Effects of unstratified and centre-stratified randomization in multi-centre clinical trials.

Science.gov (United States)

Anisimov, Vladimir V

2011-01-01

This paper deals with the analysis of randomization effects in multi-centre clinical trials. The two randomization schemes most often used in clinical trials are considered: unstratified and centre-stratified block-permuted randomization. The prediction of the number of patients randomized to different treatment arms in different regions during the recruitment period accounting for the stochastic nature of the recruitment and effects of multiple centres is investigated. A new analytic approach using a Poisson-gamma patient recruitment model (patients arrive at different centres according to Poisson processes with rates sampled from a gamma distributed population) and its further extensions is proposed. Closed-form expressions for corresponding distributions of the predicted number of the patients randomized in different regions are derived. In the case of two treatments, the properties of the total imbalance in the number of patients on treatment arms caused by using centre-stratified randomization are investigated and for a large number of centres a normal approximation of imbalance is proved. The impact of imbalance on the power of the study is considered. It is shown that the loss of statistical power is practically negligible and can be compensated by a minor increase in sample size. The influence of patient dropout is also investigated. The impact of randomization on predicted drug supply overage is discussed. Copyright © 2010 John Wiley & Sons, Ltd.

Study protocol: SPARCLE – a multi-centre European study of the relationship of environment to participation and quality of life in children with cerebral palsy

Directory of Open Access Journals (Sweden)

Colver Allan

2006-04-01

Full Text Available Abstract Background SPARCLE is a nine-centre European epidemiological research study examining the relationship of participation and quality of life to impairment and environment (physical, social and attitudinal in 8–12 year old children with cerebral palsy. Concepts are adopted from the International Classification of Functioning, Disability and Health which bridges the medical and social models of disability. Methods/Design A cross sectional study of children with cerebral palsy sampled from total population databases in 9 European regions. Children were visited by research associates in each country who had been trained together. The main instruments used were KIDSCREEN, Life-H, Strength and Difficulties Questionnaire, Parenting Stress Index. A measure of environment was developed within the study. All instruments were translated according to international guidelines. The potential for bias due to non response and missing data will be examined. After initial analysis using multivariate regression of how the data captured by each instrument relate to impairment and socio-economic characteristics, relationships between the latent traits captured by the instruments will then be analysed using structural equation modelling. Discussion This study is original in its methods by directly engaging children themselves, ensuring those with learning or communication difficulty are not excluded, and by studying in quantitative terms the crucial outcomes of participation and quality of life. Specification and publication of this protocol prior to analysis, which is not common in epidemiology but well established for randomised controlled trials and systematic reviews, should avoid the pitfalls of data dredging and post hoc analyses.

PREGO (presentation of Graves' orbitopathy) study: changes in referral patterns to European Group On Graves' Orbitopathy (EUGOGO) centres over the period from 2000 to 2012

NARCIS (Netherlands)

Perros, Petros; Žarković, Miloš; Azzolini, Claudio; Ayvaz, Göksun; Baldeschi, Lelio; Bartalena, Luigi; Boschi, Antonella; Bournaud, Claire; Brix, Thomas Heiberg; Covelli, Danila; Ćirić, Slavica; Daumerie, Chantal; Eckstein, Anja; Fichter, Nicole; Führer, Dagmar; Hegedüs, Laszlo; Kahaly, George J.; Konuk, Onur; Lareida, Jürg; Lazarus, John; Leo, Marenza; Mathiopoulou, Lemonia; Menconi, Francesca; Morris, Daniel; Okosieme, Onyebuchi; Orgiazzi, Jaques; Pitz, Susanne; Salvi, Mario; Vardanian-Vartin, Cristina; Wiersinga, Wilmar; Bernard, Martine; Clarke, Lucy; Currò, Nicola; Dayan, Colin; Dickinson, Jane; Knežević, Miroslav; Lane, Carol; Marcocci, Claudio; Marinò, Michele; Möller, Lars; Nardi, Marco; Neoh, Christopher; Pearce, Simon; von Arx, George; Törüner, Fosun Baloş

2015-01-01

The epidemiology of Graves' orbitopathy (GO) may be changing. The aim of the study was to identify trends in presentation of GO to tertiary centres and initial management over time. Prospective observational study of European Group On Graves' Orbitopathy (EUGOGO) centres. All new referrals with a

Nuclear safety research at the European Commission's Joint Research Centre

International Nuclear Information System (INIS)

Toerroenen, K.

2003-01-01

Nuclear power plants currently generate some 35 % of electricity used in the European Union and applicant countries. Nuclear safety will therefore remain a priority for the EU, particularly in view of enlargement, the need to monitor ageing nuclear installations and the licencing of advanced new reactor systems. The European Commission's Joint Research Centre (JRC), with its long involvement and recognised competence in nuclear safety related activities, provides direct support to the European Commission services responsible for nuclear safety and civil protection. (author)

A multi-centre dosimetry audit on advanced radiotherapy in lung as part of the Isotoxic IMRT study

Directory of Open Access Journals (Sweden)

Yat Tsang

2017-10-01

Conclusion: This multi-centre dosimetry audit of complex IMRT/VMAT delivery provides confidence in the accuracy of modern planning and delivery systems in inhomogeneous tissues. The findings from this study can be used as a reference for future dosimetry audits.

Coronary CT angiography using 64 detector rows: methods and design of the multi-centre trial CORE-64

Energy Technology Data Exchange (ETDEWEB)

Miller, Julie M.; Vavere, Andrea L.; Arbab-Zadeh, Armin; Bush, David E.; Lardo, Albert C.; Texter, John; Brinker, Jeffery; Lima, Joao A.C. [Johns Hopkins Hospital, Johns Hopkins University, Department of Medicine, Division of Cardiology, Baltimore, MD (United States); Dewey, Marc [Charite - Universitaetsmedizin Berlin, Medical School, Humboldt-Universitaet und Freie Universitaet zu Berlin, Department of Radiology, Berlin, PO Box 10098 (Germany); Rochitte, Carlos E.; Lemos, Pedro A. [University of Sao Paulo Medical School, Heart Institute (InCor), Sao Paulo (Brazil); Niinuma, Hiroyuki [Iwate Medical University, Department of Cardiology, Morioka (Japan); Paul, Narinder [Toronto General Hospital, Department of Medical Imaging, Toronto (Canada); Hoe, John [Medi-Rad Associates Ltd, CT Centre, Mt Elizabeth Hospital, Singapore (Singapore); Roos, Albert de [Leiden University Medical Center, Department of Radiology, Leiden (Netherlands); Yoshioka, Kunihiro [Iwate Medical University, Department of Radiology, Morioka (Japan); Cox, Christopher [Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, MD (United States); Clouse, Melvin E. [Harvard University, Department of Radiology, Beth Israel Deaconess, Boston, MA (United States)

2009-04-15

Multislice computed tomography (MSCT) for the noninvasive detection of coronary artery stenoses is a promising candidate for widespread clinical application because of its non-invasive nature and high sensitivity and negative predictive value as found in several previous studies using 16 to 64 simultaneous detector rows. A multi-centre study of CT coronary angiography using 16 simultaneous detector rows has shown that 16-slice CT is limited by a high number of nondiagnostic cases and a high false-positive rate. A recent meta-analysis indicated a significant interaction between the size of the study sample and the diagnostic odds ratios suggestive of small study bias, highlighting the importance of evaluating MSCT using 64 simultaneous detector rows in a multi-centre approach with a larger sample size. In this manuscript we detail the objectives and methods of the prospective ''CORE-64'' trial (''Coronary Evaluation Using Multidetector Spiral Computed Tomography Angiography using 64 Detectors''). This multi-centre trial was unique in that it assessed the diagnostic performance of 64-slice CT coronary angiography in nine centres worldwide in comparison to conventional coronary angiography. In conclusion, the multi-centre, multi-institutional and multi-continental trial CORE-64 has great potential to ultimately assess the per-patient diagnostic performance of coronary CT angiography using 64 simultaneous detector rows. (orig.)

Person-centred web-based support--development through a Swedish multi-case study.

Science.gov (United States)

Josefsson, Ulrika; Berg, Marie; Koinberg, Ingalill; Hellström, Anna-Lena; Nolbris, Margaretha Jenholt; Ranerup, Agneta; Lundin, Carina Sparud; Skärsäter, Ingela

2013-10-19

Departing from the widespread use of the internet in modern society and the emerging use of web applications in healthcare this project captures persons' needs and expectations in order to develop highly usable web recourses. The purpose of this paper is to outline a multi-case research project focused on the development and evaluation of person-centred web-based support for people with long-term illness. To support the underlying idea to move beyond the illness, we approach the development of web support from the perspective of the emergent area of person-centred care. The project aims to contribute to the ongoing development of web-based supports in health care and to the emerging field of person-centred care. The research design uses a meta-analytical approach through its focus on synthesizing experiences from four Swedish regional and national cases of design and use of web-based support in long-term illness. The cases include children (bladder dysfunction and urogenital malformation), young adults (living close to persons with mental illness), and two different cases of adults (women with breast cancer and childbearing women with type 1 diabetes). All of the cases are ongoing, though in different stages of design, implementation, and analysis. This, we argue, will lead to a synthesis of results on a meta-level not yet described. To allow valid comparisons between the four cases we explore and problematize them in relation to four main aspects: 1) The use of people's experiences and needs; 2) The role of use of theories in the design of person-centred web-based supports; 3) The evaluation of the effects of health outcomes for the informants involved and 4) The development of a generic person-centred model for learning and social support for people with long-term illness and their significant others. Person-centred web-based support is a new area and few studies focus on how web-based interventions can contribute to the development of person-centred care. In

Multi-disciplinary facilities at the centre for nuclear sciences, U.W.I

International Nuclear Information System (INIS)

Lalor, G.C.; Robotham, H.

1994-01-01

The Centre for Nuclear Sciences was established in 1984 with the mandate to introduce Caribbean scientists to the application of nuclear technology in multi-disciplinary studies, and to carry out research in areas of national and regional importance. It describes the present facilities and the major programmes being carried out at the Centre. (author) 9 refs

The challenges facing the European Union Centres of Excellence

International Nuclear Information System (INIS)

Dupre, Bruno; )

2012-10-01

On 19 April 2012, the United Nation Security Council congratulated the European Union for its initiative on centres of excellence in the nuclear, radiological, biological, and chemical fields. The time for glowing reports is over. Three years after its creation, the support of EU Member Sates, the Security Council, the G8, the IEAE, the WHO, the USA, Interpol, the ICRC, has been obtained. Other diplomatic, organisational, and communicative challenges have now arisen regarding implementation. The manifest challenges include: 1/Political exploitation of the centres. Following a recent round table in Algiers, the Algerian press ran headlines such as 'terrorism, the Malian crisis arrives in Algiers' CBRN centres of excellence' and 'Bouteflika, the centres of excellence slight'. 2/Communication errors. A unanimously approved expert in South East Asia became a persona non grata over the last six months despite not making any fundamental mistake, aside from his inability to evaluate the degree of a country's sensitivity and pride. The countries in the region went so far as to threaten to pull out of the Manila centre as a result of this ultimately minor error in communication. 3/The scope of the centres' role complicates the grasp of its objectives. To date, the focus has essentially been on non-proliferation and the fight against CBRN terrorism, under the well-established theme of Resolution 1540. The shift of CBRN focus, at the behest of certain regions, on to real natural risks (pandemics) or industrial risks (protection of crucial infrastructure following an earthquake, flooding, or a tsunami) fundamentally changes the teams' make-up and the mobilization of resources. The emergency services culture is different to that of nonproliferation. However, they both very much address CBRN risks and threats. 4/The limits of the 'bottom-up' approach. To date, the centres' success has been due to the lack of restrictive rules. The policy is to enlist willing third-party States

Evaluation of the preliminary auditory profile test battery in an international multi-centre study

NARCIS (Netherlands)

van Esch, T.E.M.; Kollmeier, B.; Vormann, M.; Lijzenga, J.; Houtgast, T.; Hallgren, M.; Larsby, B.; Athalye, S.P.; Lutman, M.E.; Dreschler, W.A.

2013-01-01

Objective: This paper describes the composition and international multi-centre evaluation of a battery of tests termed the preliminary auditory profile. It includes measures of loudness perception, listening effort, speech perception, spectral and temporal resolution, spatial hearing, self-reported

Authorship issues in multi-centre clinical trials

DEFF Research Database (Denmark)

Rosenberg, Jacob; Burcharth, Jakob; Pommergaard, Hans-Christian

2015-01-01

Discussions about authorship often arise in multi-centre clinical trials. Such trials may involve up to hundreds of contributors of whom some will eventually co-author the final publication. It is, however, often impossible to involve all contributors in the manuscript process sufficiently for th...

Prevalence of maternal anaemia and its predictors: a multi-centre study.

Science.gov (United States)

Barroso, Filipa; Allard, Shubha; Kahan, Brennan C; Connolly, Catriona; Smethurst, Heather; Choo, Louise; Khan, Khalid; Stanworth, Simon

2011-11-01

To investigate the prevalence, predictors, and management of anaemia in pregnancy. A multi centre study across 11 maternity units in the UK. Data were collected over a two week study period in 2008 on maternal history, haemoglobin (Hb) and ferritin concentrations, iron therapy during pregnancy and in the postpartum period. Logistic regression models were used to explore factors associated with anaemia during pregnancy. Main outcomes included anaemia, defined as Hbanaemia by 32 weeks gestation included young maternal age (odds ratio 1.96, 95% CI 1.38-2.79), non-white ethnic origin (odds ratios varied 1.37-2.89 depending on ethnic origin) and increasing parity (odds ratio 1.24, 95% CI 1.08-1.41). Of women who had postnatal Hb levels checked, 30% (309/1031) were anaemic and, depending on centre, 16% to 86% of these received iron therapy. Anaemia was reported in nearly one in four women in the antenatal period, and nearly one in three of the women who had a postpartum Hb checked. Despite national guidelines, there was considerable variation in administration of iron including low utilisation of parenteral iron therapy. Future research needs to focus on the consequences of iron deficiency anaemia for maternal and infant health outcomes and effectiveness of implementation strategies to reduce anaemia. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Harmonization process and reliability assessment of anthropometric measurements in the elderly EXERNET multi-centre study.

Directory of Open Access Journals (Sweden)

Alba Gómez-Cabello

Full Text Available BACKGROUND: The elderly EXERNET multi-centre study aims to collect normative anthropometric data for old functionally independent adults living in Spain. PURPOSE: To describe the standardization process and reliability of the anthropometric measurements carried out in the pilot study and during the final workshop, examining both intra- and inter-rater errors for measurements. MATERIALS AND METHODS: A total of 98 elderly from five different regions participated in the intra-rater error assessment, and 10 different seniors living in the city of Toledo (Spain participated in the inter-rater assessment. We examined both intra- and inter-rater errors for heights and circumferences. RESULTS: For height, intra-rater technical errors of measurement (TEMs were smaller than 0.25 cm. For circumferences and knee height, TEMs were smaller than 1 cm, except for waist circumference in the city of Cáceres. Reliability for heights and circumferences was greater than 98% in all cases. Inter-rater TEMs were 0.61 cm for height, 0.75 cm for knee-height and ranged between 2.70 and 3.09 cm for the circumferences measured. Inter-rater reliabilities for anthropometric measurements were always higher than 90%. CONCLUSION: The harmonization process, including the workshop and pilot study, guarantee the quality of the anthropometric measurements in the elderly EXERNET multi-centre study. High reliability and low TEM may be expected when assessing anthropometry in elderly population.

ZOOM or Non-ZOOM? Assessing Spinal Cord Diffusion Tensor Imaging Protocols for Multi-Centre Studies.

Directory of Open Access Journals (Sweden)

Rebecca S Samson

Full Text Available The purpose of this study was to develop and evaluate two spinal cord (SC diffusion tensor imaging (DTI protocols, implemented at multiple sites (using scanners from two different manufacturers, one available on any clinical scanner, and one using more advanced options currently available in the research setting, and to use an automated processing method for unbiased quantification. DTI parameters are sensitive to changes in the diseased SC. However, imaging the cord can be technically challenging due to various factors including its small size, patient-related and physiological motion, and field inhomogeneities. Rapid acquisition sequences such as Echo Planar Imaging (EPI are desirable but may suffer from image distortions. We present a multi-centre comparison of two acquisition protocols implemented on scanners from two different vendors (Siemens and Philips, one using a reduced field-of-view (rFOV EPI sequence, and one only using options available on standard clinical scanners such as outer volume suppression (OVS. Automatic analysis was performed with the Spinal Cord Toolbox for unbiased and reproducible quantification of DTI metrics in the white matter. Images acquired using the rFOV sequence appear less distorted than those acquired using OVS alone. SC DTI parameter values obtained using both sequences at all sites were consistent with previous measurements made at 3T. For the same scanner manufacturer, DTI parameter inter-site SDs were smaller for the rFOV sequence compared to the OVS sequence. The higher inter-site reproducibility (for the same manufacturer and acquisition details, i.e. ZOOM data acquired at the two Philips sites of rFOV compared to the OVS sequence supports the idea that making research options such as rFOV more widely available would improve accuracy of measurements obtained in multi-centre clinical trials. Future multi-centre studies should also aim to match the rFOV technique and signal-to-noise ratios in all

Authorship issues in multi-centre clinical trials

DEFF Research Database (Denmark)

Rosenberg, Jacob; Burcharth, Jakob; Pommergaard, Hans-Christian

2015-01-01

to qualify for authorship as defined by the International Committee of Medical Journal Editors. Therefore, rules for authorship in multi-centre trials are strongly recommended. We propose two contracts to prevent conflicts regarding authorship; both are freely available for use without pay but with reference...... to the original source....

Qualified and Unqualified (N-R C) mental health nursing staff--minor differences in sources of stress and burnout. A European multi-centre study.

Science.gov (United States)

Sorgaard, Knut W; Ryan, Peter; Dawson, Ian

2010-06-14

Unqualified/non-registered caregivers (N-R Cs) will continue to play important roles in the mental health services. This study compares levels of burnout and sources of stress among qualified and N-R Cs working in acute mental health care. A total of 196 nursing staff --124 qualified staff (mainly nurses) and 72 N-R Cs with a variety of different educational backgrounds--working in acute wards or community mental teams from 5 European countries filled out the Maslach Burnout Inventory (MBI), the Mental Health Professional Scale (MHPSS) and the Psychosocial Work Environment and Stress Questionnaire (PWSQ). (a) The univariate differences were generally small and restricted to a few variables. Only Social relations (N-R Cs being less satisfied) at Work demands (nurses reporting higher demands) were different at the .05 level. (b) The absolute scores both groups was highest on variables that measured feelings of not being able to influence a work situation characterised by great demands and insufficient resources. Routines and educational programs for dealing with stress should be available on a routine basis. (c) Multivariate analyses identified three extreme groups: (i) a small group dominated by unqualified staff with high depersonalization, (ii) a large group that was low on depersonalisation and high on work demands with a majority of qualified staff, and (iii) a small N-R C-dominated group (low depersonalization, low work demands) with high scores on professional self-doubt. In contrast to (ii) the small and N-R C-dominated groups in (i) and (iii) reflected mainly centre-dependent problems. The differences in burnout and sources of stress between the two groups were generally small. With the exception of high work demands the main differences between the two groups appeared to be centre-dependent. High work demands characterized primarily qualified staff. The main implication of the study is that no special measures addressed towards N-R Cs in general with regard

European multi-centre case-control study on risk factors for rare cancers of unknown aetiology

DEFF Research Database (Denmark)

Lynge, Elsebeth; Afonso, Noemia; Kaerlev, Linda

2005-01-01

To search for occupational risk factors, we conducted a case-control study in nine European countries of cancers of the small intestine, male gall bladder, thymus, bone, male breast, melanoma of the eye, and mycosis fungoides. Recruitment was population based in Denmark, Latvia, France, Germany...... recruited 3374 population (61% interviewed) and 1284 colon cancer controls (86% interviewed). It was possible to undertake this complicated study across Europe, but we encountered three main problems. It was difficult to ensure complete case ascertainment, for population controls, we found a clear divide......, Italy, and Sweden, from hospital areas in Spain and Portugal, and from one United Kingdom (UK) hospital. We recruited 1457 cases (84% interviewed). Numbers identified corresponded to those in the EUROCIM database for Denmark, but were below those observed for France, Italy and Sweden in the database. We...

Retrospective exposure assessment and quality control in an international multi-centre case-control study

DEFF Research Database (Denmark)

Tinnerberg, H; Heikkilä, P; Huici-Montagud, A

2003-01-01

The paper presents the exposure assessment method and quality control procedure used in an international, multi-centre case-control study within a joint Nordic and Italian cohort. This study was conducted to evaluate whether occupational exposure to carcinogens influenced the predictivity of high...... was higher among the original assessors (the assessor from the same country as the subject) than the average prevalence assessed by the other four in the quality control round. The original assessors classified more job situations as exposed than the others. Several reasons for this are plausible: real...... country-specific differences, differences in information available to the home assessor and the others and misunderstandings or difficulties in translation of information. To ensure the consistency of exposure assessments in international retrospective case-control studies it is important to have a well...

