long list of professors giving lectures today, I may not be the most scientific of speakers: I will be talking mainly from my experience with the people from STOLA. (author)

Risk perception of diagnostic and therapeutic radiological applications. Comparison of experts and the public

International Nuclear Information System (INIS)

Arranz, L.; Macias, M.T.; Prades, A.; Sola, R.; Martinez-Arias, R.

2000-01-01

Recent research has found many differences between experts and lay people in judgements of radiological risks. However, most of these studies were carried out on experts from nuclear power plants, regulatory bodies etc. This paper analyses the differences among several groups of 'experts' coming from the Health area and the lay people. A survey was designed to assess the perceived seriousness of seven diagnostic and therapeutic applications: conventional diagnostic radiology, computed tomography, chemotherapy, ecography examinations, radiotherapy, and diagnostic and therapeutic nuclear medicine. The questionnaire was distributed to samples of experts (professionals exposed to ionizing radiations, and other health professionals), and outpatients. All samples were selected from ten countries: Argentine, Brazil, Colombia, Cuba, Ecuador, Mexico, Panama, Peru, Uruguay, and Spain, thanks to the collaboration of the different National Radioprotection Societies of the above mentioned countries, and of other concerned professionals (in case they didn't have any association at the time). The following comparisons will be presented: 1) Differences between experts' and the public; 2) differences among several groups of 'experts'; 3) within the 'expert' sample, differences between perceived seriousness as a patient and as a professional at risk; 4) within the public sample, individual differences related to some socio-demographic variables. A cross-cultural analysis of the above mentioned comparisons will also be carried out. (author)

Risk perception of diagnostic and therapeutic radiological applications. Comparison of experts and the public

Energy Technology Data Exchange (ETDEWEB)

Arranz, L. [Hospital Ramon y Cajal, Madrid (Spain); Macias, M.T. [CSIC, Madrid (Spain); Prades, A.; Sola, R. [Ciemat, Madrid (Spain); Martinez-Arias, R. [Universidad Complutense, Madrid (Spain)

2000-05-01

Recent research has found many differences between experts and lay people in judgements of radiological risks. However, most of these studies were carried out on experts from nuclear power plants, regulatory bodies etc. This paper analyses the differences among several groups of 'experts' coming from the Health area and the lay people. A survey was designed to assess the perceived seriousness of seven diagnostic and therapeutic applications: conventional diagnostic radiology, computed tomography, chemotherapy, ecography examinations, radiotherapy, and diagnostic and therapeutic nuclear medicine. The questionnaire was distributed to samples of experts (professionals exposed to ionizing radiations, and other health professionals), and outpatients. All samples were selected from ten countries: Argentine, Brazil, Colombia, Cuba, Ecuador, Mexico, Panama, Peru, Uruguay, and Spain, thanks to the collaboration of the different National Radioprotection Societies of the above mentioned countries, and of other concerned professionals (in case they didn't have any association at the time). The following comparisons will be presented: 1) Differences between experts' and the public; 2) differences among several groups of 'experts'; 3) within the 'expert' sample, differences between perceived seriousness as a patient and as a professional at risk; 4) within the public sample, individual differences related to some socio-demographic variables. A cross-cultural analysis of the above mentioned comparisons will also be carried out. (author)

DEGRO practical guidelines: radiotherapy of breast cancer III - radiotherapy of the lymphatic pathways

International Nuclear Information System (INIS)

Sautter-Bihl, M.L.; Sedlmayer, F.; Fussl, C.; Budach, W.; Dunst, J.; Feyer, P.; Fietkau, R.; Sauer, R.; Harms, W.; Piroth, M.D.; Souchon, R.; Wenz, F.; Haase, W.

2014-01-01

The purpose of this work is to update the practical guidelines for adjuvant radiotherapy of the regional lymphatics of breast cancer published in 2008 by the breast cancer expert panel of the German Society of Radiation Oncology (DEGRO). A comprehensive survey of the literature concerning regional nodal irradiation (RNI) was performed using the following search terms: ''breast cancer'', ''radiotherapy'', ''regional node irradiation''. Recent randomized trials were analyzed for outcome as well as for differences in target definition. Field arrangements in the different studies were reproduced and superimposed on CT slices with individually contoured node areas. Moreover, data from recently published meta-analyses and guidelines of international breast cancer societies, yielding new aspects compared to 2008, provided the basis for defining recommendations according to the criteria of evidence-based medicine. In addition to the more general statements of the German interdisciplinary S3 guidelines updated in 2012, this paper addresses indications, targeting, and techniques of radiotherapy of the lymphatic pathways after surgery for breast cancer. International guidelines reveal substantial differences regarding indications for RNI. Patients with 1-3 positive nodes seem to profit from RNI compared to whole breast (WBI) or chest wall irradiation alone, both with regard to locoregional control and disease-free survival. Irradiation of the regional lymphatics including axillary, supraclavicular, and internal mammary nodes provided a small but significant survival benefit in recent randomized trials and one meta-analysis. Lymph node irradiation yields comparable tumor control in comparison to axillary lymph node dissection (ALND), while reducing the rate of lymph edema. Data concerning the impact of 1-2 macroscopically affected sentinel node (SN) or microscopic metastases on prognosis are conflicting. Recent data suggest that the current restrictive use of RNI should be

A Child's Concept of Pain: An International Survey of Pediatric Pain Experts.

Science.gov (United States)

Pate, Joshua W; Hush, Julia M; Hancock, Mark J; Moseley, G Lorimer; Butler, David S; Simons, Laura E; Pacey, Verity

2018-01-15

A child's 'concept of pain' refers to how they understand what pain actually is, what function pain serves, and what biological processes are thought to underpin it. We aimed to determine pediatric pain experts' opinions of: (1) the importance and usefulness of assessing a child's concept of pain in clinical and/or research settings; (2) the usefulness of the content of items within currently published adult-targeted resources for assessing a child's concept of pain; and (3) important domains of a child's concept of pain to assess. Forty-nine pediatric pain experts (response rate = 75.4%) completed an online survey. Descriptive statistics and frequency of responses were analyzed. Experts from all included disciplines reported that assessing a child's concept of pain is important and useful both clinically and in a research setting (>80% reported very or extremely useful for each item). Experts considered that the content of 13 items from currently published adult-targeted resources was useful, but the wording was too complex for children aged 8-12 years. Experts considered that all seven of the proposed domains of a child's concept of pain was important to assess. The findings can be used to inform the development of an assessment tool for a child's concept of pain.

Ramadan fasting: Evidence or expert opinion? Results of preliminary studies

Directory of Open Access Journals (Sweden)

1Maryam Kazemi

2013-11-01

Full Text Available Each year, over a billion Muslims fast worldwide during the month of Ramadan. Through this religious practice, not only will one have spiritual growth, but can improve his/her diet, which is of pivotal importance in this month. Conversely, the available evidence regarding the health benefits of Ramadan fasting is scarce and highly contentious. Although Islam exempts patients from fasting, many of them fast conceivably and their clinical condition is prone to deteriorate. This is due to the persistent gap between current expert knowledge and conclusive, strong evidence regarding the pathophysiologic and metabolic alterations by fasting, and the consensus that healthcare professionals should reach, in order to manage various patient groups during this month. In this review, we summarize the results of our initial studies regarding the effects of Ramadan fasting on some clinical conditions including alterations of body composition. We also go through the important clinical results of patients who have had previous history of cardiovascular disease, type 2 diabetes, asthma and renal colic. Our studies have presented some evidence in favor of Ramadan fasting and encourage those with mentioned diseases to consult their physicians and follow medical and scientific recommendations. We attempt to present some relevant evidence clarify future scopes in this area of study, and provide suggestions for future investigations.

Ramadan fasting: Evidence or expert opinion? Results of preliminary studies

Directory of Open Access Journals (Sweden)

Maryam Kazemi

2013-12-01

Full Text Available Each year, over a billion Muslims fast worldwide during the month of Ramadan.  Through this religious practice, not only will one have spiritual growth, but can improve his/her diet, which is of pivotal importance in this month. Conversely, the available evidence regarding the health benefits of Ramadan fasting is scarce and highly contentious. Although Islam exempts patients from fasting, many of them fast conceivably and their clinical condition is prone to deteriorate. This is due to the persistent gap between current expert knowledge and conclusive, strong evidence regarding the pathophysiologic and metabolic alterations by fasting, and the consensus that healthcare professionals should reach, in order to manage various patient groups during this month. In this review, we summarize the results of our initial studies regarding the effects of Ramadan fasting on some clinical conditions including alterations of body composition. We also go through the important clinical results of patients who have had previous history of cardiovascular disease, type 2 diabetes, asthma and renal colic. Our studies have presented some evidence in favor of Ramadan fasting and encourage those with mentioned diseases to consult their physicians and follow medical and scientific recommendations. We attempt to present some relevant evidence clarify future scopes in this area of study, and provide suggestions for future investigations.

Does a too risk-averse approach to the implementation of new radiotherapy technologies delay their clinical use?

Science.gov (United States)

Garcia, R; Nyström, H; Fiorino, C; Thwaites, D

2015-07-01

Radiotherapy is a generally safe treatment modality in practice; nevertheless, recent well-reported accidents also confirm its potential risks. However, this may obstruct or delay the introduction of new technologies and treatment strategies/techniques into clinical practice. Risks must be addressed and judged in a realistic context: risks must be assessed realistically. Introducing new technology may introduce new possibilities of errors. However, delaying the introduction of such new technology therefore means that patients are denied the potentially better treatment opportunities. Despite the difficulty in quantitatively assessing the risks on both sides of the possible choice of actions, including the "lost opportunity", the best estimates should be included in the overall risk-benefit and cost-benefit analysis. Radiotherapy requires a sufficiently high level of support for the safety, precision and accuracy required: radiotherapy development and implementation is exciting. However, it has been anxious with a constant awareness of the consequences of mistakes or misunderstandings. Recent history can be used to show that for introduction of advanced radiotherapy, the risk-averse medical physicist can act as an electrical fuse in a complex circuit. The lack of sufficient medical physics resource or expertise can short out this fuse and leave systems unsafe. Future technological developments will continue to present further safety and risk challenges. The important evolution of radiotherapy brings different management opinions and strategies. Advanced radiotherapy technologies can and should be safely implemented in as timely a manner as possible for the patient groups where clinical benefit is indicated.

Adjuvant Versus Salvage Radiotherapy for Patients With Adverse Pathological Findings Following Radical Prostatectomy: A Decision Analysis

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Christopher J. D. Wallis MD

2017-05-01

Full Text Available Background: Patients undergoing surgery for prostate cancer who have adverse pathological findings experience high rates of recurrence. While there are data supporting adjuvant radiotherapy compared to a wait-and-watch strategy to reduce recurrence rates, there are no randomized controlled trials comparing adjuvant radiotherapy with the other standard of care, salvage radiotherapy (radiotherapy administered at the time of recurrence. Methods: We constructed a health state transition (Markov model employing two-dimensional Monte Carlo simulation using a lifetime horizon to compare the quality-adjusted survival associated with postoperative strategies using adjuvant or salvage radiotherapy. Prior to analysis, we calibrated and validated our model using the results of previous randomized controlled trials. We considered clinically important oncological health states from immediately postoperative to prostate cancer–specific death, commonly described complications from prostate cancer treatment, and other causes of mortality. Transition probabilities and utilities for disease states were derived from a literature search of MEDLINE and expert consensus. Results: Salvage radiotherapy was associated with an increased quality-adjusted life expectancy (QALE (58.3 months as compared with adjuvant radiotherapy (53.7 months, a difference of 4.6 months (standard deviation 8.8. Salvage radiotherapy had higher QALE in 53% of hypothetical cohorts. There was a minimal difference in overall life expectancy (-0.1 months. Examining recurrence rates, our model showed validity when compared with available randomized controlled data. Conclusions: A salvage radiotherapy strategy appears to provide improved QALE for patients with adverse pathological findings following radical prostatectomy, compared with adjuvant radiotherapy. As these findings reflect, population averages, specific patient and tumor factors, and patient preferences remain central for individualized

Expert Systems: What Is an Expert System?

Science.gov (United States)

Duval, Beverly K.; Main, Linda

1994-01-01

Describes expert systems and discusses their use in libraries. Highlights include parts of an expert system; expert system shells; an example of how to build an expert system; a bibliography of 34 sources of information on expert systems in libraries; and a list of 10 expert system shells used in libraries. (Contains five references.) (LRW)

Identification of component performance degradations caused by ageing using expert panels

International Nuclear Information System (INIS)

Nitoi, Mirela; Cristea, Dumitru; Pavelescu, Margarit

2008-01-01

Since the component ageing can be considered as one of the important causes of operating events reported, the identification of ageing effects and implementation of appropriate methods for mitigation of these effects represent an important preoccupation of many organizations and research activities. In the process of identification of ageing manifestation we can use either analysis of operational data or expert opinions, each of the methods having specific advantages and disadvantages. A reasonable combination of statistical, structural reliability and expert panel methods would be an appropriate approach in the failure probability assessments. In case when there are not enough operational data, the expert judgments represent the only viable alternative in the effort dedicated to identification of components and systems vulnerability to ageing. The panel use judgments to analyse the degradation produced by ageing, to score the components based on specific criteria and to rank them relative to one another. The paper presents the approach developed, including evaluation criteria and assigning indices for assessment of particular types of ageing degradation (the case of secondary system of TRIGA reactor). (authors)

On the use of expert judgments to estimate the pressure increment in the Sequoyah containment at vessel breach

International Nuclear Information System (INIS)

Chhibber, S.; Apostolakis, G.E.; Okrent, D.

1994-01-01

The use of expert judgments in probabilistic risk assessments has become common. Simple aggregation methods have often been used with the result that expert biases and interexpert dependence are often neglected. Sophisticated theoretical models for the use of expert opinions have been proposed that offer ways of incorporating expert biases and dependence, but they have not found wide acceptance because of the difficulty and rigor of these methods. Practical guidance on the use of the versatile Bayesian expert judgment aggregation model is provided. In particular, the case study of pressure increment due to vessel breach in the Sequoyah nuclear power plant is chosen to illustrate how phenomenological uncertainty can be addressed by using the Bayesian aggregation model. The results indicate that the Bayesian aggregation model is a suitable candidate model for aggregating expert judgments, especially if there is phenomenological uncertainty. Phenomenological uncertainty can be represented through the dependence parameter of the Bayesian model. This is because the sharing of assumptions by the experts tends to introduce dependence between the experts. The extent of commonality in the experts' beliefs can be characterized by assessing their interdependence. The results indicate that uncertainty is possibly underestimated by ignoring dependence

Setting health research priorities using the CHNRI method: VI. Quantitative properties of human collective opinion.

Science.gov (United States)

Yoshida, Sachiyo; Rudan, Igor; Cousens, Simon

2016-06-01

Crowdsourcing has become an increasingly important tool to address many problems - from government elections in democracies, stock market prices, to modern online tools such as TripAdvisor or Internet Movie Database (IMDB). The CHNRI method (the acronym for the Child Health and Nutrition Research Initiative) for setting health research priorities has crowdsourcing as the major component, which it uses to generate, assess and prioritize between many competing health research ideas. We conducted a series of analyses using data from a group of 91 scorers to explore the quantitative properties of their collective opinion. We were interested in the stability of their collective opinion as the sample size increases from 15 to 90. From a pool of 91 scorers who took part in a previous CHNRI exercise, we used sampling with replacement to generate multiple random samples of different size. First, for each sample generated, we identified the top 20 ranked research ideas, among 205 that were proposed and scored, and calculated the concordance with the ranking generated by the 91 original scorers. Second, we used rank correlation coefficients to compare the ranks assigned to all 205 proposed research ideas when samples of different size are used. We also analysed the original pool of 91 scorers to to look for evidence of scoring variations based on scorers' characteristics. The sample sizes investigated ranged from 15 to 90. The concordance for the top 20 scored research ideas increased with sample sizes up to about 55 experts. At this point, the median level of concordance stabilized at 15/20 top ranked questions (75%), with the interquartile range also generally stable (14-16). There was little further increase in overlap when the sample size increased from 55 to 90. When analysing the ranking of all 205 ideas, the rank correlation coefficient increased as the sample size increased, with a median correlation of 0.95 reached at the sample size of 45 experts (median of the rank

Effect of radiotherapy on immunity function of cancer patients receiving radiotherapy

International Nuclear Information System (INIS)

Li Xinli; Zhu Shentao; Xu Jiuhong

2003-01-01

Objective: In order to observe the effect of radiotherapy on immunity function of cancer patients receiving radiotherapy. Methods: Cellular immunity is determined by APAAP; Humoral immunity is determined by transmission method. Results: The items of cellular immunity is lower than the control after radiotherapy. These items decrease continually. The difference between before and after radiotherapy has statistic significance. Of all Humoral immunity items, IgA, IgM decreased after radiotherapy and the difference has statistic significance. Conclusions: Radiotherapy can damage patients' immunity function

[The CSI effect and its impact on the perceptions of forensic science experts' work].

Science.gov (United States)

Stojer, Joanna

2011-01-01

The issue that has been analyzed in this work is the potential effect of crime films and TV series on people's perceptions of forensic medicine and science, and especially on the forming of expectations towards forensic science experts. This syndrome is being called the "CSI effect" after the popular franchise Crime Scene Investigation (CSI). Questionnaire surveys that have been conducted included "experts": 50 experts in various specialities, 77 prosecutors, 119 judges, 64 lay judges, 161 police staff and 80 members of general public. In-depth interviews have been conducted with 20 police staff, and also a focus group has been carried out with 15 law students. In the opinion of the respondents, people's perceptions and expectations of forensic science--as it can be observed during criminal trials--are largely inflated by the entertainment media. Among the surveyed persons, the category that declares watching crime series most rarely, is forensic science experts. Around half of the surveyed experts pointed out to excessive expectations towards they work instigated by TV crime series. The most common expectations towards forensic medicine experts are: immediate conclusiveness of post mortem examinations (going as far as indicating the cause of death at the crime scene), precision of death time estimation and a routine use of sophisticated methods known from TV.

Results of expert response when forming an exhaustive list of potential risks of constructions projects using energy efficient technologies

Directory of Open Access Journals (Sweden)

Ryzhkova Anastasiya Igorevna

2016-10-01

Full Text Available The author deals with the most widely used methods of risk events identification. The expert response method is most applicable for construction projects using energy efficient technologies. The article presents the results of an opinion poll of the professional expert community using expert response method, which is aimed to identify the most likely potential “pure” risk of construction projects with energy-efficient technologies in use. 74 experts representing different levels of the construction process were polled: customers and directors of construction companies, project managers, risk managers, advisors. The answers were collected during private talks and also using a special website Survey Monkey. Experts from different countries took part: Russia, Great Britain, Austria, Luxemburg, Switzerland and Norway. Also the article presents the expert evaluation of the “effect” of risk implementation on the cost of a project, implementation time, the product quality, the environment and safety on the construction site.

Opinion and Persuasion

OpenAIRE

Ioan Constantin Dima; Daniela Gîfu

2014-01-01

The research proves that persuasion has two types of objectives. Its main objective is the change of opinion. Its fundamental and foundational objectives are the change in attitude, generic conduct and situational behaviour. The main objective controls the fundamental objectives. The change in attitudes and conduct/behaviour is presided by changes in opinion. Persuasion is thus shown to be primarily and ultimately a matter of opinion. As such, its mechanism to manage and generate ...

On the use of the analytic hierarchy process in the aggregation of expert judgments

International Nuclear Information System (INIS)

Zio, E.

1996-01-01

Expert judgments are involved in many aspects of scientific research, either formally or informally. In order to combine the different opinions elicited, simple aggregation methods have often been used with the result that expert biases, interexpert dependencies and other factors which might affect the judgments of the experts are often ignored. A more comprehensive approach, based on the analytic hierarchy process, is proposed in this paper to account for the large variety of factors influencing the experts. A structured hierarchy is constructed to decompose the overall problem in the elementary factors that can influence the expert's judgements. The importance of the different elements of the hierarchy is then assessed by pairwise comparison. The overall approach is simple, presents a systematic character and offers a good degree of flexibility. The approach provides the decision maker with a tool to quantitatively measure the significance of the judgments provided by the different experts involved in the elicitation. The resulting values can be used as weights in an aggregation scheme such as, for example, the simple weighted averaging scheme. Two applications of the approach are presented with reference to case studies of formal expert judgment elicitation previously analyzed in literature: the elicitation of the pressure increment in the containment building of the Sequoyah nuclear power plant following reactor vessel breach, and the prediction of the future changes in precipitation in the vicinity of Yucca Mountain

Opinion dynamics in activity-driven networks

Science.gov (United States)

Li, Dandan; Han, Dun; Ma, Jing; Sun, Mei; Tian, Lixin; Khouw, Timothy; Stanley, H. Eugene

2017-10-01

Social interaction between individuals constantly affects the development of their personal opinions. Previous models such as the Deffuant model and the Hegselmann-Krause (HK) model have assumed that individuals only update their opinions after interacting with neighbors whose opinions are similar to their own. However, people are capable of communicating widely with all of their neighbors to gather their ideas and opinions, even if they encounter a number of opposing attitudes. We propose a model in which agents listen to the opinions of all their neighbors. Continuous opinion dynamics are investigated in activity-driven networks with a tolerance threshold. We study how the initial opinion distribution, tolerance threshold, opinion-updating speed, and activity rate affect the evolution of opinion. We find that when the initial fraction of positive opinion is small, all opinions become negative by the end of the simulation. As the initial fraction of positive opinions rises above a certain value —about 0.45— the final fraction of positive opinions sharply increases and eventually equals 1. Increased tolerance threshold δ is found to lead to a more varied final opinion distribution. We also find that if the negative opinion has an initial advantage, the final fraction of negative opinion increases and reaches its peak as the updating speed λ approaches 0.5. Finally we show that the lower the activity rate of individuals, the greater the fluctuation range of their opinions.

Recent progress in radiotherapy, as shown by the example of the bronchial carcinoma and the brain tumor

International Nuclear Information System (INIS)

Schnabel, K.; Trendelenburg, F.

1986-01-01

This volume presents reports of selected novel radiotherapeutical methods for treatment of the bronchial carcinoma and the brain tumor, and an evaluation of first results obtained. The reports also are intended to show that advances in modern radiotherapy very much rely on basic research activities in the physical and radiobiological field, and on close cooperation between the various clinical disciplines. This is why opinions of other clinics are presented as well. (orig.) [de

The admissibility of offender profiling in courtroom: a review of legal issues and court opinions.

Science.gov (United States)

Bosco, Dario; Zappalà, Angelo; Santtila, Pekka

2010-01-01

What is the future of Offender Profiling? Is it an important field of forensic science or is it only a glamorous art? After the trilogy "Daubert-Joiner-Kumho" and after the last version, in 2009, of the Federal Rules of Evidence (F.R.E.), the opinion of American Courts concerning the admissibility of scientific evidence has changed, and the questions above can now have new answers. The change is closely tied to the perceived difference between hard and soft sciences and, in this way, the new gatekeeping role of the Courts also concerns whether offender profiling can be regarded as scientific evidence and if offender profiling should be admitted in the Courtroom as scientific evidence. In this work we present a comprehensive review concerning the most important Court opinions in U.S.A, U.K., Canada and Australia, about reliability and admissibility of offender profiling, in its different forensic application, as scientific evidence, and we suggest how and when an expert witness in the field of offender profiling can, in the light of these opinions, be admitted in Court.

Management of uncertainties on parameters elicited by experts - Applications to sea-level rise and to CO2 storage operations risk assessment

Science.gov (United States)

Manceau, Jean-Charles; Loschetter, Annick; Rohmer, Jérémy; Le Cozannet, Gonéri; Lary Louis, de; Guénan Thomas, Le; Ken, Hnottavange-Telleen

2017-04-01

In a context of high degree of uncertainty, when very few data are available, experts are commonly requested to provide their opinions on input parameters of risk assessment models. Not only might each expert express a certain degree of uncertainty on his/her own statements, but the set of information collected from the pool of experts introduces an additional level of uncertainty. It is indeed very unlikely that all experts agree on exactly the same data, especially regarding parameters needed for natural risk assessments. In some cases, their opinions may differ only slightly (e.g. the most plausible value for a parameter is similar for different experts, and they only disagree on the level of uncertainties that taint the said value) while on other cases they may express incompatible opinions for a same parameter. Dealing with these different kinds of uncertainties remains a challenge for assessing geological hazards or/and risks. Extra-probabilistic approaches (such as the Dempster-Shafer theory or the possibility theory) have shown to offer promising solutions for representing parameters on which the knowledge is limited. It is the case for instance when the available information prevents an expert from identifying a unique probability law to picture the total uncertainty. Moreover, such approaches are known to be particularly flexible when it comes to aggregating several and potentially conflicting opinions. We therefore propose to discuss the opportunity of applying these new theories for managing the uncertainties on parameters elicited by experts, by a comparison with the application of more classical probability approaches. The discussion is based on two different examples. The first example deals with the estimation of the injected CO2 plume extent in a reservoir in the context of CO2 geological storage. This estimation requires information on the effective porosity of the reservoir, which has been estimated by 14 different experts. The Dempster

An investigation of anxiety about radiotherapy deploying the radiotherapy categorical anxiety scale

International Nuclear Information System (INIS)

Shimotsu, Sakie; Karasawa, Kumiko; Ito, Kana; Saito, Anneyuko I.; Izawa, Hiromi; Kawase, Eri; Horikawa, Naoshi

2010-01-01

Radiotherapy is one of the major methods for treating cancer, but many patients undergoing radiotherapy have deep concerns about receiving radiation treatment. This problem is not generally appreciated and has not been adequately studied. The objective of this investigation was to empirically investigate the anxieties that cancer patients feel towards radiotherapy by using questionnaires to classify and quantitatively measure their concerns. A preliminary interview to develop a questionnaire was carried out with 48 patients receiving radiotherapy to discover their anxieties about on-going treatments. Subsequently, a main study was performed using a questionnaire with 185 patients to classify their types of anxiety and to ascertain the reliability and validity of the responses. Confirmatory factor analysis was then carried out with a 17-item Radiotherapy Categorical Anxiety Scale. Three anxiety factors were abstracted by factor analysis: adverse effects of radiotherapy, environment of radiotherapy, and treatment effects of radiotherapy. Reliability, content validity, and concurrent validity were obtained. The adequacy of the three-factor model of anxiety concerning radiotherapy was confirmed. A 17-item Radiotherapy Categorical Anxiety Scale was formulated to quantitatively measure the specific types of anxiety among cancer patients receiving radiotherapy. (author)

PP22. PROGRESSING RADIOTHERAPY-DRUG COMBINATIONS TOWARDS EARLY PHASE CLINICAL TRIALS

Science.gov (United States)

Jones, Dr Hazel; Stock, Dr Julie; Chalmers, Prof Anthony

2017-01-01

Abstract The Radiotherapy-Drug Combinations consortium (RaDCom) works with UK-based investigators to design and deliver high quality preclinical projects evaluating specific radiotherapy-drug combinations. We have several collaborations with industry, from in vitro projects to understand the novel agent in the context of radiobiology, through to preclinical studies that will generate data to support the development of radiotherapy combination trials. RaDCom facilitates the coordination of industry interactions, triage new proposals, monitor active projects, and engages with the radiotherapy community to promote collaboration and networking (via a capability map). The CRUK New Agents Committee Preclinical Combination Grant scheme provides one of the funding options for these studies, with the potential to feed into early phase clinical trials via the ECMC Combinations Alliance. RaDCom also supports broader radiotherapy research initiatives, by working to improve preclinical quality assurance and identifying a route to registration for radiotherapy-drug treatments. These activities will place the UK at the forefront of radiotherapy-drug preclinical research and provide a significant incentive for pharmaceutical companies to invest in this area and utilise the RaDCom network. Further information can be found on our webpage: http://ctrad.ncri.org.uk/research-support/radiation-drug-combinations-radcom Successful projects from RaDCom can then move into early phase combinations trials within the Combinations Alliance. The Combinations Alliance supports early phase combination studies in the UK via the ECMC (Experimental Cancer Medicine Centres) network. It focuses on translational research, and enables clinical project teams to work with disease experts to set up investigator led trials. The CRUK Centre of Drug Development (CDD) supports these studies with further management and coordination ensuring more robust timelines and delivery. The Combinations Alliance framework

Travel opinion leaders and seekers

DEFF Research Database (Denmark)

Yoo, Kyung-Hyan; Gretzel, Ulrike; Zach, Florian

2011-01-01

While opinion leadership has been recognized as important in tourism, there has been very little empirical research investigating the phenomenon. Given new developments in social media technologies, it is especially important to understand whether travel opinion leadership and seeking are drivers...... of specific social media perceptions and behaviours. Based on an online survey of US online travellers, this paper seeks to identify travel opinion leaders and seekers and their characteristics. Further, the research conducted investigated linkages between travel opinion leadership/seeking and travel social...... media use. The findings suggest that travel opinion leadership and seeking are distinct but connected. Both opinion leaders and seekers are technology savvy, young, educated, involved in travel planning and engaged in social media use for travel. What distinguishes opinion leaders is their greater...

Identifying key conservation threats to Alpine birds through expert knowledge

Science.gov (United States)

Pedrini, Paolo; Brambilla, Mattia; Rolando, Antonio; Girardello, Marco

2016-01-01

Alpine biodiversity is subject to a range of increasing threats, but the scarcity of data for many taxa means that it is difficult to assess the level and likely future impact of a given threat. Expert opinion can be a useful tool to address knowledge gaps in the absence of adequate data. Experts with experience in Alpine ecology were approached to rank threat levels for 69 Alpine bird species over the next 50 years for the whole European Alps in relation to ten categories: land abandonment, climate change, renewable energy, fire, forestry practices, grazing practices, hunting, leisure, mining and urbanization. There was a high degree of concordance in ranking of perceived threats among experts for most threat categories. The major overall perceived threats to Alpine birds identified through expert knowledge were land abandonment, urbanization, leisure and forestry, although other perceived threats were ranked highly for particular species groups (renewable energy and hunting for raptors, hunting for gamebirds). For groups of species defined according to their breeding habitat, open habitat species and treeline species were perceived as the most threatened. A spatial risk assessment tool based on summed scores for the whole community showed threat levels were highest for bird communities of the northern and western Alps. Development of the approaches given in this paper, including addressing biases in the selection of experts and adopting a more detailed ranking procedure, could prove useful in the future in identifying future threats, and in carrying out risk assessments based on levels of threat to the whole bird community. PMID:26966659

Identifying key conservation threats to Alpine birds through expert knowledge

Directory of Open Access Journals (Sweden)

Dan E. Chamberlain

2016-02-01

Full Text Available Alpine biodiversity is subject to a range of increasing threats, but the scarcity of data for many taxa means that it is difficult to assess the level and likely future impact of a given threat. Expert opinion can be a useful tool to address knowledge gaps in the absence of adequate data. Experts with experience in Alpine ecology were approached to rank threat levels for 69 Alpine bird species over the next 50 years for the whole European Alps in relation to ten categories: land abandonment, climate change, renewable energy, fire, forestry practices, grazing practices, hunting, leisure, mining and urbanization. There was a high degree of concordance in ranking of perceived threats among experts for most threat categories. The major overall perceived threats to Alpine birds identified through expert knowledge were land abandonment, urbanization, leisure and forestry, although other perceived threats were ranked highly for particular species groups (renewable energy and hunting for raptors, hunting for gamebirds. For groups of species defined according to their breeding habitat, open habitat species and treeline species were perceived as the most threatened. A spatial risk assessment tool based on summed scores for the whole community showed threat levels were highest for bird communities of the northern and western Alps. Development of the approaches given in this paper, including addressing biases in the selection of experts and adopting a more detailed ranking procedure, could prove useful in the future in identifying future threats, and in carrying out risk assessments based on levels of threat to the whole bird community.

Social workers as "experts" in the family court system: is evidence-based practice a missing link or host-created knowledge?

Science.gov (United States)

Prescott, Dana E

2013-10-01

The graduate school curriculum for social workers requires that students learn to critically distinguish between opinion-based knowledge and evidence-based practices, or empirically-supported interventions. Once graduated, licensed social workers are often called upon to offer diagnostic and predictive opinions as experts in a variety of macro-environments. When the family courts are that "host" environment, social workers proffer expert opinions that may categorize and label parents or children for purposes of a judge's allocation of physical or legal custody. In this article, it is suggested that the social work profession, within all three domains of education, practice, and research, should more precisely link the design and fidelity of an evidence-based practice (EBP) with its potential misapplication or warping when proffered as science in "host" environments like family courts. As Foucault and other scholars warn, the failure to verify that an intervention is applied correctly may actually enhance the risk of social injustice by interpreting and translating EBP knowledge in the non-empirical form of authority-by-license. This article, therefore, proposes that the social work profession, from the classroom to the field, has an obligation to thoroughly understand and engage interdisciplinary practices that assure respect for the strengths and limits of social work knowledge.

In vivo dosimetry in external beam radiotherapy

International Nuclear Information System (INIS)

Mijnheer, Ben; Beddar, Sam; Izewska, Joanna; Reft, Chester

2013-01-01

In vivo dosimetry (IVD) is in use in external beam radiotherapy (EBRT) to detect major errors, to assess clinically relevant differences between planned and delivered dose, to record dose received by individual patients, and to fulfill legal requirements. After discussing briefly the main characteristics of the most commonly applied IVD systems, the clinical experience of IVD during EBRT will be summarized. Advancement of the traditional aspects of in vivo dosimetry as well as the development of currently available and newly emerging noninterventional technologies are required for large-scale implementation of IVD in EBRT. These new technologies include the development of electronic portal imaging devices for 2D and 3D patient dosimetry during advanced treatment techniques, such as IMRT and VMAT, and the use of IVD in proton and ion radiotherapy by measuring the decay of radiation-induced radionuclides. In the final analysis, we will show in this Vision 20/20 paper that in addition to regulatory compliance and reimbursement issues, the rationale for in vivo measurements is to provide an accurate and independent verification of the overall treatment procedure. It will enable the identification of potential errors in dose calculation, data transfer, dose delivery, patient setup, and changes in patient anatomy. It is the authors’ opinion that all treatments with curative intent should be verified through in vivo dose measurements in combination with pretreatment checks

In vivo dosimetry in external beam radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Mijnheer, Ben [Department of Radiation Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam 1066 CX (Netherlands); Beddar, Sam [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas 77030 (United States); Izewska, Joanna [Division of Human Health, International Atomic Energy Agency, Vienna 1400 (Austria); Reft, Chester [Department of Radiation and Cellular Oncology, University of Chicago Medical Center, Chicago, Illinois 60637 (United States)

2013-07-15

In vivo dosimetry (IVD) is in use in external beam radiotherapy (EBRT) to detect major errors, to assess clinically relevant differences between planned and delivered dose, to record dose received by individual patients, and to fulfill legal requirements. After discussing briefly the main characteristics of the most commonly applied IVD systems, the clinical experience of IVD during EBRT will be summarized. Advancement of the traditional aspects of in vivo dosimetry as well as the development of currently available and newly emerging noninterventional technologies are required for large-scale implementation of IVD in EBRT. These new technologies include the development of electronic portal imaging devices for 2D and 3D patient dosimetry during advanced treatment techniques, such as IMRT and VMAT, and the use of IVD in proton and ion radiotherapy by measuring the decay of radiation-induced radionuclides. In the final analysis, we will show in this Vision 20/20 paper that in addition to regulatory compliance and reimbursement issues, the rationale for in vivo measurements is to provide an accurate and independent verification of the overall treatment procedure. It will enable the identification of potential errors in dose calculation, data transfer, dose delivery, patient setup, and changes in patient anatomy. It is the authors' opinion that all treatments with curative intent should be verified through in vivo dose measurements in combination with pretreatment checks.

Four years with FALCON – An ESTRO educational project: Achievements and perspectives

International Nuclear Information System (INIS)

Eriksen, Jesper Grau; Salembier, Carl; Rivera, Sofia; De Bari, Berardino; Berger, Daniel; Mantello, Giovanna; Müller, Arndt-Christian; Martin, Arturo Navarro; Pasini, Danilo; Tanderup, Kari; Palmu, Miika; Verfaillie, Christine; Pötter, Richard; Valentini, Vincenzo

2014-01-01

Variability in anatomical contouring is one of the important uncertainties in radiotherapy. FALCON (Fellowship in Anatomic deLineation and CONtouring) is an educational ESTRO (European SocieTy for Radiation and Oncology) project devoted to improve interactive teaching, the homogeneity in contouring and to compare individual contours with endorsed guidelines or expert opinions. This report summarizes the experience from the first 4 years using FALCON for educational activities within ESTRO School and presents the perspectives for the future

Radiotherapy of bronchogenic carcinoma

International Nuclear Information System (INIS)

Heilmann, H.P.

1982-01-01

Radiotherapy of branchogenic carcinoma comprises; palliative treatment, postoperative or pre-operative radiotherapy, radiotherapy as part of a combination of chemotherapy and radiotherapy of small cell carcinoma and curative radiotherapy of non-operable non-small cell carcinoma. Atelectasis and obstruction are indications for palliative radiotherapy. Postoperative radiotherapy is given only in cases of incomplete resection or mediastinal metastases. In the treatment of small cell carcinoma by combined irradiation and chemotherapy the mediastinum and primary tumour are irradiated, generally after chemotherapy, and the C.N.S. receives prophylactic radiotherapy. Curative radiotherapy is indicated in cases of non-operable small cell carcinoma. Irradiation with doses of 60-70 Gy produced 5-years-survival rates of 10-14% in cases classified as T 1 -T 2 N 0 M 0 . (orig.) [de

Radiotherapy physics

International Nuclear Information System (INIS)

Chen, G.T.Y.; Collier, J.M.; Lyman, J.T.; Pitluck, S.

1982-01-01

The Radiotherapy Physics Group works on the physical and biophysical aspects of charged particle radiotherapy. Our activities include the development of isosurvival beams (beams of uniform biological effect), computerized treatment planning development for charged particle radiotherapy, design of compensation to shape dose distributions, and development of dosimetry techniques to verify planned irradiations in both phantoms and patients

Public opinion polls on nuclear energy

International Nuclear Information System (INIS)

Heller, E.D.

1980-07-01

Future developments in the attitude towards nuclear energy can not be predicted on account of this public opinion survey. The survey shows just how many different factors influence the attitude towards issues of public and political interst. For this reason in particular, it would be desirable to include such aspects into future surveys. The survey shows that public opinion polls quite often investigate on the ordering party's opinion rather than the pollees opinion. The attempt at making public opinion polls a means of forming political opinions, implying a certain desired opinion to be the majority opinion has brought those polls into disrepute. If real results are not required and manipulation prevails, results are prevented, which must not be blamed on the principle of public opinion polls as such. (orig.) [de

Standardized quality audit procedures for on-site dosimetry visits to radiotherapy hospitals. Report of the IAEA consultants' meeting, IAEA, Vienna, 27 September - 1 October 1999; revised in 2001

International Nuclear Information System (INIS)

Izewska, Joanna; Dutreix, A.; Followill, D.S.; Nisbet, A.; Novotny, J.; Sipila, P.; Dam, J. van

2002-01-01

Since 1969 the International Atomic Energy Agency (IAEA), together with the World Health Organization (WHO), has performed postal TLD audits to verify the calibration of radiotherapy beams in developing countries. The IAEA over the past 30 years, has verified the calibration of more than 3500 clinical photon beams at approximately 1000 radiotherapy hospitals. Detailed follow-up procedures have been implemented since 1996. When the TLD result of a participating institution falls outside the acceptance limits of ±5%, the institution is initially informed that there is a discrepancy and requested to try to identify the reasons why it occurred. The institution is not informed of the actual magnitude of the discrepancy (blind conditions) but is offered a second TLD audit. If the deviation cannot be resolved by the local radiotherapy institution or the national SSDL, then an on-site visit is suggested which, if accepted, is made by an IAEA expert in clinical dosimetry. The on-site visit includes a review of the dosimetry data and techniques, corrective measurements and ad-hoc training. The reasons for the discrepancy are then traced, explained, corrected and reported. Until the discrepancies are resolved and changes have been implemented by hospitals to ensure that the discrepancies do not reoccur, the safe and effective delivery of radiation doses to patients is questionable. This document provides a standardised set of procedures for resolving discrepancies during onsite visits to radiotherapy hospitals by the IAEA experts. The table below summarises the acceptance criteria to be used by the IAEA experts for dosimetry and mechanical parameters of the hospital treatment units. If some of the parameters are outside the acceptance criterion, it will not be possible for an institution to assure the adequate quality of the dosimetry practices in radiotherapy. The criteria are based on analyses of clinical data and the measurement uncertainties for various dosimetry and

Opinion Integration and Summarization

Science.gov (United States)

Lu, Yue

2011-01-01

As Web 2.0 applications become increasingly popular, more and more people express their opinions on the Web in various ways in real time. Such wide coverage of topics and abundance of users make the Web an extremely valuable source for mining people's opinions about all kinds of topics. However, since the opinions are usually expressed as…

The tissue injury and repair in cancer radiotherapy. A concept of tissue architecture and radio sensitivity

Energy Technology Data Exchange (ETDEWEB)

Matsuzawa, T [Tohoku Univ., Sendai (Japan). Research Inst. for Tuberculosis, Leprosy and Cancer

1975-06-01

One of the difficulties in cancer radiotherapy arises from the fact that the tissue tolerance dose is much smaller than the tumor lethal dose. In our opinion the former depends upon the tolerance of the endothelial cell of the blood vessel in the normal tissue. In this introduction, a new concept regarding the estimation of tissue radiosensitivity was described, and the possible significance of the mode of radiation injury and the repair capability of normal tissue in the cancer radiotheraphy was discussed.

Study on advanced nuclear power plants expert evaluation system in China

International Nuclear Information System (INIS)

Zhang Qi; Yoshikawa, Hidekazu; Shimoda, Hiroshi; Zhou Zhiwei; Zhu Shutang; Ren Junsheng; Yang Mengjia; Gu Junyang

2005-01-01

Based on current status and developing trend of nuclear power plant technology, an evaluation software system is developed to assess advanced NPPs systematically according to a set of pre-established evaluation indices. The selection and classification of the indices, the determination of their weighting factors in applying AHP (analytic hierarchy process) method are discussed. The Fuzzy Comprehensive method and the Fuzzy Borda Number method are studied in detail. The original input data required by the evaluation system are deduced from the expert survey sheets Evaluation results with common significance of public attraction are discussed and analyzed according to the opinions of different experts grouped by age, profession and working expertise etc. The evaluation system is computer network based with high flexible and user friendly human-machine interface on which it is easy to manipulate and update the evaluation system, and to display evaluation results as well. (author)

Image guided multibeam radiotherapy

International Nuclear Information System (INIS)

Freijo, J.L.

2008-01-01

This paper provides an outlook of the status of the first development stages for an updated design of radiotherapy conformal system based on tumor 3D images obtained as an output the last generation imaging machines as PET, CT and MR which offer a very valuable output in cancer diagnosis. Prospective evaluation of current software codes and acquisition of useful experience in surgical planning involves a multidisciplinary process as an initial and unavoidable stage to develop an expert software and user skills which assures the delivery of the radiation dose is done correctly in geometry and value in each voxel as a radiation protection basic condition. The validation of the images obtained has been done by the production of anatomical models of interest regions by rapid proto typing of the 3D segmented images and its evaluation by contrasting with the real regions during surgical procedures. (author)

An Investigation of Marketing via Mobile Devices - Attitudes of Croatian Marketing Experts

Directory of Open Access Journals (Sweden)

Damir Dobrinić

2008-06-01

Full Text Available Marketing activities supported by mobile devices offer great opportunities for direct communication with consumers without the barriers of time, place, location and other. This article explores opinions and expectations Croatian marketing experts have towards use of m-advertising and other available advertising media, where we take the perspective of marketing experts to predict the future of m-marketing and m-advertising in Croatia. The paper also discusses the relevance of m-advertising and investigates the future of m-marketing and m-advertising in Croatia. This research focuses mainly on understanding the potential and effectiveness of the use of mobile phones as a promotional medium, but we also try to recognize the level of concern of marketing experts associated with spam, relating to privacy intrusion and ethics components in m-advertising. Privacy and ethics concerns could create resistance to the adoption of m-advertising. Media selection becomes the most critical factor for the success of a promotional and advertising marketing campaign. Croatian experts still consider TV or newspapers the best way to reach a large number of potential consumers, but what are their expectations towards mobile advertising? To answer this question, we built a model that links attitudes towards advertising via classical media to the intention to use m-advertising.

The Natural Gas Dilemma in New England's Electricity Sector: Experts' Perspectives on Long Term Climate Issues and Policy Opportunities

Science.gov (United States)

Griffith, Steven

This thesis is an interpretive analysis of experts' perspectives on the climate implications of New England's reliance on natural gas for electricity generation. Specifically, this research, conducted through interviews and literature review, examines experts' opinions on the desired role of natural gas within the regional electricity sector, alternative energy resources, and state and regional policy opportunities toward the achievement of New England's ambitious long-term greenhouse gas reduction goals. Experts expressed concern about the climate dilemma posed by a dependence on natural gas. However, interviews revealed that short-term reliability and cost considerations are paramount for many experts, and therefore a reliance on natural gas is the existing reality. To incentivize renewable generation technologies for the purposes of long-term climate stabilization, experts advocated for the expanded implementation of renewable portfolio standard, net metering, and feed-in tariff policies. More broadly, interviewees expressed the need for an array of complementary state and regional policies.

Sustainability as a challenge to radiotherapy in Nigeria

International Nuclear Information System (INIS)

Elegba, S.B.

2005-01-01

In Nigeria there are 5 radiotherapy centres for a population of 140 million, i.e. 1 machine to 28 million. About 100,000 new cases are diagnosed/yr. The cancer register was not updated since 1999, the services are poor and serve poor patients. Affluent patients seek treatment abroad. The legislative and regulatory infrastructure comprise the Medical and Dental Practitioners Act Cap 2221 of 1990 amended by Decree 78 of 1992, the Radiographers Registration Board of Nigeria Decree 1987, the Nuclear Safety and Radiation Protection Act 1995, the Nigerian Nuclear Regulatory Authority 2001, the Nigerian Basic Ionising Radiation Regulations 2003 and the Guidance on Radiation Protection. Audit report of radiotherapy practice revealed inadequate number of oncologists, medical physicist and radiographers as well as inadequate level of competence but high patient-to-expert ratio in radiotherapy. The equipment and machines are obsolete, second hand, without manuals or parts, poorly maintained, unaccredited maintenance group and lack of accessories as against spare parts. Concerning premises there is little or no shielding materials, re-configuration without drawings and lack of records. There is no operational manual, radiation protection programme, quality assurance manual and radiological emergency plan. There is no structured communication channel between management and the operating unit, no programme for equipment maintenance and replacement, no financial plan budget for the operation and maintenance of the facilities, no commitment from management to radiation protection and safety and inadequate communication between management and facility owners. Sustainability means meeting the needs of the present generation without compromising the needs of future generations. The triple bottom line is economic, social and environmental sustainability. There will be a National Policy of Integrating Radiotherapy into the National Cancer Control Programme in 2005 and the International

SU-E-T-51: Bayesian Network Models for Radiotherapy Error Detection

International Nuclear Information System (INIS)

Kalet, A; Phillips, M; Gennari, J

2014-01-01

Purpose: To develop a probabilistic model of radiotherapy plans using Bayesian networks that will detect potential errors in radiation delivery. Methods: Semi-structured interviews with medical physicists and other domain experts were employed to generate a set of layered nodes and arcs forming a Bayesian Network (BN) which encapsulates relevant radiotherapy concepts and their associated interdependencies. Concepts in the final network were limited to those whose parameters are represented in the institutional database at a level significant enough to develop mathematical distributions. The concept-relation knowledge base was constructed using the Web Ontology Language (OWL) and translated into Hugin Expert Bayes Network files via the the RHugin package in the R statistical programming language. A subset of de-identified data derived from a Mosaiq relational database representing 1937 unique prescription cases was processed and pre-screened for errors and then used by the Hugin implementation of the Estimation-Maximization (EM) algorithm for machine learning all parameter distributions. Individual networks were generated for each of several commonly treated anatomic regions identified by ICD-9 neoplasm categories including lung, brain, lymphoma, and female breast. Results: The resulting Bayesian networks represent a large part of the probabilistic knowledge inherent in treatment planning. By populating the networks entirely with data captured from a clinical oncology information management system over the course of several years of normal practice, we were able to create accurate probability tables with no additional time spent by experts or clinicians. These probabilistic descriptions of the treatment planning allow one to check if a treatment plan is within the normal scope of practice, given some initial set of clinical evidence and thereby detect for potential outliers to be flagged for further investigation. Conclusion: The networks developed here support the

SU-E-T-51: Bayesian Network Models for Radiotherapy Error Detection

Energy Technology Data Exchange (ETDEWEB)

Kalet, A; Phillips, M; Gennari, J [UniversityWashington, Seattle, WA (United States)

2014-06-01

Purpose: To develop a probabilistic model of radiotherapy plans using Bayesian networks that will detect potential errors in radiation delivery. Methods: Semi-structured interviews with medical physicists and other domain experts were employed to generate a set of layered nodes and arcs forming a Bayesian Network (BN) which encapsulates relevant radiotherapy concepts and their associated interdependencies. Concepts in the final network were limited to those whose parameters are represented in the institutional database at a level significant enough to develop mathematical distributions. The concept-relation knowledge base was constructed using the Web Ontology Language (OWL) and translated into Hugin Expert Bayes Network files via the the RHugin package in the R statistical programming language. A subset of de-identified data derived from a Mosaiq relational database representing 1937 unique prescription cases was processed and pre-screened for errors and then used by the Hugin implementation of the Estimation-Maximization (EM) algorithm for machine learning all parameter distributions. Individual networks were generated for each of several commonly treated anatomic regions identified by ICD-9 neoplasm categories including lung, brain, lymphoma, and female breast. Results: The resulting Bayesian networks represent a large part of the probabilistic knowledge inherent in treatment planning. By populating the networks entirely with data captured from a clinical oncology information management system over the course of several years of normal practice, we were able to create accurate probability tables with no additional time spent by experts or clinicians. These probabilistic descriptions of the treatment planning allow one to check if a treatment plan is within the normal scope of practice, given some initial set of clinical evidence and thereby detect for potential outliers to be flagged for further investigation. Conclusion: The networks developed here support the

A multi-institution evaluation of deformable image registration algorithms for automatic organ delineation in adaptive head and neck radiotherapy

International Nuclear Information System (INIS)

Hardcastle, Nicholas; Kumar, Prashant; Oechsner, Markus; Richter, Anne; Song, Shiyu; Myers, Michael; Polat, Bülent; Bzdusek, Karl; Tomé, Wolfgang A; Cannon, Donald M; Brouwer, Charlotte L; Wittendorp, Paul WH; Dogan, Nesrin; Guckenberger, Matthias; Allaire, Stéphane; Mallya, Yogish

2012-01-01

Adaptive Radiotherapy aims to identify anatomical deviations during a radiotherapy course and modify the treatment plan to maintain treatment objectives. This requires regions of interest (ROIs) to be defined using the most recent imaging data. This study investigates the clinical utility of using deformable image registration (DIR) to automatically propagate ROIs. Target (GTV) and organ-at-risk (OAR) ROIs were non-rigidly propagated from a planning CT scan to a per-treatment CT scan for 22 patients. Propagated ROIs were quantitatively compared with expert physician-drawn ROIs on the per-treatment scan using Dice scores and mean slicewise Hausdorff distances, and center of mass distances for GTVs. The propagated ROIs were qualitatively examined by experts and scored based on their clinical utility. Good agreement between the DIR-propagated ROIs and expert-drawn ROIs was observed based on the metrics used. 94% of all ROIs generated using DIR were scored as being clinically useful, requiring minimal or no edits. However, 27% (12/44) of the GTVs required major edits. DIR was successfully used on 22 patients to propagate target and OAR structures for ART with good anatomical agreement for OARs. It is recommended that propagated target structures be thoroughly reviewed by the treating physician

Radiotherapy

International Nuclear Information System (INIS)

Zedgenidze, G.A.; Kulikov, V.A.; Mardynskij, Yu.S.

1984-01-01

The technique for roentgenotopometric and medicamentous preparation of patients for radiotherapy has been reported in detail. The features of planning and performing of remote, intracavitary and combined therapy in urinary bladder cancer are considered. The more effective methods of radiotherapy have been proposed taking into account own experience as well as literature data. The comparative evaluation of treatment results and prognosis are given. Radiation pathomorphism of tumors and tissues of urinary bladder is considered in detail. The problems of diagnosis, prophylaxis and treatment of complications following radiodiagnosis and radiotherapy in patients with urinary bladder cancer are illustrated widely

The use of expert judgement in decision making

Energy Technology Data Exchange (ETDEWEB)

NONE

2005-07-01

Expert judgment (EJ) techniques and protocols have been used in different areas for more than half a century. the Nuclear Energy Division of the Commissariat a l'Energie Atomique (CEA), via the Risk Control Domain of the Nuclear Development and Innovation Division and the Innovative Systems Studies Service, and the Institute for Energy of JRC (Petten), via the Nuclear Safety Unit, organized a 'workshop on the use of expert judgment in decision making'. The objectives of this workshop were to create an exchange forum about this topic and to gather a first state of the art, in order to identify the needs for R and D. This workshop brought together approximately 55 participants, from different industry sectors (energy, both nuclear and non-nuclear, food and communication among others) and from universities, research organizations and technical support organizations. The workshop was divided in one opening session, four thematic sessions plus a round table and a final general discussion session. The first session was dedicated to the elicitation of expertise and the combination of opinions given by different experts. The papers in this session had more theoretical contents than most of the papers in other session. The second session was dedicated to expert knowledge management. It consisted of four papers, two of them in the area of the food industry, one of them in the area of e-business and the last one in the area of human reliability assessment (HRA) and its impact on Probabilistic Safety Analysis (PSA) calculations. The third session was dedicated to industrial applications and consisted of four papers, all of them in the area of energy production. The last session was about the use of EJ in risk analysis and decision making processes. Four papers were included in this session, EJ has been applied for a very long time in very different fields, which has brought as a consequence a broad diversity of methodologies The workshop did also show the

The use of expert judgement in decision making

International Nuclear Information System (INIS)

2005-01-01

Expert judgment (EJ) techniques and protocols have been used in different areas for more than half a century. the Nuclear Energy Division of the Commissariat a l'Energie Atomique (CEA), via the Risk Control Domain of the Nuclear Development and Innovation Division and the Innovative Systems Studies Service, and the Institute for Energy of JRC (Petten), via the Nuclear Safety Unit, organized a 'workshop on the use of expert judgment in decision making'. The objectives of this workshop were to create an exchange forum about this topic and to gather a first state of the art, in order to identify the needs for R and D. This workshop brought together approximately 55 participants, from different industry sectors (energy, both nuclear and non-nuclear, food and communication among others) and from universities, research organizations and technical support organizations. The workshop was divided in one opening session, four thematic sessions plus a round table and a final general discussion session. The first session was dedicated to the elicitation of expertise and the combination of opinions given by different experts. The papers in this session had more theoretical contents than most of the papers in other session. The second session was dedicated to expert knowledge management. It consisted of four papers, two of them in the area of the food industry, one of them in the area of e-business and the last one in the area of human reliability assessment (HRA) and its impact on Probabilistic Safety Analysis (PSA) calculations. The third session was dedicated to industrial applications and consisted of four papers, all of them in the area of energy production. The last session was about the use of EJ in risk analysis and decision making processes. Four papers were included in this session, EJ has been applied for a very long time in very different fields, which has brought as a consequence a broad diversity of methodologies The workshop did also show the variety of techniques

The use of expert judgement in decision making

Energy Technology Data Exchange (ETDEWEB)

NONE

2005-07-01

Expert judgment (EJ) techniques and protocols have been used in different areas for more than half a century. the Nuclear Energy Division of the Commissariat a l'Energie Atomique (CEA), via the Risk Control Domain of the Nuclear Development and Innovation Division and the Innovative Systems Studies Service, and the Institute for Energy of JRC (Petten), via the Nuclear Safety Unit, organized a 'workshop on the use of expert judgment in decision making'. The objectives of this workshop were to create an exchange forum about this topic and to gather a first state of the art, in order to identify the needs for R and D. This workshop brought together approximately 55 participants, from different industry sectors (energy, both nuclear and non-nuclear, food and communication among others) and from universities, research organizations and technical support organizations. The workshop was divided in one opening session, four thematic sessions plus a round table and a final general discussion session. The first session was dedicated to the elicitation of expertise and the combination of opinions given by different experts. The papers in this session had more theoretical contents than most of the papers in other session. The second session was dedicated to expert knowledge management. It consisted of four papers, two of them in the area of the food industry, one of them in the area of e-business and the last one in the area of human reliability assessment (HRA) and its impact on Probabilistic Safety Analysis (PSA) calculations. The third session was dedicated to industrial applications and consisted of four papers, all of them in the area of energy production. The last session was about the use of EJ in risk analysis and decision making processes. Four papers were included in this session, EJ has been applied for a very long time in very different fields, which has brought as a consequence a broad diversity of methodologies The workshop did also show the variety of techniques

Expert Recommendations on Treating Psoriasis in Special Circumstances (Part II).