Dosimetry audit for a multi-centre IMRT head and neck trial

International Nuclear Information System (INIS)

Clark, Catharine H.; Hansen, Vibeke Nordmark; Chantler, Hannah; Edwards, Craig; James, Hayley V.; Webster, Gareth; Miles, Elizabeth A.; Guerrero Urbano, M. Teresa; Bhide, Shree A.; Bidmead, A. Margaret; Nutting, Christoper M.

2009-01-01

Background and purpose: PARSPORT was a multi-centre randomised trial in the UK which compared Intensity-Modulated Radiotherapy (IMRT) and conventional radiotherapy (CRT) for patients with head and neck cancer. The dosimetry audit goals were to verify the plan delivery in participating centres, ascertain what tolerances were suitable for head and neck IMRT trials and develop an IMRT credentialing program. Materials and methods: Centres enrolling patients underwent rigorous quality assurance before joining the trial. Following this each centre was visited for a dosimetry audit, which consisted of treatment planning system tests, fluence verification films, combined field films and dose point measurements. Results: Mean dose point measurements were made at six centres. For the primary planning target volume (PTV) the differences with the planned values for the IMRT and CRT arms were -0.6% (1.8% to -2.4%) and 0.7% (2.0% to -0.9%), respectively. Ninety-four percent of the IMRT fluence films for individual fields passed gamma criterion of 3%/3 mm and 75% of the films for combined fields passed gamma criterion 4%/3 mm (no significant difference between dynamic delivery and step and shoot delivery). Conclusions: This audit suggests that a 3% tolerance could be applied for PTV point doses. For dose distributions tolerances of 3%/3 mm on individual fields and 4%/3 mm for combined fields are proposed for multi-centre head and neck IMRT trials.

European Federation of Associations of Families of People with Mental Illness initiatives on person-centred care.

Science.gov (United States)

Steffen, Sigrid

2011-04-01

European Federation of Associations of Families of People with Mental Illness is working towards the goal of shifting the emphasis of care for people with metal illness from the treatment of the symptoms to a more holistic approach of treating the whole person - in other words 'person-centred care'. It is also working with the Geneva conference on person-centred medicine and various interested groupings and organizations to ensure that the role of the family is fully recognized and supported. By engaging primarily with the medical community in bringing to fruition certain initiatives which European Federation of Associations of Families of People with Mental Illness considers as important to the success of person-centred care. To date, no formal reviews have taken place and feedback from the initiatives has been informal and anecdotal. Early reports from the various initiatives are positive. But they also indicate that there is still much work to be done in order for the concept to become a reality across the majority of European countries. © 2010 Blackwell Publishing Ltd.

Species distribution and susceptibility profile to fluconazole, voriconazole and MXP-4509 of 551 clinical yeast isolates from a Romanian multi-centre study

NARCIS (Netherlands)

Minea, B; Nastasa, V; Moraru, R F; Kolecka, A; Flonta, M M; Marincu, I; Man, A; Toma, F; Lupse, M; Doroftei, B; Marangoci, N; Pinteala, M; Boekhout, T; Mares, M

This is the first multi-centre study regarding yeast infections in Romania. The aim was to determine the aetiological spectrum and susceptibility pattern to fluconazole, voriconazole and the novel compound MXP-4509. The 551 isolates were identified using routine laboratory methods, matrix-assisted

Distributed Scheduling to Support a Call Centre: a Co-operative Multi-Agent Approach

NARCIS (Netherlands)

Brazier, F.M.; Jonker, C.M.; Jungen, F.J.; Treur, J.; Nwana, H.S.

1998-01-01

This paper describes a multi-agent system architecture to increase the value of 24 hour a day call centre service. This system supports call centres in making appointments with clients on the basis of knowledge of employees and their schedules. Relevant activities of employees are scheduled for

Planning a multi-institutional information for development study centre

CSIR Research Space (South Africa)

Moreno, A

2010-05-01

Full Text Available . The I4D Study Centre tasks are to increase both the research expertise pool available for Meraka and the partner university, and the joint development of study programs with universities that will prepare students for a researcher career with an ICT4D...

Consent: an event or a memory in lumbar spinal surgery? A multi-centre, multi-specialty prospective study of documentation and patient recall of consent content.

Science.gov (United States)

Lo, William B; McAuley, Ciaran P; Gillies, Martin J; Grover, Patrick J; Pereira, Erlick A C

2017-11-01

Prospective, multi-centre, multi-specialty medical notes review and patient interview. The consenting process is an important communication tool which also carries medico-legal implications. While written consent is a pre-requisite before spinal surgery in the UK, the standard and effectiveness of the process have not been assessed previously. This study assesses standard of written consent for elective lumbar decompressive surgery for degenerative disc disease across different regions and specialties in the UK; level of patient recall of the consent content; and identifies factors which affect patient recall. Consent forms of 153 in-patients from 4 centres a, b, c, d were reviewed. Written documentation of intended benefits, alternative treatments and operative risks was assessed. Of them, 108 patients were interviewed within 24 h before or after surgeries to assess recall. The written documentation rates of the operative risks showed significant inter-centre variations in haemorrhage and sphincter disturbance (P = 0.000), but not for others. Analysis of pooled data showed variations in written documentation of risks (P recall of these risks, there was no inter-centre variation. Patients' recall of paralysis as a risk was highest (50.9%) and that of recurrence was lowest (6.5%). Patients recalled risks better than those ≥65, significantly so for infection (29.9 vs 9.7%, P = 0.027). Patients consented >14 days compared to recall for paralysis (65.2 vs 43.7%) and recurrence (17.4 vs 2.8%). Patient recall was independent of consenter grade. Overall, the standard of written consent for elective lumbar spinal decompressive surgery was sub-optimal, which was partly reflected in the poor patient recall. While consenter seniority did not affect patient recall, younger age and longer consent-to-surgery time improved it.

Effect of medication-related factors on adherence in people with schizophrenia: a European multi-centre study

NARCIS (Netherlands)

Meier, Johanna; Becker, Thomas; Patel, Anita; Robson, Debbie; Schene, Aart; Kikkert, Martijn; Barbui, Corrado; Burti, Lorenzo; Puschner, Bernd

2010-01-01

To investigate the relation between medication-related factors and adherence in people with schizophrenia in outpatient treatment. The sample comprised 409 outpatients (ICD-10 diagnosis of schizophrenia) with clinician-rated instability in four European cities (Amsterdam, The Netherlands; Verona,

Cities, Europeanization and Multi-level Governance: Governing Climate Change through Transnational Municipal Networks

NARCIS (Netherlands)

Kern, K.; Bulkeley, H.

2009-01-01

This article focuses on a variant of multi-level governance and Europeanization, i.e. the transnational networking of local authorities. Focusing on local climate change policy, the article examines how transnational municipal networks (TMNs) govern in the context of multi-level European governance.

Authorship issues in multi-centre clinical trials: the importance of making an authorship contract.

Science.gov (United States)

Rosenberg, Jacob; Burcharth, Jakob; Pommergaard, Hans-Christian; Vinther, Siri

2015-02-01

Discussions about authorship often arise in multi-centre clinical trials. Such trials may involve up to hundreds of contributors of whom some will eventually co-author the final publication. It is, however, often impossible to involve all contributors in the manuscript process sufficiently for them to qualify for authorship as defined by the International Committee of Medical Journal Editors. Therefore, rules for authorship in multi-centre trials are strongly recommended. We propose two contracts to prevent conflicts regarding authorship; both are freely available for use without pay but with reference to the original source.

Museums as brokers of participation: how visitors view the emerging role of European science centres and museums in policy

Directory of Open Access Journals (Sweden)

Andrea Bandelli

2016-05-01

Full Text Available Science centres and museums in Europe traditionally offer opportunities for public participation, such as dialogues, debates and workshops. In recent years, starting with the support of grants from the European Commission, the purpose of these initiatives is increasingly more connected with the policy making processes where science centres play a role as brokers between the public and other stakeholders. This article begins an investigation on how these two levels of participation – the participation of museums in policy, and the participation of visitors in museums – are related in seven European science centres and museums. The results suggest that science centres and museums are regarded by their visitors as potential platforms to facilitate public participation in policy, especially in countries where the general infrastructure for public participation in science is weak.

Pilomatricoma in childhood: a retrospective study from three European paediatric centres.

Science.gov (United States)

Cigliano, Bruno; Baltogiannis, Nikolaos; De Marco, Marianna; Faviou, Elsa; Settimi, Alesandro; Tilemis, Stefanos; Soutis, Michail; Papandreou, Evangellos; D'Agostino, Sergio; Fabbro, Maria Angelica

2005-11-01

Pilomatricoma is characterised as a common, slowly growing benign cutaneous tumour that appears generally within the first decades of life. The clinical diagnosis is frequently missed, especially by the paediatrician unfamiliar with these tumours. We present the experience gained in three European tertiary care paediatric centres with the treatment of pilomatricoma and also current data on the aetiology, clinical presentation and management. A retrospective study was carried out in 83 patients suspected for pilomatricoma during a 7-year period (1996-2002) at the departments of Paediatric Surgery of the Children's University Hospital "Federico II", Naples, Hospital "San Bortolo", Vicenza and "Aghia Sophia" Children's Hospital, Athens. The age range was from 10 months to 17 years, median age 8 years. All patients were treated by surgical excision and all specimens were examined by histopathological assessment. The follow-up varied from 5 months to 6 years. The correct diagnosis was made preoperatively in 68 patients (82%). The female/male ratio was 2:1. The sites of occurrence were the head (47.5%), especially in the periorbital region, the neck (9%), the upper limbs (35.5%), the inferior limbs (4%) and the thorax (4%). Each patient exhibited a single pilomatricoma except for two patients who had multiple lesions (2.4%). One of them had Steinert disease (myotonic dystrophy). No recurrences were observed during the follow-up period. Pilomatricoma is one of the most common cutaneous adnexal neoplasms in children. Surgical excision including clear margins and its overlying skin in most cases is the treatment of choice. The recurrence as well as malignant evolution is rare.

Multi-sectoral action for child safety-a European study exploring implicated sectors.

Science.gov (United States)

Scholtes, Beatrice; Schröder-Bäck, Peter; Förster, Katharina; MacKay, Morag; Vincenten, Joanne; Brand, Helmut

2017-06-01

Injury to children in Europe, resulting in both death and disability, constitutes a significant burden on individuals, families and society. Inequalities between high and low-income countries are growing. The World Health Organisation Health 2020 strategy calls for inter-sectoral collaboration to address injury in Europe and advocates the whole of government and whole of society approaches to wicked problems. In this study we explore which sectors (e.g. health, transport, education) are relevant for four domains of child safety (intentional injury, water, road and home safety). We used the organigraph methodology, originally developed to demonstrate how organizations work, to describe the governance of child safety interventions. Members of the European Child Safety Alliance, working in the field of child safety in 24 European countries, drew organigraphs of evidence-based interventions. They included the different actors involved and the processes between them. We analyzed the organigraphs by counting the actors presented and categorizing them into sectors using a pre-defined analysis framework. We received 44 organigraphs from participants in 24 countries. Twenty-seven sectors were identified across the four domains. Nine of the 27 identified sectors were classified as 'core sectors' (education, health, home affairs, justice, media, recreation, research, social/welfare services and consumers). This study reveals the multi-sectoral nature of child safety in practice. It provides information for stakeholders working in child safety to help them implement inter-sectoral child safety interventions taking a whole-of-government and whole-of-society approach to health governance. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

DALI: Defining Antibiotic Levels in Intensive care unit patients: a multi-centre point of prevalence study to determine whether contemporary antibiotic dosing for critically ill patients is therapeutic.

Science.gov (United States)

Roberts, Jason A; De Waele, Jan J; Dimopoulos, George; Koulenti, Despoina; Martin, Claude; Montravers, Philippe; Rello, Jordi; Rhodes, Andrew; Starr, Therese; Wallis, Steven C; Lipman, Jeffrey

2012-07-06

The clinical effects of varying pharmacokinetic exposures of antibiotics (antibacterials and antifungals) on outcome in infected critically ill patients are poorly described. A large-scale multi-centre study (DALI Study) is currently underway describing the clinical outcomes of patients achieving pre-defined antibiotic exposures. This report describes the protocol. DALI will recruit over 500 patients administered a wide range of either beta-lactam or glycopeptide antibiotics or triazole or echinocandin antifungals in a pharmacokinetic point-prevalence study. It is anticipated that over 60 European intensive care units (ICUs) will participate. The primary aim will be to determine whether contemporary antibiotic dosing for critically ill patients achieves plasma concentrations associated with maximal activity. Secondary aims will compare antibiotic pharmacokinetic exposures with patient outcome and will describe the population pharmacokinetics of the antibiotics included. Various subgroup analyses will be conducted to determine patient groups that may be at risk of very low or very high concentrations of antibiotics. The DALI study should inform clinicians of the potential clinical advantages of achieving certain antibiotic pharmacokinetic exposures in infected critically ill patients.

Consumption of added fats and oils in the European Prospective Investigation into Cancer and Nutrition (EPIC) centres across 10 European countries as assessed by 24-hour dietary recalls.

Science.gov (United States)

Linseisen, J; Bergström, E; Gafá, L; González, C A; Thiébaut, A; Trichopoulou, A; Tumino, R; Navarro Sánchez, C; Martínez Garcia, C; Mattisson, I; Nilsson, S; Welch, A; Spencer, E A; Overvad, K; Tjønneland, A; Clavel-Chapelon, F; Kesse, E; Miller, A B; Schulz, M; Botsi, K; Naska, A; Sieri, S; Sacerdote, C; Ocké, M C; Peeters, P H M; Skeie, G; Engeset, D; Charrondière, U R; Slimani, N

2002-12-01

To evaluate the consumption of added fats and oils across the European centres and countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). 24-Hour dietary recalls were collected by means of standardised computer-guided interviews in 27 redefined EPIC centres across 10 European countries. From an initial number of 36 900 subjects, single dietary recalls from 22 924 women and 13 031 men in the age range of 35-74 years were included. Mean daily intake of added fats and oils varied between 16.2 g (Varese, Italy) and 41.1 g (Malmö, Sweden) in women and between 24.7 g (Ragusa, Italy) and 66.0 g (Potsdam, Germany) in men. Total mean lipid intake by consumption of added fats and oils, including those used for sauce preparation, ranged between 18.3 (Norway) and 37.2 g day-1 (Greece) in women and 28.4 (Heidelberg, Germany) and 51.2 g day-1 (Greece) in men. The Mediterranean EPIC centres with high olive oil consumption combined with low animal fat intake contrasted with the central and northern European centres where fewer vegetable oils, more animal fats and a high proportion of margarine were consumed. The consumption of added fats and oils of animal origin was highest in the German EPIC centres, followed by the French. The contribution of added fats and oils to total energy intake ranged from 8% in Norway to 22% in Greece. The results demonstrate a high variation in dietary intake of added fats and oils in EPIC, providing a good opportunity to elucidate the role of dietary fats in cancer aetiology.

The role of the Joint Research Centre from the European Commission in the European Structural Integrity Networks AMES, ENIQ and NESC

International Nuclear Information System (INIS)

Estorff, U. von; Torronen, K.

1999-01-01

Due to the reduction in many countries of the research budget for nuclear safety several European institutions and organisations and the Institute for Advanced Materials (IAM) of the Joint Research Centre (JRC) of the European Commission (EC) have developed co-operative programmes now organised into 'Networks' for mutual benefit. They include utilities, engineering companies, research and development (R and D) laboratories and regulatory bodies. These Networks are all organised and managed in a similar way, i.e. like the successful Programme for the Inspection of Steel Components (PISC). The IAM plays the role of Operating Agent, Reference Laboratory and Network Manager of these Networks: European Network on Ageing Materials Evaluation and Studies (AMES), European Network for Inspection Qualification (ENIQ) and Network for Evaluating Steel Components (NESC), each of them dealing with a specific aspect of fitness for purpose of materials in structural components. This article will describe how the network organisation works, which was the positive experience from the past, why the networks are a tool for integrating fragmented research in Europe and how they fit into the mission of the JRC and therefore follow the EC policy. (orig.)

EFSA (European Food Safety Authority) and ECDC (European Centre for Disease Prevention and Control), 2015. The European Union summary report on trends and sources of zoonoses, zoonotic agents and food-borne outbreaks in 2014

OpenAIRE

Helwigh, Birgitte; Porsbo, Lone Jannok; Boysen, Louise; Bager, Flemming

2015-01-01

This report of the European Food Safety Authority and the European Centre for Disease Prevention and Control presents the results of the zoonoses monitoring activities carried out in 2014 in 32 European countries (28 Member States (MS) and four non-MS). Campylobacteriosis was the most commonly reported zoonosis with an increase in confirmed human cases in the European Union (EU) since 2008. In food the occurrence of Campylobacter remained high in broiler meat. The decreasing EU trend for conf...

EFSA and ECDC (European Food Safety Authority and European Centre for Disease Prevention and Control), 2015. The European Union Summary Report on Trends and Sources of Zoonoses, Zoonotic Agents and Food-borne Outbreaks in 2013

OpenAIRE

Helwigh, Birgitte

2015-01-01

This report of the European Food Safety Authority and the European Centre for Disease Prevention and Control presents the results of the zoonoses monitoring activities carried out in 2013 in 32 European countries (28 Member States and four non-Member States). Campylobacter iosis was the most commonly reported zoonosis. After several years of an increasing European Union (EU) trend, the human Campylobacter iosis notification rate has stabilised. In food and animals no EU trends were observed a...

The Science Case for Multi-Object Spectroscopy on the European ELT

NARCIS (Netherlands)

Evans, Chris; Puech, Mathieu; Afonso, Jose; Almaini, Omar; Amram, Philippe; Aussel, Hervé; Barbuy, Beatriz; Basden, Alistair; Bastian, Nate; Battaglia, Giuseppina; Biller, Beth; Bonifacio, Piercarlo; Bouché, Nicholas; Bunker, Andy; Caffau, Elisabetta; Charlot, Stephane; Cirasuolo, Michele; Clenet, Yann; Combes, Francoise; Conselice, Chris; Contini, Thierry; Cuby, Jean-Gabriel; Dalton, Gavin; Davies, Ben; de Koter, Alex; Disseau, Karen; Dunlop, Jim; Epinat, Benoît; Fiore, Fabrizio; Feltzing, Sofia; Ferguson, Annette; Flores, Hector; Fontana, Adriano; Fusco, Thierry; Gadotti, Dimitri; Gallazzi, Anna; Gallego, Jesus; Giallongo, Emanuele; Gonçalves, Thiago; Gratadour, Damien; Guenther, Eike; Hammer, Francois; Hill, Vanessa; Huertas-Company, Marc; Ibata, Roridgo; Kaper, Lex; Korn, Andreas; Larsen, Søren; Le Fèvre, Olivier; Lemasle, Bertrand; Maraston, Claudia; Mei, Simona; Mellier, Yannick; Morris, Simon; Östlin, Göran; Paumard, Thibaut; Pello, Roser; Pentericci, Laura; Peroux, Celine; Petitjean, Patrick; Rodrigues, Myriam; Rodríguez-Muñoz, Lucía; Rouan, Daniel; Sana, Hugues; Schaerer, Daniel; Telles, Eduardo; Trager, Scott; Tresse, Laurence; Welikala, Niraj; Zibetti, Stefano; Ziegler, Bodo

2015-01-01

This White Paper presents the scientific motivations for a multi-object spectrograph (MOS) on the European Extremely Large Telescope (E-ELT). The MOS case draws on all fields of contemporary astronomy, from extra-solar planets, to the study of the halo of the Milky Way and its satellites, and from

Market Attractiveness Classification of European Union Countries for Establishing Logistics Centres

Directory of Open Access Journals (Sweden)

Schüller David

2016-10-01

Full Text Available At present, enterprises are forced to serve their customers as quickly as possible if they want to succeed on turbulent global markets. Enterprises are looking for regions with high-quality infrastructure where they can establish new logistics centres that enable enterprises to serve their customers quickly. This paper focuses on the segmentation of the European Union market for enterprises that are willing to set up logistics centres in order to be able to distribute products fluently and more quickly to their customers in Europe. An agglomerative hierarchical clustering algorithm was used and Ward’s criterion applied for the purposes of market segmentation. A Logistic Performance Index and the indicator Dealing with Construction Permits were used as two relevant dimensions reflecting the market attractiveness of identified clusters. Based on the given statistical output, fundamental marketing concepts were formulated for each cluster composed of EU countries with similar characteristics.

Proposal for the standardisation of multi-centre trials in nuclear medicine imaging

DEFF Research Database (Denmark)

Dickson, John Caddell; Tossici-Bolt, Livia; Sera, Terez

2012-01-01

Multi-centre trials are an important part of proving the efficacy of procedures, drugs and interventions. Imaging components in such trials are becoming increasingly common; however, without sufficient control measures the usefulness of these data can be compromised. This paper describes a framew...

EFSA and ECDC (European Food Safety Authority and European Centre for Disease Prevention and Control), 2015. The European Union Summary Report on Trends and Sources of Zoonoses, Zoonotic Agents and Food-borne Outbreaks in 2013

DEFF Research Database (Denmark)

Helwigh, Birgitte

This report of the European Food Safety Authority and the European Centre for Disease Prevention and Control presents the results of the zoonoses monitoring activities carried out in 2013 in 32 European countries (28 Member States and four non-Member States). Campylobacter iosis was the most comm...... chain of tuberculosis due to Mycobacterium bovis, Brucella, Trichinella, Echinococcus, Toxoplasma , rabies, Coxiella burnetii (Q fever), West Nile Virus and tularaemia....

Analysis of the European Food Industry

OpenAIRE

Banse, Martin; McDonald, Scott; Joint Research Centre; Institute for Prospective Technological Studies; Kaditi, Eleni

2008-01-01

This report is based on a study assigned to the Centre for European Policy Studies (CEPS) by the European Commission¿s Joint Research Centre, Institute for Prospective Technological Studies (JRC-IPTS) to investigate recent developments in the European food industry and the impact of foreign direct investment (FDI) and trade flows on the food industry in the EU-25. The report illustrates trends in and the structure of the European food industry. Past and possible future developments are ana...

'Away Days' in multi-centre randomised controlled trials: a questionnaire survey of their use and a case study on the effect of one Away Day on patient recruitment.

Science.gov (United States)

Jefferson, Laura; Cook, Liz; Keding, Ada; Brealey, Stephen; Handoll, Helen; Rangan, Amar

2015-11-06

'Away Days' (trial promotion and training events for trial site personnel) are a well-established method used by trialists to encourage engagement of research sites in the recruitment of patients to multi-centre randomised controlled trials (RCTs). We explored the use of Away Days in multi-centre RCTs and analysed the effect on patient recruitment in a case study. Members of the United Kingdom Trial Managers' Network were surveyed in June 2013 to investigate their experiences in the design and conduct of Away Days in RCTs. We used data from a multi-centre pragmatic surgical trial to explore the effects of an Away Day on the screening and recruitment of patients. A total of 94 people responded to the survey. The majority (78%), who confirmed had organised an Away Day previously, found them to be useful. This is despite their costs.. There was no evidence, however, from the analysis of data from a surgical trial that attendance at an Away Day increased the number of patients screened or recruited at participating sites. Although those responsible for managing RCTs in the UK tend to believe that trial Away Days are beneficial, evidence from a multi-centre surgical trial shows no improvement on a key indicator of trial success. This points to the need to carefully consider the aims, design and conduct of Away Days. Further more rigorous research nested within RCTs would be valuable to evaluate the design and conduct of Away Days. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Efficacy and safety of acupuncture for chronic pain caused by gonarthrosis: A study protocol of an ongoing multi-centre randomised controlled clinical trial [ISRCTN27450856

Directory of Open Access Journals (Sweden)

Krämer Jürgen

2004-03-01

Full Text Available Abstract Background Controlled clinical trials produced contradictory results with respect to a specific analgesic effect of acupuncture. There is a lack of large multi-centre acupuncture trials. The German Acupuncture Trial represents the largest multi-centre study of acupuncture in the treatment of chronic pain caused by gonarthrosis up to now. Methods 900 patients will be randomised to three treatment arms. One group receives verum acupuncture, the second sham acupuncture, and the third conservative standard therapy. The trial protocol is described with eligibility criteria, detailed information on the treatment definition, blinding, endpoints, safety evaluation, statistical methods, sample size determination, monitoring, legal aspects, and the current status of the trial. Discussion A critical discussion is given regarding the considerations about standardisation of the acupuncture treatment, the choice of the control group, and the blinding of patients and observers.

Computerized detection of breast lesions in multi-centre and multi-instrument DCE-MR data using 3D principal component maps and template matching

Science.gov (United States)

Ertas, Gokhan; Doran, Simon; Leach, Martin O.

2011-12-01

In this study, we introduce a novel, robust and accurate computerized algorithm based on volumetric principal component maps and template matching that facilitates lesion detection on dynamic contrast-enhanced MR. The study dataset comprises 24 204 contrast-enhanced breast MR images corresponding to 4034 axial slices from 47 women in the UK multi-centre study of MRI screening for breast cancer and categorized as high risk. The scans analysed here were performed on six different models of scanner from three commercial vendors, sited in 13 clinics around the UK. 1952 slices from this dataset, containing 15 benign and 13 malignant lesions, were used for training. The remaining 2082 slices, with 14 benign and 12 malignant lesions, were used for test purposes. To prevent false positives being detected from other tissues and regions of the body, breast volumes are segmented from pre-contrast images using a fast semi-automated algorithm. Principal component analysis is applied to the centred intensity vectors formed from the dynamic contrast-enhanced T1-weighted images of the segmented breasts, followed by automatic thresholding to eliminate fatty tissues and slowly enhancing normal parenchyma and a convolution and filtering process to minimize artefacts from moderately enhanced normal parenchyma and blood vessels. Finally, suspicious lesions are identified through a volumetric sixfold neighbourhood connectivity search and calculation of two morphological features: volume and volumetric eccentricity, to exclude highly enhanced blood vessels, nipples and normal parenchyma and to localize lesions. This provides satisfactory lesion localization. For a detection sensitivity of 100%, the overall false-positive detection rate of the system is 1.02/lesion, 1.17/case and 0.08/slice, comparing favourably with previous studies. This approach may facilitate detection of lesions in multi-centre and multi-instrument dynamic contrast-enhanced breast MR data.

The new European Competence Centre for Moor and Climate - A European initiative for practical peat bog and climate protection

Science.gov (United States)

Smidt, Geerd; Tänzer, Detlef

2013-04-01

The new European Competence Centre for Moor and Climate (EFMK) is an initiative by different local communities, environmental protection NGOs, agricultural services, and partners from the peat and other industries in Lower Saxony (Germany). The Centre aims to integrate practical peat bog conservation with a focus on green house gas emission after drainage and after water logging activities. Together with our partners we want to break new ground to protect the remaining bogs in the region. Sphagnum mosses will be produced in paludiculture on-site in cooperation with the local peat industry to provide economic and ecologic alternatives for peat products used in horticulture business. Land-use changes are needed in the region and will be stimulated in cooperation with agricultural services via compensation money transfers from environmental protection funds. On a global scale the ideas of Carbon Credit System have to be discussed to protect the peat bogs for climate protection issues. Environmental education is an important pillar of the EFMK. The local society is invited to explore the unique ecosystem and to participate in peat bog protection activities. Future generations will be taught to understand that the health of our peat bogs is interrelated with the health of the local and global climate. Besides extracurricular classes for schools the centre will provide infrastructure for Master and PhD students, as well for senior researchers for applied research in the surrounding moor. International partners in the scientific and practical fields of peat bog ecology, renaturation, green house gas emissions from peat bogs, and environmental policy are invited to participate in the European Competence Center for Moor and Climate.

DALI: Defining Antibiotic Levels in Intensive care unit patients: a multi-centre point of prevalence study to determine whether contemporary antibiotic dosing for critically ill patients is therapeutic

Directory of Open Access Journals (Sweden)

Roberts Jason A

2012-07-01

Full Text Available Abstract Background The clinical effects of varying pharmacokinetic exposures of antibiotics (antibacterials and antifungals on outcome in infected critically ill patients are poorly described. A large-scale multi-centre study (DALI Study is currently underway describing the clinical outcomes of patients achieving pre-defined antibiotic exposures. This report describes the protocol. Methods DALI will recruit over 500 patients administered a wide range of either beta-lactam or glycopeptide antibiotics or triazole or echinocandin antifungals in a pharmacokinetic point-prevalence study. It is anticipated that over 60 European intensive care units (ICUs will participate. The primary aim will be to determine whether contemporary antibiotic dosing for critically ill patients achieves plasma concentrations associated with maximal activity. Secondary aims will compare antibiotic pharmacokinetic exposures with patient outcome and will describe the population pharmacokinetics of the antibiotics included. Various subgroup analyses will be conducted to determine patient groups that may be at risk of very low or very high concentrations of antibiotics. Discussion The DALI study should inform clinicians of the potential clinical advantages of achieving certain antibiotic pharmacokinetic exposures in infected critically ill patients.

Obstetric risk indicators for labour dystocia in nulliparous women: A multi-centre cohort study

Science.gov (United States)

Kjærgaard, Hanne; Olsen, Jørn; Ottesen, Bent; Nyberg, Per; Dykes, Anna-Karin

2008-01-01

Background In nulliparous women dystocia is the most common obstetric problem and its etiology is largely unknown. The frequency of augmentation and cesarean delivery related to dystocia is high although it is not clear if a slow progress justifies the interventions. Studies of risk factors for dystocia often do not provide diagnostic criteria for the diagnosis. The aim of the present study was to identify obstetric and clinical risk indicators of dystocia defined by strict and explicit criteria. Methods A multi-centre population based cohort study with prospectively collected data from 2810 nulliparous women in term spontaneous labour with a singleton infant in cephalic presentation. Data were collected by self-administered questionnaires and clinical data-records. Logistic regression analyses were used to estimate adjusted Odds Ratios (OR) and 95% confidence intervals (CI) are given. Results The following characteristics, present at admission to hospital, were associated with dystocia during labour (OR, 95% CI): dilatation of cervix dystocia. Conclusion Vaginal examinations at admission provide useful information on risk indicators for dystocia. The strongest risk indicator was use of epidural analgesia and if part of that is causal, it is of concern. PMID:18837972

Obstetric risk indicators for labour dystocia in nulliparous women: A multi-centre cohort study

Directory of Open Access Journals (Sweden)

Ottesen Bent

2008-10-01

Full Text Available Abstract Background In nulliparous women dystocia is the most common obstetric problem and its etiology is largely unknown. The frequency of augmentation and cesarean delivery related to dystocia is high although it is not clear if a slow progress justifies the interventions. Studies of risk factors for dystocia often do not provide diagnostic criteria for the diagnosis. The aim of the present study was to identify obstetric and clinical risk indicators of dystocia defined by strict and explicit criteria. Methods A multi-centre population based cohort study with prospectively collected data from 2810 nulliparous women in term spontaneous labour with a singleton infant in cephalic presentation. Data were collected by self-administered questionnaires and clinical data-records. Logistic regression analyses were used to estimate adjusted Odds Ratios (OR and 95% confidence intervals (CI are given. Results The following characteristics, present at admission to hospital, were associated with dystocia during labour (OR, 95% CI: dilatation of cervix Conclusion Vaginal examinations at admission provide useful information on risk indicators for dystocia. The strongest risk indicator was use of epidural analgesia and if part of that is causal, it is of concern.

EFSA (European Food Safety Authority) and ECDC (European Centre for Disease Prevention and Control), 2015. The European Union summary report on trends and sources of zoonoses, zoonotic agents and food-borne outbreaks in 2014

DEFF Research Database (Denmark)

Helwigh, Birgitte; Porsbo, Lone Jannok; Boysen, Louise

This report of the European Food Safety Authority and the European Centre for Disease Prevention and Control presents the results of the zoonoses monitoring activities carried out in 2014 in 32 European countries (28 Member States (MS) and four non-MS). Campylobacteriosis was the most commonly re......, molluscs and products thereof’. The report further summarises trends and sources along the food chain of tuberculosis due to Mycobacterium bovis, Brucella, Trichinella, Echinococcus, Toxoplasma, rabies, Coxiella burnetii (Q fever), West Nile virus and tularaemia....

Heterogeneous FDG-guided dose-escalation for locally advanced NSCLC (the NARLAL2 trial): Design and early dosimetric results of a randomized, multi-centre phase-III study

DEFF Research Database (Denmark)

Møller, Ditte Sloth; Nielsen, Tine Bjørn; Brink, Carsten

2017-01-01

Background and purpose: Local recurrence is frequent in locally advanced NSCLC and is primarily located in FDG-avid parts of tumour and lymph nodes. Aiming at improving local control without increasing toxicity, we designed a multi-centre phase-III trial delivering inhomogeneous dose-escalation d......Background and purpose: Local recurrence is frequent in locally advanced NSCLC and is primarily located in FDG-avid parts of tumour and lymph nodes. Aiming at improving local control without increasing toxicity, we designed a multi-centre phase-III trial delivering inhomogeneous dose...

An inter-centre quality assurance network for IMRT verification: Results of the ESTRO QUASIMODO project

International Nuclear Information System (INIS)

Gillis, Sofie; Wagter, Carlos de; Bohsung, Joerg; Perrin, Bruce; Williams, Peter; Mijnheer, Ben J.

2005-01-01

Background and purpose: IMRT necessitates extension of existing inter-centre quality assurance programs due to its increased complexity. We assessed the feasibility of an inter-centre verification method for different IMRT techniques. Materials and methods: Eight European radiotherapy institutions of the QUASIMODO network, have designed an IMRT plan for a horseshoe-shaped PTV surrounding a cylindrical OAR in a simplified pelvic phantom. All centres applied common plan objectives but used their own equipment for planning and delivery. They verified the delivery of this plan according to a common protocol with radiographic film and ionisation chamber measurements. The irradiated films, the results of the ionisation chamber measurements and the computed dose distributions were sent to one analysis centre that compared the measured and computed dose distributions with the gamma method and composite dose-area histograms. Results: 4% (relative to the prescribed dose) and 3 mm (distance-to-agreement) were decided feasible gamma criteria. The composite dose-area histograms showed a maximum local deviation of 3.5% in the mean dose of the PTV and 5% in the OAR. Systematic differences could be identified, and in some cases explained. Conclusions: This multi-centre dosimetric verification study demonstrated both the feasibility of a multi-centre quality assurance network to evaluate any IMRT planning and delivery system combination, as well as the validity of the methodology involved

A designated centre for people with disabilities operated by Sunbeam House Services Ltd, Wicklow

LENUS (Irish Health Repository)

Muller, Ueli C

2011-04-07

Abstract Background The International Multi-centre ADHD Genetics (IMAGE) project with 11 participating centres from 7 European countries and Israel has collected a large behavioural and genetic database for present and future research. Behavioural data were collected from 1068 probands with the combined type of attention deficit\\/hyperactivity disorder (ADHD-CT) and 1446 \\'unselected\\' siblings. The aim was to analyse the IMAGE sample with respect to demographic features (gender, age, family status, and recruiting centres) and psychopathological characteristics (diagnostic subtype, symptom frequencies, age at symptom detection, and comorbidities). A particular focus was on the effects of the study design and the diagnostic procedure on the homogeneity of the sample in terms of symptom-based behavioural data, and potential consequences for further analyses based on these data. Methods Diagnosis was based on the Parental Account of Childhood Symptoms (PACS) interview and the DSM-IV items of the Conners\\' teacher questionnaire. Demographics of the full sample and the homogeneity of a subsample (all probands) were analysed by using robust statistical procedures which were adjusted for unequal sample sizes and skewed distributions. These procedures included multi-way analyses based on trimmed means and winsorised variances as well as bootstrapping. Results Age and proband\\/sibling ratios differed between participating centres. There was no significant difference in the distribution of gender between centres. There was a significant interaction between age and centre for number of inattentive, but not number of hyperactive symptoms. Higher ADHD symptom frequencies were reported by parents than teachers. The diagnostic symptoms differed from each other in their frequencies. The face-to-face interview was more sensitive than the questionnaire. The differentiation between ADHD-CT probands and unaffected siblings was mainly due to differences in hyperactive

Multi-centre audit of VMAT planning and pre-treatment verification.

Science.gov (United States)

Jurado-Bruggeman, Diego; Hernández, Victor; Sáez, Jordi; Navarro, David; Pino, Francisco; Martínez, Tatiana; Alayrach, Maria-Elena; Ailleres, Norbert; Melero, Alejandro; Jornet, Núria

2017-08-01

We performed a multi-centre intercomparison of VMAT dose planning and pre-treatment verification. The aims were to analyse the dose plans in terms of dosimetric quality and deliverability, and to validate whether in-house pre-treatment verification results agreed with those of an external audit. The nine participating centres encompassed different machines, equipment, and methodologies. Two mock cases (prostate and head and neck) were planned using one and two arcs. A plan quality index was defined to compare the plans and different complexity indices were calculated to check their deliverability. We compared gamma index pass rates using the centre's equipment and methodology to those of an external audit (global 3D gamma, absolute dose differences, 10% of maximum dose threshold). Log-file analysis was performed to look for delivery errors. All centres fulfilled the dosimetric goals but plan quality and delivery complexity were heterogeneous and uncorrelated, depending on the manufacturer and the planner's methodology. Pre-treatment verifications results were within tolerance in all cases for gamma 3%-3mm evaluation. Nevertheless, differences between the external audit and in-house measurements arose due to different equipment or methodology, especially for 2%-2mm criteria with differences up to 20%. No correlation was found between complexity indices and verification results amongst centres. All plans fulfilled dosimetric constraints, but plan quality and complexity did not correlate and were strongly dependent on the planner and the vendor. In-house measurements cannot completely replace external audits for credentialing. Copyright © 2017 Elsevier B.V. All rights reserved.

Denmark and the European Union

DEFF Research Database (Denmark)

Manners, Ian

2011-01-01

Over the past two decades Morten Kelstrup’s work has been at the centre of three important intellectual innovations in political science – the study of the EU as a regional political system; European security studies; and small states in European integration. Kelstrup’s best known books (Buzan, K...... of this book, two of Kelstrup’s most important intellectual contributions come from his work on Denmark’s relations with the European Union, and his use of systems theory to understand the EU.......Over the past two decades Morten Kelstrup’s work has been at the centre of three important intellectual innovations in political science – the study of the EU as a regional political system; European security studies; and small states in European integration. Kelstrup’s best known books (Buzan...

Low sodium diet and pregnancy-induced hypertension: a multi-centre randomised controlled trial

NARCIS (Netherlands)

Knuist, M.; Bonsel, G. J.; Zondervan, H. A.; Treffers, P. E.

1998-01-01

To examine the effectiveness of the standard policy in the Netherlands to prescribe a sodium restricted diet to prevent or to treat mild pregnancy-induced hypertension. Multi-centre randomised controlled trial between April 1992 and April 1994. Seven practices of independent midwives and one

Yield of chest X-ray tuberculosis screening of immigrants during the European refugee crisis of 2015: a single-centre experience

Energy Technology Data Exchange (ETDEWEB)

Weinrich, Julius Matthias; Sauer, Markus; Henes, Frank Oliver; Adam, Gerhard; Bannas, Peter [University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Hamburg (Germany); Diel, Roland [University Medical Hospital Schleswig-Holstein, Airway Research Center North (ARCN), Institute for Epidemiology, Kiel (Germany); Meywald-Walter, Karen [Public Health Department Hamburg Central, Hamburg (Germany); Schoen, Gerhard [University Medical Center Hamburg-Eppendorf, Department of Medical Biometry and Epidemiology, Hamburg (Germany)

2017-08-15

Our aim was to determine the prevalence of tuberculosis (TB), the number needed to screen (NNS), and the diagnostic accuracy of chest X-ray (CXR) screening to detect active pulmonary TB during the 2015 European refugee crisis. We evaluated data of all refugees who underwent CXR screening in a single-centre of one German metropolitan area in 2015. We determined the prevalence of TB, NNS, and accuracy of CXR to detect active pulmonary TB. Reference method for active TB was the database of all definite TB cases registered at the Department of Public Health. A total of 17,487 immigrants underwent single-centre CXR screening in 2015; prevalence of definite pulmonary TB was 0.103%. The NNS for detecting one case of active pulmonary TB was 1749. CXR had a sensitivity of 55.6% 95% confidence interval (CI 30.8-78.5%) and a specificity 98.3% (CI 98.1-98.5%) to reveal one case of active TB. Our single-centre study indicates that chest X-ray screening for TB during the 2015 European refugee crisis was of low yield due the low prevalence of TB and high number needed to screen, thus implicating the need for improved screening algorithms adapted to the overwhelming number of refugees. (orig.)