Science.gov (United States)

Carrascosa, J M; Galán, M; de Lucas, R; Pérez-Ferriols, A; Ribera, M; Yanguas, I

2016-11-01

There is insufficient information on how best to treat moderate to severe psoriasis in difficult clinical circumstances. We considered 5 areas where there is conflicting or insufficient evidence: pediatric psoriasis, risk of infection in patients being treated with biologics, psoriasis in difficult locations, biologic drug survival, and impact of disease on quality of life. Following discussion of the issues by an expert panel of dermatologists specialized in the management of psoriasis, participants answered a questionnaire survey according to the Delphi method. Consensus was reached on 66 (70.9%) of the 93 items analyzed; the experts agreed with 49 statements and disagreed with 17. It was agreed that body mass index, metabolic comorbidities, and quality of life should be monitored in children with psoriasis. The experts also agreed that the most appropriate systemic treatment for this age group was methotrexate, while the most appropriate biologic treatment was etanercept. Although it was recognized that the available evidence was inconsistent and difficult to extrapolate, the panel agreed that biologic drug survival could be increased by flexible, individualized dosing regimens, continuous treatment, and combination therapies. Finally, consensus was reached on using the Dermatology Quality of Life Index to assess treatment effectiveness and aid decision-making in clinical practice. The structured opinion of experts guides decision-making regarding aspects of clinical practice for which there is incomplete or conflicting information. Copyright © 2016 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

The Complex Neutrosophic Soft Expert Relation and Its Multiple Attribute Decision-Making Method

Directory of Open Access Journals (Sweden)

Ashraf Al-Quran

2018-01-01

Full Text Available This paper introduces a novel soft computing technique, called the complex neutrosophic soft expert relation (CNSER, to evaluate the degree of interaction between two hybrid models called complex neutrosophic soft expert sets (CNSESs. CNSESs are used to represent two-dimensional data that are imprecise, uncertain, incomplete and indeterminate. Moreover, it has a mechanism to incorporate the parameter set and the opinions of all experts in one model, thus making it highly suitable for use in decision-making problems where the time factor plays a key role in determining the final decision. The complex neutrosophic soft expert set and complex neutrosophic soft expert relation are both defined. Utilizing the properties of CNSER introduced, an empirical study is conducted on the relationship between the variability of the currency exchange rate and Malaysian exports and the time frame (phase of the interaction between these two variables. This study is supported further by an algorithm to determine the type and the degree of this relationship. A comparison between different existing relations and CNSER to show the ascendancy of our proposed CNSER is provided. Then, the notion of the inverse, complement and composition of CNSERs along with some related theorems and properties are introduced. Finally, we define the symmetry, transitivity and reflexivity of CNSERs, as well as the equivalence relation and equivalence classes on CNSESs. Some interesting properties are also obtained.

Energy policy decision making and public opinion

International Nuclear Information System (INIS)

Gerstein, L.

1989-09-01

By the example of nuclear the author demonstrates the interactions of short-term fluctuations on the world energy market, energy forecasts, specific events and discussions on energy policy both within political parties and in the general public, and draws conclusions which are valid beyond the Federal Republic of Germany: An analysis of the general public's attitude towards nuclear energy shows two initial phases, i.e. euphoria and scepticism/ideology/agitation. The early eighties, then, led to a third phase - realism. Up to 1983 a consensus prevailed between the leading political parties in Germany regarding the basic energy-policy objective of minimizing the supply risk by providing for a well-balanced use of all available energy sources. The resulting attitude had a positive bearing on the public opinion: more than two thirds of the population were in favour of nuclear. In the mid-eighties, the development of nuclear was by and large completed in the Federal Republic of Germany as well as in the United States and other western industrialized countries and the capacity of nuclear power plants is considered sufficient for the years to come. In addition, abundant long-term reserves of domestic lignite and hardcoal are available: this also should have furnished a good reason to envisage calmly the issues of power supply. Instead, we are again facing emotional discussions on the acceptance of nuclear. Public opinion in the Federal Republic of Germany has changed since the Social Democrats followed the example of the Ecologists and advocated a rapid withdrawal from nuclear. In a recent poll four-fifths of the persons asked did not rule out the possibility of a major accident in a German power station. The wish to ignore today's energy supply problems by escaping into a supposedly safe but yet distant and vague future is part of every public debate. Technical and scientific issues are examined no longer in this global context. Predictions of experts and counter-experts

[Ophthalmological opinions for liability affairs material damage (Part I) (author's transl)].

Science.gov (United States)

Burggraf, H

1979-02-01

German law abides anyone reponsible for the damage he or she has caused to another person's property or corporal integrity. This includes all medical costs directed towards the restitution of health as well as economical damage in direct consequence of the corporal damage. An ophthalmological expert is to state his opinion therefore in accordance with the specific conditions of every individual case and not just according to general charts. Financial compensation is only granted for the actual results of damage inquestion. Prior damage and disability have to be remarked but not to justify a financial compensation. The question of smart-money is dealt with in Part II.

Evaluation of a Delphi technique based expert judgement method for LCA valuation - DELPHI II

International Nuclear Information System (INIS)

Hakala, S.; Wilson, B.

1999-01-01

Transparency and certainty are essential qualities for an acceptable and trusted valuation method. Based on the evaluation of the expert judgement method developed in the Delphi I study both of these criteria may be only partially accomplished by such a method. As for the technical procedure the method is well documented and transparency is good. Argumentation of the judgements, however, should be increased. The quality of the valuation indexes is explicitly available, but their certainty is very low for most interventions. The opinions of the experts differ much from each other. How much this depends on different values and how much on differences in knowledge etc. is impossible to assess. Also, how much the technique used and the statistical handling of the expert answers may have impacted the eventual scores of different interventions is difficult to assess. However, application of the expert judgement by means of the Delphi-technique to LCA valuation is a new idea, and, consequently, the method is still very much under development, far from maturity. This should be taken into account when considering the results out of the evaluation of the case study, which was the third of the kind in Europe

National arrangements for radiotherapy

International Nuclear Information System (INIS)

2007-01-01

After a presentation of several letters exchanged between the French health ministry and public agencies in charge of public health or nuclear safety after a radiotherapy accident in Epinal, this report comments the evolution of needs in cancerology care and the place given to radiotherapy. It outlines the technological and organisational evolution of radiotherapy and presents the distribution of radiotherapy equipment, of radio-therapists and other radiotherapy professionals in France. Within the context of radiotherapy accidents which occurred in 2007, it presents the regulatory arrangements which aimed at improving the safety, short term and middle term arrangements which are needed to support and structure radiotherapy practice quality. It stresses the fact that the system will deeply evolve by implementing a radiotherapy vigilance arrangement and a permanent follow-on and adaptation plan based on surveys and the creation of a national committee

Development and evaluation of an instrument to measure health-related quality of life in Cuban breast cancer patients receiving radiotherapy.

Science.gov (United States)

Lugo, Josefina; Nápoles, Misleidy; Pérez, Inés; Ordaz, Niurka; Luzardo, Mario; Fernández, Leticia

2014-01-01

INTRODUCTION Although modern technology has extended the survival of breast cancer patients, treatment's adverse effects impact their health-related quality of life. Currently, no instrument exists capable of identifying the range of problems affecting breast cancer patients receiving radiotherapy in Cuba's socioeconomic and cultural context. OBJECTIVES Construct and validate an instrument to measure the effects of breast cancer and radiotherapy on health-related quality of life in Cuban patients. METHODS The study was conducted at the Oncology and Radiobiology Institute, Havana, Cuba, from January 2010 through December 2011. Inclusion criteria were: adult female, histological diagnosis of breast cancer, treated with ambulatory radiotherapy, and written informed consent; patients unable to communicate orally or in writing, or who had neurologic or psychiatric conditions were excluded. Development phase: focus groups guided by a list of questions were carried out with 50 women. The patients reported 61 problems affecting their health-related quality-of-life. A nominal group (six oncologists and two nurses) identified the same problems. A syntactic analysis of the information was performed to create items for study and measurement scales. Content validity was determined by a nominal group of seven experts using professional judgment. Another 20 patients were selected to evaluate face validity. Validation phase: the instrument was applied to 230 patients at three different points: before radiotherapy, at the end of radiotherapy and four weeks after radiotherapy was concluded. Reliability, construct validity, discriminant validity, predictive validity, interpretability and response burden were evaluated. RESULTS The final instrument developed had 33 items distributed in 4 domains: physical functioning, psychological functioning, social and family relationships, and physical and emotional adverse effects of disease and treatment. There were two discrete items: perceived

Opinions on Fresh Produce Food Safety and Quality Standards by Fresh Produce Supply Chain Experts from the Global South and North.

Science.gov (United States)

Jacxsens, Liesbeth; Van Boxstael, Sigrid; Nanyunja, Jessica; Jordaan, Danie; Luning, Pieternel; Uyttendaele, Mieke

2015-10-01

This study describes the results of an on-line survey of fresh produce supply chain experts who work with producers from the Global North (n = 41, 20 countries) and the Global South (n = 63, 29 countries). They expressed their opinion using 1 to 5 Likert scales on several items related to four types of food safety and quality standards and legislation: Codex Alimentarius standards, European Union legislation, national legislation, and private standards. The results reflect the different circumstances under which the Southern and Northern producers operate in relation to the local organization, regulation, and support of the sector; but they also indicate similar challenges, in particular, the challenge of private standards, which were perceived to demand a higher implementation effort than the other three types of standards. Private standards were also strongly perceived to exclude Southern and Northern small- and medium-scale producers from high-value markets, whereas European Union legislation was perceived to strongly exclude, in particular, small- and medium-scale Southern producers. The results further highlight concerns about costly control measures and third-party certification that are required by downstream buyers but that are mostly paid for by upstream suppliers. Food standards are seen in their dual role as a catalyst for implementation of structured food safety management systems on the one hand and as a nontariff barrier to trade on the other hand. The results of the survey also pointed up the advantages of enforcing food safety and food quality standards in terms of knowledge spillover to noncertified activities, increased revenues, and improved food safety of delivered produce. Survey results highlight the importance of technical assistance and support of producers by governments and producer cooperatives or trade associations in the implementation and certification of food standards, along with increased awareness of and training of individuals in

Whither radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Ross, W M

1987-03-01

The 1986 Glyn Evans Memorial Lecture, given at the Joint Provincial Meeting of the Royal College of Radiologists, Sheffield, September 1986, sketches an outline of the history of radiotherapy and discusses the future development of the art. Topics included are siting of centres, training needs, the relationship of radiotherapy to other medical specialities, and the advantages and disadvantages of radiotherapy practitioners forming a separate medical College. (U.K.)

Radiotherapy in bladder cancer

International Nuclear Information System (INIS)

Rozan, R.

1992-01-01

In 1992, the problem of the vesical radiotherapy is not resolved. The author presents the situation and the different techniques of radiotherapy in bladder cancers: external radiotherapy, only and associated with surgery, interstitial curietherapy and non-classical techniques as per operative radiotherapy, neutron therapy and concurrent radiotherapy with chemotherapy. In order to compare their efficiency, the five-year survival are given in all cases.(10 tabs)

[Medical expert consensus in AH on the clinical use of triple fixed-dose antihypertensive therapy in Spain].

Science.gov (United States)

Mazón, P; Galve, E; Gómez, J; Gorostidi, M; Górriz, J L; Mediavilla, J D

The opinion of experts (different specialties) on the triple fixed-dose antihypertensive therapy in clinical practice may differ. Online questionnaire with controversial aspects of the triple therapy answered by panel of experts in hypertension (HT) using two-round modified Delphi method. The questionnaire was completed by 158 experts: Internal Medicine (49), Nephrology (26), Cardiology (83). Consensus was reached (agreement) on 27/45 items (60%); 7 items showed differences statistically significant. Consensus was reached regarding: Predictive factors in the need for combination therapy and its efficacy vs. increasing the dose of a pretreatment, and advantage of triple therapy (prescription/adherence/cost/pressure control) vs. free combination. This consensus provides an overview of the clinical use of triple therapy in moderate-severe and resistant/difficult to control HT. Copyright © 2016 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.

Treating an Established Episode of Delirium in Palliative Care: Expert Opinion and Review of the Current Evidence Base With Recommendations for Future Development

Science.gov (United States)

Pereira, José L.; Davis, Daniel H.J.; Currow, David C.; Meagher, David; Rabheru, Kiran; Wright, David; Bruera, Eduardo; Hartwick, Michael; Gagnon, Pierre R.; Gagnon, Bruno; Breitbart, William; Regnier, Laura; Lawlor, Peter G.

2014-01-01

Context Delirium is a highly prevalent complication in patients in palliative care settings, especially in the end-of-life context. Objectives To review the current evidence base for treating episodes of delirium in palliative care settings and propose a framework for future development. Methods We combined multidisciplinary input from delirium researchers and other purposely selected stakeholders at an international delirium study planning meeting. This was supplemented by a literature search of multiple databases and relevant reference lists to identify studies regarding therapeutic interventions for delirium. Results The context of delirium management in palliative care is highly variable. The standard management of a delirium episode includes the investigation of precipitating and aggravating factors followed by symptomatic treatment with drug therapy. However, the intensity of this management depends on illness trajectory and goals of care in addition to the local availability of both investigative modalities and therapeutic interventions. Pharmacologically, haloperidol remains the practice standard by consensus for symptomatic control. Dosing schedules are derived from expert opinion and various clinical practice guidelines as evidence-based data from palliative care settings are limited. The commonly used pharmacologic interventions for delirium in this population warrant evaluation in clinical trials to examine dosing and titration regimens, different routes of administration, and safety and efficacy compared with placebo. Conclusion Delirium treatment is multidimensional and includes the identification of precipitating and aggravating factors. For symptomatic management, haloperidol remains the practice standard. Further high-quality collaborative research investigating the appropriate treatment of this complex syndrome is needed. PMID:24480529

National arrangements for radiotherapy; Mesures nationales pour la radiotherapie. Travail collectif des missions

Energy Technology Data Exchange (ETDEWEB)

NONE

2007-07-01

After a presentation of several letters exchanged between the French health ministry and public agencies in charge of public health or nuclear safety after a radiotherapy accident in Epinal, this report comments the evolution of needs in cancerology care and the place given to radiotherapy. It outlines the technological and organisational evolution of radiotherapy and presents the distribution of radiotherapy equipment, of radio-therapists and other radiotherapy professionals in France. Within the context of radiotherapy accidents which occurred in 2007, it presents the regulatory arrangements which aimed at improving the safety, short term and middle term arrangements which are needed to support and structure radiotherapy practice quality. It stresses the fact that the system will deeply evolve by implementing a radiotherapy vigilance arrangement and a permanent follow-on and adaptation plan based on surveys and the creation of a national committee.

Evaluation of time, attendance of medical staff, and resources during stereotactic radiotherapy/radiosurgery. QUIRO-DEGRO trial

Energy Technology Data Exchange (ETDEWEB)

Zabel-du Bois, A.; Milker-Zabel, S.; Debus, J. [Heidelberg Univ. (Germany). Dept. of Radiotherapy and Radiooncology; Henzel, M.; Engenhart-Cabillic, R. [Marburg Univ. (Germany). Dept. of Radiotherapy and Radiation Oncology; Popp, W. [Prime Networks AG, Basel (Switzerland); Sack, H. [Essen Univ. (Germany). Dept. of Radiation Oncology

2012-09-15

Background: The German Society of Radiation Oncology ('Deutsche Gesellschaft fuer Radioonkologie', DEGRO) initiated a multicenter trial to develop and evaluate adequate modules to assert core processes and subprocesses in radiotherapy. The aim of this prospective evaluation was to methodical assess the required resources (technical equipment and medical staff) for stereotactic radiotherapy/radiosurgery. Material and methods: At two radiotherapy centers of excellence (University Hospitals of Heidelberg and Marburg/Giessen), the manpower and time required for the implementation of intra- and extracranial stereotactic radiotherapy was prospectively collected consistently over a 3-month period. The data were collected using specifically developed process acquisition tools and standard forms and were evaluated using specific process analysis tools. Results: For intracranial (extracranial) fractionated stereotactic radiotherapy (FSRT) and radiosurgery (RS), a total of 1,925 (270) and 199 (36) records, respectively, could be evaluated. The approximate time needed to customize the immobilization device was median 37 min (89 min) for FRST and 31 min (26 min) for RS, for the contrast enhanced planning studies 22 and 27 min (25 and 28 min), for physical treatment planning 122 and 59 min (187 and 27 min), for the first and routine radiotherapy sessions for FSRT 40 and 13 min (58 and 31 min), respectively. The median time needed for the RS session was 58 min (45 min). The corresponding minimal manpower needed was 2 technicians for customization of the immobilization device, 2.5 technicians and 1 consultant for the contrast-enhanced planning studies, 1 consultant, 0.5 resident and 0.67 medical physics expert (MPE) for physical treatment planning, as well as 1 consultant, 0.5 resident, and 2.5 technicians for the first radiotherapy treatment and 2.33 technicians for routine radiotherapy sessions. Conclusion: For the first time, the resource requirements for a

To understand radiotherapy

International Nuclear Information System (INIS)

2009-01-01

Dealing with the use of radiotherapy for adults, this guide indicates when a radiotherapy is suggested, how it acts, how the treatment is chosen, which are the professionals involved. It describes how an external radiotherapy takes place and its various techniques, the different types of side effects (general, specific to the treated zone, late effects). It indicates which organs can be treated by curie-therapy, the different curie-therapy treatment modalities, how a curie-therapy takes place and which are its side effects. It outlines how to better cope with radiotherapy (how to be supported, the important role of relatives, everyday life questions, rights). It indicates and comments the different measures adopted for the safety and quality of radiotherapy

Spallation Neutron Source Availability Top-Down Apportionment Using Characteristic Factors and Expert Opinion

International Nuclear Information System (INIS)

Haire, M.J.; Schryver, J.C.

1999-01-01

Apportionment is the assignment of top-level requirements to lower tier elements of the overall facility. A method for apportioning overall facility availability requirements among systems and subsystems is presented. Characteristics that influence equipment reliability and maintainability are discussed. Experts, using engineering judgment, scored each characteristic for each system whose availability design goal is to be established. The Analytic Hierarchy Process (AHP) method is used to produce a set of weighted rankings for each characteristic for each alternative system. A mathematical model is derived which incorporates these weighting factors. The method imposes higher availability requirements on those systems in which an incremental increase in availability is easier to achieve, and lower availability requirements where greater availability is more difficult and costly. An example is given of applying this top-down apportionment methodology to the Spallation Neutron Source (SNS) facility

Price competition between an expert and a non-expert

OpenAIRE

Bouckaert, J.M.C.; Degryse, H.A.

1998-01-01

This paper characterizes price competition between an expert and a non-expert. In contrast with the expert, the non-expert’s repair technology is not always successful. Consumers visit the expert after experiencing an unsuccessful match at the non-expert. This re-entry affects the behaviour of both sellers. For low enough probability of successful repair at the non-expert, all consumers first visit the non-expert, and a ‘timid-pricing’ equilibrium results. If the non-expert’s repair technolog...

TOOL: The Open Opinion Layer

OpenAIRE

Masum, Hassan

2002-01-01

Shared opinions drive society: what we read, how we vote, and where we shop are all heavily influenced by the choices of others. However, the cost in time and money to systematically share opinions remains high, while the actual performance history of opinion generators is often not tracked. This article explores the development of a distributed open opinion layer, which is given the generic name of TOOL. Similar to the evolution of network protocols as an underlying layer for many comput...

'What on earth can this possibly mean'? French reentry courts and experts' risk assessment.

Science.gov (United States)

Herzog-Evans, Martine

2016-01-01

Against the backdrop of ten years of punitive criminal justice policies, the number of cases in which risk assessments by psychiatrist experts are mandatory has considerably increased in France. Because of complex and deeply ingrained cultural factors, most experts and academics oppose the use of actuarial or other structured judgement tools, which they assimilate to these policy changes. Parallel to this, the reentry judges in charge of making release and other community sentence decisions have maintained a strong rehabilitative and desistance-focused culture. Drawing on interviews with these judges and experts, the author wanted to assess the judges' expectations of experts' reports, their opinion on actuarial tools, and how they perceived experts and their aptitude to assess risk. The study showed that French reentry judges manage to keep experts' conclusions at bay when they do not fit with their desistance goals, as they can draw upon their own expertise and that of probation services. They do not have much faith in the professionalism and methodology of experts, and would like them to better demonstrate how they reach their conclusions. Moreover, criminogenic needs assessment would be much more useful to them than static risk assessment, which raises the issue as to why this is not the French probation services' role. Reentry judges who never encountered a report which uses a structured tool are influenced by the French ideological debate; those who have read such reports are unanimously in favour of such tools. It thus seems clear that they would like experts to be more strongly guided by science, but are not yet fully aware of what this entails. Copyright © 2015 Elsevier Ltd. All rights reserved.

IRSN 2011 opinion survey. The perception of risks and safety by French people. Global results

International Nuclear Information System (INIS)

2011-01-01

Like every year, this report presents and comments the results of an opinion survey on risks, and more particularly on nuclear and radiological risks. The first part addresses the current concerns of French people (the main concerns in the present society and with respect to the environment, how science is considered). The second part addresses the opinion on expertise (who should control a hazardous installation, the role and image of experts, the access to expertise files, the perception of pluralist bodies). The third part examines the reaction of people in front of 33 different hazardous situations (risks to which people feel being exposed, confidence in authorities, confidence in information on hazards, hierarchy of 33 situations and relationship with installation acceptability). The fourth part addresses the nuclear issue (nuclear risk, ability and credibility of nuclear actors, the Chernobyl accident, radioactive wastes, demand of information on the nuclear risk).

Iranian Expert Opinion about Necessary Criteria for Hospitals Management Performance Assessments

Directory of Open Access Journals (Sweden)

Elham Dadgar

2012-12-01

Full Text Available Background: Managers in the hospital should have enough managerial skill to be coordinated with the complex environment. Defining a competency framework assessment for hospital man-agement will help to establish core competencies for hospital managers. The aim of this study was to develop concrete and suitable performance assessment criteria using expert's view.Methods: In this qualitative study in total, 20 professionals participated in the interview and Fo-cus Group Discussions (FGD. Two of informants were interviewed and 18 professionals par-ticipants in three focus group discussions. Discussions and interviews were well planned, the FGD environments were suitable and after interviews completion the notes were checked with participant for completeness. Thematic analysis method was used for the analysis of qualitative data.Results: Findings from 3 FGDs and 2 semi structured interviews done with 20 professionals were categorized accordance to themes. The findings were classified in 7 major and 41 sub themes. The major themes include competency related to planning, organization and staff per-formance management, leadership, information management, and clinical governance and per-formance indicators.Conclusion: All participants had hospital administration experience; so their explanation impor-tant in identifying the criteria and developing hospital managers’ performance assessment tool. In addition to professional perspectives and studies done in other countries, in order to design this kind of tools, it is necessary to adopt the obtained findings to the local hospital conditions.

Expert opinions on good practice in evaluation of health promotion and primary prevention measures related to children and adolescents in Germany.

Science.gov (United States)

Korber, Katharina; Becker, Christian

2017-10-02

Determining what constitutes "good practice" in the measurement of the costs and effects of health promotion and disease prevention measures is of particular importance. The aim of this paper was to gather expert knowledge on (economic) evaluations of health promotion and prevention measures for children and adolescents, especially on the practical importance, the determinants of project success, meaningful parameters for evaluations, and supporting factors, but also on problems in their implementation. This information is targeted at people responsible for the development of primary prevention or health promotion programs. Partially structured open interviews were conducted by two interviewers and transcribed, paraphrased, and summarized for further use. Eight experts took part in the interviews. The interviewed experts saw evaluation as a useful tool to establish the effects of prevention programs, to inform program improvement and further development, and to provide arguments to decision making. The respondents' thought that determinants of a program's success were effectiveness with evidence of causality, cost benefit relation, target-group reach and sustainability. It was considered important that hard and soft factors were included in an evaluation; costs were mentioned only by one expert. According to the experts, obstacles to evaluation were lacking resources, additional labor requirements, and the evaluators' unfamiliarity with a program's contents. It was recommended to consider evaluation design before a program is launched, to co-operate with people involved in a program and to make use of existing structures. While in in this study only a partial view of expert knowledge is represented, it could show important points to consider when developing evaluations of prevention programs. By considering these points, researchers could further advance towards a more comprehensive approach of evaluation targeting measures in children and adolescents.

Lymphedema and employability - Review and results of a survey of Austrian experts.

Science.gov (United States)

Neubauer, Markus; Schoberwalter, Dieter; Cenik, Fadime; Keilani, Mohammad; Crevenna, Richard

2017-03-01

Literature about lymphedema and its influence on the ability to work and employability is limited. The aim of the present study was to investigate the opinion of Austrian experts on factors influencing the ability to work and employability in patients suffering from lymphedema. A self-administered questionnaire consisting of 6 questions was sent to 12 Austrian lymphedema experts with 6 different specializations from May to August 2016. These experts were asked about suitable and unsuitable professions, the possible influence of lymphedema on the ability to work and employability as well as about existing and additional measures to improve the return to work. The reply rate was 100% (12 out of 12). All experts agreed that lymphedema can restrict the ability to work and employability. The leading reason for limited ability to work and employability was restricted mobility or function of the affected limb along with time-consuming therapeutic modalities, pain and psychological stress. The most suitable job named was teacher and the most unsuitable job named was cook. As easements for return to work, early rehabilitation, self-management, coping strategies, patient education, employer's goodwill and employer's cooperation were reported. Furthermore, experts stressed the need for an adjustment of the legal framework as well as low-barrier and more therapy offers. Adjusted work demands seem to be of greater importance to support the ability to work and employability than recommendations for specific job profiles alone. Experts suggest an adjustment of the legal framework for affected patients, claiming a right for early rehabilitation as well as for life-long therapy. Even though some clinically useful conclusions may be drawn from this article, further research in the field is warranted.

New treatments on the horizon for chemoradiotherapy-induced nausea and vomiting

DEFF Research Database (Denmark)

Ruhlmann, Christina H; Herrstedt, Jørn

2016-01-01

the proper timing, duration, and combination of antiemetic drugs for the prevention of chemoradiotherapy-induced nausea and vomiting (C-RINV). AREAS COVERED: The article summarises the available antiemetic studies, the evidence for antiemetic prophylaxis of C-RINV, and the future perspectives for antiemetic...... research in chemoradiotherapy. EXPERT OPINION: Antiemetic prophylaxis for patients receiving concomitant chemoradiotherapy has, for many years, been an orphan research area. The distinction between acute and delayed nausea and vomiting does not apply to fractionated radiotherapy, and prophylaxis should...... be considered to cover the entire course of treatment and not only the acute and delayed chemotherapy-induced nausea and vomiting. The best prophylaxis in women receiving fractionated radiotherapy and concomitant weekly cisplatin is a combination of the neurokinin receptor antagonist fosaprepitant...

Substitution of Assisted Living Services by Assistive Technology - Experts Opinions and Technical Feasibility.

Science.gov (United States)

Schwartze, Jonas; Prekazi, Arianit; Schrom, Harald; Marschollek, Michael

2017-01-01

Ambient assisted living (AAL) may support ageing in place but is primarily driven by technology. The aim of this work is, to identifying reasons to move into assisted living institutions, their range of service and possible substitutability. We did semi-structured interviews with five experts from assisted living institutions and used results to design and implement assistive technologies in an AAL environment using BASIS, a cross domain bus system for smart buildings. Reasons for moving to assisted living institutions are expected benefits for chronic health problems, safety, social isolation and carefree living. We implemented six application systems for inactivity monitoring, stove shutdown, air quality monitoring, medication and appointment reminders, detection of unwanted situations before leaving and optical ringing of the doorbell. Substitution of selected assisted living services is feasible and has potential to delay necessity to move into assisted living institution if complement social services are installed.

PLANNING NATIONAL RADIOTHERAPY SERVICES

Directory of Open Access Journals (Sweden)

Eduardo eRosenblatt

2014-11-01

Full Text Available Countries, states and island nations often need forward planning of their radiotherapy services driven by different motives. Countries without radiotherapy services sponsor patients to receive radiotherapy abroad. They often engage professionals for a feasibility study in order to establish whether it would be more cost-beneficial to establish a radiotherapy facility. Countries where radiotherapy services have developed without any central planning, find themselves in situations where many of the available centres are private and thus inaccessible for a majority of patients with limited resources. Government may decide to plan ahead when a significant exodus of cancer patients travel to another country for treatment, thus exposing the failure of the country to provide this medical service for its citizens. In developed countries the trigger has been the existence of highly visible waiting lists for radiotherapy revealing a shortage of radiotherapy equipment.This paper suggests that there should be a systematic and comprehensive process of long-term planning of radiotherapy services at the national level, taking into account the regulatory infrastructure for radiation protection, planning of centres, equipment, staff, education pr

Opinion competition dynamics on multiplex networks

Science.gov (United States)

Amato, R.; Kouvaris, N. E.; San Miguel, M.; Díaz-Guilera, A.

2017-12-01

Multilayer and multiplex networks represent a good proxy for the description of social phenomena where social structure is important and can have different origins. Here, we propose a model of opinion competition where individuals are organized according to two different structures in two layers. Agents exchange opinions according to the Abrams-Strogatz model in each layer separately and opinions can be copied across layers by the same individual. In each layer a different opinion is dominant, so each layer has a different absorbing state. Consensus in one opinion is not the only possible stable solution because of the interaction between the two layers. A new mean field solution has been found where both opinions coexist. In a finite system there is a long transient time for the dynamical coexistence of both opinions. However, the system ends in a consensus state due to finite size effects. We analyze sparse topologies in the two layers and the existence of positive correlations between them, which enables the coexistence of inter-layer groups of agents sharing the same opinion.

Competing opinion diffusion on social networks.

Science.gov (United States)

Hu, Haibo

2017-11-01

Opinion competition is a common phenomenon in real life, such as with opinions on controversial issues or political candidates; however, modelling this competition remains largely unexplored. To bridge this gap, we propose a model of competing opinion diffusion on social networks taking into account degree-dependent fitness or persuasiveness. We study the combined influence of social networks, individual fitnesses and attributes, as well as mass media on people's opinions, and find that both social networks and mass media act as amplifiers in opinion diffusion, the amplifying effect of which can be quantitatively characterized. We analytically obtain the probability that each opinion will ultimately pervade the whole society when there are no committed people in networks, and the final proportion of each opinion at the steady state when there are committed people in networks. The results of numerical simulations show good agreement with those obtained through an analytical approach. This study provides insight into the collective influence of individual attributes, local social networks and global media on opinion diffusion, and contributes to a comprehensive understanding of competing diffusion behaviours in the real world.

Communication skills training in oncology: a position paper based on a consensus meeting among European experts in 2009.

Science.gov (United States)

Stiefel, F; Barth, J; Bensing, J; Fallowfield, L; Jost, L; Razavi, D; Kiss, A

2010-02-01

Communication in cancer care has become a major topic of interest. Since there is evidence that ineffective communication affects both patients and oncology clinicians (physicians and nurses), so-called communication skills trainings (CSTs) have been developed over the last decade. While these trainings have been demonstrated to be effective, there is an important heterogeneity with regard to implementation and with regard to evidence of different aspects of CST. In order to review and discuss the scientific literature on CST in oncology and to formulate recommendations, the Swiss Cancer League has organised a consensus meeting with European opinion leaders and experts in the field of CST, as well as oncology clinicians, representatives of oncology societies and patient organisations. On the basis of a systematic review and a meta-analysis, recommendations have been developed and agreed upon. Recommendations address (i) the setting, objectives and participants of CST, (ii) its content and pedagogic tools, (iii) organisational aspects, (iv) outcome and (v) future directions and research. This consensus meeting, on the basis of European expert opinions and a systematic review and meta-analysis, defines key elements for the current provision and future development and evaluation of CST in oncology.

A condition metric for Eucalyptus woodland derived from expert evaluations.

Science.gov (United States)

Sinclair, Steve J; Bruce, Matthew J; Griffioen, Peter; Dodd, Amanda; White, Matthew D

2018-02-01

The evaluation of ecosystem quality is important for land-management and land-use planning. Evaluation is unavoidably subjective, and robust metrics must be based on consensus and the structured use of observations. We devised a transparent and repeatable process for building and testing ecosystem metrics based on expert data. We gathered quantitative evaluation data on the quality of hypothetical grassy woodland sites from experts. We used these data to train a model (an ensemble of 30 bagged regression trees) capable of predicting the perceived quality of similar hypothetical woodlands based on a set of 13 site variables as inputs (e.g., cover of shrubs, richness of native forbs). These variables can be measured at any site and the model implemented in a spreadsheet as a metric of woodland quality. We also investigated the number of experts required to produce an opinion data set sufficient for the construction of a metric. The model produced evaluations similar to those provided by experts, as shown by assessing the model's quality scores of expert-evaluated test sites not used to train the model. We applied the metric to 13 woodland conservation reserves and asked managers of these sites to independently evaluate their quality. To assess metric performance, we compared the model's evaluation of site quality with the managers' evaluations through multidimensional scaling. The metric performed relatively well, plotting close to the center of the space defined by the evaluators. Given the method provides data-driven consensus and repeatability, which no single human evaluator can provide, we suggest it is a valuable tool for evaluating ecosystem quality in real-world contexts. We believe our approach is applicable to any ecosystem. © 2017 State of Victoria.

Non-consensus Opinion Models on Complex Networks

Science.gov (United States)

Li, Qian; Braunstein, Lidia A.; Wang, Huijuan; Shao, Jia; Stanley, H. Eugene; Havlin, Shlomo

2013-04-01

Social dynamic opinion models have been widely studied to understand how interactions among individuals cause opinions to evolve. Most opinion models that utilize spin interaction models usually produce a consensus steady state in which only one opinion exists. Because in reality different opinions usually coexist, we focus on non-consensus opinion models in which above a certain threshold two opinions coexist in a stable relationship. We revisit and extend the non-consensus opinion (NCO) model introduced by Shao et al. (Phys. Rev. Lett. 103:01870, 2009). The NCO model in random networks displays a second order phase transition that belongs to regular mean field percolation and is characterized by the appearance (above a certain threshold) of a large spanning cluster of the minority opinion. We generalize the NCO model by adding a weight factor W to each individual's original opinion when determining their future opinion (NCO W model). We find that as W increases the minority opinion holders tend to form stable clusters with a smaller initial minority fraction than in the NCO model. We also revisit another non-consensus opinion model based on the NCO model, the inflexible contrarian opinion (ICO) model (Li et al. in Phys. Rev. E 84:066101, 2011), which introduces inflexible contrarians to model the competition between two opinions in a steady state. Inflexible contrarians are individuals that never change their original opinion but may influence the opinions of others. To place the inflexible contrarians in the ICO model we use two different strategies, random placement and one in which high-degree nodes are targeted. The inflexible contrarians effectively decrease the size of the largest rival-opinion cluster in both strategies, but the effect is more pronounced under the targeted method. All of the above models have previously been explored in terms of a single network, but human communities are usually interconnected, not isolated. Because opinions propagate not

Using Fuzzy Logic to Increase the Accuracy of E-Commerce Risk Assessment Based on an Expert System

Directory of Open Access Journals (Sweden)

H. Beheshti

2017-12-01

Full Text Available Strong adaptive control can be exercised even without access to accurate data inputs. Such control is possible through fuzzy mathematics, which is a meta-collection of Boolean logic principles that imply relative accuracy. Fuzzy mathematics find applications in e-commerce, where different risk analysis methods are available for risk assessment and estimation. Such approaches can be quantitative or qualitative, depending on the type of examined data. Quantitative methods are grounded in statistics, whereas qualitative methods are based on expert judgments and fuzzy set theory. Given that qualitative methods are very subjective and deal with vague or inaccurate data, fuzzy logic can be used to extract useful information from data inaccuracies. In this study, a model based on the opinions of e-commerce security experts was designed and implemented by using fuzzy expert systems and MATLAB. A case study was conducted to validate the effectiveness of the Model.

Quality control of involved field radiotherapy in the HD 13 and HD 14 trials. Report of the radiotherapy panel of the German Hodgkin Study Group (GHSG)

International Nuclear Information System (INIS)

Kriz, J.; Haverkamp, U.; Eich, H.T.; Baues, C.; Engenhart-Cabillic, R.; Herfarth, K.; Lukas, P.; Pluetschow, A.; Fuchs, M.; Engert, A.; Schmidberger, H.; Staar, S.

2017-01-01

As part of the foundation of the German Hodgkin Study Group (GHSG) in 1978, a central radiotherapy (RT) reference centre was established to evaluate and to improve the quality of treatment. During the study generations, the quality assurance programs (QAP) were continued and adapted to the demands of each study. The purpose of this article is to demonstrate the results of the fifth study generation and to compare them to the previous findings. With the start of the fourth GHSG study generation (HD10-12), a central prospective review of all diagnostic images was established to create an individual treatment plan for each early stage study patient. The quality of involved field RT was retrospectively evaluated by an expert panel of radiation oncologists. In the fifth study generation (HD13-15), the retrospective review of radiotherapy performed was refined and the results were compared with the findings of the fourth generation. The expert panel analyzed the RT planning and application of 1037 (28 %) patients (HD13 n = 465, HD14 n = 572). Simulation films were available in 85 % of cases and verification films in 87 %. RT was assessed as major violation in 46 % (HD13 = 38 %, HD14 = 52 %), minor violation in 9 % (HD13 = 9 %, HD14 = 9 %) and according to the protocol in 45 % (HD13 = 52 %, HD14 = 38 %). The value for QAP of RT within the GHSG trials is well known. Still there were several protocol violations. In the future, the QAP program has to be adapted to the requirements of ''modern RT'' in malignant lymphoma. (orig.) [de

Desirability and feasibility of sustainable urban transport systems. An expert-based strategic scenario approach

Energy Technology Data Exchange (ETDEWEB)

Nijkamp, P.; Ouwersloot, H.; Rienstra, S.A. [Department of Spatial Economics, Faculty of Economics and Econometrics, Vrije Universiteit, Amsterdam (Netherlands)

1995-09-01

Current trends in transport indicate that the system is moving away from sustainability and that major changes are necessary to make the transport system more compatible with environmental sustainability. Main problems may occur in urban transport, where not many promising solutions are expected, while the problems are severe. In view of the great number of uncertainties, we will in our paper resort to scenarios. In the paper, expert scenarios, which lead to a sustainable transport system are constructed by applying the recently developed `Spider model`. Based on a set of distinct characteristics, leading to eight axes in the spatial, institutional, economic and social-psychological field, an evaluation framework is constructed, which visualizes the driving forces that largely influence the future of the transport system. Next, expected and desired scenarios are constructed by means of opinions of Dutch transport experts - both average scenarios and scenarios of segments of the respondents - which have been investigated by means of a survey. The expected scenarios indicate that many current trends will continue, while the transport system is largely the same as the current one. The desired scenarios on the other hand, suggest the emergence and the need for a more collective system, in which also many new modes are operating. In the paper the resulting urban transport systems are also discussed. By calculating the CO2 emissions in the average expected and desired scenario, it appears that the expected scenario does not lead to a large scale reduction of those emissions; the desired scenario however, may lead to a large scale reduction of the emissions. The conclusion is that the differences in expert opinion are small and that the road towards a sustainable (urban) transport system is still far away, although the compact city concept may perhaps offer some solution. 6 figs., 2 tabs., 18 refs.

Risk-adapted targeted intraoperative radiotherapy versus whole-breast radiotherapy for breast cancer

DEFF Research Database (Denmark)

Vaidya, Jayant S; Wenz, Frederik; Bulsara, Max

2014-01-01

The TARGIT-A trial compared risk-adapted radiotherapy using single-dose targeted intraoperative radiotherapy (TARGIT) versus fractionated external beam radiotherapy (EBRT) for breast cancer. We report 5-year results for local recurrence and the first analysis of overall survival....

Treatment outcome in patients with vulvar cancer: comparison of concurrent radiotherapy to postoperative radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Lee, Ja Young; Kim, Sung Hwan; Kim, Ki Won; Park, Dong Choon; Yoon, Joo Hee; Yoon, Sei Chul [St. Vincent' s Hospital, The Catholic University of Korea School of Medicine, Seoul (Korea, Republic of); Yu, Mina [St. Mary' s Hospital, The Catholic University of Korea School of Medicine, Seoul (Korea, Republic of)

2012-03-15

To evaluate outcome and morbidity in patients with vulvar cancer treated with radiotherapy, concurrent chemoradiotherapy or postoperative radiotherapy. The records of 24 patients treated with radiotherapy for vulvar cancer between July 1993 and September 2009 were retrospectively reviewed. All patients received once daily 1.8-4 Gy fractions external beam radiotherapy to median 51.2 Gy (range, 19.8 to 81.6 Gy) on pelvis and inguinal nodes. Seven patients were treated with primary concurrent chemoradiotherapy, one patient was treated with primary radiotherapy alone, four patients received palliative radiotherapy, and twelve patients were treated with postoperative radiotherapy. Twenty patients were eligible for response evaluation. Response rate was 55% (11/20). The 5-year disease free survival was 42.2% and 5-year overall survival was 46.2%, respectively. Fifty percent (12/24) experienced with acute skin complications of grade III or more during radiotherapy. Late complications were found in 8 patients. 50% (6/12) of patients treated with lymph node dissection experienced severe late complications. One patient died of sepsis from lymphedema. However, only 16.6% (2/12) of patients treated with primary radiotherapy developed late complications. Outcome of patients with vulvar cancer treated with radiotherapy showed relatively good local control and low recurrence. Severe late toxicities remained higher in patients treated with both node dissection and radiotherapy.

Fashion clothing involvement, opinion leadership and opinion seeking amongst black generation Y students / Pulaki Joseph Tshabalala

OpenAIRE

Tshabalala, Pulaki Joseph

2014-01-01

Opinion leadership and opinion seeking are central constructs in academic studies of new product innovations. Fashion opinion leaders as those individuals who accelerate the fashion maturity process by legitimising a fashionable trend and influence other consumers to adopt the new innovative style as a replacement for the current accepted one. Consumers who accept information and adopt new style innovations are called opinion seekers and are important to the diffusion of new fashions because ...

Recurrent issues in efforts to prevent homicidal youth violence in schools: expert opinions.

Science.gov (United States)

Dill, Karen E; Redding, Richard E; Smith, Peter K; Surette, Ray; Cornell, Dewey G

2011-01-01

Developmental research on social influences on adolescents can guide practices aimed to prevent homicidal youth violence. School shootings have repeatedly raised questions about the contributory role of bullying and entertainment violence, how news media publicity might produce copycat crimes, and whether stiffer criminal sanctions might have a deterrent effect. This article presents the thoughts and recommendations of a group of experts on these topics summarizing the current knowledge base. In brief, bullying reduction programs may be a useful early prevention effort. Television and video games with violent themes can encourage aggressive behavior, but these media can be used to teach more prosocial behavior as well. The potential copycat effects of highly publicized crimes might be diminished with more restrained reporting, although more research is needed. Finally, there is substantial evidence that increased criminal sanctions for youthful offenders have not had a deterrent effect. Copyright © 2011 Wiley Periodicals, Inc., A Wiley Company.

The Desired Learning Outcomes of School-Based Nutrition/Physical Activity Health Education: A Health Literacy Constructed Delphi Survey of Finnish Experts

Science.gov (United States)

Ormshaw, Michael James; Kokko, Sami Petteri; Villberg, Jari; Kannas, Lasse

2016-01-01

Purpose: The purpose of this paper is to utilise the collective opinion of a group of Finnish experts to identify the most important learning outcomes of secondary-level school-based health education, in the specific domains of physical activity and nutrition. Design/ Methodology/ Approach: The study uses a Delphi survey technique to collect the…

Radiotherapy in small countries.

Science.gov (United States)

Barton, Michael B; Zubizarreta, Eduardo H; Polo Rubio, J Alfredo

2017-10-01

To examine the availability of radiotherapy in small countries. A small country was defined as a country with a population less than one million persons. The economic status of each country was defined using the World Bank Classification. The number of cancers in each country was obtained from GLOBOCAN 2012. The number of cancer cases with an indication or radiotherapy was calculated using the CCORE model. There were 41 countries with a population of under 1 million; 15 were classified as High Income, 15 Upper Middle Income, 10 Lower Middle Income and one Low Income. 28 countries were islands. Populations ranged from 799 (Holy See) to 886450 (Fiji) and the total number of cancer cases occurring in small countries was 21,043 (range by country from 4 to 2476). Overall the total number of radiotherapy cases in small countries was 10982 (range by country from 2 to 1239). Radiotherapy was available in all HIC islands with 80 or more new cases of cancer in 2012 but was not available in any LMIC island. Fiji was the only LMIC island with a large radiotherapy caseload. Similar caseloads in non-island LMIC all had radiotherapy services. Most non-island HIC did not have radiotherapy services presumably because of the easy access to radiotherapy in neighbouring countries. There are no radiotherapy services in any LMIC islands. Copyright © 2017. Published by Elsevier Ltd.

Status of Radiotherapy around the World: Radiotherapy in China. Chapter 25.6

International Nuclear Information System (INIS)

Zhu, Ci; Yin, Wei Bo; Chen, Bo; Zhang, Chun Li; Zhang, Hong Zhi; Li, Ye Xiong

2017-01-01

China’s experience of using radiotherapy to treat cancer began with the installation of the first superficial X ray machine at Peking Union Medical College Hospital in early 1920, followed by the first 200 kV deep X ray machine installed at the French Hospital in Shanghai in 1923, and the first Chinese radiotherapy department established at the Affiliated Hospital of Peking University in 1932. However, the field of radiotherapy in China was still in its infancy between the 1930s and 1960s, as all operating machines were imported from foreign countries, making radiotherapy very difficult to access for cancer patients. Progress was slow until the mid-1970s, when the first batch of megavoltage machines (cobalt-60 machines and linacs) was produced by Chinese manufacturers. Owing to the efforts of radiotherapy pioneers such as Wu Huanxing, Gu Xianzhi, Liu Taifu, and Yin Weibo, who brought radiotherapy to China and shaped how Chinese patients would be treated today, radiotherapy was installed as one of the mainstream modalities of cancer treatment. In 1986, the China Society for Radiation Oncology (CSTRO) was founded, indicating that a network advancing radiation oncology practice in China was taking shape. One year later, the first issue of the Chinese Journal of Radiation Oncology was published, offering a platform for the timely exchange and sharing of laboratory and clinical research outcomes among radiation oncology professions across the country. During the past two decades, with the introduction of the gamma knife and stereotactic radiotherapy, 3-D conformal radiotherapy, IMRT, IGRT and other advanced techniques, China experienced not only a big jump in its radiotherapy equipment and facilities, but also a dramatic growth in the excellence of radiation oncology specialist staff nationwide

Hyperthermia and radiotherapy

International Nuclear Information System (INIS)

Fitspatrick, C.

1990-01-01

Hyperthermia and radiotherapy have for long been used to assist in the control of tumours, either as separate entities, or, in a combined treatment scheme. This paper outlines why hyperthermia works, thermal dose and the considerations required in the timing when hyperthermia is combined with radiotherapy. Previously reported results for hyperthermia and radiotherapy used together are also presented. 8 refs., 8 tabs

Radiotherapy

International Nuclear Information System (INIS)

Wannenmacher, M.; Debus, J.; Wenz, F.

2006-01-01

The book is focussed on the actual knowledge on the clinical radiotherapy and radio-oncology. Besides fundamental and general contributions specific organ systems are treated in detail. The book contains the following contributions: Basic principles, radiobiological fundamentals, physical background, radiation pathology, basics and technique of brachytherapy, methodology and technique of the stereotactic radiosurgery, whole-body irradiation, operative radiotherapy, hadron therapy, hpyerthermia, combined radio-chemo-therapy, biometric clinical studies, intensity modulated radiotherapy, side effects, oncological diagnostics; central nervous system and sense organs, head-neck carcinomas, breast cancer, thorax organs, esophagus carcinoma, stomach carcinoma, pancreas carcinoma, heptabiliary cancer and liver metastases, rectal carcinomas, kidney and urinary tract, prostate carcinoma, testicular carcinoma, female pelvis, lymphatic system carcinomas, soft tissue carcinoma, skin cancer, bone metastases, pediatric tumors, nonmalignant diseases, emergency in radio-oncology, supporting therapy, palliative therapy

Measurement of the absorbed dose in the very small size photon beams used in stereotactic radiotherapy

International Nuclear Information System (INIS)

Derreumaux, S.; Huet, C.; Robbes, I.; Trompier, F.; Boisserie, G.; Brunet, G.; Buchheit, I.; Sarrazin, T.; Chea, M.

2008-01-01

After the radiotherapy accident in Toulouse, the French authority of nuclear safety and the French agency of health products safety have asked the IR.S.N. to establish, together with experts from the French society of medical physics and the French society of radiotherapy and oncology, a national protocol on dose calibration for the very small beams used in stereotactic radiotherapy. The research and reflexions of the working group 'GT minifaisceaux ' set up by the I.R.S.N. are presented in this final report. A review of the international literature has been performed. A national survey has been done to know the present practices in the dosimetry of small fields. A campaign of measurements of the data needed to characterize the small beams for the different stereotactic systems has started, using different types of detectors acquired by the I.R.S.N.. In this report are presented a deep synthesis on the problems related to the dosimetry of small fields, the results of the national survey, the first results of the campaign of measurements and the recommendations of the GT. (authors)

Strategies for the prevention of MP3-induced hearing loss among adolescents : Expert opinions from a Delphi study

NARCIS (Netherlands)

Vogel, I.; Brug, J.; Ploeg, C.P.B. van der; Raat, H.

2009-01-01

OBJECTIVE. To identify parties involved in the prevention of MP3-induced hearing loss among adolescents and potentially effective prevention strategies and interventions. METHODS. Thirty experts in fields such as scientific research, medical practice, community health professions, education, youth

Australian and New Zealand Faculty of Radiation Oncology Genito-Urinary Group: 2011 consensus guidelines for curative radiotherapy for urothelial carcinoma of the bladder

International Nuclear Information System (INIS)

Hindson, Benjamin R.; Turner, Sandra L.; Millar, Jeremy L.

2012-01-01

Curative radiotherapy, with or without concurrent chemotherapy, is recognized as a standard treatment option for muscle-invasive bladder cancer. It is commonly used for two distinct groups of patients: either for those medically unfit for surgery, or as part of a 'bladder preserving' management plan incorporating the possibility of salvage cystectomy. However, in both situations, the approach to radiotherapy varies widely around the world. The Australian and New Zealand Faculty of Radiation Oncology Genito-Urinary Group recognised a need to develop consistent, evidence-based guidelines for patient selection and radiotherapy technique in the delivery of curative radiotherapy. Following a workshop convened in May 2009, a working party collated opinions and conducted a wide literature appraisal linking each recommendation with the best available evidence. This process was subject to ongoing re-presentation to the Faculty of Radiation Oncology Genito-Urinary Group members prior to final endorsement. These Guidelines include patient selection, radiation target delineation, dose and fractionation schedules, normal tissue constraints and investigational techniques. Particular emphasis is given to the rationale for the target volumes described. These Guidelines provide a consensus-based framework for the delivery of curative radiotherapy for muscle-invasive bladder cancer. Widespread input from radiation oncologists treating bladder cancer ensures that these techniques are feasible in practice. We recommend these Guidelines be adopted widely in order to encourage a uniformly high standard of radiotherapy in this setting, and to allow for better comparison of outcomes.

Scientific Opinion on the re-evaluation of carnauba wax (E 903) as a food additive

OpenAIRE

EFSA Panel on Food Additives and Nutrient Sources added to Food (ANS)

2012-01-01

The Panel on Food Additives and Nutrient Sources added to Food (ANS) delivers a scientific opinion re-evaluating the safety of carnauba wax (E 903). Carnauba wax (E 903) is authorised in the EU as food additive as glazing agent. It has been evaluated by the Scientific Committee on Food (SCF) and by the Joint FAO/WHO Expert Committee on Food Additives (JECFA) who allocated an Acceptable Daily Intake (ADI) of 7 mg/kg bw/day. The SCF did not establish an ADI but considered the use of ca...

Identification and management of comorbidity in psoriatic arthritis: evidence- and expert-based recommendations from a multidisciplinary panel from Spain.