Yield of chest X-ray tuberculosis screening of immigrants during the European refugee crisis of 2015: a single-centre experience

International Nuclear Information System (INIS)

Weinrich, Julius Matthias; Sauer, Markus; Henes, Frank Oliver; Adam, Gerhard; Bannas, Peter; Diel, Roland; Meywald-Walter, Karen; Schoen, Gerhard

2017-01-01

Our aim was to determine the prevalence of tuberculosis (TB), the number needed to screen (NNS), and the diagnostic accuracy of chest X-ray (CXR) screening to detect active pulmonary TB during the 2015 European refugee crisis. We evaluated data of all refugees who underwent CXR screening in a single-centre of one German metropolitan area in 2015. We determined the prevalence of TB, NNS, and accuracy of CXR to detect active pulmonary TB. Reference method for active TB was the database of all definite TB cases registered at the Department of Public Health. A total of 17,487 immigrants underwent single-centre CXR screening in 2015; prevalence of definite pulmonary TB was 0.103%. The NNS for detecting one case of active pulmonary TB was 1749. CXR had a sensitivity of 55.6% 95% confidence interval (CI 30.8-78.5%) and a specificity 98.3% (CI 98.1-98.5%) to reveal one case of active TB. Our single-centre study indicates that chest X-ray screening for TB during the 2015 European refugee crisis was of low yield due the low prevalence of TB and high number needed to screen, thus implicating the need for improved screening algorithms adapted to the overwhelming number of refugees. (orig.)

Variability of fish consumption within the 10 European countries participating in the European Investigation into Cancer and Nutrition (EPIC) study

DEFF Research Database (Denmark)

Welch, A.A.; Lund, E.; Amiano, P.

2002-01-01

OBJECTIVE: To describe and compare the consumption of total fish (marine foods) and the fish sub-groups - white fish, fatty fish, very fatty fish, fish products and crustacea, in participants from the European Investigation into Cancer and Nutrition (EPIC) study. DESIGN: Cross-sectional analysis...... of dietary intake using a computerised standardised 24-hour recall interview. Crude means, means and standard errors adjusted by age, season and day of the week were calculated, stratified by centre and gender. SETTING: Twenty-seven redefined centres in the 10 European countries participating in the EPIC...... study. SUBJECTS: In total, 35 955 subjects (13 031 men and 22 924 women), aged 35-74 years, selected from the main EPIC cohort. RESULTS: A six- to sevenfold variation in total fish consumption exists in women and men, between the lowest consumption in Germany and the highest in Spain. Overall, white...

IDRANAP - European Centre of Excellence

International Nuclear Information System (INIS)

Buzatu, Florin D.

2003-01-01

Selected by the European Commission (EC) experts out of 185 proposals from 11 countries, IDRANAP (Inter-Disciplinary Research and Applications based on Nuclear and Atomic Physics) is the only EC Centre of Excellence in nuclear physics. The project, initiated and developed by a remarkable team from our institute, researchers with a recognized international scientific level, has as main objectives: - promotion in Romania and in the region of modern applications derived from basic and applied research in nuclear and atomic physics; - disciplinary research in ecology, health, biology, science of materials; - specific nuclear and atomic physics research aimed to open new possibilities for applications; - to ensure stimulative conditions for PhD students from Romania and other EC candidate countries to improve their knowledge and experience by joining scientific activities in the region, a fact that might counteract their tendency to migrate to Western countries. The high scientific level of researchers, their access to national and international facilities as well as the link with prestigious laboratories abroad and the socio-economic demand motivated the development of the project. Among expected results, we mention: improving and spreading the scientific knowledge by publications; producing new facilities, devices and instruments; application of nuclear methods in industry, health-care and environment protection, and training of young researchers. The project consists of 18 workpackages structured in 5 distinct areas: - Determining environmental pollution; - Nuclear methods in biology and medicine; - Radionuclide metrology; - Analysis and characterization of materials; - Nuclei far from stability, decay modes, cosmic rays, and facilities.We make an up-to-date presentation of obtained results and activities performed within IDRANAP project, as well as a short overview of our institute. (author)

A multi-centre evaluation of oral cancer in Southern and Western Nigeria: an African oral pathology research consortium initiative.

Science.gov (United States)

Omitola, Olufemi Gbenga; Soyele, Olujide Oladele; Sigbeku, Opeyemi; Okoh, Dickson; Akinshipo, Abdulwarith Olaitan; Butali, Azeez; Adeola, Henry Ademola

2017-01-01

Oral cancer is a leading cause of cancer deaths among African populations. Lack of standard cancer registries and under-reporting has inaccurately depicted its magnitude in Nigeria. Development of multi-centre collaborative oral pathology networks such as the African Oral Pathology Research Consortium (AOPRC) facilitates skill and expertise exchange and fosters a robust and systematic investigation of oral diseases across Africa. In this descriptive cross-sectional study, we have leveraged the auspices of the AOPRC to examine the burden of oral cancer in Nigeria, using a multi-centre approach. Data from 4 major tertiary health institutions in Western and Southern Nigeria was generated using a standardized data extraction format and analysed using the SPSS data analysis software (version 20.0; SPSS Inc. Chicago, IL). Of the 162 cases examined across the 4 centres, we observed that oral squamous cell carcinomas (OSCC) occurred mostly in the 6 th and 7 th decades of life and maxillary were more frequent than mandibular OSCC lesions. Regional variations were observed both for location, age group and gender distribution. Significant regional differences was found between poorly, moderately and well differentiated OSCC (p value = 0.0071). A multi-centre collaborative oral pathology research approach is an effective way to achieve better insight into the patterns and distribution of various oral diseases in men of African descent. The wider outlook for AOPRC is to employ similar approaches to drive intensive oral pathology research targeted at addressing the current morbidity and mortality of various oral diseases across Africa.

Clustering of European winter storms: A multi-model perspective

Science.gov (United States)

Renggli, Dominik; Buettner, Annemarie; Scherb, Anke; Straub, Daniel; Zimmerli, Peter

2016-04-01

The storm series over Europe in 1990 (Daria, Vivian, Wiebke, Herta) and 1999 (Anatol, Lothar, Martin) are very well known. Such clusters of severe events strongly affect the seasonally accumulated damage statistics. The (re)insurance industry has quantified clustering by using distribution assumptions deduced from the historical storm activity of the last 30 to 40 years. The use of storm series simulated by climate models has only started recently. Climate model runs can potentially represent 100s to 1000s of years, allowing a more detailed quantification of clustering than the history of the last few decades. However, it is unknown how sensitive the representation of clustering is to systematic biases. Using a multi-model ensemble allows quantifying that uncertainty. This work uses CMIP5 decadal ensemble hindcasts to study clustering of European winter storms from a multi-model perspective. An objective identification algorithm extracts winter storms (September to April) in the gridded 6-hourly wind data. Since the skill of European storm predictions is very limited on the decadal scale, the different hindcast runs are interpreted as independent realizations. As a consequence, the available hindcast ensemble represents several 1000 simulated storm seasons. The seasonal clustering of winter storms is quantified using the dispersion coefficient. The benchmark for the decadal prediction models is the 20th Century Reanalysis. The decadal prediction models are able to reproduce typical features of the clustering characteristics observed in the reanalysis data. Clustering occurs in all analyzed models over the North Atlantic and European region, in particular over Great Britain and Scandinavia as well as over Iberia (i.e. the exit regions of the North Atlantic storm track). Clustering is generally weaker in the models compared to reanalysis, although the differences between different models are substantial. In contrast to existing studies, clustering is driven by weak

European networks in the field of structural integrity managed by the Joint Research Centre of the EC

International Nuclear Information System (INIS)

Crutzen, S.; Estorff, U. von

1998-01-01

Three European networks on structural integrity aspects of ageing nuclear components are presently managed by the Institute for Advanced Materials of the Joint Research Centre of the European Commission: AMES (Ageing Materials Evaluation and Studies), ENIQ (European Network for Inspection Qualification) and NESC (Network for Evaluating Steel Components). These club-type co-operations involving nuclear industry have the following broad objectives: 1) the integration of fragmented R and D work on structural integrity through the execution of studies and projects at European level; 2) the support or introduction of a long term strategy in some of the European groups or actions conducted by the Commission; 3) the use of European networks to influence studies and project results in the direction of codes and standards in Europe and for the harmonisation of codes in general The networks were launched during 1992 and 1993. Since then considerable progress has been achieved: AMES has identified priority items in reactor materials ageing research, which are of common interest. They were fit into a general strategy to be followed by AMES. ENIQ has moved to a Steering Committee composed of utilities as voting members. An important step was reached by issuing a consensus document about a European methodology for qualification of non-destructive testing and by developing pilot exercises. The NESC initiative provides a means for EU countries to collaborate in large scale shared cost experiments that investigate the entire process of structural integrity assessment. The pressurised thermal shock experiment of the first project NESC I has taken place during spring 1997 and it made use of the AEA Technology spinning cylinder facility. Evaluation of the test data is going on through destructive examination. (author)

The outcome of a multi-centre feasibility study of online adaptive radiotherapy for muscle-invasive bladder cancer TROG 10.01 BOLART

International Nuclear Information System (INIS)

Foroudi, Farshad; Pham, Daniel; Rolfo, Aldo; Bressel, Mathias; Tang, Colin I.; Tan, Alex; Turner, Sandra; Hruby, George; Williams, Stephen; Hayne, Dickon; Lehman, Margot; Skala, Marketa; Jose, Chakiath C.; Gogna, Kumar; Kron, Tomas

2014-01-01

Purpose: To assess whether online adaptive radiotherapy for bladder cancer is feasible across multiple Radiation Oncology departments using different imaging, delivery and recording technology. Materials and methods: A multi-centre feasibility study of online adaptive radiotherapy, using a choice of three “plan of the day”, was conducted at 12 departments. Patients with muscle-invasive bladder cancer were included. Departments were activated if part of the pilot study or after a site-credentialing visit. There was real time review of the first two cases from each department. Results: 54 patients were recruited, with 50 proceeding to radiotherapy. There were 43 males and 7 females with a mean age of 78 years. The tumour stages treated included T1 (1 patient), T2 (35), T3 (10) and T4 (4). One patient died of an unrelated cause during radiotherapy. The three adaptive plans were created before the 10th fraction in all cases. In 8 (16%) of the patients, a conventional plan using a ‘standard’ CTV to PTV margin of 1.5 cm was used for one or more fractions where the pre-treatment bladder CTV was larger than any of the three adaptive plans. The bladder CTV extended beyond the PTV on post treatment imaging in 9 (18%) of the 49 patients. Conclusions: From a technical perspective an online adaptive radiotherapy technique can be instituted in a multi-centre setting. However, without further bladder filling control or imaging, a CTV to PTV margin of 7 mm is insufficient

The Scandinavian Propaten(®) trial - 1-year patency of PTFE vascular prostheses with heparin-bonded luminal surfaces compared to ordinary pure PTFE vascular prostheses - a randomised clinical controlled multi-centre trial

DEFF Research Database (Denmark)

Lindholt, J S; Gottschalksen, B; Johannesen, N

2011-01-01

To compare 1-year potencies' of heparin-bonded PTFE [(Hb-PTFE) (Propaten(®))] grafts with those of ordinary polytetraflouroethylene (PTFE) grafts in a blinded, randomised, clinically controlled, multi-centre study.......To compare 1-year potencies' of heparin-bonded PTFE [(Hb-PTFE) (Propaten(®))] grafts with those of ordinary polytetraflouroethylene (PTFE) grafts in a blinded, randomised, clinically controlled, multi-centre study....

The adaptive reuse of historic city centres. Bologna and Lisbon: solutions for urban regeneration

Directory of Open Access Journals (Sweden)

Andrea Boeri

2016-11-01

Full Text Available The European historic city centres are currently experiencing innovative approaches for rehabilitation of urban spaces afflicted by social and physical decay. The revitalization challenges are a consequence of the integration of contemporary technologies and solutions to achieve new requirements and of the impacts of socio-economic dynamics. Understanding and boosting the drivers connected to the cultural potential of the historic city centres can play an important role in adaptive re-use. This paper focuses on the synergy between cultural heritage and urban development, cultural heritage preservation and local economic growth, proposing adaptive reuse design practices applied in historic city centre, through the adoption of a multi-criteria methodology for heritage-led regeneration.

Dietary management practices in phenylketonuria across European centres

DEFF Research Database (Denmark)

Ahring, Kirsten; Bélanger-Quintana, Amaya; Dokoupil, Katharina

2009-01-01

, and the definition of foods that could be eaten without restriction ('free foods'). Eighty percent (n=8/10) of centres encouraged breastfeeding together with protein substitute in infants with PKU. CONCLUSIONS: Important differences exist among centres across Europe in the dietary management of PKU, and in support...... systems designed to assist patients in managing their diets. Further studies are needed to compare different dietary treatments with the aim of identifying best practice to optimise phenylalanine control and dietary adherence....

A case for multi-model and multi-approach based event attribution: The 2015 European drought

Science.gov (United States)

Hauser, Mathias; Gudmundsson, Lukas; Orth, René; Jézéquel, Aglaé; Haustein, Karsten; Seneviratne, Sonia Isabelle

2017-04-01

Science on the role of anthropogenic influence on extreme weather events such as heat waves or droughts has evolved rapidly over the past years. The approach of "event attribution" compares the occurrence probability of an event in the present, factual world with the probability of the same event in a hypothetical, counterfactual world without human-induced climate change. Every such analysis necessarily faces multiple methodological choices including, but not limited to: the event definition, climate model configuration, and the design of the counterfactual world. Here, we explore the role of such choices for an attribution analysis of the 2015 European summer drought (Hauser et al., in preparation). While some GCMs suggest that anthropogenic forcing made the 2015 drought more likely, others suggest no impact, or even a decrease in the event probability. These results additionally differ for single GCMs, depending on the reference used for the counterfactual world. Observational results do not suggest a historical tendency towards more drying, but the record may be too short to provide robust assessments because of the large interannual variability of drought occurrence. These results highlight the need for a multi-model and multi-approach framework in event attribution research. This is especially important for events with low signal to noise ratio and high model dependency such as regional droughts. Hauser, M., L. Gudmundsson, R. Orth, A. Jézéquel, K. Haustein, S.I. Seneviratne, in preparation. A case for multi-model and multi-approach based event attribution: The 2015 European drought.

The Science Case for Multi-Object Spectroscopy on the European ELT

OpenAIRE

Evans, Chris; Puech, Mathieu; Afonso, Jose; Almaini, Omar; Amram, Philippe; Aussel, Hervé; Barbuy, Beatriz; Basden, Alistair; Bastian, Nate; Battaglia, Giuseppina; Biller, Beth; Bonifacio, Piercarlo; Bouché, Nicholas; Bunker, Andy; Caffau, Elisabetta

2015-01-01

This White Paper presents the scientific motivations for a multi-object spectrograph (MOS) on the European Extremely Large Telescope (E-ELT). The MOS case draws on all fields of contemporary astronomy, from extra-solar planets, to the study of the halo of the Milky Way and its satellites, and from resolved stellar populations in nearby galaxies out to observations of the earliest 'first-light' structures in the partially-reionised Universe. The material presented here results from thorough di...

The impact of mild induced hypothermia on the rate of transfusion and the mortality in severely injured patients: a retrospective multi-centre study.

Science.gov (United States)

Jensen, Kai Oliver; Held, Leonhard; Kraus, Andrea; Hildebrand, Frank; Mommsen, Philipp; Mica, Ladislav; Wanner, Guido A; Steiger, Peter; Moos, Rudolf M; Simmen, Hans-Peter; Sprengel, Kai

2016-10-06

Although under discussion, induced hypothermia (IH) is an established therapy for patients with cardiac arrest or traumatic brain injuries. The influences on coagulopathy and bleeding tendency in severely injured patients (SIP) with concomitant traumatic brain injury are most widely unclear. Therefore, the aim of this study was to quantify the effect of mild IH in SIP with concomitant severe traumatic brain injuries on transfusion rate and mortality. In this retrospective multi-centre study, SIP from three European level-1 trauma centres with an ISS ≥16 between 2009 and 2011 were included. At hospital A, patients qualified for IH with age ≤70 years and a severe head injury with an abbreviated injury scale (AIS Head ) of ≥3. IH was defined as target core body temperature of 35 °C. Hypothermic patients were matched with two patients, one from hospital B and one from hospital C using age and AIS Head . The effect of IH on the transfusion rate, complications and mortality was quantified with 95 % confidence intervals (CI). Patients not treated with IH in hospital A and those from hospital B and C, who were not matched, were used to adjust the CI for the effect of inter-hospital therapy protocol differences. Mean age of patients in the IH-group (n = 43) was 35.7 years, mean ISS 30 points and sex distribution showed 83.7 % male. Mean age of matched patients in the normotherm-group (n = 86) was 36.7 years, mean ISS 33 points and there were 75.6 % males. For the hypothermic patients, we pointed out an estimate of mean difference for the number of transfused units of packed red blood cells as well as for mortality which does not indicate a decrease in the benefit gained by hypothermia. It is suggested that hypothermic patients tend to a higher rate of lung failure and thromboembolisms. Though tending to an increased rate of complications, there is no evidence for a difference in both; rate of transfusion and mortality in SIP. Mild IH as an option for

Investigation of reference levels and radiation dose associated with abdominal EVAR (endovascular aneurysm repair) procedures across several European Centres

Energy Technology Data Exchange (ETDEWEB)

Tuthill, E.; Rainford, L. [University College Dublin, Diagnostic Imaging, School of Medicine, Dublin (Ireland); O' Hora, L.; O' Donohoe, M. [Mater Misericordiae University Hospital, Dublin (Ireland); Panci, S. [San Giovanni di Dio Hospital, Florence (Italy); Gilligan, P.; Fox, E. [Mater Private Hospital, Dublin (Ireland); Campion, D. [Mauriziano-Umberto Hospital, Turin (Italy); Trenti, R. [Policlinico S. Orsola-Malpighi, Bologna (Italy); Catania, D. [AITRI, Association of Italian Interventional Radiographers, Milan (Italy)

2017-11-15

Endovascular aneurysm repair (EVAR) is considered the treatment of choice for abdominal aortic aneurysms with suitable anatomy. In order to improve radiation safety, European Directive (2013/59) requires member states to implement diagnostic reference levels (DRLs) in radio-diagnostic and interventional procedures. This study aimed to determine local DRLs for EVAR across five European centres and identify an interim European DRL, which currently remains unestablished. Retrospective data was collected for 180 standard EVARs performed between January 2014 and July 2015 from five specialist centres in Ireland (n=2) and Italy (n=3). Data capture included: air kerma-area product (P{sub KA}), total air kerma at the reference point (K{sub a,r}), fluoroscopic time (FT), number of acquisitions, frame rate of acquisition, type of acquisition, patient height, weight, and gender. The mean values for each site A, B, C, D, and E were: P{sub KA}s of 4343 ± 994 μGym{sup 2}, 18,200 ± 2141 μGym{sup 2}, 11,423 ± 1390 μGym{sup 2}, 7796 ± 704 μGym{sup 2}, 31,897 ± 5798 μGym{sup 2}; FTs of 816 ± 92 s, 950 ± 150 s, 708 ± 70 s, 972 ± 61 s, 827 ± 118 s; and number of acquisitions of 6.72 ± 0.56, 10.38 ± 1.54, 4.74 ± 0.19, 5.64 ± 0.36, 7.28 ± 0.65, respectively. The overall pooled 75th percentile P{sub KA} was 15,849 μGym{sup 2}. Local reference levels were identified. The pooled data has been used to establish an interim European DRL for EVAR procedures. (orig.)

Multi-level governance: The way forward for European illicit drug policy?

Science.gov (United States)

Chatwin, Caroline

2007-12-01

Illicit drug policy has long been an area that has attracted international policy intervention, however, the European Union has declared it an area of subsidiarity, leaving ultimate control to national governments. Nevertheless, European Union preoccupation with the illicit drug issue and international drug trafficking and organised crime concerns have ensured that continued and increased cooperation in illicit drug policy is never off the agenda. This article examines the history of European integration in contrasting areas of policy and considers both the desirability and the viability of an increasingly harmonised drug policy for Europe. Finally, it proposes a model of integrated illicit drug policy that is strongly connected to developing patterns of European social policy, calling on multi-level governance and close involvement at the level of the citizen.

A multi-dimensional framework to assist in the design of successful shared services centres

Directory of Open Access Journals (Sweden)

Mark Borman

2012-04-01

Full Text Available Organisations are increasingly looking to realise the benefits of shared services yet there is little guidance available as to the best way to proceed. A multi-dimensional framework is presented that considers the service provided, the design of the shared services centre and the organisational context it sits within. Case studies are then used to determine what specific attributes from each dimension are associated with success and how they should be aligned. It is concluded that there appears to be a single, broadly standard pattern of attributes for successful Shared Services Centres (SSCs across the proposed dimensions of Activity, Environment, History, Resources, Strategy, Structure, Management, Technology and Individual Skills. It should also be noted though that some deviation from the identified standard along some dimensions is possible without adverse effect – ie that the alignment identified appears to be relatively soft.

SLA-based optimisation of virtualised resource for multi-tier web applications in cloud data centres

Science.gov (United States)

Bi, Jing; Yuan, Haitao; Tie, Ming; Tan, Wei

2015-10-01

Dynamic virtualised resource allocation is the key to quality of service assurance for multi-tier web application services in cloud data centre. In this paper, we develop a self-management architecture of cloud data centres with virtualisation mechanism for multi-tier web application services. Based on this architecture, we establish a flexible hybrid queueing model to determine the amount of virtual machines for each tier of virtualised application service environments. Besides, we propose a non-linear constrained optimisation problem with restrictions defined in service level agreement. Furthermore, we develop a heuristic mixed optimisation algorithm to maximise the profit of cloud infrastructure providers, and to meet performance requirements from different clients as well. Finally, we compare the effectiveness of our dynamic allocation strategy with two other allocation strategies. The simulation results show that the proposed resource allocation method is efficient in improving the overall performance and reducing the resource energy cost.