Science.gov (United States)

Torre-Alonso, Juan Carlos; Carmona, Loreto; Moreno, Mireia; Galíndez, Eva; Babío, Jesús; Zarco, Pedro; Linares, Luis; Collantes-Estevez, Eduardo; Barrial, Manuel Fernández; Hermosa, Juan Carlos; Coto, Pablo; Suárez, Carmen; Almodóvar, Raquel; Luelmo, Jesús; Castañeda, Santos; Gratacós, Jordi

2017-08-01

The objective is to establish recommendations, based on evidence and expert opinion, for the identification and management of comorbidities in patients with psoriatic arthritis (PsA). The following techniques were applied: discussion group, systematic review, and Delphi survey for agreement. A panel of professionals from four specialties defined the users, the sections of the document, possible recommendations, and what systematic reviews should be performed. A second discussion was held with the results of the systematic reviews. Recommendations were formulated in the second meeting and voted online from 1 (total disagreement) to 10 (total agreement). Agreement was considered if at least 70% voted ≥7. The level of evidence and grade of recommendation were assigned using the Oxford Centre for Evidence-Based Medicine guidance. The full document was critically appraised by the experts, and the project was supervised at all times by a methodologist. In a final step, the document was reviewed and commented by a patient and a health management specialist. Fourteen recommendations were produced, together with a checklist to facilitate the implementation. The items with the largest support from evidence were those related to cardiovascular disease and risk factors. The panel recommends paying special attention to obesity, smoking, and alcohol consumption, as they are all modifiable factors with an impact on treatment response or complications of PsA. Psychological and organizational aspects were also deemed important. We herein suggest practical recommendations for the management of comorbidities in PsA based on evidence and expert opinion.

Adaptation and Validation of the Brief Sexual Opinion Survey (SOS) in a Colombian Sample and Factorial Equivalence with the Spanish Version

Science.gov (United States)

Sierra, Juan Carlos; Soler, Franklin

2016-01-01

Attitudes toward sexuality are a key variable for sexual health. It is really important for psychology and education to have adapted and validated questionnaires to evaluate these attitudes. Therefore, the objective of this research was to adapt, validate and calculate the equivalence of the Colombia Sexual Opinion Survey as compared to the same survey from Spain. To this end, a total of eight experts were consulted and 1,167 subjects from Colombia and Spain answered the Sexual Opinion Survey, the Sexual Assertiveness Scale, the Massachusetts General Hospital-Sexual Functioning Questionnaire, and the Sexuality Scale. The evaluation was conducted by online and the results show adequate qualitative and quantitative properties of the items, with adequate reliability and external validity and compliance with the strong invariance between the two countries. Consequently, the Colombia Sexual Opinion Survey is a valid and reliable scale and its scores can be compared with the ones from the Spain survey, with minimum bias. PMID:27627114

NESSUS/EXPERT - An expert system for probabilistic structural analysis methods

Science.gov (United States)

Millwater, H.; Palmer, K.; Fink, P.

1988-01-01

An expert system (NESSUS/EXPERT) is presented which provides assistance in using probabilistic structural analysis methods. NESSUS/EXPERT is an interactive menu-driven expert system that provides information to assist in the use of the probabilistic finite element code NESSUS/FEM and the fast probability integrator. NESSUS/EXPERT was developed with a combination of FORTRAN and CLIPS, a C language expert system tool, to exploit the strengths of each language.

Therapeutic Results of Radiotherapy in Rectal Carcinoma -Comparison of Sandwich Technique Radiotherapy with Postoperative Radiotherapy

International Nuclear Information System (INIS)

Huh, Gil Cha; Suh, Hyun Suk; Lee, Hyuk Sang; Kim, Re Hwe; Kim, Chul Soo; Kim, Hong Yong; Kim, Sung Rok

1996-01-01

Purpose : To evaluate the potential advantage for 'sandwich' technique radiotherapy compared to postoperative radiotherapy in respectable rectal cancer. Between January 1989 and May 1994, 60 patients with respectable rectal cancer were treated at Inje University Seoul and Sanggye Paik Hospital.Fifty one patients were available for analysis : 20 patients were treated with sandwich technique radiotherapy and 31 patients were treated with postoperative radiotherapy. In sandwich technique radiotherapy(RT), patients were treated with preoperative RT 1500 cGy/5fx followed by immediate curative resection. Patients staged as Astler-Coller B2, C were considered for postoperative RT with 2500-4500 cGy. In postoperative RT, total radiation dose of 4500-6120 cGy, 180 cGy daily at 4-6 weeks was delivered. Patients were followed for median period of 25 months. Results : The overall 5-year survival rates for sandwich technique RT group and postoperative RT group were 60% and 71%, respectively(p>0.05). The 5-year disease free survival rates for each group were 63%. There was no difference in local failure rate between two groups(11% versus 7%). Incidence of distant metastasis was 11%(2/20) in the sandwich technique RT group and 20%(6/31) in the postoperative RT group(p>0.05). The frequencies of acute and chronic complications were comparable in both groups. Conclusion : The sandwich technique radiotherapy group shows local recurrence and survival similar to those of postoperative RT alone group but reduced distant metastasis compared to postoperative RT group. But long term follow-up and large number of patients is needed to make an any firm conclusion regarding the value of this sandwich technique RT

Ultrasonic and computed tomography in radiotherapy planning - a comparison

International Nuclear Information System (INIS)

Schertel, L.

1980-01-01

The precondition of any radiotherapy is radiation planning. This must be done individually for every patient and must be applicable for any region of the body. Modern irradiation planning requires pictures of the body parts concerned; these can be made by means of the ultrasonic method and computed tomography. This comparative investigation leads to the result (see fig. 4 and 5) that computed tomographic body part pictures should be preferred to those made sonographically. The opinion of Huenig and Co. [8] that ultrasonic tomography will soon lose some of its importance within irradiation planning once computed tomography is introduced could be confirmed by the latest developments. The authors can confirm this also out of their own experience and agree with Winkel and Hermann [23] that computed tomography cannot be done without any more irradiation planning. (orig.) [de

Comprehensive audits of radiotherapy practices: A tool for quality improvement: Quality Assurance Team for Radiation Oncology (QUATRO)

International Nuclear Information System (INIS)

2007-10-01

As part of a comprehensive approach to quality assurance (QA) in the treatment of cancer by radiation, an independent external audit (peer review) is important to ensure adequate quality of practice and delivery of treatment. Quality audits can be of various types and at various levels, either reviewing critical parts of the radiotherapy process (partial audits) or assessing the whole process (comprehensive audits). The IAEA has a long history of providing assistance for dosimetry (partial) audits in radiotherapy to its Member States. Together with the World Health Organization (WHO), it has operated postal audit programmes using thermoluminescence dosimetry (TLD) to verify the calibration of radiotherapy beams since 1969. Furthermore, it has developed a set of procedures for experts undertaking missions to radiotherapy hospitals in Member States for on-site review of dosimetry equipment, data and techniques, measurements and training of local staff. This methodology involves dosimetry and medical radiation physics aspects of the radiotherapy process without entering into clinical areas. The IAEA, through its technical cooperation programme, has received numerous requests from developing countries to perform comprehensive audits of radiotherapy programmes to assess the whole process. including aspects such as organization, infrastructure, and clinical and medical physics components. The objective of a comprehensive clinical audit is to review and evaluate thc quality of all of the components of the practice of radiotherapy at an institution, including its professional competence, with a view to quality improvement. A multidisciplinary team, comprising a radiation oncologist, a medical physicist and a radiotherapy technologist, carries out the audit. The present publication has been field tested by IAEA teams performing audits in radiotherapy programmes in hospitals in Africa, Asia, Europe and Latin America. Their comments, corrections and feedback have been taken

Comprehensive audits of radiotherapy practices: A tool for quality improvement: Quality Assurance Team for Radiation Oncology (QUATRO)

International Nuclear Information System (INIS)

2008-08-01

As part of a comprehensive approach to quality assurance (QA) in the treatment of cancer by radiation, an independent external audit (peer review) is important to ensure adequate quality of practice and delivery of treatment. Quality audits can be of various types and at various levels, either reviewing critical parts of the radiotherapy process (partial audits) or assessing the whole process (comprehensive audits). The IAEA has a long history of providing assistance for dosimetry (partial) audits in radiotherapy to its Member States. Together with the World Health Organization (WHO), it has operated postal audit programmes using thermoluminescence dosimetry (TLD) to verify the calibration of radiotherapy beams since 1969. Furthermore, it has developed a set of procedures for experts undertaking missions to radiotherapy hospitals in Member States for on-site review of dosimetry equipment, data and techniques, measurements and training of local staff. This methodology involves dosimetry and medical radiation physics aspects of the radiotherapy process without entering into clinical areas. The IAEA, through its technical cooperation programme, has received numerous requests from developing countries to perform comprehensive audits of radiotherapy programmes to assess the whole process. including aspects such as organization, infrastructure, and clinical and medical physics components. The objective of a comprehensive clinical audit is to review and evaluate thc quality of all of the components of the practice of radiotherapy at an institution, including its professional competence, with a view to quality improvement. A multidisciplinary team, comprising a radiation oncologist, a medical physicist and a radiotherapy technologist, carries out the audit. The present publication has been field tested by IAEA teams performing audits in radiotherapy programmes in hospitals in Africa, Asia, Europe and Latin America. Their comments, corrections and feedback have been taken

Board composition and firm reputation: The role of business experts, support specialists and community influentials

Directory of Open Access Journals (Sweden)

Emma García-Meca

2018-04-01

Full Text Available The objective of this paper is to analyze the influence of board resource diversity on firm reputation. We classify board members as business experts, support specialists, political directors and other community influentials, in an effort to address whether business, technical expertise or political ties in the boardroom affect stakeholders’ opinion and, therefore, firm reputation.This study confirms that not all outside directors are equally effective in improving firm reputation, and that certain kinds of outside directors, especially business experts, help increase it. However, the findings note an inverted U-shaped non-linear relationship with these directors, which means that the effect of business experts on reputation is positive up to a point, after which the relationship becomes negative. The findings also evidence that, contrary to popular beliefs, directors with previous experience as politicians are not negatively viewed by stakeholders. Moreover, this type of community influential directors has positive effects on firm reputation in regulated firms as well as in those of the public work sector. JEL classification: G30, Keywords: Reputation, Board, Expertise, Corporate governance, Directors

Rank aggregation of local expert knowledge for conservation planning of the critically endangered saola.

Science.gov (United States)

Wilkinson, Nicholas M; Van Duc, Luong

2017-06-01

There has been much recent interest in using local knowledge and expert opinion for conservation planning, particularly for hard-to-detect species. Although it is possible to ask for direct estimation of quantities such as population size, relative abundance is easier to estimate. However, an expert's knowledge is often geographically restricted relative to the area of interest. Combining (or aggregating) experts' assessments of relative abundance is difficult when each expert only knows a part of the area of interest. We used Google's PageRank algorithm to aggregate ranked abundance scores elicited from local experts through a rapid rural-appraisal method. We applied this technique to conservation planning for the saola (Pseudoryx nghetinhensis), a poorly known bovid. Near a priority landscape for the species, composed of 3 contiguous protected areas, we asked groups of local people to indicate relative abundances of saola and other species by placing beans on community maps. For each village, we used this information to rank areas within the knowledge area of that village for saola abundance. We used simulations to compare alternative methods to aggregate the rankings from the different villages. The best-performing method was then used to produce a single map of relative abundance across the entire landscape, an area larger than that known to any one village. This map has informed prioritization of surveys and conservation action in the continued absence of direct information about the saola. © 2016 Society for Conservation Biology.

Palliative radiotherapy. Ranking within an interdisciplinary treatment concept in case of advanced tumor disease

International Nuclear Information System (INIS)

Seegenschmiedt, M.H.

1998-01-01

Many tumor-induced symptoms can be alleviated by suitable irradiation in a direct, effective and sparing manner. The clinical response amounts to 80% and is independent of tumor histology. Careful diagnosis and accurate localisation of the causes of symptoms as well as exact therapy planning and execution are required. Based on individual dose planning harmonising single dosis and total dosis, pin-pointed definition of target areas, and application of modern planning and irradiation techniques, palliative radiotherapy is able to achieve long-term improvement with neglectible side-effects, sometimes within only a few days or weeks. It is a valuable part of a consistant therapy concept that is tailored to the individual needs of a patient, by cooperative action of experts from a variety of medical disciplines, intended to optimize the quality of life of patients, and sometimes may exclude conventional radiotherapy. (orig./CB) [de

Historical review of radiotherapy

International Nuclear Information System (INIS)

Onai, Yoshio

1993-01-01

The techniques of radiotherapy have been improved by development of particle accelerators, radionuclides and computers. This paper presents a historical review of the physical and technical aspects of radiotherapy in Japan. Changes in the kinds of radiation, such as X-rays, gamma rays, electrons, neutrons and protons used for external radiotherapy, and the equipment involved are described chronologically, and historical changes in the quality of radiotherapy apparatus are outlined. Patient data acquisition equipment, such as X-ray simulator and X-ray CT, beam modifying devices, patient setup devices, and devices to verify treatment fields and patient doses are reviewed historically. Radiation sources for brachytherapy and internal radiotherapy, and remotely controlled afterloading systems are reviewed chronologically. Historical changes in methods to evaluate absorbed doses, dose monitor systems and beam data acquisition systems are outlined. Changes in methods of calculating dose distributions for external X-ray and electron therapy, brachytherapy and internal radiotherapy by unsealded radionuclides are described and calculation techniques for treatment planning system are reviewed. Annual figures in the numbers of radiotherapy equipment, such as telecobalt and telecesium units, linear accelerators, betatrons, microtrons, stereotactic gamma units, conformation radiotherapy units, remotely controlled afterloading systems, and associated equipment such as X-ray simulators and treatment planning systems are provided, as are changes in the number of accelerators by maximum X-ray energy and maximum electron energy, and in the number of licensed hospitals and clinics using small sealed sources. Changes in techniques of external radiotherapy and brachytherapy are described briefly from the point of view of dose distributions. (author)

Expert systems

International Nuclear Information System (INIS)

Haldy, P.A.

1988-01-01

The definitions of the terms 'artificial intelligence' and 'expert systems', the methodology, areas of employment and limits of expert systems are discussed. The operation of an expert system is described, especially the presentation and organization of knowledge as well as interference and control. Methods and tools for expert system development are presented and their application in nuclear energy are briefly addressed. 7 figs., 2 tabs., 6 refs

Public opinions and antinuclear contestations

International Nuclear Information System (INIS)

Silveira, P.R.N. da

1978-01-01

With the aim of demonstrating the importance of public opinion in the development of a nuclear program, a historical analysis of the different forms of anti-technological reactions is shown, starting with a study of the general aspects of mass communication and public opinion. The world-wide communication strategy adopted in the implantation of nuclear programs is discussed and, finally, the nuclear energy issue and public opinion in Brazil are analysed. (F.E.) [pt

Seeking a second medical opinion: composition, reasons and perceived outcomes in Israel.

Science.gov (United States)

Shmueli, Liora; Davidovitch, Nadav; Pliskin, Joseph S; Balicer, Ran D; Hekselman, Igal; Greenfield, Geva

2017-12-08

Seeking a second-opinion (SO) is a common clinical practice that can optimize treatment and reduce unnecessary procedures and risks. We aim to characterize the composition of the population of SO seekers, their reasons for seeking a SO and choosing a specific physician, and their perceived outcomes following the SO. A cross-sectional national telephone survey, using a representative sample of the general Israeli population (n = 848, response rate = 62%). SO utilization was defined as seeking an additional clinical opinion from a specialist within the same specialty, for the same medical concern. We describe the characteristics of respondents who obtained SOs, their reasons for doing so and their perceived outcomes: (1) Satisfaction with the SO; (2) Experiencing health improvement after receiving a SO; (3) A difference in the diagnosis or treatment suggested in the first opinions and the second opinions; (4) Preference of the SO over the first one. Most of the respondents who sought a SO (n = 344) were above 60 years old, secular, living with a partner, perceived their income to be above average and their health status to be not so good. For the patients who utilized SOs, orthopedic surgeons were sought out more than any other medical professional.Reasons for seeking a SO included doubts about diagnosis or treatment (38%), search for a sub-specialty expert (19%) and dissatisfaction with communication (19%). SO seekers most frequently chose a specific specialist based on a recommendation from a friend or a relative (33%). About half of the SO seekers also searched for information on the internet. Most of the respondents who sought a SO mentioned that they were satisfied with it (84%), felt health improvement (77%), mentioned that there was a difference between the diagnosis or treatment between the first opinion and the SO (56%) and preferred the SO over the first one (91%). Clinical uncertainty or dissatisfaction with patient-physician communication

A methodology for uncertainty quantification in quantitative technology valuation based on expert elicitation

Science.gov (United States)

Akram, Muhammad Farooq Bin

The management of technology portfolios is an important element of aerospace system design. New technologies are often applied to new product designs to ensure their competitiveness at the time they are introduced to market. The future performance of yet-to- be designed components is inherently uncertain, necessitating subject matter expert knowledge, statistical methods and financial forecasting. Estimates of the appropriate parameter settings often come from disciplinary experts, who may disagree with each other because of varying experience and background. Due to inherent uncertain nature of expert elicitation in technology valuation process, appropriate uncertainty quantification and propagation is very critical. The uncertainty in defining the impact of an input on performance parameters of a system makes it difficult to use traditional probability theory. Often the available information is not enough to assign the appropriate probability distributions to uncertain inputs. Another problem faced during technology elicitation pertains to technology interactions in a portfolio. When multiple technologies are applied simultaneously on a system, often their cumulative impact is non-linear. Current methods assume that technologies are either incompatible or linearly independent. It is observed that in case of lack of knowledge about the problem, epistemic uncertainty is the most suitable representation of the process. It reduces the number of assumptions during the elicitation process, when experts are forced to assign probability distributions to their opinions without sufficient knowledge. Epistemic uncertainty can be quantified by many techniques. In present research it is proposed that interval analysis and Dempster-Shafer theory of evidence are better suited for quantification of epistemic uncertainty in technology valuation process. Proposed technique seeks to offset some of the problems faced by using deterministic or traditional probabilistic approaches for

Choice Shift in Opinion Network Dynamics

Science.gov (United States)

Gabbay, Michael

Choice shift is a phenomenon associated with small group dynamics whereby group discussion causes group members to shift their opinions in a more extreme direction so that the mean post-discussion opinion exceeds the mean pre-discussion opinion. Also known as group polarization, choice shift is a robust experimental phenomenon and has been well-studied within social psychology. In opinion network models, shifts toward extremism are typically produced by the presence of stubborn agents at the extremes of the opinion axis, whose opinions are much more resistant to change than moderate agents. However, we present a model in which choice shift can arise without the assumption of stubborn agents; the model evolves member opinions and uncertainties using coupled nonlinear differential equations. In addition, we briefly describe the results of a recent experiment conducted involving online group discussion concerning the outcome of National Football League games are described. The model predictions concerning the effects of network structure, disagreement level, and team choice (favorite or underdog) are in accord with the experimental results. This research was funded by the Office of Naval Research and the Defense Threat Reduction Agency.

Opinion dynamics with confirmation bias.

Directory of Open Access Journals (Sweden)

Armen E Allahverdyan

Full Text Available Confirmation bias is the tendency to acquire or evaluate new information in a way that is consistent with one's preexisting beliefs. It is omnipresent in psychology, economics, and even scientific practices. Prior theoretical research of this phenomenon has mainly focused on its economic implications possibly missing its potential connections with broader notions of cognitive science.We formulate a (non-Bayesian model for revising subjective probabilistic opinion of a confirmationally-biased agent in the light of a persuasive opinion. The revision rule ensures that the agent does not react to persuasion that is either far from his current opinion or coincides with it. We demonstrate that the model accounts for the basic phenomenology of the social judgment theory, and allows to study various phenomena such as cognitive dissonance and boomerang effect. The model also displays the order of presentation effect-when consecutively exposed to two opinions, the preference is given to the last opinion (recency or the first opinion (primacy -and relates recency to confirmation bias. Finally, we study the model in the case of repeated persuasion and analyze its convergence properties.The standard Bayesian approach to probabilistic opinion revision is inadequate for describing the observed phenomenology of persuasion process. The simple non-Bayesian model proposed here does agree with this phenomenology and is capable of reproducing a spectrum of effects observed in psychology: primacy-recency phenomenon, boomerang effect and cognitive dissonance. We point out several limitations of the model that should motivate its future development.

Patients' reflections on communication in the second-opinion hematology-oncology consultation.

Science.gov (United States)

Goldman, Roberta E; Sullivan, Amy; Back, Anthony L; Alexander, Stewart C; Matsuyama, Robin K; Lee, Stephanie J

2009-07-01

The nature of communication between patients and their second-opinion hematology consultants may be very different in these one-time consultations than for those that are within long-term relationships. This study explored patients' perceptions of their second-opinion hematology-oncology consultation to investigate physician-patient communication in malignant disease at a critical juncture in cancer patients' care and decision-making. In-depth telephone interviews with a subset of 20 patients from a larger study, following their subspecialty hematology consultations. Most patients wanted to contribute to the consultation agenda, but were unable to do so. Patients sought expert and honest advice delivered with empathy, though most did not expect the consultant to directly address their emotions. They wanted the physician to apply his/her knowledge to the specifics of their individual cases, and were disappointed and distrustful when physicians cited only general prognostic statistics. In contrast, physicians' consideration of the unique elements of patients' cases, and demonstrations of empathy and respect made patients' feel positively about the encounter, regardless of the prognosis. Patients provided concrete recommendations for physician and patient behaviors to enhance the consultation. Consideration of these recommendations may result in more effective communication and increased patient satisfaction with medical visits.

Contact radiotherapy. Report of technological assessment

International Nuclear Information System (INIS)

Ortholan, Cecile; Melin, Nicole; Lee-Robin, Sun Hae; David, Denis Jean; Pages, Frederique; Devaud, Christine; Noel, Georges; Biga, Julie; Moty-Monnereau, Celine; Canet, Philippe; Lascols, Sylvie; Lamas, Muriel; Ramdine, Jessica; Tuil, Louise

2008-10-01

This report aims at assessing safety, indications, the role in therapeutic strategy, and efficiency of contact radiotherapy. It also aims at answering questions like: is the contact radiotherapy technique validated? What are the indications for contact radiotherapy? What about the efficiency and safety of contact radiotherapy? After a presentation of preliminary notions on radiotherapy (radiation types, dose, and irradiation techniques), the report presents this specific technique of contact radiotherapy: definition, devices, use recommendations, issues of radiation protection, modalities of performance of a contact radiotherapy session, and concerned pathologies. Then, based on a literature survey, this report addresses the various concerned tumours (skin, rectum, brain, breast), indicates some general information about these tumours (epidemiological data, anatomy and classification, therapeutic options, radiotherapy), and proposes an assessment of the efficiency and safety of contact radiotherapy

OpinionSeer: interactive visualization of hotel customer feedback.

Science.gov (United States)

Wu, Yingcai; Wei, Furu; Liu, Shixia; Au, Norman; Cui, Weiwei; Zhou, Hong; Qu, Huamin

2010-01-01

The rapid development of Web technology has resulted in an increasing number of hotel customers sharing their opinions on the hotel services. Effective visual analysis of online customer opinions is needed, as it has a significant impact on building a successful business. In this paper, we present OpinionSeer, an interactive visualization system that could visually analyze a large collection of online hotel customer reviews. The system is built on a new visualization-centric opinion mining technique that considers uncertainty for faithfully modeling and analyzing customer opinions. A new visual representation is developed to convey customer opinions by augmenting well-established scatterplots and radial visualization. To provide multiple-level exploration, we introduce subjective logic to handle and organize subjective opinions with degrees of uncertainty. Several case studies illustrate the effectiveness and usefulness of OpinionSeer on analyzing relationships among multiple data dimensions and comparing opinions of different groups. Aside from data on hotel customer feedback, OpinionSeer could also be applied to visually analyze customer opinions on other products or services.

Environmental problems: the expert opinions

International Nuclear Information System (INIS)

Anon.

1996-01-01

The environmental problems constitute one of the questions the most complicated which sets up to modern societies. Indeed, their reasons are multiple and their consequences are not always known with certainty. Several scientific contributions are given in this book on the following fields: the stratospheric ozone, the oceans pollution, the industrial and municipal wastes, the urbanization, the transports, the civil nuclear, the greenhouse effect, the air pollution, the water pollution and the main industrial accidents. Only the five last points are detailed later on. (O.L.). refs., tabs

Prostate specific antigen levels during and after external beam radiotherapy for localized carcinoma of the prostate: Predictor of therapeutic efficancy

International Nuclear Information System (INIS)

Rodrigus, P.; Landeghem, A.A.J. van

1992-01-01

For 105 patients with locoregional carcinoma of the prostate, prostate specific antigen (PSA) levels were evaluated before, during and after external beam radiotherapy. The median follow-up is 17 months. In 51 patients (48.5%) initial PSA levels exceeded the maximum normal value of 20 ng/ml. Nine patients kept non-declining high levels just after radiotherapy. Only one of these is free of disease. Assuming PSA levels decrease exponentially during radiotherapy, a mean half-life of 62 days (median 54, SD 26 days) was calculated. Three out of five patients with a PSA half-life of more than 88 days relapsed as compared to a 8% (3/37) relapse rate in patients with a 'normal' half-life. Prolonged PSA half-life suggests residual disease. PSA levels are expected to further decrease after radiation. Six months after irradiation persistent high PSA levels were found in 14/51 (27.5%) patients. Only four of them had no evidence of manifest disease. Important negative prognostic factors for disease control in our series were non-declining high levels of PSA, a PSA serum half-life exceeding 88 days and persistence of elevated PSA values longer than six months after treatment. In our opinion, PSA is a valuable marker in the follow-up of prostate cancer patients during and after radiotherapy. (orig.) [de

Expert Systems

OpenAIRE

Lucas, P.J.F.

2005-01-01

Expert systems mimic the problem-solving activity of human experts in specialized domains by capturing and representing expert knowledge. Expert systems include a knowledge base, an inference engine that derives conclusions from the knowledge, and a user interface. Knowledge may be stored as if-then rules, orusing other formalisms such as frames and predicate logic. Uncertain knowledge may be represented using certainty factors, Bayesian networks, Dempster-Shafer belief functions, or fuzzy se...