Yield of chest X-ray tuberculosis screening of immigrants during the European refugee crisis of 2015: a single-centre experience.

Science.gov (United States)

Weinrich, Julius Matthias; Diel, Roland; Sauer, Markus; Henes, Frank Oliver; Meywald-Walter, Karen; Adam, Gerhard; Schön, Gerhard; Bannas, Peter

2017-08-01

Our aim was to determine the prevalence of tuberculosis (TB), the number needed to screen (NNS), and the diagnostic accuracy of chest X-ray (CXR) screening to detect active pulmonary TB during the 2015 European refugee crisis. We evaluated data of all refugees who underwent CXR screening in a single-centre of one German metropolitan area in 2015. We determined the prevalence of TB, NNS, and accuracy of CXR to detect active pulmonary TB. Reference method for active TB was the database of all definite TB cases registered at the Department of Public Health. A total of 17,487 immigrants underwent single-centre CXR screening in 2015; prevalence of definite pulmonary TB was 0.103%. The NNS for detecting one case of active pulmonary TB was 1749. CXR had a sensitivity of 55.6% [95% confidence interval (CI) 30.8-78.5%) and a specificity 98.3% (CI 98.1-98.5%) to reveal one case of active TB. Our single-centre study indicates that chest X-ray screening for TB during the 2015 European refugee crisis was of low yield due the low prevalence of TB and high number needed to screen, thus implicating the need for improved screening algorithms adapted to the overwhelming number of refugees. • Prevalence of pulmonary tuberculosis (TB) among refugees in 2015 was low (0.103%). • The number needed to screen to detect one case of active pulmonary TB was 1749. • Tuberculosis X-ray screening resulted in a low sensitivity and high specificity. • Tuberculosis X-ray screening during the European refugee crisis is of low yield. • Improved screening algorithms are needed due to the overwhelming the number of refugees.

A designated centre for people with disabilities operated by Daughters of Charity Disability Support Services Ltd., Dublin 7

LENUS (Irish Health Repository)

Muller, Ueli C

2011-04-07

Abstract Background The International Multi-centre ADHD Genetics (IMAGE) project with 11 participating centres from 7 European countries and Israel has collected a large behavioural and genetic database for present and future research. Behavioural data were collected from 1068 probands with the combined type of attention deficit\\/hyperactivity disorder (ADHD-CT) and 1446 \\'unselected\\' siblings. The aim was to analyse the IMAGE sample with respect to demographic features (gender, age, family status, and recruiting centres) and psychopathological characteristics (diagnostic subtype, symptom frequencies, age at symptom detection, and comorbidities). A particular focus was on the effects of the study design and the diagnostic procedure on the homogeneity of the sample in terms of symptom-based behavioural data, and potential consequences for further analyses based on these data. Methods Diagnosis was based on the Parental Account of Childhood Symptoms (PACS) interview and the DSM-IV items of the Conners\\' teacher questionnaire. Demographics of the full sample and the homogeneity of a subsample (all probands) were analysed by using robust statistical procedures which were adjusted for unequal sample sizes and skewed distributions. These procedures included multi-way analyses based on trimmed means and winsorised variances as well as bootstrapping. Results Age and proband\\/sibling ratios differed between participating centres. There was no significant difference in the distribution of gender between centres. There was a significant interaction between age and centre for number of inattentive, but not number of hyperactive symptoms. Higher ADHD symptom frequencies were reported by parents than teachers. The diagnostic symptoms differed from each other in their frequencies. The face-to-face interview was more sensitive than the questionnaire. The differentiation between ADHD-CT probands and unaffected siblings was mainly due to differences in hyperactive

Centre of the European gas market. The European Autumn Gas Conference

International Nuclear Information System (INIS)

Van Hasselt, F.; Van der Wal, W.; Ruinen, H.

1998-01-01

From the results of the 1997 European Autumn Gas Conference in Barcelona, Spain, it appears that the European gas industry is mainly focused on the liberalization of the European energy market. The main topic of the Conference was 'dealing with surplus'. A brief overview is given of the natural gas trade developments in the European countries. 1 ill., 1 tab. 2 ills

Multi-centre European study of breakthrough cancer pain: pain characteristics and patient perceptions of current and potential management strategies

DEFF Research Database (Denmark)

Davies, Andrew; Zeppetella, Giovambattista; Andersen, Steen

2011-01-01

This study involved 320 cancer patients from four Northern European countries. Patients with breakthrough pain were questioned about the characteristics of their pain, the current management of their pain, and the acceptability/utility of alternative routes of administration. The median number...... of episodes was 3/day. Forty-four percent patients reported incident-type pain, 39% spontaneous-type pain, and 17% a combination of these pains. The median duration was 60 min, and the median time to peak intensity was 15 min. Three percent patients reported "mild" pain, 37% "moderate" pain, and 60% "severe......" pain. Ninety percent patients stated that the pain interfered with their daily activities. All patients were using opioids as rescue medication (mainly oral morphine/oxycodone), whilst 28% patients were using non-opioids, and 50% patients were using non-pharmacological interventions. Only 55% patients...

I-MOVE multi-centre case control study 2010-11: overall and stratified estimates of influenza vaccine effectiveness in Europe.

Directory of Open Access Journals (Sweden)

Esther Kissling

Full Text Available BACKGROUND: In the third season of I-MOVE (Influenza Monitoring Vaccine Effectiveness in Europe, we undertook a multicentre case-control study based on sentinel practitioner surveillance networks in eight European Union (EU member states to estimate 2010/11 influenza vaccine effectiveness (VE against medically-attended influenza-like illness (ILI laboratory-confirmed as influenza. METHODS: Using systematic sampling, practitioners swabbed ILI/ARI patients within seven days of symptom onset. We compared influenza-positive to influenza laboratory-negative patients among those meeting the EU ILI case definition. A valid vaccination corresponded to > 14 days between receiving a dose of vaccine and symptom onset. We used multiple imputation with chained equations to estimate missing values. Using logistic regression with study as fixed effect we calculated influenza VE adjusting for potential confounders. We estimated influenza VE overall, by influenza type, age group and among the target group for vaccination. RESULTS: We included 2019 cases and 2391 controls in the analysis. Adjusted VE was 52% (95% CI 30-67 overall (N = 4410, 55% (95% CI 29-72 against A(H1N1 and 50% (95% CI 14-71 against influenza B. Adjusted VE against all influenza subtypes was 66% (95% CI 15-86, 41% (95% CI -3-66 and 60% (95% CI 17-81 among those aged 0-14, 15-59 and ≥60 respectively. Among target groups for vaccination (N = 1004, VE was 56% (95% CI 34-71 overall, 59% (95% CI 32-75 against A(H1N1 and 63% (95% CI 31-81 against influenza B. CONCLUSIONS: Results suggest moderate protection from 2010-11 trivalent influenza vaccines against medically-attended ILI laboratory-confirmed as influenza across Europe. Adjusted and stratified influenza VE estimates are possible with the large sample size of this multi-centre case-control. I-MOVE shows how a network can provide precise summary VE measures across Europe.

Low social interactions in eating disorder patients in childhood and adulthood: a multi-centre European case control study.

Science.gov (United States)

Krug, Isabel; Penelo, Eva; Fernandez-Aranda, Fernando; Anderluh, Marija; Bellodi, Laura; Cellini, Elena; di Bernardo, Milena; Granero, Roser; Karwautz, Andreas; Nacmias, Benedetta; Ricca, Valdo; Sorbi, Sandro; Tchanturia, Kate; Wagner, Gudrun; Collier, David; Treasure, Janet

2013-01-01

The objective of this article was to examine lifestyle behaviours in eating disorder (ED) patients and healthy controls. A total of 801 ED patients and 727 healthy controls from five European countries completed the questions related to lifestyle behaviours of the Cross-Cultural Questionnaire (CCQ). For children, the ED sample exhibited more solitary activities (rigorously doing homework [psocializing with friends [pgroup and this continued in adulthood. There were minimal differences across ED sub-diagnoses and various cross-cultural differences emerged. Reduced social activities may be an important risk and maintaining factor for ED symptomatology.

Assessment of data quality in an international multi-centre randomised trial of coronary artery surgery

Directory of Open Access Journals (Sweden)

Bochenek Andrzej

2011-09-01

Full Text Available Abstract Background ART is a multi-centre randomised trial of cardiac surgery which provided a unique opportunity to evaluate the data from a large number of centres from a variety of countries. We attempted to assess data quality, including recruitment rates, timeliness and completeness of the data obtained from the centres in different socio-economic strata. Methods The analysis was based on the 2-page CRF completed at the 6 week follow-up. CRF pages were categorised into "clean" (no edit query and "dirty" (any incomplete, inconsistent or illegible data. The timelines were assessed on the basis of the time interval from the visit and receipt of complete CRF. Data quality was defined as the number of data queries (in percent and time delay (in days between visit and receipt of correct data. Analyses were stratified according to the World Bank definitions into: "Developing" countries (Poland, Brazil and India and "Developed" (Italy, UK, Austria and Australia. Results There were 18 centres in the "Developed" and 10 centres in the "Developing" countries. The rate of enrolment did not differ significantly by economic level ("Developing":4.1 persons/month, "Developed":3.7 persons/month. The time interval for the receipt of data was longer for "Developing" countries (median:37 days compared to "Developed" ones (median:11 days (p Conclusions In this study we showed that data quality was comparable between centres from "Developed" and "Developing" countries. Data was received in a less timely fashion from Developing countries and appropriate systems should be instigated to minimize any delays. Close attention should be paid to the training of centres and to the central management of data quality. Trial registration ISRCTN46552265

Peptic Ulcer Disease in Bangladesh: A Multi-centre Study.

Science.gov (United States)

Ghosh, C K; Khan, M R; Alam, F; Shil, B C; Kabir, M S; Mahmuduzzaman, M; Das, S C; Masud, H; Roy, P K

2017-01-01

The incidence of peptic ulcer has steadily declined through out the world. This decreasing trend is also noticeable in this subcontinent. The point prevalence of peptic ulcer (PUD) in Bangladesh was around 15% in eighties. The aim of this study was to see the present prevalence of peptic ulcer at endoscopy and to identify changing trends in the occurrence of peptic ulcer in Bangladesh. This retrospective analysis of the endoscopic records of multiple tertiary referral centres of Dhaka city were done from January 2012 to July 2013. A total of 5608 subjects were the study samples. We included those patients having peptic ulcer in the form of duodenal ulcer, benign gastric ulcer including pre-pyloric ulcer and gastric outlet obstruction due to peptic ulcer. Duodenal ulcer and benign gastric ulcer were found in 415(7.4%) and 184(3.28%) patients respectively and gastric outlet obstruction due to peptic ulcer was found in 23(0.40%) patients.

Multi-agent simulation of competitive electricity markets: Autonomous systems cooperation for European market modeling

International Nuclear Information System (INIS)

Santos, Gabriel; Pinto, Tiago; Morais, Hugo; Sousa, Tiago M.; Pereira, Ivo F.; Fernandes, Ricardo; Praça, Isabel; Vale, Zita

2015-01-01

Highlights: • Definition of an ontology allowing the communication between multi-agents systems. • Social welfare evaluation in different electricity markets. • Demonstration of the use of the proposed ontology between two multi-agents systems. • Strategic biding in electricity markets. • European electricity markets comparison. - Abstract: The electricity market restructuring, and its worldwide evolution into regional and even continental scales, along with the increasing necessity for an adequate integration of renewable energy sources, is resulting in a rising complexity in power systems operation. Several power system simulators have been developed in recent years with the purpose of helping operators, regulators, and involved players to understand and deal with this complex and constantly changing environment. The main contribution of this paper is given by the integration of several electricity market and power system models, respecting to the reality of different countries. This integration is done through the development of an upper ontology which integrates the essential concepts necessary to interpret all the available information. The continuous development of Multi-Agent System for Competitive Electricity Markets platform provides the means for the exemplification of the usefulness of this ontology. A case study using the proposed multi-agent platform is presented, considering a scenario based on real data that simulates the European Electricity Market environment, and comparing its performance using different market mechanisms. The main goal is to demonstrate the advantages that the integration of various market models and simulation platforms have for the study of the electricity markets’ evolution

Europol’s Cybercrime Centre (EC3), its Agreements with Third Parties and the Growing Role of Law Enforcement on the European Security Scene

DEFF Research Database (Denmark)

Vendius, Trine Thygesen

2015-01-01

The European Cyber Crime Centre, EC3, established under the umbrella of Europol, started operations on January 1 2013. It is to act as the focal point in the fight against cybercrime in the European Union. Using a “shared, cross-community approach” the EC3 is concluding partnerships with member...... states, European agencies, international partners and the private sector. This article describes the coming about of EC3 and its efforts to address cybercrime. Furthermore, the article is an attempt to assess the growing role of the European law enforcement community on the European security scene...

How European centres diagnose, treat, and prevent CIED infections

DEFF Research Database (Denmark)

Bongiorni, Maria Grazia; Marinskis, Germanas; Lip, Gregory Y H

2012-01-01

in most centres and is substantially under 2% in the majority of centres interviewed. However, there are still differences in terms of prophylactic antibiotic therapy: 8.9% of the centres administer oxacillin as preoperative treatment, 4.4% of them do not give any antibiotic therapy, all centres use some...

A multi-centre phase 3 study comparing efficacy and safety of Bemfola® versus Gonal-f® in women undergoing ovarian stimulation for IVF

DEFF Research Database (Denmark)

Rettenbacher, M; Andersen, A N; Garcia-Velasco, J A

2015-01-01

injection (n = 372) showed Bemfola yielding similar efficacy and safety profiles to Gonal-f. Women aged 20-38 years of age were randomized 2:1 to receive a single, daily, subcutaneous 150 IU dose of either Bemfola or Gonal-f. This study tested equivalence in the number of retrieved oocytes using a pre......Bemfola (follitropin alfa) (Finox AG, Switzerland), a new recombinant FSH, has a comparable pharmacological profile to that of Gonal-f (Merck Serono, Germany), the current standard for ovarian stimulation. A randomized, multi-centre, Phase 3 study in women undergoing IVF or intracytoplasmic sperm...

Multi-centre experience of implementing image-guided intensity-modulated radiotherapy using the TomoTherapy platform

International Nuclear Information System (INIS)

Dean, J.C.; Tudor, G.S.J.; Mott, J.H.; Dunlop, P.R.; Morris, S.L.; Harron, E.C.; Christian, J.A.; Sanghera, P.; Elsworthy, M.; Burnet, N.G.

2013-01-01

Use of image guided (IG) intensity modulated radiotherapy (IMRT) is increasing, and helical tomotherapy provides an effective, integrated solution. Practical experience of implementation, shared at a recent UK TomoTherapy Users' meeting, may help centres introducing these techniques using TomoTherapy or other platforms. Seven centres participated, with data shared from 6, varying from 2500 - 4800 new patients per year. Case selection of patients “most likely” to benefit from IG-IMRT was managed in all centres by multi-professional groups comprising clinical oncologists, physicists, treatment planners and radiographers. Radical treatments ranged from 94% to 100%. The proportions of tumour types varied substantially: head and neck: range 0%–100% (mean of centres 50%), prostate: 3%–96% (mean of centres 28%). Head and neck cases were considered most likely to benefit from IMRT, prostate cases from IGRT, or IG-IMRT if pelvic nodes were being treated. IMRT was also selected for complex target volumes, to avoid field junctions, for technical treatment difficulties, and retreatments. Across the centres, every patient was imaged every day, with positional correction before treatment. In one centre, for prostate patients including pelvic treatment, the pelvis was also imaged weekly. All centres had designed a ‘ramp up’ of patient numbers, which was similar in 5. One centre, treating 96% prostate patients, started with 3 and increased to 36 patients per day within 3 months. The variation in case mix implies wide applicability of IG-IMRT. Daily on-line IGRT with IMRT can be routinely implemented into busy departments

Current management of intracerebral haemorrhage in China: a national, multi-centre, hospital register study

Directory of Open Access Journals (Sweden)

Heeley Emma L

2011-01-01

Full Text Available Abstract Background We aimed to examine current practice of the management and secondary prevention of intracerebral haemorrhage (ICH in China where the disease is more common than in Western populations. Methods Data on baseline characteristics, management in-hospital and post-stroke, and outcome of ICH patients are from the ChinaQUEST (QUality Evaluation of Stroke Care and Treatment study, a multi-centre, prospective, 62 hospital registry in China during 2006-07. Results Nearly all ICH patients (n = 1572 received an intravenous haemodiluting agent such as mannitol (96% or a neuroprotectant (72%, and there was high use of intravenous traditional Chinese medicine (TCM (42%. Neurosurgery was undertaken in 137 (9% patients; being overweight, having a low Glasgow Coma Scale (GCS score on admission, and Total Anterior Circulation Syndrome (TACS clinical pattern on admission, were the only baseline factors associated with this intervention in multivariate analyses. Neurosurgery was associated with nearly three times higher risk of death/disability at 3 months post-stroke (odd ratio [OR] 2.60, p Conclusions The management of ICH in China is characterised by high rates of use of intravenous haemodiluting agents, neuroprotectants, and TCM, and of antihypertensives for secondary prevention. The controversial efficacy of these therapies, coupled with the current lack of treatments of proven benefit, is a call for action for more outcomes based research in ICH.

Multi-centre evaluation of recent troponin assays for the diagnosis of NSTEMI

Directory of Open Access Journals (Sweden)

Camille Chenevier-Gobeaux

2018-07-01

Full Text Available Objectives: We aimed to compare the use of nine different cardiac troponin (cTn assays (2 cTnT and 7 cTnI for the diagnosis of NSTEMI in a single multi-centre population. Design and methods: One hundred and fifty-eight patients were included (mean age 60 years, SD 17 years, including 23 patients (14% with NSTEMI. Results: The analytical comparison highlighted a large heterogeneity of cTn assays, as reflected by percentages of patients with detectable cTn, correlation coefficients, Passing-Bablok comparisons and concordance coefficients. Correlations within cTnI assays were good and correlation within cTnT assays was excellent. Diagnostic performances demonstrated that each cTn assay has specific threshold values. Furthermore, some assays (HS-cTnI and T, cTnI-Pathfast and cTnI-Centaur indicated high sensitivity and negative predictive value using the limit of detection (LoD diagnostic strategy. For the latter assays, a significant increase in specificity was found when using the 99th percentile or the H0-H3 strategies, in comparison to the LoD strategy. When applying the European Society of Cardiology H0-H3 algorithm, comparable diagnostic performances were obtained. Conclusion: All 9 cTn assays indicated overall good diagnostic performances for the diagnosis of NSTEMI in emergency departments when the recommended algorithm based on the variation of cTn value between two measurements at admission and 3 h later was used. Keywords: Cardiac troponin, High-sensitivity assay, Chest pain, Emergency department, NSTEMI, Analytical evaluation

Governing the energy challenge : Canada and Germany in a multi-level regional and global context

International Nuclear Information System (INIS)

Eberlein, B.; Doern, G.B.; Exeter Univ.,

2009-01-01

This book features essays by leading energy and public policy specialists from Canada and Germany. It originated in the Transatlantic Energy Conference which was hosted by the Canadian Centre for German and European Studies at Toronto's York University in September 2005. The conference was attended by leading energy scholars and experts from Canadian and European universities, research institutes and governmental and non-governmental organizations. The purpose of this book was to compare the dynamics of multi-level energy regulatory governance in Germany and Canada, notably the energy policy challenges that include energy security, environmental sustainability and a competitive resource economy. Many strategies to produce more efficient and sustainable energy are presented in the book. Part 1 of the book focuses on the energy industry, with particular emphasise on electricity, nuclear energy and natural gas. Part 2 of the book focuses on domestic patterns of multi-level energy governance and regulation in the two countries. As a member of the European Union, Germany is more advanced in dealing with multi-level governmental and sustainability constraints than Canada is as a member of the North American Free Trade Agreement (NAFTA). The book focuses on the influence that the energy sector and multi-level institutional arrangements have on energy governance, with particular attention to the link between environmental study, climate change issues and economic market reforms. The growing differences between NAFTA and European Union member countries were highlighted. refs., tabs., figs.

Sentinel European Node Trial (SENT)

DEFF Research Database (Denmark)

Schilling, Clare; Stoeckli, Sandro J; Haerle, Stephan K

2015-01-01

in patients with early-stage oral squamous cell carcinoma. METHODS: An European Organisation for Research and Treatment of Cancer-approved prospective, observational study commenced in 2005. Fourteen European centres recruited 415 patients with radiologically staged T1-T2N0 squamous cell carcinoma. SNB...