Transition from 2-D radiotherapy to 3-D conformal and intensity modulated radiotherapy

International Nuclear Information System (INIS)

2008-05-01

Cancer is one of the leading causes of death globally and radiotherapy is currently an essential component in the management of cancer patients, either alone or in combination with surgery or chemotherapy, both for cure or palliation. It is now recognized that safe and effective radiotherapy service needs not only substantial capital investment in radiotherapy equipment and specially designed facilities but also continuous investment in maintenance and upgrading of the equipment to comply with the technical progress, but also in training the staff. The recent IAEA-TECDOC publication 'Setting up a Radiotherapy Programme: Clinical, Medical Physics, Radiation Protection and Safety Aspects' provides general guidelines for designing and implementing radiotherapy services in Member States. Advances in computer technology have enabled the possibility of transitioning from basic 2- dimensional treatment planning and delivery (2-D radiotherapy) to a more sophisticated approach with 3-dimensional conformal radiotherapy (3-D CRT). Whereas 2-D radiotherapy can be applied with simple equipment, infrastructure and training, transfer to 3-D conformal treatments requires more resources in technology, equipment, staff and training. A novel radiation treatment approach using Intensity Modulated Radiation Therapy (IMRT) that optimizes the delivery of radiation to irregularly shaped tumour volumes demands even more sophisticated equipment and seamless teamwork, and consequentially more resources, advanced training and more time for treatment planning and verification of dose delivery than 3-D CRT. Whereas 3-D CRT can be considered as a standard, IMRT is still evolving. Due to the increased interest of Member States to the modern application of radiotherapy the IAEA has received a number of requests for guidance coming from radiotherapy departments that wish to upgrade their facilities to 3-D CRT and IMRT through Technical Cooperation programme. These requests are expected to increase

Automated planning target volume generation: an evaluation pitting a computer-based tool against human experts

International Nuclear Information System (INIS)

Ketting, Case H.; Austin-Seymour, Mary; Kalet, Ira; Jacky, Jon; Kromhout-Schiro, Sharon; Hummel, Sharon; Unger, Jonathan; Fagan, Lawrence M.; Griffin, Tom

1997-01-01

Purpose: Software tools are seeing increased use in three-dimensional treatment planning. However, the development of these tools frequently omits careful evaluation before placing them in clinical use. This study demonstrates the application of a rigorous evaluation methodology using blinded peer review to an automated software tool that produces ICRU-50 planning target volumes (PTVs). Methods and Materials: Seven physicians from three different institutions involved in three-dimensional treatment planning participated in the evaluation. Four physicians drew partial PTVs on nine test cases, consisting of four nasopharynx and five lung primaries. Using the same information provided to the human experts, the computer tool generated PTVs for comparison. The remaining three physicians, designated evaluators, individually reviewed the PTVs for acceptability. To exclude bias, the evaluators were blinded to the source (human or computer) of the PTVs they reviewed. Their scorings of the PTVs were statistically examined to determine if the computer tool performed as well as the human experts. Results: The computer tool was as successful as the human experts in generating PTVs. Failures were primarily attributable to insufficient margins around the clinical target volume and to encroachment upon critical structures. In a qualitative analysis, the human and computer experts displayed similar types and distributions of errors. Conclusions: Rigorous evaluation of computer-based radiotherapy tools requires comparison to current practice and can reveal areas for improvement before the tool enters clinical practice

Image-guided radiotherapy for effective radiotherapy delivery

CERN Document Server

Karlsson, Ulf Lennart

2016-01-01

Image-guided radiotherapy (IGRT) is a new radiotherapy technology that combines the rapid dose fall off associated with intensity-modulated radiotherapy (IMRT) and daily tumor imaging allowing for high precision tumor dose delivery and effective sparing of surrounding normal organs. The new radiation technology requires close collaboration between radiologists, nuclear medicine specialists, and radiation oncologists to avoid marginal miss. Modern diagnostic imaging such as positron emission tomography (PET) scans, positron emission tomography with Computed Tomograpgy (PET-CT), and magnetic resonance imaging (MRI) allows the radiation oncologist to target the positive tumor with high accuracy. As the tumor is well visualized during radiation treatment, the margins required to avoid geographic miss can be safely reduced , thus sparing the normal organs from excessive radiation. When the tumor is located close to critical radiosensitive structures such as the spinal cord, IGRT can deliver a high dose of radiatio...

Attitudes of Agricultural Experts Toward Genetically Modified Crops: A Case Study in Southwest Iran.

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Ghanian, Mansour; Ghoochani, Omid M; Kitterlin, Miranda; Jahangiry, Sheida; Zarafshani, Kiumars; Van Passel, Steven; Azadi, Hossein

2016-04-01

The production of genetically modified (GM) crops is growing around the world, and with it possible opportunities to combat food insecurity and hunger, as well as solutions to current problems facing conventional agriculture. In this regard the use of GMOs in food and agricultural applications has increased greatly over the past decade. However, the development of GM crops has been a matter of considerable interest and worldwide public controversy. This, in addition to skepticism, has stifled the use of this practice on a large scale in many areas, including Iran. It stands to reason that a greater understanding of this practice could be formed after a review of the existing expert opinions surrounding GM crops. Therefore, the purpose of this study was to analyze the predictors that influence agricultural experts' attitudes toward the development of and policies related to GM crops. Using a descriptive correlational research method, questionnaire data was collected from 65 experts from the Agricultural Organization in the Gotvand district in Southwest Iran. Results indicated that agricultural experts were aware of the environmental benefits and possible risks associated with GM crops. The majority of participants agreed that GM crops could improve food security and accelerate rural development, and were proponents of labeling practices for GM crops. Finally, there was a positive correlation between the perception of benefits and attitudes towards GM crops.

Opinion formation models on a gradient.

Directory of Open Access Journals (Sweden)

Michael T Gastner

Full Text Available Statistical physicists have become interested in models of collective social behavior such as opinion formation, where individuals change their inherently preferred opinion if their friends disagree. Real preferences often depend on regional cultural differences, which we model here as a spatial gradient g in the initial opinion. The gradient does not only add reality to the model. It can also reveal that opinion clusters in two dimensions are typically in the standard (i.e., independent percolation universality class, thus settling a recent controversy about a non-consensus model. However, using analytical and numerical tools, we also present a model where the width of the transition between opinions scales proportional g(-1/4, not proportional g(-4/7 as in independent percolation, and the cluster size distribution is consistent with first-order percolation.

Carbon-ion radiotherapy for marginal lymph node recurrences of cervical cancer after definitive radiotherapy: a case report

International Nuclear Information System (INIS)

Tamaki, Tomoaki; Nakano, Takashi; Ohno, Tatsuya; Kiyohara, Hiroki; Noda, Shin-ei; Ohkubo, Yu; Ando, Ken; Wakatsuki, Masaru; Kato, Shingo; Kamada, Tadashi

2013-01-01

Recurrences of cervical cancer after definitive radiotherapy often occur at common iliac or para-aortic lymph nodes as marginal lymph node recurrences. Patients with these recurrences have a chance of long-term survival by optimal re-treatment with radiotherapy. However, the re-irradiation often overlaps the initial and the secondary radiotherapy fields and can result in increased normal tissue toxicities in the bowels or the stomach. Carbon-ion radiotherapy, a form of particle beam radiotherapy using accelerated carbon ions, offers more conformal and sharp dose distribution than X-ray radiotherapy. Therefore, this approach enables the delivery of high radiation doses to the target while sparing its surrounding normal tissues. Marginal lymph node recurrences in common iliac lymph nodes after radiotherapy were treated successfully by carbon-ion radiotherapy in two patients. These two patients were initially treated with a combination of external beam radiotherapy and intracavitary and interstitial brachytherapy. However, the diseases recurred in the lymph nodes near the border of the initial radiotherapy fields after 22 months and 23 months. Because re-irradiation with X-ray radiotherapy may deliver high doses to a section of the bowels, carbon-ion radiotherapy was selected to treat the lymph node recurrences. A total dose of 48 Gy (RBE) in 12 fractions over 3 weeks was given to the lymph node recurrences, and the tumors disappeared completely with no severe acute toxicities. The two patients showed no evidence of disease for 75 months and 63 months after the initial radiotherapy and for 50 months and 37 months after the carbon-ion radiotherapy, respectively. No severe late adverse effects are observed in these patients. The two presented cases suggest that the highly conformal dose distribution of carbon-ion radiotherapy may be beneficial in the treatment of marginal lymph node recurrences after radiotherapy. In addition, the higher biological effect of carbon

Non small cells stage I bronchial cancers: three-dimensional radiotherapy and radiotherapy in stereotactic conditions; Cancers bronchiques non a petites cellules de stade I: radiotherapie tridimensionnelle et radiotherapie en conditions stereotaxiques

Energy Technology Data Exchange (ETDEWEB)

Schipman, B.; Bosset, J.F. [CHU, 25 - Besancon (France); Marchesi, V.; Beckendorf, V.; Desandes, E.; Peiffert, D. [CRLCC Alexis-Vautrin, 54 - Vandaeuvre-les-Nancy (France); Bosset, M. [CHU, 26 - Valence (France)

2010-10-15

The authors report a comparison between three-dimensional conformation radiotherapy and robotic irradiation in stereotactic conditions (with CyberKnife) for patients suffering from a bronchial cancer with no small cells of stage I. Acute and late toxicity have been recorded, and the monitoring comprised a clinic examination and a thoracic scanography. The external radiotherapy results in an important local control rate and an acceptable toxicity. Some prospective studies are still needed to compare three-dimensional conformation respiratory-gated radiotherapy and radiotherapy in stereotactic conditions. Short communication

Expert estimation of human error probabilities in nuclear power plant operations: a review of probability assessment and scaling

International Nuclear Information System (INIS)

Stillwell, W.G.; Seaver, D.A.; Schwartz, J.P.

1982-05-01

This report reviews probability assessment and psychological scaling techniques that could be used to estimate human error probabilities (HEPs) in nuclear power plant operations. The techniques rely on expert opinion and can be used to estimate HEPs where data do not exist or are inadequate. These techniques have been used in various other contexts and have been shown to produce reasonably accurate probabilities. Some problems do exist, and limitations are discussed. Additional topics covered include methods for combining estimates from multiple experts, the effects of training on probability estimates, and some ideas on structuring the relationship between performance shaping factors and HEPs. Preliminary recommendations are provided along with cautions regarding the costs of implementing the recommendations. Additional research is required before definitive recommendations can be made

IRSN 2014 opinion survey - The perception of risks and security by the French population. Global results

International Nuclear Information System (INIS)

El Jammal, Marie-Helene; Mur, Emmanuelle; Rollinger, Francois; Schuler, Matthieu; Tchernia, Jean-Francois

2014-06-01

A first and synthetic part of this report comments the most remarkable results of the opinion survey. It first addresses results related to a context of economic crisis (importance of the economic crisis and unemployment as major concerns for French people, environmental concerns) and then analyzes the different aspects of the nuclear risk, from the accident to nuclear safety: strong fears of a nuclear accident, Fukushima and Chernobyl are immediately present in people's mind, concerns about nuclear are also related to the environment and health, the actual benefit of nuclear is an economic one, nuclear safety is a major challenge on which French people doubt, French people wish a citizen look on nuclear safety, the opinion of French people on nuclear worsened in 2013. Then, this report, illustrated by several graphs, presents and discusses the results of an annual opinion survey on the present concerns of French people (in the present society, for the environment, and as far as science is concerned), the opinion of French people on expertise (about who must control a risky installation, about the role and image of scientific experts, about the diffusion and sharing of scientific expertise, and about the perception of pluralistic structures), on the attitude of French people in front of 33 risk situations (risks to which French people feel exposed to, confidence of French people in authorities to protect them, the truth of information on hazards, the hierarchy of 33 situations according to 3 aspects and their relationship with installation acceptability). The fourth part addresses more particularly the nuclear sector: expectations in terms of nuclear risk management, fear of a serious accident, benefits and drawbacks of nuclear energy, skill and credibility of interveners. Graphs notably present the evolution of opinions with respect to last year or over the past years

Radiological incidents in radiotherapy

International Nuclear Information System (INIS)

Hobzova, L.; Novotny, J.

2008-01-01

In many countries a reporting system of radiological incidents to national regulatory body exists and providers of radiotherapy treatment are obliged to report all major and/or in some countries all incidents occurring in institution. State Office for Nuclear Safety (SONS) is providing a systematic guidance for radiotherapy departments from 1997 by requiring inclusion of radiation safety problems into Quality assurance manual, which is the basic document for obtaining a license of SONS for handling with sources of ionizing radiation. For that purpose SONS also issued the recommendation 'Introduction of QA system for important sources in radiotherapy-radiological incidents' in which the radiological incidents are defined and the basic guidance for their classification (category A, B, C, D), investigation and reporting are given. At regular periods the SONS in co-operation with radiotherapy centers is making a survey of all radiological incidents occurring in institutions and it is presenting obtained information in synoptic communication (2003 Motolske dny, 2005 Novy Jicin). This presentation is another summary report of radiological incidents that occurred in our radiotherapy institutions during last 3 years. Emphasis is given not only to survey and statistics, but also to analysis of reasons of the radiological incidents and to their detection and prevention. Analyses of incidents in radiotherapy have led to a much broader understanding of incident causation. Information about the error should be shared as early as possible during or after investigation by all radiotherapy centers. Learning from incidents, errors and near misses should be a part of improvement of the QA system in institutions. Generally, it is recommended that all radiotherapy facilities should participate in the reporting, analyzing and learning system to facilitate the dissemination of knowledge throughout the whole country to prevent errors in radiotherapy.(authors)

Application of Delphi expert panel in joint venture projects

Science.gov (United States)

Adnan, H.; Rosman, M. R.; Rashid, Z. Z. Ahmad; Mohamad Yusuwan, N.; Bakhary, N. A.

2018-02-01

This study was conducted with the aim to identify the application of the Delphi Technique in validating findings obtained from questionnaire surveys and interviews done in- depth on the subject of joint venture projects in Malaysia. The Delphi technique aims to achieve a consensus of opinion amongst expert panellist that were selected on the primary factors in JV projects. To achieve research objectives, a progressive series of questions was designed where a selected panel of expert to confirm and validate the final findings. The rationale, benefits, limitations and recommendations for the use of Delphi were given in this study. From the literature review done, twenty-one factors were identified as critical factors to the making any joint venture project successful. Detail information from contractors were obtained by using the questionnaire survey method and forty-three in-depth interviews were carried out. Trust between partners, mutual understanding, partner selection criteria, agreement of contract, objective compatibility, conflict, and commitment were confirmed by the Delphi panel to be the critical success factors besides another fourteen factors which were found to be the Failure Reduction Criteria. Delphi techniques has proven to successfully assist in recognising the main factors and would be beneficial in supplementing the success of joint venture arrangements application for construction projects in Malaysia.

Expert - Non-expert differences in visual behaviour during alpine slalom skiing.

Science.gov (United States)

Decroix, Marjolein; Wazir, Mohd Rozilee Wazir Norjali; Zeuwts, Linus; Deconinck, Frederik F J A; Lenoir, Matthieu; Vansteenkiste, Pieter

2017-10-01

The aim of this study was to investigate visual behaviour of expert and non-expert ski athletes during an alpine slalom. Fourteen non-experts and five expert slalom skiers completed an alpine slalom course in an indoor ski slope while wearing a head-mounted eye tracking device. Experts completed the slalom clearly faster than non-experts, but no significant difference was found in timing and position of the turn initiation. Although both groups already looked at future obstacles approximately 0,5s before passing the upcoming pole, the higher speed of experts implied that they shifted gaze spatially earlier in the bend than non-experts. Furthermore, experts focussed more on the second next pole while non-expert slalom skiers looked more to the snow surface immediately in front of their body. No difference was found in the fixation frequency, average fixation duration, and quiet eye duration between both groups. These results suggest that experts focus on the timing of their actions while non-experts still need to pay attention to the execution of these actions. These results also might suggest that ski trainers should instruct non-experts and experts to focus on the next pole and, shift their gaze to the second next pole shortly before reaching it. Based on the current study it seems unadvisable to instruct slalom skiers to look several poles ahead during the actual slalom. However, future research should test if these results still hold on a real outdoor slope, including multiple vertical gates. Copyright © 2017 Elsevier B.V. All rights reserved.

Assessment of effectiveness of geologic isolation systems: the feasibility of computer interrogation of experts for WISAP

Energy Technology Data Exchange (ETDEWEB)

Wight, L.H.

1980-05-01

Simulation of the response of a waste repository to events that could initiate a fault tree to breach and failure is currently a keystone to the Battelle Waste Isolation Safety Assessment Program (WISAP). The repository simulation, which is part of the Disruptive Event Analysis Task, models the repository for its entire design life, one million years. This is clearly a challenging calculation, requiring input unlike any other response analysis by virtue of the long design life of the facility. What technology will provide design criteria for a million year design life. Answers to questions like this can, to some extent, be based on data, but always require some subjective judgments. The subjectivity, which is sometimes driven by inadequate or incomplete data or by a lack of understanding of the physical process, is therefore a crucial ingredient in an analysis of initiating events. Because of the variety of possible initiating events (glaciation, man-caused disruption, volcanism, etc.), many expert opinions will be solicited as input. The complexity of the simulation, the variety of experts involved, and the volume of applicable data all suggest that there may be a more direct, economical method to solicit the expert opinion. This report addresses the feasibility of such a system. Background information is presented that demonstrates the advantages of a computer interrogation system over conventional interrogation and assessment techniques. In the subsequent three sections the three elements - structure and decomposition, scaling, and synthesis - that are basic to any interrogation and assessment technique are reviewed. The interrelationship are schematically illustrated between these three fundamental elements and, therefore, serves as a useful guide to these three sections. Each of these three sections begins with a recommended approach to the particular element and ends with an illustration of representative dialogue.

Assessment of effectiveness of geologic isolation systems: the feasibility of computer interrogation of experts for WISAP

International Nuclear Information System (INIS)

Wight, L.H.

1980-05-01

Simulation of the response of a waste repository to events that could initiate a fault tree to breach and failure is currently a keystone to the Battelle Waste Isolation Safety Assessment Program (WISAP). The repository simulation, which is part of the Disruptive Event Analysis Task, models the repository for its entire design life, one million years. This is clearly a challenging calculation, requiring input unlike any other response analysis by virtue of the long design life of the facility. What technology will provide design criteria for a million year design life. Answers to questions like this can, to some extent, be based on data, but always require some subjective judgments. The subjectivity, which is sometimes driven by inadequate or incomplete data or by a lack of understanding of the physical process, is therefore a crucial ingredient in an analysis of initiating events. Because of the variety of possible initiating events (glaciation, man-caused disruption, volcanism, etc.), many expert opinions will be solicited as input. The complexity of the simulation, the variety of experts involved, and the volume of applicable data all suggest that there may be a more direct, economical method to solicit the expert opinion. This report addresses the feasibility of such a system. Background information is presented that demonstrates the advantages of a computer interrogation system over conventional interrogation and assessment techniques. In the subsequent three sections the three elements - structure and decomposition, scaling, and synthesis - that are basic to any interrogation and assessment technique are reviewed. The interrelationship are schematically illustrated between these three fundamental elements and, therefore, serves as a useful guide to these three sections. Each of these three sections begins with a recommended approach to the particular element and ends with an illustration of representative dialogue

The Quality of Life of High-Skilled Employees in Hungary. The Experts' Opinion

Directory of Open Access Journals (Sweden)

CRISTINA LEOVARIDIS

2012-04-01

Full Text Available This article aims to provide an overview of the working conditions of high-skilled employees in Hungary, by resorting to comparisons with the other Central and Eastern European countries, based on research carried out by the author during a three-month placement (August 1st-October 31st 2011 at the Institute of Sociology of the Hungarian Academy of Sciences. This work combines several sources and methods for gathering information: theoretical documentation, secondary analysis of data, in-depth interviews with some experts in the field. The study results indicate the presence, for the knowledge workers in Hungary, of some common problems of this category of employees in all former communist countries, such as number of working hours per week more than EU average, low rate of participation in training, problems health such as stress, depression, heart disease etc., employees' complaints related to overworking associated with low wages in the public sector and with rigid hierarchy, lack of work-life balance, standards imposed by the parent company etc. in some multinational firms; cases of good practice appear at the micro level, mainly in Scandinavian capital firms or in companies in the IT sector.

Demand for radiotherapy in Spain.

Science.gov (United States)

Rodríguez, A; Borrás, J M; López-Torrecilla, J; Algara, M; Palacios-Eito, A; Gómez-Caamaño, A; Olay, L; Lara, P C

2017-02-01

Assessing the demand for radiotherapy in Spain based on existing evidence to estimate the human resources and equipment needed so that every person in Spain has access to high-quality radiotherapy when they need it. We used data from the European Cancer Observatory on the estimated incidence of cancer in Spain in 2012, along with the evidence-based indications for radiotherapy developed by the Australian CCORE project, to obtain an optimal radiotherapy utilisation proportion (OUP) for each tumour. About 50.5 % of new cancers in Spain require radiotherapy at least once over the course of the disease. Additional demand for these services comes from reradiation therapy and non-melanoma skin cancer. Approximately, 25-30 % of cancer patients with an indication for radiotherapy do not receive it due to factors that include access, patient preference, familiarity with the treatment among physicians, and especially resource shortages, all of which contribute to its underutilisation. Radiotherapy is underused in Spain. The increasing incidence of cancer expected over the next decade and the greater frequency of reradiations necessitate the incorporation of radiotherapy demand into need-based calculations for cancer services planning.

Manual of dosimetry in radiotherapy. A practical guide for testing and calibrating equipment used in external beam treatments

International Nuclear Information System (INIS)

Massey, J.B.

1971-01-01

In order to achieve safe and efficient radiotherapy, one should respect a number of technical criteria, meaning that the irradiation facility should be adapted every time to the specific patient and the dose received by the patient should be fixed. If the radio therapist should decide about the characteristics of the treatment, he might not have the technical education needed to ensure that the applied devices are appropriate for obtaining the wanted results. This is the responsibility of the medical radio physicist. Unfortunately many countries lack qualified medical doctors experienced in radiotherapy. Although these countries can supply numerous hospitals with radiotherapeutic devices and x-ray sources they cannon make good use of them. That is why the IAEA, WHO and Pan-American Health Organization organised an experts team to study the problems of dosimetry in the radiotherapeutic centres. The objective of the present manual is to supply specialists in radiotherapy with practical instructions which will enable them to apply precise physical data on the irradiation volume and applied doses

An intra-patient dose-escalation study of disodium pamidronate plus radiotherapy versus radiotherapy alone for the treatment of osteolytic metastases. Monitoring of recalcification using image-processing techniques

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Vassilis Kouloulias, E. [Dept. of Radiology, Aretaieion Univ. Hospital, Athens (Greece); Dept. of Electrical and Computer Engineering, Inst. of Communication and Computer Systems, National Technical Univ. of Athens (Greece); John Kouvaris, R.; Antypas, C.; Mystakidou, K.; Moulopoulos, A.; Lambros Vlahos, J. [Dept. of Radiology, Aretaieion Univ. Hospital, Athens (Greece); Matsopoulos, G.; Nikolaos Uzunoglu, C. [Dept. of Electrical and Computer Engineering, Inst. of Communication and Computer Systems, National Technical Univ. of Athens (Greece)

2003-07-01

Objective: To evaluate the clinical benefit and mainly to monitor quantitatively the recalcification of osteolytic lesions after radiotherapy with or without intravenous infusion of disodium pamidronate (DP) in different doses. Patients and Methods: 42 patients with solitary lytic metastasis in weight-bearing bones were studied. Primary endpoints were the mean value and energy of gray-level histogram in plain radiographs (MVGLH and EGLH) and relative electron density (RED) of CT scans in bone lesions. In eleven patients (group A) the DP dose was increased stepwise from 90 up to 180 mg (flat dose), while in other 15 patients (group B) a flat dose of 180 mg was administered intravenously in 2 h. In both groups, the first session of DP was given concurrently with local radiotherapy (30 Gy in ten fractions, 5 days a week). Another 16 patients (group C) underwent radiotherapy only. Results: Morbidity related to pamidronate was mild. Significant differences from the baseline (p < 0.05, Wilcoxon test) were recorded for MVGLH, EGLH and RED values, regarding all groups. Improvement was significantly higher in patients of group B versus A, while the results of pamidronate groups (A and B) were superior to group C, concerning the above indices (p < 0.05, Mann-Whitney test). Additionally, pamidronate groups had significantly lower skeletal morbidity than group C. Conclusion: The 2-h infusional flat dose of 180 mg every 4 weeks seems to be tolerable and superior to 90 mg regarding palliation and mainly recalcification of osteolytic lesions. Radiotherapy alone is effective but inferior to the combined treatment. Last but not least, the findings of MVGLH, EGLH and RED indicate an important increase in bone mass and bone formation, which was difficult to be identified visually by the experts. (orig.)

Opinion evolution in different social acquaintance networks

Science.gov (United States)

Chen, Xi; Zhang, Xiao; Wu, Zhan; Wang, Hongwei; Wang, Guohua; Li, Wei

2017-11-01

Social acquaintance networks influenced by social culture and social policy have a great impact on public opinion evolution in daily life. Based on the differences between socio-culture and social policy, three different social acquaintance networks (kinship-priority acquaintance network, independence-priority acquaintance network, and hybrid acquaintance network) incorporating heredity proportion ph and variation proportion pv are proposed in this paper. Numerical experiments are conducted to investigate network topology and different phenomena during opinion evolution, using the Deffuant model. We found that in kinship-priority acquaintance networks, similar to the Chinese traditional acquaintance networks, opinions always achieve fragmentation, resulting in the formation of multiple large clusters and many small clusters due to the fact that individuals believe more in their relatives and live in a relatively closed environment. In independence-priority acquaintance networks, similar to Western acquaintance networks, the results are similar to those in the kinship-priority acquaintance network. In hybrid acquaintance networks, similar to the Chinese modern acquaintance networks, only a few clusters are formed indicating that in modern China, opinions are more likely to reach consensus on a large scale. These results are similar to the opinion evolution phenomena in modern society, proving the rationality and applicability of network models combined with social culture and policy. We also found a threshold curve pv+2 ph=2.05 in the results for the final opinion clusters and evolution time. Above the threshold curve, opinions could easily reach consensus. Based on the above experimental results, a culture-policy-driven mechanism for the opinion dynamic is worth promoting in this paper, that is, opinion dynamics can be driven by different social cultures and policies through the influence of heredity and variation in interpersonal relationship networks. This

Survey Methods, Traditional, Public Opinion Polling

DEFF Research Database (Denmark)

Elmelund-Præstekær, Christian; Hopmann, David Nicolas; Pedersen, Rasmus Tue

2017-01-01

Traditional public opinion polls are surveys in which a random sample of a given population is asked questions about their attitudes, knowledge, or behavior. If conducted properly, the answers from such surveys are approximately representative of the entire population. Traditional public opinion...... polling is typically based on four different methods of data gathering, or combinations hereof: face-to-face, postal surveys, phone surveys, and web surveys. Given that opinion polls are based on a sample, we cannot be sure that the sample reflects public opinion perfectly, however—even if randomness...... is perfect. Moreover, responses may be highly dependent on the contextual information provided with the question. Also, it may be difficult to capture past or complex causes of attitudes or behavior. In short, surveys are a precise way of measuring public opinion, but they do not come without challenges....

Formulation and communication of evaluative forensic science expert opinion-A GHEP-ISFG contribution to the establishment of standards.

Science.gov (United States)

Amorim, António; Crespillo, Manuel; Luque, Juan A; Prieto, Lourdes; Garcia, Oscar; Gusmão, Leonor; Aler, Mercedes; Barrio, Pedro A; Saragoni, Victor G; Pinto, Nadia

2016-11-01

Communicating and interpreting genetic evidence in the administration of justice is currently a matter of great concern, due to the theoretical and technical complexity of the evaluative reporting and large difference in expertise between forensic experts and law professionals. A large number of initiatives have been taken trying to bridge this gap, contributing to the education of both parties. Results however have not been very encouraging, as most of these initiatives try to cope globally with the problem, addressing simultaneously theoretical and technical approaches which are in a quite heterogeneous state of development and validation. In consequence, the extension and complexity of the resulting documents disheartens their study by professionals (both jurists and geneticists) and makes a consensus very hard to reach even among the genetic experts' community. Here we propose a 'back-to-basics', example-driven approach, in which a model report for the two most common situations faced by forensic laboratories is presented. We do hope that this strategy will provide a solid basis for a stepwise generalisation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The learning continuum of ecology based on teachers' opinion about student's level of competence and specific pedagogical learning material

Science.gov (United States)

Pramesti, Indah Cahaya; Subali, Bambang

2017-08-01

This study aims at designing learning continuum for developing a curriculum based on teachers' opinion about student's level of competence and specific pedagogical learning material on ecological aspect targeted for students of Primary and Secondary Education. This research is a descriptive research using survey methods. The researchers conducted a census by distributing questionnaires that had been validated from the aspects of construct validity and experts judgements to 147 natural science teachers at junior high school and 134 Biology teachers at senior high school as a population throughout 4 regencies and 1 city in Yogyakarta Special Region.. Data analysis techniques used descriptive analysis. In conclusion, teacher's opinion is influenced by curriculum that exist today. According to the opinions of Natural Science teachers at Junior High School, most of the ecological aspects such as characteristics of biomes, characteristics of ecosystems, characteristics of communities, characteristics of populations, etc. should be taught in grade VII with the level of competence: to understand (C2), while Biology teachers at Senior High School state that the ecological aspect should be taught in class X with the level of competence: to understand (C2), apply (C3) and analyze (C4). Teachers should be a privy in the formulation of the curriculum, so they're not only accept and apply the existing curriculum but also give opinions to improve the curriculum, especially in terms of ecology.

Expert elicitation, uncertainty, and the value of information in controlling invasive species

Science.gov (United States)

Johnson, Fred A.; Smith, Brian J.; Bonneau, Mathieu; Martin, Julien; Romagosa, Christina; Mazzotti, Frank J.; Waddle, J. Hardin; Reed, Robert; Eckles, Jennifer Kettevrlin; Vitt, Laurie J.

2017-01-01

We illustrate the utility of expert elicitation, explicit recognition of uncertainty, and the value of information for directing management and research efforts for invasive species, using tegu lizards (Salvator merianae) in southern Florida as a case study. We posited a post-birth pulse, matrix model in which four age classes of tegus are recognized: hatchlings, 1 year-old, 2 year-olds, and 3 + year-olds. This matrix model was parameterized using a 3-point process to elicit estimates of tegu demographic rates in southern Florida from 10 herpetology experts. We fit statistical distributions for each parameter and for each expert, then drew and pooled a large number of replicate samples from these to form a distribution for each demographic parameter. Using these distributions, as well as the observed correlations among elicited values, we generated a large sample of matrix population models to infer how the tegu population would respond to control efforts. We used the concepts of Pareto efficiency and stochastic dominance to conclude that targeting older age classes at relatively high rates appears to have the best chance of minimizing tegu abundance and control costs. We conclude that expert opinion combined with an explicit consideration of uncertainty can be valuable in conducting an initial assessment of what control strategy, effort, and monetary resources are needed to reduce and eventually eliminate the invader. Scientists, in turn, can use the value of information to focus research in a way that not only increases the efficacy of control, but minimizes costs as well.

Opinion Change: Information or Partisanship?

DEFF Research Database (Denmark)

Justesen, Mogens K.; Klemmensen, Robert; Leavitt, Thomas

Currently two paradigms seek to explain how voters change their opinion when they are confronted with new information. One school argues that voters are bayesian updaters who rationally change their opinion. Another school argues that voters are inherently biased in their evaluation of new...... information. According to this line of thought voters are more likely to accept information that con_rms their opinion compared to information that contradict their point of view. Using a quasi experiment we investigate the extent to which voters rely on bayesian updating or on motivated reasoning when...

Opinion Summarizationof CustomerComments

Science.gov (United States)

Fan, Miao; Wu, Guoshi

Web 2.0 technologies have enabled more and more customers to freely comment on different kinds of entities, such as sellers, products and services. The large scale of information poses the need and challenge of automatic summarization. In many cases, each of the user-generated short comments implies the opinions which rate the target entity. In this paper, we aim to mine and to summarize all the customer comments of a product. The algorithm proposed in this researchis more reliable on opinion identification because it is unsupervised and the accuracy of the result improves as the number of comments increases. Our research is performed in four steps: (1) mining the frequent aspects of a product that have been commented on by customers; (2) mining the infrequent aspects of a product which have been commented by customers (3) identifying opinion words in each comment and deciding whether each opinion word is positive, negative or neutral; (4) summarizing the comments. This paper proposes several novel techniques to perform these tasks. Our experimental results using comments of a number of products sold online demonstrate the effectiveness of the techniques.

IRSN 2017 opinion survey. The perception of risks and safety by French people. Global results

International Nuclear Information System (INIS)

El Jammal, Marie-Helene; Charron, Sylvie; Mur, Emmanuelle; Schuler, Matthieu; Tchernia, Jean-francois

2017-07-01

Like every year, this report presents and comments the results of an opinion survey on risks, and more particularly on risks related to nuclear and radiological activities. The first part addresses the current concerns of French people (main concerns in the present society, with respect to the environment, and risks related to industrial installations). The second part addresses the opinion on expertise (the role and image of experts, diffusion and sharing of scientific expertise, and the perception of pluralistic structures). The third part examines the reaction of people in front of 34 different hazardous situations (risks to which people feel being exposed, confidence people have in authorities to protect them, confidence in information on hazards, hierarchy of the 34 situations according to three different aspects, and relationship with installation acceptability). The fourth part addresses the nuclear domain: expectations related to the control of the nuclear risk, benefits and drawbacks of nuclear energy, fear of a severe accident, attention given by French people to nuclear energy, expertise and credibility of interveners in the nuclear sector

IRSN 2016 opinion survey. The perception of risks and safety by French people. Global results

International Nuclear Information System (INIS)

El Jammal, Marie-Helene; Charron, Sylvie; Mur, Emmanuelle; Schuler, Matthieu; Tchernia, Jean-francois

2016-07-01

Like every year, this report presents and comments the results of an opinion survey on risks, and more particularly on risks related to nuclear and radiological activities. The first part addresses the current concerns of French people (main concerns in the present society, with respect to the environment, and risks related to industrial installations). The second part addresses the opinion on expertise (the role and image of experts, diffusion and sharing of scientific expertise, and the perception of pluralistic structures). The third part examines the reaction of people in front of 34 different hazardous situations (risks to which people feel being exposed, confidence people have in authorities to protect them, confidence in information on hazards, hierarchy of the 34 situations according to three different aspects, and relationship with installation acceptability). The fourth part addresses the nuclear domain: expectations related to the control of the nuclear risk, fear of a severe accident, benefits and drawbacks of nuclear energy, expertise and credibility of interveners in the nuclear sector, fear of serious nuclear accidents, perception of the two main nuclear accidents: Chernobyl (1986) and Fukushima (2011)

IRSN opinion survey - The perception of risks and security by the French population. Global results June 2013

International Nuclear Information System (INIS)

2013-06-01

After having commented the most remarkable results (importance of the economic crisis as a major concern for French people before environmental concerns, an improved perception of industrial risks, the Fukushima accident is fading away but specific traces remain, expectations regarding nuclear energy), this report, illustrated by several graphs, presents and discusses the results of an annual opinion survey on the present concerns of French people (in the present society, for the environment, and as far as science is concerned), the opinion of French people on expertise (about who must control a risky installation, about the role and image of scientific experts, about the diffusion and sharing of scientific expertise, and about the perception of pluralistic structures), on the attitude of French people in front of 33 risk situations (risks to which French people feel exposed to, confidence of French people in authorities to protect them, the truth of information on hazards, the hierarchy of 33 situations according to three aspects and their relationship with installation acceptability). The fourth part addresses more particularly the nuclear sector: nuclear risk, ability and credibility of interveners, debate on energy transition. A last part addresses the perception of the Fukushima accident. Graphs notably present the evolution of opinions with respect to last year or over the past years

Optimal timing of salvage radiotherapy for biochemical recurrence after radical prostatectomy: is ultra-early salvage radiotherapy beneficial?

International Nuclear Information System (INIS)

Taguchi, Satoru; Shiraishi, Kenshiro; Fukuhara, Hiroshi; Nakagawa, Keiichi; Morikawa, Teppei; Naito, Akihiro; Kakutani, Shigenori; Takeshima, Yuta; Miyazaki, Hideyo; Nakagawa, Tohru; Fujimura, Tetsuya; Kume, Haruki; Homma, Yukio

2016-01-01

The optimal timing of salvage radiotherapy for biochemical recurrence after radical prostatectomy is controversial. In particular, the prognostic significance of salvage radiotherapy delivered before a current definition of biochemical recurrence, i.e. ultra-early salvage radiotherapy, is unclear. We reviewed 76 patients with pT2-3N0M0 prostate cancer who underwent salvage radiotherapy for post-prostatectomy biochemical recurrence at the following three timings: ultra-early salvage radiotherapy (n = 20) delivered before meeting a current definition of biochemical recurrence (two consecutive prostate-specific antigen [PSA] values ≥0.2 ng/mL); early salvage radiotherapy (n = 40) delivered after meeting the definition but before PSA reached 0.5 ng/mL; and delayed salvage radiotherapy (n = 16) delivered after PSA reached 0.5 ng/mL. The primary endpoint was failure of salvage radiotherapy, defined as a PSA value ≥0.2 ng/mL. The log-rank test and Cox proportional hazards model were used for univariate and multivariate analyses, respectively. During the follow-up period (median: 70 months), four of 20 (20 %), nine of 40 (23 %) and seven of 16 (44 %) patients failed biochemically in the ultra-early, early and delayed salvage radiotherapy groups, respectively. On univariate analyses, the outcome of delayed salvage radiotherapy was worse than the others, while there was no significant difference between ultra-early and early groups. Multivariate analysis demonstrated the presence of Gleason pattern 5, perineural invasion and delayed salvage radiotherapy as independent predictors of poorer survival. No survival benefit of ultra-early salvage radiotherapy was demonstrated, whereas delayed salvage radiotherapy was associated with worse outcome as reported in previous studies. Our results may support the current recommendations that salvage radiotherapy should be undertaken after two consecutive PSA values ≥0.2 ng/mL and before reaching 0.5 ng/mL

European Food Safety Authority; Outcome of the Public consultation on the Draft Opinion of the Scientific Panel on Dietetic Products, Nutrition, and Allergies (NDA) on principles for deriving and applying Dietary Reference Values

DEFF Research Database (Denmark)

Tetens, Inge

consultation and outlines how these were taken into account in the final opinion. EFSA had received 38 contributions from 12 interested parties (individuals, non-governmental organisations, industry organisations, academia and national assessment bodies). After a meeting with national experts on Dietary...

Breast cancer radiotherapy: controversies and prospectives

Institute of Scientific and Technical Information of China (English)

YU Jin-ming; WANG Yong-sheng

2008-01-01

@@ Despite consensus on breast cancer radiotherapy, there are still some controversies over post-mastectomy radiotherapy (PMRT) in patients with 1-3 positive lymph nodes, accelerated partial breast irradiation (APBI), appropriate sequence of radiotherapy, chemotherapy and hormonal treatment, and radiotherapy after preoperative systemic therapy.

International survey on the management of Chiari 1 malformation and syringomyelia: evolving worldwide opinions.

Science.gov (United States)

Singhal, Ash; Cheong, Alexander; Steinbok, Paul

2018-03-12

In 2003, pediatric neurosurgeons were surveyed under the auspices of the education committee of the International Society for Pediatric Neurosurgery (ISPN) to determine prevailing opinions regarding the management of Chiari I malformation (C1M) with and without associated syringomyelia. In the ensuing years, there has been further information from multiple C1M studies, with regards to indications, success rates of different surgical interventions, and complications. The purpose of this study was to re-evaluate current opinions and practices in pediatric C1M. Pediatric neurosurgeons worldwide were surveyed, using an e-mail list provided by the ISPN communication committee chairperson. Respondents were given scenarios similar to the 2003 C1M survey in order to determine opinions regarding whether to surgically intervene, and if so, with which operations. Of 300 surveys electronically distributed, 122 responses were received (40.6% response rate)-an improvement over the 30.8% response rate in 2003. Pediatric neurosurgeons from 34 different countries responded. There was broad consensus that non-operative management is appropriate in asymptomatic C1M (> 90%) as well as asymptomatic C1M with a small syrinx (> 65%). With a large syrinx, a majority (almost 80%) recommended surgical intervention. Scoliotic patients with CIM were generally offered surgery only when there was a large syrinx. There has been a shift in the surgical management over the past decade, with a bone-only decompression now being offered more commonly. There remains, however, great variability in the operation offered. This survey, with a relatively strong response rate, and with broad geographic representation, summarizes current worldwide expert opinion regarding management of pediatric C1M. Asymptomatic C1M and C1M with a small syrinx are generally managed non-operatively. When an operation is indicated, there has been a shift towards less invasive surgical approaches.

Elite Repudiation of the R-Word and Public Opinion About Intellectual Disability.

Science.gov (United States)

Lyle, Monique L; Simplican, Stacy Clifford

2015-06-01

Part of the motivation for encouraging elite stakeholders—like governments, professionals, and advocacy groups—to replace the language of "mental retardation" with "intellectual disability" (ID) is the belief that elite endorsement could undermine negative attitudes and influence the public to follow suit. We examine the veracity of this expectation empirically with an experiment that exposed individuals to information about endorsements of the terminology change made by the federal government, Special Olympics, or professional psychologists. We subsequently measured attitudes about persons with ID and the language used to describe ID. Results indicate that exposure to information about elite endorsement of the terminological shift either exacerbated negative attitudes or had no effect, suggesting that other factors may have primacy over "expert" opinion.

A Self-Categorization Explanation for Opinion Consensus Perceptions

Science.gov (United States)

Zhang, Jinguang; Reid, Scott A.

2013-01-01

The public expression of opinions (and related communicative activities) hinges upon the perception of opinion consensus. Current explanations for opinion consensus perceptions typically focus on egocentric and other biases, rather than functional cognitions. Using self-categorization theory we showed that opinion consensus perceptions flow from…

Treatment of Liver Tumors with Lipiodol TACE: Technical Recommendations from Experts Opinion

Energy Technology Data Exchange (ETDEWEB)

Baere, Thierry de, E-mail: thierry.debaere@gustaveroussy.fr [Gustave Roussy, Department of Interventional Radiology (France); Arai, Yasuaki, E-mail: arai-y3111@mvh.biglobe.ne.jp [National Cancer Center, Department of Diagnostic Radiology (Japan); Lencioni, Riccardo, E-mail: riccardo.lencioni@med.unipi.it [Pisa University School of Medicine, Division of Diagnostic Imaging and Intervention (R.L.) (Italy); Geschwind, Jean-Francois, E-mail: jfg@jhmi.edu [The Johns Hopkins Hospital, Vascular and Interventional Radiology (United States); Rilling, William, E-mail: wrilling@mcw.edu [Medical College of Wisconsin, Division of Vascular and Interventional Radiology Rm2803 (United States); Salem, Riad, E-mail: r-salem@northwestern.edu [Northwestern University, Department of Radiology (United States); Matsui, Osamu, E-mail: matsuio@med.kanazawa-u.ac.jp [Kanazawa University Graduate School of Medical Sciences, Department of Advanced Medical Imaging (Japan); Soulen, Michael C., E-mail: michael.soulen@uphs.upenn.edu [University of Pennsylvania, Division of Interventional Radiology (MCS) (United States)

2016-03-15

Transarterial chemoembolization with Lipiodol (Lipiodol TACE), also called conventional TACE, was developed in the early 1980s and widely adopted worldwide after randomized control trials and meta-analysis demonstrated superiority of Lipiodol TACE to best supportive care. Presently, there is no level one evidence that other TACE techniques are superior to Lipiodol TACE for intermediate stage hepatocellular carcinoma (HCC), which includes patients with preserved liver function and nonsurgical large or multinodular HCC without distant metastases. In addition, TACE is part of the treatment for progressive or symptomatic liver metastases from gastroenteropancreatic neuroendocrine tumors. When injected into the hepatic artery, Lipiodol has the unique property of selective uptake and retention in hyperarterialyzed liver tumors. Lipiodol/drug emulsion followed by particle embolization has been demonstrated to improve the pharmacokinetic of the drug and tumor response. Radio opacity of Lipiodol helps to monitor treatment delivery, with retention of Lipiodol serving as an imaging biomarker for tumor response. For 30 years, Lipiodol TACE has been inconsistently referenced in many publications with various levels of details for the method of preparation and administration, with reported progressive outcomes following improvements in the technique and the devices used to deliver the treatment and better patient selection. Consequently, there is no consensus on the standard method of TACE regarding the use of anticancer agents, embolic material, technical details, and the treatment schedule. In order to develop an internationally validated technical recommendation to standardize the Lipiodol TACE procedure, a worldwide panel of experts participated in a consensus meeting held on May 10, 2014.

Teachers' opinion about learning continuum based on student's level of competence and specific pedagogical material in classification topics

Science.gov (United States)

Andriani, Aldina Eka; Subali, Bambang

2017-08-01

This research discusses learning continuum development for designing a curriculum. The objective of this study is to gather the opinion of public junior and senior high school teachers about learning continuum based on student's level of competence and specific pedagogical material in classification topics. This research was conducted in Yogyakarta province from October 2016 to January 2017. This research utilizes a descriptive survey method. Respondents in this study consist of 281 science teachers at junior and senior high school in Yogyakarta city and 4 regencies namely Sleman, Bantul, Kulonprogo, and Gunung Kidul. The sample were taken using a census. The collection of data used questionnaire that had been validated from the aspects of construct validity and experts judgements. Data were analyzed using a descriptive analysis technique. The results of the analysis show that the opinions of teachers regarding specific pedagogical material in classification topics of living things at the junior high school taught in grade VII to the ability level of C2 (Understanding). At senior high school level, it is taught in grade X with the ability level C2 (Understanding). Based on these results, it can be concluded that the opinions of teachers still refer to the current syllabus and curriculum so that the teachers do not have pure opinions about the student's competence level in classification topics that should be taught at the level of the grade in accordance with the level of corresponding competency.

DEGRO practical guidelines: radiotherapy of breast cancer III - radiotherapy of the lymphatic pathways

Energy Technology Data Exchange (ETDEWEB)

Sautter-Bihl, M.L. [Staedtisches Klinikum Karlsruhe, Klinik fuer Radioonkologie und Strahlentherapie, Karlsruhe (Germany); Sedlmayer, F.; Fussl, C. [LKH Salzburg, Paracelsus Medical University Hospital, Department of Radiotherapy and Radiation Oncology, Salzburg (Austria); Budach, W. [University Hospital Duesseldorf, Duesseldorf (Germany); Dunst, J. [University Hospital Schleswig-Holstein, Luebeck (Germany); Feyer, P. [Klinikum Neukoelln, Berlin (Germany); Fietkau, R.; Sauer, R. [University Hospital Erlangen, Erlangen (Germany); Harms, W. [St. Clara Hospital, Basel, Basel (Switzerland); Piroth, M.D. [Helios-Klinikum Wuppertal, Klinik fuer Strahlentherapie und Radioonkologie, Wuppertal (Germany); Souchon, R. [University Hospital Tuebingen, Tuebingen (Germany); Wenz, F. [University Hospital Mannheim, Mannheim (Germany); Haase, W.

2014-04-15

The purpose of this work is to update the practical guidelines for adjuvant radiotherapy of the regional lymphatics of breast cancer published in 2008 by the breast cancer expert panel of the German Society of Radiation Oncology (DEGRO). A comprehensive survey of the literature concerning regional nodal irradiation (RNI) was performed using the following search terms: ''breast cancer'', ''radiotherapy'', ''regional node irradiation''. Recent randomized trials were analyzed for outcome as well as for differences in target definition. Field arrangements in the different studies were reproduced and superimposed on CT slices with individually contoured node areas. Moreover, data from recently published meta-analyses and guidelines of international breast cancer societies, yielding new aspects compared to 2008, provided the basis for defining recommendations according to the criteria of evidence-based medicine. In addition to the more general statements of the German interdisciplinary S3 guidelines updated in 2012, this paper addresses indications, targeting, and techniques of radiotherapy of the lymphatic pathways after surgery for breast cancer. International guidelines reveal substantial differences regarding indications for RNI. Patients with 1-3 positive nodes seem to profit from RNI compared to whole breast (WBI) or chest wall irradiation alone, both with regard to locoregional control and disease-free survival. Irradiation of the regional lymphatics including axillary, supraclavicular, and internal mammary nodes provided a small but significant survival benefit in recent randomized trials and one meta-analysis. Lymph node irradiation yields comparable tumor control in comparison to axillary lymph node dissection (ALND), while reducing the rate of lymph edema. Data concerning the impact of 1-2 macroscopically affected sentinel node (SN) or microscopic metastases on prognosis are conflicting. Recent data

Automatic segmentation of thoracic and pelvic CT images for radiotherapy planning using implicit anatomic knowledge and organ-specific segmentation strategies

International Nuclear Information System (INIS)

Haas, B; Coradi, T; Scholz, M; Kunz, P; Huber, M; Oppitz, U; Andre, L; Lengkeek, V; Huyskens, D; Esch, A van; Reddick, R

2008-01-01

Automatic segmentation of anatomical structures in medical images is a valuable tool for efficient computer-aided radiotherapy and surgery planning and an enabling technology for dynamic adaptive radiotherapy. This paper presents the design, algorithms and validation of new software for the automatic segmentation of CT images used for radiotherapy treatment planning. A coarse to fine approach is followed that consists of presegmentation, anatomic orientation and structure segmentation. No user input or a priori information about the image content is required. In presegmentation, the body outline, the bones and lung equivalent tissue are detected. Anatomic orientation recognizes the patient's position, orientation and gender and creates an elastic mapping of the slice positions to a reference scale. Structure segmentation is divided into localization, outlining and refinement, performed by procedures with implicit anatomic knowledge using standard image processing operations. The presented version of algorithms automatically segments the body outline and bones in any gender and patient position, the prostate, bladder and femoral heads for male pelvis in supine position, and the spinal canal, lungs, heart and trachea in supine position. The software was developed and tested on a collection of over 600 clinical radiotherapy planning CT stacks. In a qualitative validation on this test collection, anatomic orientation correctly detected gender, patient position and body region in 98% of the cases, a correct mapping was produced for 89% of thorax and 94% of pelvis cases. The average processing time for the entire segmentation of a CT stack was less than 1 min on a standard personal computer. Two independent retrospective studies were carried out for clinical validation. Study I was performed on 66 cases (30 pelvis, 36 thorax) with dosimetrists, study II on 52 cases (39 pelvis, 13 thorax) with radio-oncologists as experts. The experts rated the automatically produced

Radiotherapy; Strahlentherapie

Energy Technology Data Exchange (ETDEWEB)

Wannenmacher, M. [Heidelberg Univ., Mannheim (Germany). Abt. fuer Klinische Radiologie; Debus, J. [Univ. Heidelberg (Germany). Abt. Radioonkologie und Strahlentherapie; Wenz, F. (eds.) [Universitaetsklinikum Mannheim (Germany). Klinik fuer Strahlentherapie und Radioonkologie

2006-07-01

The book is focussed on the actual knowledge on the clinical radiotherapy and radio-oncology. Besides fundamental and general contributions specific organ systems are treated in detail. The book contains the following contributions: Basic principles, radiobiological fundamentals, physical background, radiation pathology, basics and technique of brachytherapy, methodology and technique of the stereotactic radiosurgery, whole-body irradiation, operative radiotherapy, hadron therapy, hpyerthermia, combined radio-chemo-therapy, biometric clinical studies, intensity modulated radiotherapy, side effects, oncological diagnostics; central nervous system and sense organs, head-neck carcinomas, breast cancer, thorax organs, esophagus carcinoma, stomach carcinoma, pancreas carcinoma, heptabiliary cancer and liver metastases, rectal carcinomas, kidney and urinary tract, prostate carcinoma, testicular carcinoma, female pelvis, lymphatic system carcinomas, soft tissue carcinoma, skin cancer, bone metastases, pediatric tumors, nonmalignant diseases, emergency in radio-oncology, supporting therapy, palliative therapy.

Anisotropic opinion dynamics

Science.gov (United States)

Neirotti, Juan

2016-07-01

We consider the process of opinion formation in a society of interacting agents, where there is a set B of socially accepted rules. In this scenario, we observed that agents, represented by simple feed-forward, adaptive neural networks, may have a conservative attitude (mostly in agreement with B ) or liberal attitude (mostly in agreement with neighboring agents) depending on how much their opinions are influenced by their peers. The topology of the network representing the interaction of the society's members is determined by a graph, where the agents' properties are defined over the vertexes and the interagent interactions are defined over the bonds. The adaptability of the agents allows us to model the formation of opinions as an online learning process, where agents learn continuously as new information becomes available to the whole society (online learning). Through the application of statistical mechanics techniques we deduced a set of differential equations describing the dynamics of the system. We observed that by slowly varying the average peer influence in such a way that the agents attitude changes from conservative to liberal and back, the average social opinion develops a hysteresis cycle. Such hysteretic behavior disappears when the variance of the social influence distribution is large enough. In all the cases studied, the change from conservative to liberal behavior is characterized by the emergence of conservative clusters, i.e., a closed knitted set of society members that follow a leader who agrees with the social status quo when the rule B is challenged.

Opinion evolution in different social acquaintance networks.

Science.gov (United States)

Chen, Xi; Zhang, Xiao; Wu, Zhan; Wang, Hongwei; Wang, Guohua; Li, Wei

2017-11-01

Social acquaintance networks influenced by social culture and social policy have a great impact on public opinion evolution in daily life. Based on the differences between socio-culture and social policy, three different social acquaintance networks (kinship-priority acquaintance network, independence-priority acquaintance network, and hybrid acquaintance network) incorporating heredity proportion p h and variation proportion p v are proposed in this paper. Numerical experiments are conducted to investigate network topology and different phenomena during opinion evolution, using the Deffuant model. We found that in kinship-priority acquaintance networks, similar to the Chinese traditional acquaintance networks, opinions always achieve fragmentation, resulting in the formation of multiple large clusters and many small clusters due to the fact that individuals believe more in their relatives and live in a relatively closed environment. In independence-priority acquaintance networks, similar to Western acquaintance networks, the results are similar to those in the kinship-priority acquaintance network. In hybrid acquaintance networks, similar to the Chinese modern acquaintance networks, only a few clusters are formed indicating that in modern China, opinions are more likely to reach consensus on a large scale. These results are similar to the opinion evolution phenomena in modern society, proving the rationality and applicability of network models combined with social culture and policy. We also found a threshold curve p v +2p h =2.05 in the results for the final opinion clusters and evolution time. Above the threshold curve, opinions could easily reach consensus. Based on the above experimental results, a culture-policy-driven mechanism for the opinion dynamic is worth promoting in this paper, that is, opinion dynamics can be driven by different social cultures and policies through the influence of heredity and variation in interpersonal relationship networks. This

Radiotherapy and Brachytherapy : Proceedings of the NATO Advanced Study Institute on Physics of Modern Radiotherapy & Brachytherapy

CERN Document Server

Lemoigne, Yves

2009-01-01

This volume collects a series of lectures presented at the tenth ESI School held at Archamps (FR) in November 2007 and dedicated to radiotherapy and brachytherapy. The lectures focus on the multiple facets of radiotherapy in general, including external radiotherapy (often called teletherapy) as well as internal radiotherapy (called brachytherapy). Radiotherapy strategy and dose management as well as the decisive role of digital imaging in the associated clinical practice are developed in several articles. Grouped under the discipline of Conformal Radiotherapy (CRT), numerous modern techniques, from Multi-Leaf Collimators (MLC) to Intensity Modulated RadioTherapy (IMRT), are explained in detail. The importance of treatment planning based upon patient data from digital imaging (Computed Tomography) is also underlined. Finally, despite the quasi- totality of patients being presently treated with gamma and X-rays, novel powerful tools are emerging using proton and light ions (like carbon ions) beams, bound to bec...