Design and baseline characteristics of the Food4Me study: a web-based randomised controlled trial of personalised nutrition in seven European countries.

Science.gov (United States)

Celis-Morales, Carlos; Livingstone, Katherine M; Marsaux, Cyril F M; Forster, Hannah; O'Donovan, Clare B; Woolhead, Clara; Macready, Anna L; Fallaize, Rosalind; Navas-Carretero, Santiago; San-Cristobal, Rodrigo; Kolossa, Silvia; Hartwig, Kai; Tsirigoti, Lydia; Lambrinou, Christina P; Moschonis, George; Godlewska, Magdalena; Surwiłło, Agnieszka; Grimaldi, Keith; Bouwman, Jildau; Daly, E J; Akujobi, Victor; O'Riordan, Rick; Hoonhout, Jettie; Claassen, Arjan; Hoeller, Ulrich; Gundersen, Thomas E; Kaland, Siv E; Matthews, John N S; Manios, Yannis; Traczyk, Iwona; Drevon, Christian A; Gibney, Eileen R; Brennan, Lorraine; Walsh, Marianne C; Lovegrove, Julie A; Alfredo Martinez, J; Saris, Wim H M; Daniel, Hannelore; Gibney, Mike; Mathers, John C

2015-01-01

Improving lifestyle behaviours has considerable potential for reducing the global burden of non-communicable diseases, promoting better health across the life-course and increasing well-being. However, realising this potential will require the development, testing and implementation of much more effective behaviour change interventions than are used conventionally. Therefore, the aim of this study was to conduct a multi-centre, web-based, proof-of-principle study of personalised nutrition (PN) to determine whether providing more personalised dietary advice leads to greater improvements in eating patterns and health outcomes compared to conventional population-based advice. A total of 5,562 volunteers were screened across seven European countries; the first 1,607 participants who fulfilled the inclusion criteria were recruited into the trial. Participants were randomly assigned to one of the following intervention groups for a 6-month period: Level 0-control group-receiving conventional, non-PN advice; Level 1-receiving PN advice based on dietary intake data alone; Level 2-receiving PN advice based on dietary intake and phenotypic data; and Level 3-receiving PN advice based on dietary intake, phenotypic and genotypic data. A total of 1,607 participants had a mean age of 39.8 years (ranging from 18 to 79 years). Of these participants, 60.9 % were women and 96.7 % were from white-European background. The mean BMI for all randomised participants was 25.5 kg m(-2), and 44.8 % of the participants had a BMI ≥ 25.0 kg m(-2). Food4Me is the first large multi-centre RCT of web-based PN. The main outcomes from the Food4Me study will be submitted for publication during 2015.

The group-based social skills training SOSTA-FRA in children and adolescents with high functioning autism spectrum disorder--study protocol of the randomised, multi-centre controlled SOSTA--net trial.

Science.gov (United States)

Freitag, Christine M; Cholemkery, Hannah; Elsuni, Leyla; Kroeger, Anne K; Bender, Stephan; Kunz, Cornelia Ursula; Kieser, Meinhard

2013-01-07

Group-based social skills training (SST) has repeatedly been recommended as treatment of choice in high-functioning autism spectrum disorder (HFASD). To date, no sufficiently powered randomised controlled trial has been performed to establish efficacy and safety of SST in children and adolescents with HFASD. In this randomised, multi-centre, controlled trial with 220 children and adolescents with HFASD it is hypothesized, that add-on group-based SST using the 12 weeks manualised SOSTA-FRA program will result in improved social responsiveness (measured by the parent rated social responsiveness scale, SRS) compared to treatment as usual (TAU). It is further expected, that parent and self reported anxiety and depressive symptoms will decline and pro-social behaviour will increase in the treatment group. A neurophysiological study in the Frankfurt HFASD subgroup will be performed pre- and post treatment to assess changes in neural function induced by SST versus TAU. The SOSTA - net trial is designed as a prospective, randomised, multi-centre, controlled trial with two parallel groups. The primary outcome is change in SRS score directly after the intervention and at 3 months follow-up. Several secondary outcome measures are also obtained. The target sample consists of 220 individuals with ASD, included at the six study centres. This study is currently one of the largest trials on SST in children and adolescents with HFASD worldwide. Compared to recent randomised controlled studies, our study shows several advantages with regard to in- and exclusion criteria, study methods, and the therapeutic approach chosen, which can be easily implemented in non-university-based clinical settings. ISRCTN94863788--SOSTA--net: Group-based social skills training in children and adolescents with high functioning autism spectrum disorder.

European trauma guideline compliance assessment: the ETRAUSS study.

Science.gov (United States)

Hamada, Sophie Rym; Gauss, Tobias; Pann, Jakob; Dünser, Martin; Leone, Marc; Duranteau, Jacques

2015-12-08

Haemorrhagic shock is the leading cause of preventable death in trauma patients. The 2013 European trauma guidelines emphasise a comprehensive, multidisciplinary, protocol-based approach to trauma care. The aim of the present Europe-wide survey was to compare 2015 practice with the 2013 guidelines. A group of members of the Trauma and Emergency Medicine section of the European Society of Intensive Care Medicine developed a 50-item questionnaire based upon the core recommendations of the 2013 guidelines, employing a multistep approach. The questionnaire covered five fields: care structure and organisation, haemodynamic resuscitation targets, fluid management, transfusion and coagulopathy, and haemorrhage control. The sampling used a two-step approach comprising initial purposive sampling of eminent trauma care providers in each European country, followed by snowball sampling of a maximum number of trauma care providers. A total of 296 responses were collected, 243 (81 %) from European countries. Those from outside the European Union were excluded from the analysis. Approximately three-fourths (74 %) of responders were working in a designated trauma centre. Blunt trauma predominated, accounting for more than 90 % of trauma cases. Considerable heterogeneity was observed in all five core aspects of trauma care, along with frequent deviations from the 2013 guidelines. Only 92 (38 %) of responders claimed to comply with the recommended systolic blood pressure target, and only 81 (33 %) responded that they complied with the target pressure in patients with traumatic brain injury. Crystalloid use was predominant (n = 209; 86 %), and vasopressor use was frequent (n = 171, 76 %) but remained controversial. Only 160 respondents (66 %) declared that they used tranexamic acid always or often. This is the first European trauma survey, to our knowledge. Heterogeneity is significant across centres with regard to the clinical protocols for trauma patients and as to locally

A European collaboration research programme to study and test large scale base isolated structures

International Nuclear Information System (INIS)

Renda, V.; Verzeletti, G.; Papa, L.

1995-01-01

The improvement of the technology of innovative anti-seismic mechanisms, as those for base isolation and energy dissipation, needs of testing capability for large scale models of structures integrated with these mechanisms. These kind experimental tests are of primary importance for the validation of design rules and the setting up of an advanced earthquake engineering for civil constructions of relevant interest. The Joint Research Centre of the European Commission offers the European Laboratory for Structural Assessment located at Ispra - Italy, as a focal point for an international european collaboration research programme to test large scale models of structure making use of innovative anti-seismic mechanisms. A collaboration contract, opened to other future contributions, has been signed with the national italian working group on seismic isolation (Gruppo di Lavoro sull's Isolamento Sismico GLIS) which includes the national research centre ENEA, the national electricity board ENEL, the industrial research centre ISMES and producer of isolators ALGA. (author). 3 figs

The group-based social skills training SOSTA-FRA in children and adolescents with high functioning autism spectrum disorder - study protocol of the randomised, multi-centre controlled SOSTA - net trial

Directory of Open Access Journals (Sweden)

Freitag Christine M

2013-01-01

Full Text Available Abstract Background Group-based social skills training (SST has repeatedly been recommended as treatment of choice in high-functioning autism spectrum disorder (HFASD. To date, no sufficiently powered randomised controlled trial has been performed to establish efficacy and safety of SST in children and adolescents with HFASD. In this randomised, multi-centre, controlled trial with 220 children and adolescents with HFASD it is hypothesized, that add-on group-based SST using the 12 weeks manualised SOSTA–FRA program will result in improved social responsiveness (measured by the parent rated social responsiveness scale, SRS compared to treatment as usual (TAU. It is further expected, that parent and self reported anxiety and depressive symptoms will decline and pro-social behaviour will increase in the treatment group. A neurophysiological study in the Frankfurt HFASD subgroup will be performed pre- and post treatment to assess changes in neural function induced by SST versus TAU. Methods/design The SOSTA – net trial is designed as a prospective, randomised, multi-centre, controlled trial with two parallel groups. The primary outcome is change in SRS score directly after the intervention and at 3 months follow-up. Several secondary outcome measures are also obtained. The target sample consists of 220 individuals with ASD, included at the six study centres. Discussion This study is currently one of the largest trials on SST in children and adolescents with HFASD worldwide. Compared to recent randomised controlled studies, our study shows several advantages with regard to in- and exclusion criteria, study methods, and the therapeutic approach chosen, which can be easily implemented in non-university-based clinical settings. Trial registration ISRCTN94863788 – SOSTA – net: Group-based social skills training in children and adolescents with high functioning autism spectrum disorder.

Labour Market Segmentation Revisited: A Study of the Dutch Call Centre Sector

OpenAIRE

de Grip, A.; Sieben, I.J.P.; van Jaarsveld, D.

2006-01-01

Employment in the call centre sector in the Netherlands, similar to the trend in other European countries, is expanding greatly. In 2001, Datamonitor (2002) estimated that 1,266 call centres were operating in the Netherlands. This number is expected to have risen to roughly 2,000 in 2006. An estimated 188,000 people work in this sector at the moment, representing 2.5% of the entire working population in the Netherlands. This represents the highest percentage in Europe with the exception of Ir...

The EFQM excellence model: European and Dutch experiences with the EFQM approach in health care. European Foundation for Quality Management.

Science.gov (United States)

Nabitz, U; Klazinga, N; Walburg, J

2000-06-01

One way to meet the challenges in creating a high performance organization in health care is the approach of the European Foundation for Quality Management (EFQM). The Foundation is in the tradition of the American Malcolm Baldrige Award and was initiated by the European Commission and 14 European multi-national organizations in 1988. The essence of the approach is the EFQM Model, which can be used as a self-assessment instrument on all levels of a health care organization and as an auditing instrument for the Quality Award. In 1999 the EFQM Model was revised but its principles remained the same. In The Netherlands many health care organizations apply the EFQM Model. In addition to improvement projects, peer review of professional practices, accreditation and certification, the EFQM Approach is used mainly as a framework for quality management and as a conceptualization for organizational excellence. The Dutch National Institute for Quality, the Instituut Nederlandse Kwaliteit, delivers training and supports self-assessment and runs the Dutch quality award programme. Two specific guidelines for health care organizations, 'Positioning and Improving' and 'Self-Assessment', have been developed and are used frequently. To illustrate the EFQM approach in The Netherlands, the improvement project of the Jellinek Centre is described. The Jellinek Centre conducted internal and external assessments and received in 1996, as the first health care organization, the Dutch Quality Prize.

A European multi-language initiative to make the general population aware of independent clinical research

DEFF Research Database (Denmark)

Mosconi, Paola; Antes, Gerd; Barbareschi, Giorgio

2016-01-01

2. An animated film about clinical trials, dubbed in the 23 official languages of the European Community, and an interactive tutorial 3. An inventory of resources, available in 23 languages, searchable by topic, author, and media type 4. Two educational games for young people, developed in six......BACKGROUND: The ECRAN (European Communication on Research Awareness Needs) project was initiated in 2012, with support from the European Commission, to improve public knowledge about the importance of independent, multinational, clinical trials in Europe. METHODS: Participants in the ECRAN...... materials and tools, making them freely available under a Creative Commons licence. RESULTS: The principal communication materials developed were: 1. A website ( http://ecranproject.eu ) in six languages, including a Media centre section to help journalists to disseminate information about the ECRAN project...

Commission of the european communities. Joint research centre. Petten Establishment. Annual Report 1977

International Nuclear Information System (INIS)

1977 marked the beginning of a new multiannual research programme for the European Commission's Joint research Centre. Regarding the exploitation of HFR (High Flux Reactor), the year was one of steady, on-schedule operation with high utilization, although this fell off slightly in the autumn due to overloading of our capsule project engineering team and manufacturing services. We are pleased to note that the HFR Users' Meeting, held in October, drew about 100 participants from Europe and America and demonstrated a lively interest in the Commission's materials testing reactor. Technical improvements to the plant are being examined as one means of maintaining or even increasing this interest in the 1980's. Following the wishes of the Council of Ministers, new Advisory Committees for Programme Management have been set up for all the Joint Research Centre's activities and those for HFR and High Temperature Materials Programmes have met at Petten. This latter Committee is entirely new to its task, the programme having been served until 1977 by a number of ad hoc meetings of national experts. The work of the Organic Chemistry Laboratory falls under the wings of the Community Reference Bureau Advisory Committee, who have met in Brussels and strongly encouraged the development of the activity

Multi-centre evaluation of mass spectrometric identification of anaerobic bacteria using the VITEK® MS system.

Science.gov (United States)

Garner, O; Mochon, A; Branda, J; Burnham, C-A; Bythrow, M; Ferraro, M; Ginocchio, C; Jennemann, R; Manji, R; Procop, G W; Richter, S; Rychert, J; Sercia, L; Westblade, L; Lewinski, M

2014-04-01

Accurate and timely identification of anaerobic bacteria is critical to successful treatment. Classic phenotypic methods for identification require long turnaround times and can exhibit poor species level identification. Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) is an identification method that can provide rapid identification of anaerobes. We present a multi-centre study assessing the clinical performance of the VITEK(®) MS in the identification of anaerobic bacteria. Five different test sites analysed a collection of 651 unique anaerobic isolates comprising 11 different genera. Multiple species were included for several of the genera. Briefly, anaerobic isolates were applied directly to a well of a target plate. Matrix solution (α-cyano-4-hydroxycinnamic acid) was added and allowed to dry. Mass spectra results were generated with the VITEK(®) MS, and the comparative spectral analysis and organism identification were determined using the VITEK(®) MS database 2.0. Results were confirmed by 16S rRNA gene sequencing. Of the 651 isolates analysed, 91.2% (594/651) exhibited the correct species identification. An additional eight isolates were correctly identified to genus level, raising the rate of identification to 92.5%. Genus-level identification consisted of Actinomyces, Bacteroides and Prevotella species. Fusobacterium nucleatum, Actinomyces neuii and Bacteroides uniformis were notable for an increased percentage of no-identification results compared with the other anaerobes tested. VITEK(®) MS identification of clinically relevant anaerobes is highly accurate and represents a dramatic improvement over other phenotypic methods in accuracy and turnaround time. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

A longitudinal, multi-level comparative study of quality and safety in European hospitals: the QUASER study protocol

Directory of Open Access Journals (Sweden)

Weggelaar Anne-Marie

2011-10-01

Full Text Available Abstract Background although there is a wealth of information available about quality improvement tools and techniques in healthcare there is little understanding about overcoming the challenges of day-to-day implementation in complex organisations like hospitals. The 'Quality and Safety in Europe by Research' (QUASER study will investigate how hospitals implement, spread and sustain quality improvement, including the difficulties they face and how they overcome them. The overall aim of the study is to explore relationships between the organisational and cultural characteristics of hospitals and how these impact on the quality of health care; the findings will be designed to help policy makers, payers and hospital managers understand the factors and processes that enable hospitals in Europe to achieve-and sustain-high quality services for their patients. Methods/design in-depth multi-level (macro, meso and micro-system analysis of healthcare quality policies and practices in 5 European countries, including longitudinal case studies in a purposive sample of 10 hospitals. The project design has three major features: • a working definition of quality comprising three components: clinical effectiveness, patient safety and patient experience • a conceptualisation of quality as a human, social, technical and organisational accomplishment • an emphasis on translational research that is evidence-based and seeks to provide strategic and practical guidance for hospital practitioners and health care policy makers in the European Union. Throughout the study we will adopt a mixed methods approach, including qualitative (in-depth, narrative-based, ethnographic case studies using interviews, and direct non-participant observation of organisational processes and quantitative research (secondary analysis of safety and quality data, for example: adverse incident reporting; patient complaints and claims. Discussion the protocol is based on the premise that

Turkey’s multi-polar diplomacy on its way to the European Union

Directory of Open Access Journals (Sweden)

Lika Mkrtchyan

2011-12-01

Full Text Available Turkey conducts a multi-polar foreign diplomacy in order to strengthen its positions in the region, to gain control over the neighboring countries; as well as to make its way towards the European Union. Being on the EU’s waiting list, Turkey strives to get advantages of its prolonged status as a candidate country

Multi-center study on the characteristics and treatment strategies of patients with Graves' orbitopathy: the first European Group on Graves' Orbitopathy experience

NARCIS (Netherlands)

Prummel, Mark F.; Bakker, Annemieke; Wiersinga, Wilmar M.; Baldeschi, Lelio; Mourits, Maarten P.; Kendall-Taylor, Pat; Perros, Petros; Neoh, Chris; Dickinson, A. Jane; Lazarus, John H.; Lane, Carol M.; Heufelder, Armin E.; Kahaly, George J.; Pitz, Suzanne; Orgiazzi, Jacques; Hullo, Alain; Pinchera, Aldo; Marcocci, Claudio; Sartini, Maria S.; Rocchi, Roberto; Nardi, Marco; Krassas, Gerry E.; Halkias, A.

2003-01-01

To improve management of patients with Graves' orbitopathy, a multi-center collaborative approach is necessary in order to have large enough sample sizes for meaningful randomized clinical trials. This is hampered by a lack of consensus on how to investigate the eye condition. The European Group on

Livestock-associated meticillin-resistant Staphylococcus aureus (MRSA) among human MRSA isolates, European Union/European Economic Area countries, 2013.

Science.gov (United States)

Kinross, Pete; Petersen, Andreas; Skov, Robert; Van Hauwermeiren, Evelyn; Pantosti, Annalisa; Laurent, Frédéric; Voss, Andreas; Kluytmans, Jan; Struelens, Marc J; Heuer, Ole; Monnet, Dominique L

2017-11-01

Currently, surveillance of livestock-associated meticillin-resistant Staphylococcus aureus (LA-MRSA) in humans in Europe is not systematic but mainly event-based. In September 2014, the European Centre for Disease Prevention and Control (ECDC) initiated a questionnaire to collect data on the number of LA-MRSA from human samples (one isolate per patient) from national/regional reference laboratories in European Union/European Economic Area (EU/EEA) countries in 2013. Identification of LA-MRSA as clonal complex (CC) 398 by multilocus sequence typing (MLST) was preferred, although surrogate methods such as spa -typing were also accepted. The questionnaire was returned by 28 laboratories in 27 EU/EEA countries. Overall, LA-MRSA represented 3.9% of 13,756 typed MRSA human isolates, but it represented ≥ 10% in five countries (Belgium, Denmark, Spain, the Netherlands and Slovenia). Seven of the reference laboratories did not type MRSA isolates in 2013. To monitor the dispersion of LA-MRSA and facilitate targeted control measures, we advocate periodic systematic surveys or integrated multi-sectorial surveillance.

Quality assurance network: The European pilot study

Energy Technology Data Exchange (ETDEWEB)

Chavaudra, J; Derreumaux, S; Brider, A [Institut Gustave Roussa, Villejuif (France). Service de Physique; Dutreix, A; Schueren, E van der [University Hospital, Leuven (Belgium)

1996-08-01

Based on the IAEA/WHO experience in mailed dosimetry, a Quality Assurance (QA) Network, sponsored by the EC committee ``Europe against Cancer``, has been set up in 1991 for all European centres. Besides a survey of radiotherapy infrastructure, the project includes three measurement steps: primarily, a check of beam output and quality in reference conditions with a mailed TLD-procedure, in a second step, the mailed verification of other beam data and dose calculation procedures with multipurpose phantom, and finally in vivo dosimetry at the individual patient levels with mailed dosimeters. The results concerning 162 beams from 85 centres are analysed (58 {sup 60}Co beams and 104 X-ray beams). 27 beams present minor deviations (3 to 6%) and 15 beams (4/58 {sup 60}Co beams and 11/104 X-ray beams) from 11 centres present major deviations ({>=} 6%). The analysis shows that 17/27 minor deviations and all major deviations have been detected in centres which have not benefited from an external check during the last five years; in 14 out of 15 large deviations, the measured dose is smaller than the stated dose. In most centres with major deviation, the physicists did not have the necessary experience and did not calibrate regularly the beams. In 6 centres out of 11 there was no dosimeter or the dosimeter available has not been calibrated recently. In 3 centres, the physicist did not give any explanations. The conclusions concerning the second step (multipurpose phantom), outline the larger magnitude of the deviations for off axis points, oblique surface and the use of wedge filters. (author). 32 refs, 7 figs, 2 tabs.

Quality assurance network: The European pilot study

International Nuclear Information System (INIS)

Chavaudra, J.; Derreumaux, S.; Brider, A.