Occupational scope and qualification of environment experts in public administration. Final report. Berufsfeld- und Qualifikationsanalyse fuer Umweltfachleute in der Oeffentlichen Verwaltung. Abschlussbericht

Energy Technology Data Exchange (ETDEWEB)

Brater, M; Hemmer, C; Maurus, A; Munz, C; Schluchter,

1991-12-01

The publication presents the three parts of the original report in one volume. The parts refewing to occupational qualifications consistently differentiate between occupation all specific qualification standards and those of a non-specific nature. Environmental protection is defined to be based on pollution control as a matter of engineering, pollution abatement as a matter of planning and regulatory activities, and the integrated version of the two strategies. Experts in public administration specialising in environmental protection are to be trained as experts in the following sub-areas environmental planning (innovation and strategy planning); design planning (engineering aspects); environmental law (impact statements, expert opinions, special knowledge of environmental media); enforcement of the law, licensing procedure, monitoring and supervision (efficiency evaluation); public relations (information, consultancy, education). The report presents job descriptions, qualification standards, occupational scopes and prospects for every type of qualification and education. (HSCH).

External audit in radiotherapy dosimetry

International Nuclear Information System (INIS)

Thwaites, D.I.; Western General Hospital, Edinburgh

1996-01-01

Quality audit forms an essential part of any comprehensive quality assurance programme. This is true in radiotherapy generally and in specific areas such as radiotherapy dosimetry. Quality audit can independently test the effectiveness of the quality system and in so doing can identify problem areas and minimize their possible consequences. Some general points concerning quality audit applied to radiotherapy are followed by specific discussion of its practical role in radiotherapy dosimetry, following its evolution from dosimetric intercomparison exercises to routine measurement-based on-going audit in the various developing audit networks both in the UK and internationally. Specific examples of methods and results are given from some of these, including the Scottish+ audit group. Quality audit in radiotherapy dosimetry is now well proven and participation by individual centres is strongly recommended. Similar audit approaches are to be encouraged in other areas of the radiotherapy process. (author)

Construction of a remote radiotherapy planning system

International Nuclear Information System (INIS)

Ogawa, Yoshihiro; Nemoto, Kenji; Takahashi, Chiaki; Takai, Yoshihiro; Yamada, Shogo; Seiji, Hiromasa; Sasaki, Kazuya

2005-01-01

We constructed a remote radiotherapy planning system, and we examined the usefulness of and faults in our system in this study. Two identical radiotherapy planning systems, one installed at our institution and the other installed at an affiliated hospital, were used for radiotherapy planning. The two systems were connected by a wide area network (WAN), using a leased line. Beam data for the linear accelerator at the affiliated hospital were installed in the two systems. During the period from December 2001 to December 2002, 43 remote radiotherapy plans were made using this system. Data were transmitted using a file transfer protocol (FTP) software program. The 43 radiotherapy plans examined in this study consisted of 13 ordinary radiotherapy plans, 28 radiotherapy plans sent to provide assistance for medical residents, and 2 radiotherapy plans for emergency cases. There were ten minor planning changes made in radiotherapy plans sent to provide assistance for medical residents. Our remote radiotherapy planning system based on WAN using a leased line is useful for remote radiotherapy, with advantages for both radiation oncologists and medical residents. (author)

Expert Opinion to Identify High-Risk Entry Routes of Canine Rabies into Papua New Guinea.

Science.gov (United States)

Brookes, V J; Ward, M P

2017-03-01

The proximity of Papua New Guinea (PNG) to canine rabies-endemic countries in South-East Asia presents a risk of incursion of this disease into PNG and the rest of the Oceanic region. The objective of this study was to identify the highest risk routes for entry of dogs - associated with movement of people - into PNG from canine rabies-endemic countries. A structured, in-country expert-elicitation workshop was used, and 20 entry routes were identified. The highest risk routes were three land routes from Papua, Indonesia (hunters, traditional border crossers and unregulated, unchecked 'shopper-crossers') and two sea routes (fishing and logging). These results will be used to direct more detailed risk assessments to develop surveillance strategies and incursion response plans. © 2016 Blackwell Verlag GmbH.

Guide of external radiotherapy procedures 2007

International Nuclear Information System (INIS)

Anon.

2008-01-01

This work aims at participating in the permanent optimization of the returned medical service and the ratio profit-risk. This first version of the guide of external radiotherapy procedures 2007 processes only techniques of external radiotherapy, by opposition to the techniques of brachytherapy which use radioactive sources (iridium 192 , iodine 125 , cesium 137 ) placed in the contact of the tumor to be irradiated. Only, also, will be considered the irradiations of the most frequent cunning(malignant) tumors with the exception of the radiotherapy of the mild pathologies and the re-irradiations after a first radiotherapy. The first part is shared in eight chapters as follow: introduction, the steps of a treatment by radiotherapy, infrastructure, equipment and human resources, radiobiology mechanism of action of ionising radiations in radiotherapy, dose in radiotherapy, quality of treatment and radiation protection of patients in radiotherapy, prevention and risk management in radiotherapy, quality assurance and radiation protection for the pediatrics cancers and the case of pregnant women. The second part gives the tumoral localizations and the procedures; the third part is a glossary and different annexes such regulations and legislative texts. (N.C.)

Every second cancer patient receives radiotherapy

International Nuclear Information System (INIS)

Ojala, A.

1996-01-01

Radiotherapy to treat cancer was given for the first time exactly one hundred years ago. Today, radiotherapy and surgery are the two main modes of treating cancer. One in two cancer patients receives radiotherapy at some point during the course of treatment for the disease. Radiotherapy is applied most commonly in cases where surgery is not possible. Moreover, these two modes of treatment are often used together to supplement each other. About half of new cancer cases detected today can be ordered. The estimate given by the EU for cancers cured is 45 per cent, which is divided between the various treatment modes as follows: surgery 22 %, radiotherapy 12 %, surgery plus radiotherapy 6 %, and drug therapy 6 %. In addition to curative treatment, radiotherapy plays a crucial role in palliative treatment, i.e. treatment that alleviates symptoms. The sensitivity of malignant tumours to radiotherapy varies over a wide range; the same is true for healthy tissues. Radiotherapy can only be used to cure a tumour that is more sensitive to radiation than the surrounding healthy tissue. The tumour must also be sufficiently small in size and limited to a relatively small area. (orig.)

How Public Opinion is Formed

Science.gov (United States)

Block, Edward M.

1977-01-01

Investigates the evolution of the definition of public relations by examining cultural and personal determinants of public opinion. Outlines functions of communicators and opinionmakers in forming and influencing public opinion. Available from: Public Relations Review, Ray Hiebert, Dean, College of Journalism, University of Maryland, College Park,…

Expert ease

Energy Technology Data Exchange (ETDEWEB)

1984-04-01

Expert-ease allows the most inexperienced of computer users to build an expert system in a matter of hours. It is nothing more or less than a computer based problem-solving system. It allows the expert to preserve his or her knowledge in the form of rules, which can be applied to problems put to the system by the non-expert. The crucial piece of software at the heart of Expert-Ease extracts rules from data, and is called the analogue concept learning system. It was developed by Intelligent Terminals Ltd. and supplied to Export Software International to be incorporated into a commercially attractive package for business users. The resulting product runs on the Act Sirius and the IBM PC and compatibles. It is a well conceived and polished product with a popular appeal that should ensure widespread acceptance even at a cost of >1500 plus vat.

Expert System

DEFF Research Database (Denmark)

Hildebrandt, Thomas Troels; Cattani, Gian Luca

2016-01-01

An expert system is a computer system for inferring knowledge from a knowledge base, typically by using a set of inference rules. When the concept of expert systems was introduced at Stanford University in the early 1970s, the knowledge base was an unstructured set of facts. Today the knowledge b...... for the application of expert systems, but also raises issues regarding privacy and legal liability....

Success Stories in Radiotherapy Development Projects: Lessons Learned from Radiotherapy Development Projects. Chapter 29

International Nuclear Information System (INIS)

Zubizarreta, E.; Van Der Merwe, D.

2017-01-01

This chapter examines some problems found to be common in the process of setting up, running or expanding radiotherapy facilities. The establishment of radiotherapy services is essential to consolidate any national cancer control plan. In other words, such a plan cannot exist without radiotherapy. The IAEA guidance on setting up a radiotherapy programme covering the clinical, medical physics, radiation protection and safety aspects gives an estimate of one teletherapy machine needed per million population]. The IAEA’s Directory of Radiotherapy Centres (DIRAC) shows that the number of megavoltage (MV) machines per million population varies from 8.2 in the United States of America to 5.5 in western Europe. There are still many countries without a single radiotherapy department, especially in Africa, and many others have very low coverage, e.g. up to one external beam radiotherapy machine to cover a population of 35 million, which is close to having no coverage. There are many possible reasons for this situation. In many low income countries, the combination of lower life expectancy, low income taxes, a small budget for public health, and unmet basic needs such as housing, prevention and/or treatment of infectious diseases (malaria, tuberculosis, human immunodeficiency virus (HIV), diarrhoea), drinkable water and sewerage makes the cancer control problem a lower priority. The indicators shown illustrate these points. Establishing a radiotherapy programme requires careful planning, including the requirement for successive phases. Resources should be available for designing, building, purchasing, maintaining and replacing equipment, and for providing training in its use. In the case of a first radiotherapy facility with basic staffing levels, there is not likely to be enough expertise to guide and oversee the process in many or all of these areas.

Postoperative radiotherapy for prostate cancer. Morbidity of local-only or local-plus-pelvic radiotherapy

International Nuclear Information System (INIS)

Waldstein, Cora; Poetter, Richard; Widder, Joachim; Goldner, Gregor; Doerr, Wolfgang

2018-01-01

The aim of this work was to characterise actuarial incidence and prevalence of early and late side effects of local versus pelvic three-dimensional conformal postoperative radiotherapy for prostate cancer. Based on a risk-adapted protocol, 575 patients received either local (n = 447) or local-plus-pelvic (n = 128) radiotherapy. Gastrointestinal (GI) and genitourinary (GU) side effects (≥grade 2 RTOG/EORTC criteria) were prospectively assessed. Maximum morbidity, actuarial incidence rate, and prevalence rates were compared between the two groups. For local radiotherapy, median follow-up was 68 months, and the mean dose was 66.7 Gy. In pelvic radiotherapy, the median follow-up was 49 months, and the mean local and pelvic doses were 66.9 and 48.3 Gy respectively. Early GI side effects ≥ G2 were detected in 26% and 42% of patients respectively (p < 0.001). Late GI adverse events were detected in 14% in both groups (p = 0.77). The 5-year actuarial incidence rates were 14% and 14%, while the prevalence rates were 2% and 0% respectively. Early GU ≥ G2 side effects were detected in 15% and 16% (p = 0.96), while late GU morbidity was detected in 18% and 24% (p = 0.001). The 5-year actuarial incidence rates were 16% and 35% (p = 0.001), while the respective prevalence rates were 6% and 8%. Despite the low prevalence of side effects, postoperative pelvic radiotherapy results in significant increases in the actuarial incidence of early GI and late GU morbidity using a conventional 4-field box radiotherapy technique. Advanced treatment techniques like intensity-modulated radiotherapy (IMRT) or volumetric modulated arc radiotherapy (VMAT) should therefore be considered in pelvic radiotherapy to potentially reduce these side effects. (orig.) [de

Treatment of complex PTSD: results of the ISTSS expert clinician survey on best practices.

Science.gov (United States)

Cloitre, Marylene; Courtois, Christine A; Charuvastra, Anthony; Carapezza, Richard; Stolbach, Bradley C; Green, Bonnie L

2011-12-01

This study provides a summary of the results of an expert opinion survey initiated by the International Society for Traumatic Stress Studies Complex Trauma Task Force regarding best practices for the treatment of complex posttraumatic stress disorder (PTSD). Ratings from a mail-in survey from 25 complex PTSD experts and 25 classic PTSD experts regarding the most appropriate treatment approaches and interventions for complex PTSD were examined for areas of consensus and disagreement. Experts agreed on several aspects of treatment, with 84% endorsing a phase-based or sequenced therapy as the most appropriate treatment approach with interventions tailored to specific symptom sets. First-line interventions matched to specific symptoms included emotion regulation strategies, narration of trauma memory, cognitive restructuring, anxiety and stress management, and interpersonal skills. Meditation and mindfulness interventions were frequently identified as an effective second-line approach for emotional, attentional, and behavioral (e.g., aggression) disturbances. Agreement was not obtained on either the expected course of improvement or on duration of treatment. The survey results provide a strong rationale for conducting research focusing on the relative merits of traditional trauma-focused therapies and sequenced multicomponent approaches applied to different patient populations with a range of symptom profiles. Sustained symptom monitoring during the course of treatment and during extended follow-up would advance knowledge about both the speed and durability of treatment effects. Copyright © 2011 International Society for Traumatic Stress Studies.

Expert judgements on the response of the Atlantic meridional overturning circulation to climate change

International Nuclear Information System (INIS)

Zickfeld, K.; Levermann, A.; Kuhlbrodt, T.; Rahmstorf, S.; Morgan, M.G.; Keith, D.W.

2007-01-01

We present results from detailed interviews with 12 leading climate scientists about the possible effects of global climate change on the Atlantic Meridional Overturning Circulation (AMOC). The elicitation sought to examine the range of opinions within the climatic research community about the physical processes that determine the current strength of the AMOC, its future evolution in a changing climate and the consequences of potential AMOC changes. Experts assign different relative importance to physical processes which determine the present-day strength of the AMOC as well as to forcing factors which determine its future evolution under climate change. Many processes and factors deemed important are assessed as poorly known and insufficiently represented in state-of-the-art climate models. All experts anticipate a weakening of the AMOC under scenarios of increase of greenhouse gas concentrations. Two experts expect a permanent collapse of the AMOC as the most likely response under a 4xCO2 scenario. Assuming a global mean temperature increase in the year 2100 of 4 K, eight experts assess the probability of triggering an AMOC collapse as significantly different from zero, three of them as larger than 40%. Elicited consequences of AMOC reduction include strong changes in temperature, precipitation distribution and sea level in the North Atlantic area. It is expected that an appropriately designed research program, with emphasis on long-term observations and coupled climate modeling, would contribute to substantially reduce uncertainty about the future evolution of the AMOC

Intraoperative radiotherapy in breast cancer: literature review

International Nuclear Information System (INIS)

Alfaro Hidalgo, Sabrina A.

2013-01-01

A literature review was performed on intraoperative radiotherapy of breast cancer. The strength and attractiveness is established of techniques of partial irradiation in the treatment of breast cancer. The benefit is originated to restrict the area immediate of radiotherapy to the tumor bed or quadrant index and identifying the benefit of being applied during the radiotherapy while surgical lumpectomy. The impact of local recurrence has been established using intraoperative radiotherapy. The advantages of intraoperative radiotherapy was compared in the management of the conservative surgery in early stages of breast cancer with external radiotherapy. Different methods of intraoperative radiotherapy have been compared and individual impact on local recurrence ranges. Intraoperative radiotherapy has had many advantages: radiobiological, technical, clinical, psychological and economical in the handling of conservative surgery in early stages of breast cancer, compared with external radiotherapy [es

28 CFR 80.8 - Attorney General opinion.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Attorney General opinion. 80.8 Section 80.8 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) FOREIGN CORRUPT PRACTICES ACT OPINION PROCEDURE § 80.8 Attorney General opinion. The Attorney General or his designee shall, within 30 days after...

Parameterizing Bayesian network Representations of Social-Behavioral Models by Expert Elicitation

Energy Technology Data Exchange (ETDEWEB)

Walsh, Stephen J.; Dalton, Angela C.; Whitney, Paul D.; White, Amanda M.

2010-05-23

Bayesian networks provide a general framework with which to model many natural phenomena. The mathematical nature of Bayesian networks enables a plethora of model validation and calibration techniques: e.g parameter estimation, goodness of fit tests, and diagnostic checking of the model assumptions. However, they are not free of shortcomings. Parameter estimation from relevant extant data is a common approach to calibrating the model parameters. In practice it is not uncommon to find oneself lacking adequate data to reliably estimate all model parameters. In this paper we present the early development of a novel application of conjoint analysis as a method for eliciting and modeling expert opinions and using the results in a methodology for calibrating the parameters of a Bayesian network.

Radiotherapy Technical Considerations in the Management of Locally Advanced Pancreatic Cancer: American-French Consensus Recommendations

International Nuclear Information System (INIS)

Huguet, Florence; Goodman, Karyn A.; Azria, David; Racadot, Severine; Abrams, Ross A.

2012-01-01

Summary: Pancreatic carcinoma is a leading cause of cancer-related mortality. Approximately 30% of pancreatic cancer patients present with locally advanced, unresectable nonmetastatic disease. For these patients, two therapeutic options exist: systemic chemotherapy or chemoradiotherapy. Within this context, the optimal technique for pancreatic irradiation is not clearly defined. A search to identify relevant studies was undertaken using the Medline database. All Phase III randomized trials evaluating the modalities of radiotherapy in locally advanced pancreatic cancer were included, as were some noncontrolled Phase II and retrospective studies. An expert panel convened with members of the Radiation Therapy Oncology Group and GERCOR cooperative groups to review identified studies and prepare the guidelines. Each member of the working group independently evaluated five endpoints: total dose, target volume definition, radiotherapy planning technique, dose constraints to organs at risk, and quality assurance. Based on this analysis of the literature, we recommend either three-dimensional conformal radiation therapy or intensity-modulated radiation therapy to a total dose of 50 to 54 Gy at 1.8 to 2 Gy per fraction. We propose gross tumor volume identification to be followed by an expansion of 1.5 to 2 cm anteriorly, posteriorly, and laterally, and 2 to 3 cm craniocaudally to generate the planning target volume. The craniocaudal margins can be reduced with the use of respiratory gating. Organs at risk are liver, kidneys, spinal cord, stomach, and small bowel. Stereotactic body radiation therapy should not be used for pancreatic cancer outside of clinical trials. Radiotherapy quality assurance is mandatory in clinical trials. These consensus recommendations are proposed for use in the development of future trials testing new chemotherapy combinations with radiotherapy. Not all of these recommendations will be appropriate for trials testing radiotherapy dose or dose

Radiotherapy technical considerations in the management of locally advanced pancreatic cancer: American-French consensus recommendations.

Science.gov (United States)

Huguet, Florence; Goodman, Karyn A; Azria, David; Racadot, Severine; Abrams, Ross A

2012-08-01

Pancreatic carcinoma is a leading cause of cancer-related mortality. Approximately 30% of pancreatic cancer patients present with locally advanced, unresectable nonmetastatic disease. For these patients, two therapeutic options exist: systemic chemotherapy or chemoradiotherapy. Within this context, the optimal technique for pancreatic irradiation is not clearly defined. A search to identify relevant studies was undertaken using the Medline database. All Phase III randomized trials evaluating the modalities of radiotherapy in locally advanced pancreatic cancer were included, as were some noncontrolled Phase II and retrospective studies. An expert panel convened with members of the Radiation Therapy Oncology Group and GERCOR cooperative groups to review identified studies and prepare the guidelines. Each member of the working group independently evaluated five endpoints: total dose, target volume definition, radiotherapy planning technique, dose constraints to organs at risk, and quality assurance. Based on this analysis of the literature, we recommend either three-dimensional conformal radiation therapy or intensity-modulated radiation therapy to a total dose of 50 to 54 Gy at 1.8 to 2 Gy per fraction. We propose gross tumor volume identification to be followed by an expansion of 1.5 to 2 cm anteriorly, posteriorly, and laterally, and 2 to 3 cm craniocaudally to generate the planning target volume. The craniocaudal margins can be reduced with the use of respiratory gating. Organs at risk are liver, kidneys, spinal cord, stomach, and small bowel. Stereotactic body radiation therapy should not be used for pancreatic cancer outside of clinical trials. Radiotherapy quality assurance is mandatory in clinical trials. These consensus recommendations are proposed for use in the development of future trials testing new chemotherapy combinations with radiotherapy. Not all of these recommendations will be appropriate for trials testing radiotherapy dose or dose intensity

Long-term results of radiotherapy for pituitary adenomas. Evaluation of tumor control and hypopituitarism after radiotherapy

International Nuclear Information System (INIS)

Tsuchida, Emiko; Sakai, Kunio; Matsumoto, Yasuo; Sugita, Tadashi; Sasamoto, Ryuta

1999-01-01

To evaluate the results of conventional radiotherapy for pituitary adenomas assessed with computed tomography (CT) or magnetic resonance imaging (MRI). Endpoints include tumor control, normalization of hormone levels in functioning adenomas, and hypopituitarism after radiotherapy as an adverse effect. Forty-two patients were treated with radiotherapy from 1982 to 1995 at Niigata University Hospital. Forty patients were irradiated after surgery because of residual adenomas in 33 patients and tumor regrowth in 7 patients. One patient was treated with radiotherapy alone, and the remaining 1 patient was treated with preoperative radiotherapy. Tumor size and extension were evaluated using CT or MRI, and all tumors were macroadenomas. They consisted of 18 non-functioning and 24 functioning adenomas (growth hormone (GH)-secreting: 11, prolactinomas: 7, concomitant GH and prolactin (PRL)-secreting: 5, gonadotropin-secreting: 1). Treatment was given in 200 cGy daily fraction size and a total dose of 50 Gy was given to most patients. Sixteen patients with GH- and/or PRL-secreting adenomas received bromocriptine. Tumor progression was determined by increase in tumor size as shown by CT or MRI. Hypopituitarism after radiotherapy was evaluated using the functions of corticotropin (ACTH), thyrotropin (TSH), and gonadotropin. Median follow-up time from the end of radiotherapy was 103 months. Tumor progression occurred in 2 out of 42 patients and 10-year progression-free rate for all patients was 93.7%. Normalization of GH levels was obtained in 12 of 16 GH-secreting adenomas with a mean time of 27 months after radiotherapy, and 9 of 12 PRL-secreting adenomas achieved normalization of PRL levels with a mean time of 34 months. One gonadotropin-secreting adenoma achieved normalization of gonadotropin level at 21 months after radiotherapy. The incidence of hypopituitarism after radiotherapy increased with time, and cumulative risk of deficiencies of ACTH, TSH, and gonadotropin at 10

Breast carcinoma during pregnancy. International recommendations from an expert meeting.

Science.gov (United States)

Loibl, Sibylle; von Minckwitz, Gunter; Gwyn, Karin; Ellis, Paul; Blohmer, Jens U; Schlegelberger, Brigitte; Keller, Monika; Harder, Sebastian; Theriault, Richard L; Crivellari, Diana; Klingebiel, Thomas; Louwen, Frank; Kaufmann, Manfred

2006-01-15

Breast carcinoma during pregnancy (BCP) is a difficult clinical situation, as it appears to put the health of the mother in conflict with that of the fetus. An international expert meeting was conducted to form guidelines on how to diagnose and treat women with BCP. The goal for treatment of the pregnant woman with breast carcinoma is the same as that of the nonpregnant breast carcinoma patient: local control of disease and prevention of systemic metastases. However, certain treatment modalities need to be modified because of the potential for adverse effects on the fetus. There is evidence to support the safety of anthracycline-based chemotherapy during the second and third trimesters of pregnancy (Oxford Level of Evidence [LOE] 2b). Because of the lack of evidence, the expert opinion was not to recommend the routine use of newer cytotoxic drugs like the taxanes during pregnancy (LOE 5). The recommendations provided should help to reach informed decision making by the patient. The ongoing prospective collection of data on BCP, such as that at the University of Texas M.D. Anderson Cancer Center (UTMDACC) and that of the German Breast Group/Breast International Group (GBG/BIG), is necessary to further our knowledge regarding the treatment of this unique group of breast carcinoma patients.

Nurses' expert opinions of workplace interventions for a healthy working environment: a Delphi survey.

Science.gov (United States)

Doran, Diane; Clarke, Sean; Hayes, Laureen; Nincic, Vera

2014-09-01

Much has been written about interventions to improve the nursing work environment, yet little is known about their effectiveness. A Delphi survey of nurse experts was conducted to explore perceptions about workplace interventions in terms of feasibility and likelihood of positive impact on nurse outcomes such as job satisfaction and nurse retention. The interventions that received the highest ratings for likelihood of positive impact included: bedside handover to improve communication at shift report and promote patient-centred care; training program for nurses in dealing with violent or aggressive behaviour; development of charge nurse leadership team; training program focused on creating peer-supportive atmospheres and group cohesion; and schedule that recognizes work balance and family demands. The overall findings are consistent with the literature that highlights the importance of communication and teamwork, nurse health and safety, staffing and scheduling practices, professional development and leadership and mentorship. Nursing researchers and decision-makers should work in collaboration to implement and evaluate interventions for promoting practice environments characterized by effective communication and teamwork, professional growth and adequate support for the health and well-being of nurses.

Radiotherapy and antitumor immunity. An immunomodifying effect of ionizing radiation

International Nuclear Information System (INIS)

Klimovich, V.B.

1983-01-01

It has been found that a tumor is formed and spread under the influence of opposite but not mutually exlusive immune reactions. Radiation effect along with direct injury of tumoral cells and feeding neoplasms vessels changes the established equilibrium of immunologic factors, therefore it should be considered as immunomodifying one. The wide spread opinion according to which the therapeutic effect in case of radiotherapy is attained despite its depressive effect on immunity, should be revised as not corresponding to the facts. The data available allow one to assume that immunologic factors may play an essential role in realization of therapeutic effect of irradiation as well as in limitation of its efficiency. Investigations into immunologic aspects of oncology and radiology should be therefore directed to the search of methods of control of immune reactions of organism - the tumor bearer. This may discover considerable reserves of increasing radiotherapeutic efficiency

Identifying Opinion Leaders to Promote Behavior Change

Science.gov (United States)

Valente, Thomas W.; Pumpuang, Patchareeya

2007-01-01

This article reviews 10 techniques used to identify opinion leaders to promote behavior change. Opinion leaders can act as gatekeepers for interventions, help change social norms, and accelerate behavior change. Few studies document the manner in which opinion leaders are identified, recruited, and trained to promote health. The authors categorize…

UK Public Opinion Review - Working Paper - An overview of public opinion polls since the Edward Snowden revelations in June 2013

OpenAIRE

Cable, Jonathan

2015-01-01

This document charts public opinion of the Edward Snowden leaks and associated issues\\ud since June 2013. This includes people’s opinions on surveillance, the intelligence services\\ud and personal privacy. Since the Snowden leaks there have been 38 opinion polls on these\\ud topics concerning public opinion in the UK and conducted by large polling organisations,\\ud such as YouGov, ComRes and Ipsos MORI among others.

[First results of a German second opinion program show high patient satisfaction and large discrepancies between initial therapy recommendations and second opinion].

Science.gov (United States)

Weyerstraß, Jan; Prediger, Barbara; Neugebauer, Edmund; Pieper, Dawid

2018-02-23

Although legally anchored, there are no empirical results from German second opinion programs. In this study, various aspects within a population of a second opinion program are examined. In this study patients were analyzed who sought a second opinion in the period from August 2011 to December 2016. Differences in patient characteristics, differentiated by agreement of first and second opinion, were analyzed using multivariate logistic regression. Patients' satisfaction and quality of life were examined one, three and six months after obtaining the second opinion. In total, 1,414 patients sought a second opinion. Most frequent medical indications were the knee (38.7 %), the back (26.8 %), the hip (11.7 %), and the shoulder (10.2 %). Except for the indication (p=0.035), no patient characteristic had influence on the conformation of the second opinion. Approximately two out of three initial recommendations were not confirmed by the specialists. 89 % of the patients were satisfied or very satisfied with the second opinion and the service offered. The second opinion offers patients the opportunity to seek an additional independent medical opinion and thus provide support for decision making. Further research is needed to examine the reasons for the high discrepancies between the first and second opinions. Copyright © 2018. Published by Elsevier GmbH.

Opinion survey on energy and climate in 2013

International Nuclear Information System (INIS)