1996-01-01

Based on the IAEA/WHO experience in mailed dosimetry, a Quality Assurance (QA) Network, sponsored by the EC committee ''Europe against Cancer'', has been set up in 1991 for all European centres. Besides a survey of radiotherapy infrastructure, the project includes three measurement steps: primarily, a check of beam output and quality in reference conditions with a mailed TLD-procedure, in a second step, the mailed verification of other beam data and dose calculation procedures with multipurpose phantom, and finally in vivo dosimetry at the individual patient levels with mailed dosimeters. The results concerning 162 beams from 85 centres are analysed (58 60 Co beams and 104 X-ray beams). 27 beams present minor deviations (3 to 6%) and 15 beams (4/58 60 Co beams and 11/104 X-ray beams) from 11 centres present major deviations (≥ 6%). The analysis shows that 17/27 minor deviations and all major deviations have been detected in centres which have not benefited from an external check during the last five years; in 14 out of 15 large deviations, the measured dose is smaller than the stated dose. In most centres with major deviation, the physicists did not have the necessary experience and did not calibrate regularly the beams. In 6 centres out of 11 there was no dosimeter or the dosimeter available has not been calibrated recently. In 3 centres, the physicist did not give any explanations. The conclusions concerning the second step (multipurpose phantom), outline the larger magnitude of the deviations for off axis points, oblique surface and the use of wedge filters. (author). 32 refs, 7 figs, 2 tabs

A double-edged sword!: The Dutch centre-right and the 'foreigners issue'

NARCIS (Netherlands)

van Kersbergen, C.J.; Krouwel, A.P.M.

2008-01-01

We study the impact of the 'foreigners issue' on centre-right politics in the Netherlands. This issue concerns a complex of problems related to migration, asylum-seekers, nationalism, multiculturalism and European integration. The Dutch centre-right has moved towards hard-line and restrictive

The Role of the Two Sides of Industry in Initial and Continuing Training. Documentation of the Conference Organized by the European Centre for the Development of Vocational Training (CEDEFOP) in Collaboration with the Commission of the European Communities and the Economic and Social Committee of the EC (Brussels, Belgium, November 8-9, 1988).

Science.gov (United States)

European Centre for the Development of Vocational Training, Berlin (West Germany).

This document reports the proceedings of a conference held in Brussels to take stock (on the basis of the studies conducted by the European Centre for the Development of Vocational Training and the analyses carried out in this field in all the European Community member states) of the work undertaken in the last few years and to present…

Rehabilitation of traumatic brain injury in Italy: a multi-centred study.

Science.gov (United States)

Zampolini, M; Zaccaria, B; Tolli, V; Frustaci, A; Franceschini, M

2012-01-01

The aims of this study were to analyse TBI rehabilitation in Italy, identifying the main factors conditioning motor and functional recovery and destination upon discharge of traumatic severe acquired brain injury (sABI) patients who had undergone intensive rehabilitative treatment. An observational prospective study of 863 consecutive patients admitted to 52 Rehabilitation Centres from January 2001 to December 2003. The main cause of trauma was road accidents (79.8%), the mean length of stay was 87.31 ± 77.26 days and 40.4% access to rehabilitation facilities after a month. Pressure sore rates fell from 26.1% to 6.6% during the rehabilitation programme. After discharge 615 patients returned home, whilst 212 were admitted to other health facilities. This study highlights some major criticisms of rehabilitation of TBI. The delay of admission and evitable complications such as pressure sores are correlated to a worse outcome. While LOS causes a problem of cost-effectiveness, the rate of home discharge is prevalent and very high compared with other studies.

Creating probabilistic maps of the face network in the adolescent brain: A multi-centre functional MRI study

International Nuclear Information System (INIS)

Tahmasebi, Amir M.; Mareckova, Klara; Artiges, Eric; Martinot, Jean-Luc; Banaschewski, Tobias; Barker, Gareth J.; Loth, Eva; Schumann, Gunter; Bruehl, Ruediger; Ittermann, Bernd; Buchel, Christian; Conrod, Patricia J.; Flor, Herta; Strohle, Andreas; Garavan, Hugh; Gallinat, Jurgen; Heinz, Andreas; Poline, Jean-Baptiste; Rietschel, Marcella; Smolka, Michael N.; Paus, Tomas

2012-01-01

Large-scale magnetic resonance (MR) studies of the human brain offer unique opportunities for identifying genetic and environmental factors shaping the human brain. Here, we describe a dataset collected in the context of a multi-centre study of the adolescent brain, namely the IMAGEN Study. We focus on one of the functional paradigms included in the project to probe the brain network underlying processing of ambiguous and angry faces. Using functional MR (fMRI) data collected in 1,110 adolescents, we constructed probabilistic maps of the neural network engaged consistently while viewing the ambiguous or angry faces; 21 brain regions responding to faces with high probability were identified. We were also able to address several methodological issues, including the minimal sample size yielding a stable location of a test region, namely the fusiform face area (FFA), as well as the effect of acquisition site (eight sites) and scanner (four manufacturers) on the location and magnitude of the fMRI response to faces in the FFA. Finally, we provided a comparison between male and female adolescents in terms of the effect sizes of sex differences in brain response to the ambiguous and angry faces in the 21 regions of interest. Overall, we found a stronger neural response to the ambiguous faces in several cortical regions, including the fusiform face area, in female (vs. male) adolescents, and a slightly stronger response to the angry faces in the amygdala of male (vs. female) adolescents. (authors)

European contribution to the study of ROS

DEFF Research Database (Denmark)

Egea, Javier; Fabregat, Isabel; Frapart, Yves M

2017-01-01

The European Cooperation in Science and Technology (COST) provides an ideal framework to establish multi-disciplinary research networks. COST Action BM1203 (EU-ROS) represents a consortium of researchers from different disciplines who are dedicated to providing new insights and tools for better u...

26th May 2011 -Delegate to CERN Open Council sessions and European Commission Head of Unit for Joint Programming European Research Area, DG Research and Innovation R. Lečbychová visiting the CERN Control Centre with M. Pojer, accompanied by CERN S. Stavrev.

CERN Multimedia

Maximilien Brice

2011-01-01

26th May 2011 -Delegate to CERN Open Council sessions and European Commission Head of Unit for Joint Programming European Research Area, DG Research and Innovation R. Lečbychová visiting the CERN Control Centre with M. Pojer, accompanied by CERN S. Stavrev.

The role of dosimetry audit in lung SBRT multi-centre clinical trials.

Science.gov (United States)

Clark, Catharine H; Hurkmans, Coen W; Kry, Stephen F

2017-12-01

Stereotactic Body Radiotherapy (SBRT) in the lung is a challenging technique which requires high quality clinical trials to answer the un-resolved clinical questions. Quality assurance of these clinical trials not only ensures the safety of the treatment of the participating patients but also minimises the variation in treatment, thus allowing the lowest number of patient treatments to answer the trial question. This review addresses the role of dosimetry audits in the quality assurance process and considers what can be done to ensure the highest accuracy of dose calculation and delivery and it's assessment in multi-centre trials. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Children's hand hygiene behaviour and available facilities: an observational study in Dutch day care centres.

Science.gov (United States)

van Beeck, A H Elise; Zomer, Tizza P; van Beeck, Eduard F; Richardus, Jan Hendrik; Voeten, Helene A C M; Erasmus, Vicki

2016-04-01

Children attending day care centres are at increased risk of infectious diseases, in particular gastrointestinal and respiratory infections. Hand hygiene of both caregivers and children is an effective prevention measure. This study examined hand hygiene behaviour of children attending day care centres, and describes hygiene facilities at day care centres. Data were collected at 115 Dutch day care centres, among 2318 children cared for by 231 caregivers (August to October 2010). Children's hand hygiene behaviour was observed and data on hand hygiene facilities of the day care centres collected by direct unobtrusive observation. National guidelines indicate hand hygiene is required before eating, after toilet use and after playing outside. Among 1930 observed hand hygiene opportunities for children, overall adherence to hand hygiene guidelines was 31% (95% CI: 29-33%). Adherence after both toilet use and playing outside was 48%. Hands were less frequently washed before eating, where guideline adherence was 15%. In 38% of the playrooms there was no soap within reach of children and 17% had no towel facilities. In over 40% of the playrooms, appropriate hand hygiene facilities for children were lacking. Adequate hand washing facilities were available for children in only half of the participating day care centres in our study and children washed their hands in only 15-48% of the occasions defined by official guidelines. More attention is needed to hand hygiene of children attending day care centres in the prevention of infectious diseases. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

The importance of agglomeration effects for distribution centres around Amsterdam Airport Schiphol

NARCIS (Netherlands)

Warffemius, P.; van der Hoorn, T.; Klaassen, H.

2010-01-01

Amsterdam Airport Schiphol is a main European airport and represents an important concentration of European distribution centres (EDCs). It is commonly assumed that distribution centres are attracted to the airport region because of its air transport services. However, if one considers economies of

Standard procedures for adults in accredited sleep medicine centres in Europe

DEFF Research Database (Denmark)

Fischer, Jürgen; Dogas, Zoran; Bassetti, Claudio L

2012-01-01

The present paper describes standardized procedures within clinical sleep medicine. As such, it is a continuation of the previously published European guidelines for the accreditation of sleep medicine centres and European guidelines for the certification of professionals in sleep medicine, aimed...... at creating standards of practice in European sleep medicine. It is also part of a broader action plan of the European Sleep Research Society, including the process of accreditation of sleep medicine centres and certification of sleep medicine experts, as well as publishing the Catalogue of Knowledge...... and Skills for sleep medicine experts (physicians, non-medical health care providers, nurses and technologists), which will be a basis for the development of relevant educational curricula. In the current paper, the standard operational procedures sleep medicine centres regarding the diagnostic...

European Analytical Column

DEFF Research Database (Denmark)

Karlberg, B.; Grasserbauer, M.; Andersen, Jens Enevold Thaulov

2009-01-01

for European analytical chemistry. During the period 2002–07, Professor Grasserbauer was Director of the Institute for Environment and Sustainability, Joint Research Centre of the European Commission (EC), Ispra, Italy. There is no doubt that many challenges exist at the present time for all of us representing...

Challenges in Constructing a Multi-dimensional European Job Quality Index

DEFF Research Database (Denmark)

Leschke, Janine; Watt, Andrew

2014-01-01

quality performances and the outcomes in six sub-dimensions of job quality and compare them with each other, across gender and over time. At the same time, the limitations of such a composite index need to be borne in mind. The most important challenges are the availability (over time), timeliness......There are few attempts to benchmark job quality in a multi-dimensional perspective across Europe. Against this background, we have created a synthetic job quality index (JQI) for the EU27 countries in an attempt to shed light on the question of how European countries compare with each other and how...... they are developing over time in terms of job quality. Taking account of the multi-faceted nature of job quality, the JQI is compiled on the basis of six sub-indices which cover the most important dimensions of job quality as identified in the literature. The paper addresses the methods used to construct the JQI...

The new European Hubble archive

Science.gov (United States)

De Marchi, Guido; Arevalo, Maria; Merin, Bruno

2016-01-01

The European Hubble Archive (hereafter eHST), hosted at ESA's European Space Astronomy Centre, has been released for public use in October 2015. The eHST is now fully integrated with the other ESA science archives to ensure long-term preservation of the Hubble data, consisting of more than 1 million observations from 10 different scientific instruments. The public HST data, the Hubble Legacy Archive, and the high-level science data products are now all available to scientists through a single, carefully designed and user friendly web interface. In this talk, I will show how the the eHST can help boost archival research, including how to search on sources in the field of view thanks to precise footprints projected onto the sky, how to obtain enhanced previews of imaging data and interactive spectral plots, and how to directly link observations with already published papers. To maximise the scientific exploitation of Hubble's data, the eHST offers connectivity to virtual observatory tools, easily integrates with the recently released Hubble Source Catalog, and is fully accessible through ESA's archives multi-mission interface.

Water reactor fuel research at the Joint Research Centre of the Commission of the European Union

Energy Technology Data Exchange (ETDEWEB)

Markgraf, J [HFR Unit, Inst. for Advanced Materials, Petten (Netherlands)

1997-12-01

The JRC programmes 1995-1998 are in progress within 8 JRC Institutes located within different research centres situated in five member states of the European Union. Except for the area of reactor safety and waste management, there are no JRC research programmes related to water reactor fuel directly. However, the JRC is providing support on basis of contracts and cooperations to bilateral and international R and D programmes through access to its large test facilities like the High Flux Reactor at the JRC Petten and the hot cell facilities of the Transuranium Institute at the JRC Karlsruhe. Access is available to customers from all over the world. 3 tabs.

Multi-technology control centre to integrate 460 MW renewables

International Nuclear Information System (INIS)

2016-01-01

The new RWE Innogy Aersa Control Centre that has been certified to act as an interface with CECRE (the Renewable Energy Control Centre) since February 2015, connects RWE’s 20 renewable energy facilities with REE, the Spanish Electricity Grid. As a result, it ensures that wind farms, in addition to hydropower and solar plants, can inject the energy generated by its 460 MW installed safely and with no penalties. Green Eagle Solutions, a provider of software solutions for renewable energy companies, has collaborated with RWE in the development of this Control Centre, meeting the high standards of quality and safety required by RWE. This centre uses CompactSCADA® technology to integrate power generation facilities that need to be integrated in a Control Centre to communicate with REE’s CECRE. (Author)

Multi-criteria decision analysis for bioenergy in the Centre Region of Portugal

Science.gov (United States)

Esteves, T. C. J.; Cabral, P.; Ferreira, A. J. D.; Teixeira, J. C.

2012-04-01

With the consumption of fossil fuels, the resources essential to Man's survival are being rapidly contaminated. A sustainable future may be achieved by the use of renewable energies, allowing countries without non-renewable energy resources to guarantee energetic sovereignty. Using bioenergy may mean a steep reduction and/or elimination of the external dependency, enhancing the countries' capital and potentially reducing of the negative effects that outcome from the use of fossil fuels, such as loss of biodiversity, air, water, and soil pollution, … This work's main focus is to increase bioenergy use in the centre region of Portugal by allying R&D to facilitate determination of bioenergy availability and distribution throughout the study area.This analysis is essential, given that nowadays this knowledge is still very limited in the study area. Geographic Information Systems (GIS) was the main tool used to asses this study, due to its unseeingly ability to integrate various types of information (such as alphanumerical, statistical, geographical, …) and various sources of biomass (forest, agricultural, husbandry, municipal and industrial residues, shrublands, used vegetable oil and energy crops) to determine the bioenergy potential of the study area, as well as their spatial distribution. By allying GIS with multi-criteria decision analysis, the initial table-like information of difficult comprehension is transformed into tangible and easy to read results: both intermediate and final results of the created models will facilitate the decision making process. General results show that the major contributors for the bioenergy potential in the Centre Region of Portugal are forest residues, which are mostly located in the inner region of the study area. However, a more detailed analysis should be made to analyze the viability to use energy crops. As a main conclusion, we can say that, although this region may not use only this type of energy to be completely

Multi-scale analysis of the European airspace using network community detection.

Directory of Open Access Journals (Sweden)

Gérald Gurtner

Full Text Available We show that the European airspace can be represented as a multi-scale traffic network whose nodes are airports, sectors, or navigation points and links are defined and weighted according to the traffic of flights between the nodes. By using a unique database of the air traffic in the European airspace, we investigate the architecture of these networks with a special emphasis on their community structure. We propose that unsupervised network community detection algorithms can be used to monitor the current use of the airspace and improve it by guiding the design of new ones. Specifically, we compare the performance of several community detection algorithms, both with fixed and variable resolution, and also by using a null model which takes into account the spatial distance between nodes, and we discuss their ability to find communities that could be used to define new control units of the airspace.

Free and Open Source Software underpinning the European Forest Data Centre

Science.gov (United States)

Rodriguez Aseretto, Dario; Di Leo, Margherita; de Rigo, Daniele; Corti, Paolo; McInerney, Daniel; Camia, Andrea; San-Miguel-Ayanz, Jesús

2013-04-01

Worldwide, governments are growingly focusing [1] on free and open source software (FOSS) as a move toward transparency and the freedom to run, copy, study, change and improve the software [2]. The European Commission (EC) is also supporting the development of FOSS (see e.g., [3]). In addition to the financial savings, FOSS contributes to scientific knowledge freedom in computational science (CS) [4] and is increasingly rewarded in the science-policy interface within the emerging paradigm of open science [5-8]. Since complex computational science applications may be affected by software uncertainty [4,9-11], FOSS may help to mitigate part of the impact of software errors by CS community-driven open review, correction and evolution of scientific code [10,12-15]. The continental scale of EC science-based policy support implies wide networks of scientific collaboration. Thematic information systems also may benefit from this approach within reproducible [16] integrated modelling [4]. This is supported by the EC strategy on FOSS: "for the development of new information systems, where deployment is foreseen by parties outside of the EC infrastructure, [F]OSS will be the preferred choice and in any case used whenever possible" [17]. The aim of this contribution is to highlight how a continental scale information system may exploit and integrate FOSS technologies within the transdisciplinary research underpinning such a complex system. A European example is discussed where FOSS innervates both the structure of the information system itself and the inherent transdisciplinary research for modelling the data and information which constitute the system content. The information system. The European Forest Data Centre (EFDAC, http://forest.jrc.ec.europa.eu/efdac/) has been established at the EC Joint Research Centre (JRC) as the focal point for forest data and information in Europe to supply European decision-makers with processed, quality checked and timely policy relevant

Multi-criteria correlation of tephra deposits to source centres applied in the Auckland Volcanic Field, New Zealand

Science.gov (United States)

Hopkins, Jenni L.; Wilson, Colin J. N.; Millet, Marc-Alban; Leonard, Graham S.; Timm, Christian; McGee, Lucy E.; Smith, Ian E. M.; Smith, Euan G. C.

2017-07-01

Linking tephras back to their source centre(s) in volcanic fields is crucial not only to reconstruct the eruptive history of the volcanic field but also to understand tephra dispersal patterns and thus the potential hazards posed by a future eruption. Here we present a multi-disciplinary approach to correlate distal basaltic tephra deposits from the Auckland Volcanic Field (AVF) to their source centres using proximal whole-rock geochemical signatures. In order to achieve these correlations, major and trace element tephra-derived glass compositions are compared with published and newly obtained whole-rock geochemical data for the entire field. The results show that incompatible trace element ratios (e.g. (Gd/Yb)N, (La/Yb)N, (Zr/Yb)N) vary widely across the AVF (e.g. (La/Yb)N = 5 to 40) but show a more restricted range within samples from a single volcanic centre (e.g. (La/Yb)N = 5 to 10). These ratios are also the least affected by fractional crystallisation and are therefore the most appropriate geochemical tools for correlation between tephra and whole-rock samples. However, findings for the AVF suggest that each volcanic centre does not have a unique geochemical signature in the field as a whole, thus preventing unambiguous correlation of tephras to source centre using geochemistry alone. A number of additional criteria are therefore combined to further constrain the source centres of the distal tephras including age, eruption scale, and location (of centres, and sites where tephra were sampled). The combination of tephrostratigraphy, 40Ar/39Ar dating and morphostratigraphic constraints allow, for the first time, the relative and absolute ordering of 48 of 53 volcanic centres of the Auckland Volcanic Field to be resolved. Eruption frequencies are shown to vary between 0.13 and 1.5 eruptions/kyr and repose periods between individual eruptions vary from <0.1 to 13 kyr, with 23 of the 48 centres shown to have pre-eruptive repose periods of <1000 years. No spatial

A validation of the first genome-wide association study of calcaneus ultrasound parameters in the European Male Ageing Study

Directory of Open Access Journals (Sweden)

Han Thang S

2011-01-01

Full Text Available Abstract Background A number of single nucleotide polymorphisms (SNPs have been associated with broadband ultrasound attenuation (BUA and speed of sound (SOS as measured by quantitative ultrasound (QUS at the calcaneus in the Framingham 100K genome-wide association study (GWAS but have not been validated in independent studies. The aim of this analysis was to determine if these SNPs are associated with QUS measurements assessed in a large independent population of European middle-aged and elderly men. The association between these SNPs and bone mineral density (BMD measured using dual-energy X-ray absorptiometry (DXA was also tested. Methods Men aged 40-79 years (N = 2960 were recruited from population registers in seven European centres for participation in an observational study of male ageing, the European Male Ageing Study (EMAS. QUS at the calcaneus was measured in all subjects and blood was taken for genetic analysis. Lumbar spine (LS, femoral neck (FN and total hip (TH BMD were measured by DXA in a subsample of 620 men in two centres. SNPs associated with BUA or SOS in the Framingham study with p -4 were selected and genotyped using SEQUENOM technology. Linear regression was used to test for the association between SNPs and standardised (SD bone outcomes under an additive genetic model adjusting for centre. The same direction of effect and p Results Thirty-four of 38 selected SNPs were successfully genotyped in 2377 men. Suggestive evidence of replication was observed for a single SNP, rs3754032, which was associated with a higher SOS (β(SD = 0.07, p = 0.032 but not BUA (β(SD = 0.02, p = 0.505 and is located in the 3'UTR of WDR77 (WD repeat domain 77 also known as androgen receptor cofactor p44. A single SNP, rs238358, was associated with BMD at the LS (β(SD = -0.22, p = 0.014, FN (β(SD = -0.31,p = 0.001 and TH (β(SD = -0.36, p = 0.002 in a locus previously associated with LS BMD in large-scale GWAS, incorporating AKAP11 and RANKL

Introduction to Special Issue "Gender, Culture and Alcohol Problems: A Multi-national Study

DEFF Research Database (Denmark)

Bloomfield, Kim; Gmel, Gerhard; Wilsnack, Sharon

2006-01-01

This paper provides an introduction to a series of articles reporting results from the EU concerted action "Gender, Culture and Alcohol Problems: A Multi-national Study" which examined differences in drinking among women and men in 13 European and two non-European countries. The gender gap...... analyses the smallest gender differences in drinking behaviour were found in Nordic countries, followed by western and central European countries, with the largest gender differences in countries with developing economies....

Multi-port versus single-port cholecystectomy: results of a multi-centre, randomised controlled trial (MUSIC trial).

Science.gov (United States)

Arezzo, Alberto; Passera, Roberto; Bullano, Alberto; Mintz, Yoav; Kedar, Asaf; Boni, Luigi; Cassinotti, Elisa; Rosati, Riccardo; Fumagalli Romario, Uberto; Sorrentino, Mario; Brizzolari, Marco; Di Lorenzo, Nicola; Gaspari, Achille Lucio; Andreone, Dario; De Stefani, Elena; Navarra, Giuseppe; Lazzara, Salvatore; Degiuli, Maurizio; Shishin, Kirill; Khatkov, Igor; Kazakov, Ivan; Schrittwieser, Rudolf; Carus, Thomas; Corradi, Alessio; Sitzman, Guenther; Lacy, Antonio; Uranues, Selman; Szold, Amir; Morino, Mario

2017-07-01

Single-port laparoscopic surgery as an alternative to conventional laparoscopic cholecystectomy for benign disease has not yet been accepted as a standard procedure. The aim of the multi-port versus single-port cholecystectomy trial was to compare morbidity rates after single-access (SPC) and standard laparoscopy (MPC). This non-inferiority phase 3 trial was conducted at 20 hospital surgical departments in six countries. At each centre, patients were randomly assigned to undergo either SPC or MPC. The primary outcome was overall morbidity within 60 days after surgery. Analysis was by intention to treat. The study was registered with ClinicalTrials.gov (NCT01104727). The study was conducted between April 2011 and May 2015. A total of 600 patients were randomly assigned to receive either SPC (n = 297) or MPC (n = 303) and were eligible for data analysis. Postsurgical complications within 60 days were recorded in 13 patients (4.7 %) in the SPC group and in 16 (6.1 %) in the MPC group (P = 0.468); however, single-access procedures took longer [70 min (range 25-265) vs. 55 min (range 22-185); P risk of incisional hernia following SPC do not appear to be justified. Patient satisfaction with aesthetic results was greater after SPC than after MPC.

p-Phenylenediamine sensitization is more prevalent in central and southern European patch test centres than in Scandinavian: results from a multicentre study

DEFF Research Database (Denmark)

Thyssen, Jacob Pontoppidan; Andersen, Klaus Ejner; Bruze, Magnus

2009-01-01

BACKGROUND: Positive patch test reactions to p-phenylenediamine (PPD) are common. PPD is used in oxidative hair dyes and is also present in dark henna temporary 'tattoos'. Cross-sensitization to other contact allergens may occur. Because subjects sensitized to PPD are at risk of clinically severe...... reactions upon hair dyeing, there is a need for 'current' prevalence data on PPD sensitization. OBJECTIVES: To compare PPD patch test results from dermatitis patients tested between 2003 and 2007 in 10 European patch test centres and to analyse the causes and determine relevance of positive PPD patch test...... reactions. MATERIALS: Patch testing was performed using PPD (1% free base in petrolatum from Trolab (Almirall Hermal GmbH, Reinbeck, Germany) or Chemotechnique (Malmö, Sweden), equivalent to 0.090 mg/cm(2) in the TRUE test from MEKOS Laboratories AS). Statistical analysis was performed using the chi...

Attachment Styles of Dermatological Patients in Europe: A Multi-centre Study in 13 Countries.

Science.gov (United States)

Szabó, Csanád; Altmayer, Anita; Lien, Lars; Poot, Françoise; Gieler, Uwe; Tomas-Aragones, Lucía; Kupfer, Jörg; Jemec, Gregor B E; Misery, Laurent; Linder, M Dennis; Sampogna, Francesca; van Middendorp, Henriët; Halvorsen, Jon Anders; Balieva, Flora; Szepietowski, Jacek C; Romanov, Dmitry; Marron, Servando E; Altunay, Ilknur K; Finlay, Andrew Y; Salek, Sam S; Dalgard, Florence

2017-07-06

Attachment styles of dermatological outpatients and satisfaction with their dermatologists were investigated within the framework of a multicentre study conducted in 13 European countries, organized by the European Society for Dermatology and Psychiatry. Attachment style was assessed with the Adult Attachment Scale. Patient satisfaction with the dermatologist was assessed with an 11-degree scale. A total of 3,635 adult outpatients and 1,359 controls participated in the study. Dermatological outpatients were less able to depend on others, were less comfortable with closeness and intimacy, and experienced similar rates of anxiety in relationships as did the controls. Participants who had secure attachment styles reported stressful life events during the last 6 months significantly less often than those who had insecure attachment styles. Patients with secure attachment styles tended to be more satisfied with their dermatologist than did insecure patients. These results suggest that secure attachment of dermatological outpatients may be a protective factor in the management of stress.

Defining and describing birth centres in the Netherlands - a component study of the Dutch Birth Centre Study.

Science.gov (United States)

Hermus, M A A; Boesveld, I C; Hitzert, M; Franx, A; de Graaf, J P; Steegers, E A P; Wiegers, T A; van der Pal-de Bruin, K M

2017-07-03

During the last decade, a rapid increase of birth locations for low-risk births, other than conventional obstetric units, has been seen in the Netherlands. Internationally some of such locations are called birth centres. The varying international definitions for birth centres are not directly applicable for use within the Dutch obstetric system. A standard definition for a birth centre in the Netherlands is lacking. This study aimed to develop a definition of birth centres for use in the Netherlands, to identify these centres and to describe their characteristics. International definitions of birth centres were analysed to find common descriptions. In July 2013 the Dutch Birth Centre Questionnaire was sent to 46 selected Dutch birth locations that might qualify as birth centre. Questions included: location, reason for establishment, women served, philosophies, facilities that support physiological birth, hotel-facilities, management, environment and transfer procedures in case of referral. Birth centres were visited to confirm the findings from the Dutch Birth Centre Questionnaire and to measure distance and time in case of referral to obstetric care. From all 46 birth locations the questionnaires were received. Based on this information a Dutch definition of a birth centre was constructed. This definition reads: "Birth centres are midwifery-managed locations that offer care to low risk women during labour and birth. They have a homelike environment and provide facilities to support physiological birth. Community midwives take primary professional responsibility for care. In case of referral the obstetric caregiver takes over the professional responsibility of care." Of the 46 selected birth locations 23 fulfilled this definition. Three types of birth centres were distinguished based on their location in relation to the nearest obstetric unit: freestanding (n = 3), alongside (n = 14) and on-site (n = 6). Transfer in case of referral was necessary for all

The Usher lifestyle survey: maintaining independence: a multi-centre study.

Science.gov (United States)

Damen, Godelieve W J A; Krabbe, Paul F M; Kilsby, M; Mylanus, Emmanuel A M

2005-12-01

Patients with Usher syndrome face a special set of challenges in order to maintain their independence when their sight and hearing worsen. Three different types of Usher (I, II and III) are distinguished by differences in onset, progression and severity of hearing loss, and by the presence or absence of balance problems. In this study 93 Usher patients from seven European countries filled out a questionnaire on maintaining independence (60 patients type I, 25 patients type II, four patients type III and four patients type unknown). Results of Usher type I and II patients are presented. Following the Nordic definition of maintaining independence in deaf-blindness, three domains are investigated: access to information, communication and mobility. Research variables in this study are: age and type of Usher, considered hearing loss- and the number of retinitis pigmentosa-related sight problems. Usher type I patients tend to need more help than Usher type II patients and the amount of help that they need grows when patients get older or when considered hearing loss worsens. No patterns in results were seen for the number of retinitis pigmentosa related sight problems.

Zgaga, P., Teichler, U., & Brennan, J. (Eds.) (2012). The globalisation challenge for European higher education / Convergence and Diversity, Centres and Peripheries. Frankfurt/M.: Peter Lang. [Book review

OpenAIRE

Strajn, Darko

2013-01-01

Book review of: Zgaga, P., Teichler, U., & Brennan, J. (Eds.) (2012). The globalisation challenge for European higher education / Convergence and Diversity, Centres and Peripheries. Frankfurt/M.: Peter Lang. 389 pp., ISBN 978-3-631- 6398-5.

Laser-assisted lead extraction: the European experience.

Science.gov (United States)

Kennergren, C; Bucknall, C A; Butter, C; Charles, R; Fuhrer, J; Grosfeld, M; Tavernier, R; Morgado, T B; Mortensen, P; Paul, V; Richter, P; Schwartz, T; Wellens, F

2007-08-01

The aim of this study is to investigate the safety and effectiveness of Excimer laser-assisted lead extraction in Europe. The final European multi-centre study experience is presented. The Excimer is a cool cutting laser (50 degrees C) with a wavelength of 308 nm. The energy is emitted from the tip of a flexible sheath and is absorbed by proteins and lipids, 64% of the energy is absorbed at a tissue depth of 0.06 mm. The sheath is positioned over the lead, and the fibrosis surrounding the lead is vaporized while advancing the sheath without damaging other leads. From August 1996 to March 2001, 383 leads (170 atrial, 213 ventricular) in 292 patients (mean age 61.6 years, range 13-96) were extracted at 14 European centres. Mean implantation time was 74 months (3-358). Most frequent indications were pocket infection (26%), non-functional leads (21%), patient morbidity (21%), septicaemia or endocarditis (14%), erosion (5%), and lead interference (8%). Median extraction time was 15 min (1-300). Complete extraction was achieved in 90.9% of the leads and partial extraction in 3.4%. Extraction failed in 5.7% of the leads. Major complications = perforations caused 10/22 (3.4/5.7%) of the failures. Most partially extracted patients were considered clinically successful, as only minor lead parts without clinical significance were left. Femoral non-laser technique was used to remove 8/12 of the non-complication failures. The total complication rate, including five minor complications (1.7%), was 5.1%. No in-hospital mortality occurred. Pacing and implantable cardioverter-defibrillator leads can safely, effectively, and predictably be extracted. Open-heart extractions can be limited to special cases. The results indicate that the traditional policy of abandoning redundant leads, instead of removing them, may be obsolete in many patients.

Floor heating in the multi-functional centre `Gelderhorst` in Ede, Netherlands; De Gelderhorst slaat bouwfase over

Energy Technology Data Exchange (ETDEWEB)

Wondergem, J. [Wondergem Intermedium, Weesp (Netherlands)

1997-11-01

The Gelderhorst is a multi-functional centre for elderly, deaf people. Building systems are installed normally after the rough building structure is finished. In the building process of Gelderhorst the floor heating is installed in a pre-phase of the construction of the building. Thereto, the cooperation between the installation company, the manufacturer, the wholesale business and the contractor had to be well planned. Also, problems had to be solved with respect to the choice of building materials and installation techniques. 4 ills.

First steps towards a European atlas of natural radiation: status of the European indoor radon map

International Nuclear Information System (INIS)

Dubois, G.; Bossew, P.; Tollefsen, T.; De Cort, M.

2010-01-01

Within the context of its institutional scientific support to the European Commission, in 2005 the Radioactivity Environmental Monitoring (REM) group at the Joint Research Centre of the European Commission, started to explore the possibility of mapping indoor radon in European houses as a first step towards preparing a European Atlas of Natural Radiations. The main objective of such an atlas is to contribute to familiarizing the public with its naturally radioactive environment. The process of preparing the atlas should also provide the scientific community with a database of information that can be used for further studies and for highlighting regions with elevated levels of natural radiation. This document presents the status of the European indoor radon (Rn) map, first statistical results, and outlines of forthcoming challenges.

The impact of ERP on supply chain management: exploratory findings from a European Delphi study

NARCIS (Netherlands)

Akkermans, H.A.; Bogerd, P.; Yücesan, E.; Wassenhove, van L.N.

2003-01-01

This article presents results from a Delphi study on the future impact of enterprise resource planning (ERP) systems on supply chain management (SCM). The Delphi study was conducted with 23 Dutch supply chain executives of European multi-nationals. Findings from this exploratory study were

Influence of quality of care and individual patient characteristics on quality of life and return to work in survivors of the acute respiratory distress syndrome: protocol for a prospective, observational, multi-centre patient cohort study (DACAPO).

Science.gov (United States)

Brandstetter, Susanne; Dodoo-Schittko, Frank; Blecha, Sebastian; Sebök, Philipp; Thomann-Hackner, Kathrin; Quintel, Michael; Weber-Carstens, Steffen; Bein, Thomas; Apfelbacher, Christian

2015-12-17

Health-related quality of life (HRQoL) and return to work are important outcomes in critical care medicine, reaching beyond mortality. Little is known on factors predictive of HRQoL and return to work in critical illness, including the acute respiratory distress syndrome (ARDS), and no evidence exists on the role of quality of care (QoC) for outcomes in survivors of ARDS. It is the aim of the DACAPO study ("Surviving ARDS: the influence of QoC and individual patient characteristics on quality of life") to investigate the role of QoC and individual patient characteristics on quality of life and return to work. A prospective, observational, multi-centre patient cohort study will be performed in Germany, using hospitals from the "ARDS Network Germany" as the main recruiting centres. It is envisaged to recruit 2400 patients into the DACAPO study and to analyse a study population of 1500 survivors. They will be followed up until 12 months after discharge from hospital. QoC will be assessed as process quality, structural quality and volume at the institutional level. The main outcomes (HRQoL and return to work) will be assessed by self-report questionnaires. Further data collection includes general medical and ARDS-related characteristics of patients as well as sociodemographic and psycho-social parameters. Multilevel hierarchical modelling will be performed to analyse the effects of QoC and individual patient characteristics on outcomes, taking the cluster structure of the data into account. By obtaining comprehensive data at patient and hospital level using a prospective multi-centre design, the DACAPO-study is the first study investigating the influence of QoC on individual outcomes of ARDS survivors.

Transparency about net neutrality : A translation of the new European rules into a multi-stakeholder model

NARCIS (Netherlands)

Nooren, P.; Prins, M.J.

2011-01-01

The new European framework directive contains a number of policy objectives in the area of net neutrality. In support of these objectives, the universal service directive includes a transparency obligation for ISPs. This paper proposes a multi-stakeholder model for the implementation of this

Burnout, psychological morbidity and use of coping mechanisms among palliative care practitioners: A multi-centre cross-sectional study.

Science.gov (United States)

Koh, Mervyn Yong Hwang; Chong, Poh Heng; Neo, Patricia Soek Hui; Ong, Yew Jin; Yong, Woon Chai; Ong, Wah Ying; Shen, Mira Li Juan; Hum, Allyn Yin Mei

2015-07-01

The prevalence of burnout, psychological morbidity and the use of coping mechanisms among palliative care practitioners in Singapore have not been studied. We aimed to study the prevalence of burnout and psychological morbidity among palliative care practitioners in Singapore and its associations with demographic and workplace factors as well as the use of coping mechanisms. This was a multi-centre, cross-sectional study of all the palliative care providers within the public healthcare sector in Singapore. The study was conducted in hospital palliative care services, home hospice and inpatient hospices in Singapore. The participants were doctors, nurses and social workers. The prevalence of burnout among respondents in our study was 91 of 273 (33.3%) and psychological morbidity was 77 (28.2%). Working >60 h per week was significantly associated with burnout (odds ratio: 9.02, 95% confidence interval: 2.3-35.8, p = 0.002) and psychological morbidity (odds ratio: 7.21, 95% confidence interval: 1.8-28.8, p = 0.005). Home hospice care practitioners (41.5%) were more at risk of developing psychological morbidity compared to hospital-based palliative care (17.5%) or hospice inpatient care (26.0%) (p = 0.007). Coping mechanisms like physical well-being, clinical variety, setting boundaries, transcendental (meditation and quiet reflection), passion for one's work, realistic expectations, remembering patients and organisational activities were associated with less burnout. Our results reveal that burnout and psychological morbidity are significant in the palliative care community and demonstrate a need to look at managing long working hours and promoting the use of coping mechanisms to reduce burnout and psychological morbidity. © The Author(s) 2015.

Local epidemiology and resistance profiles in acute uncomplicated cystitis (AUC) in women: a prospective cohort study in an urban urological ambulatory setting.

Science.gov (United States)

Seitz, Michael; Stief, Christian; Waidelich, Raphaela

2017-10-16

Acute uncomplicated cystitis (AUC) is a common ailment in the urological setting. Guidelines for urinary tract infections are based on large-scale multi-centre, epidemiological and international studies. The objective of this observational study was to establish whether the results of a multi-centre study on the resistance profile of Escherichia coli (E. coli) in patients with AUC could be directly applied to an urological practice in a major European city or whether there are divergences in the resistance profile. An observational study was applied prospectively to 502 patients with AUC between January 2015 and January 2017). Personal data were anonymised. Exclusion criteria were the patient's age (AUC should therefore only be treated with TRS, CIP and AMC after a susceptibility test has been carried out.

Centre for urban ecotechnology in ``Oeksnehallen``

Energy Technology Data Exchange (ETDEWEB)

1992-03-01

The Lord Mayor`s Department of the municipality of Copenhagen, Denmark, has with support from this project made a proposal for the establishment of the Centre for Urban Ecotechnology in ``Oeksnehallen``, located in the Vesterbro area of the city. The centre should contribute to the dissemination of knowledge on ecological techniques (regarding passive solar energy etc.) to the inhabitants of Vesterbro and other citizens of Copenhagen, and also serve as a centre in an European context. The ecological demonstration centre will cover an area of two thousand square meters and will also include a cafe, a room for showing coloured slides, facilities for exhibitions created by the center and interested firms etc. The centre should play an important role as part of the ecological concept of urban renewal in Vesterbro. (author).

Nuclear research and development in the European community

International Nuclear Information System (INIS)

1979-01-01

Research programmes undertaken by the European Atomic Energy Community and the European Economic Community are discussed. These programmes are carried out both at the Communities own Joint Research Centres (at Ispra, Karlsruhe, Geel and Petten) and also, although centrally managed by the Commission, at research organizations in the Member States. Such research projects include radioactive waste management and storage, decommissioning of nuclear power stations and nuclear fusion. Culham Laboratory is not only the centre for the UKAEA's research into controlled thermonuclear fusion but is also host to the Joint European Torus Joint Undertaking. (U.K.)

RESEARCH ON PROBLEMS WITH PROJECTS AND PARTNERSHIPS THAT PUBLIC INSTITUTIONS IN THE CENTRE REGION FACED IN ACCESSING EUROPEAN FUNDS

Directory of Open Access Journals (Sweden)

DUMITRASCU DANUT

2012-12-01

Full Text Available European project management is the main filed of the article. Assuming a connection between the degree of absorption of European funds and the degree of maturity of the Romanian society in terms of project management, the article seeks to identify the negative factors on accessing and carrying out European projects. The identified problem is a low degree of absorption of European funds in Romania, and the main objective of the research is to identify the problems faced by the public institutions in the Centre Region in accessing European funds and also the causes that led to the low absorption of European funds. This article’s research is based on a preliminary analysis performed by the authors on the rate of accessing of European funds published in the article called “The current state of European funds absorption through funding programmes – measure of the Romanian performances in the project management practice”. The conclusion of this article was a low rate of absorption of European funds in Romania, a fact that reveals a poor practice of the theory on project management. This article identifies part of the causes of this situation by identifying a part of the problems that stood in the way of beneficiaries of European funds The qualitative and quantitative research methods are used in combination in the research. The investigation has however a highly quantitative character, the purpose of the qualitative research being to provide the prerequisites for achieving the quantitative research. The interview-based qualitative research enabled the researcher to get acquainted with the subjects’ problems related to the theme of investigation, the causes that have generated these problems. This preliminary investigation to the questionnaire-based research aims to provide information that would help the researcher prepare the questionnaire, so that the questions allow getting the most comprehensive information to

Day-Case Treatment of Peripheral Arterial Disease: Results from a Multi-Center European Study

Energy Technology Data Exchange (ETDEWEB)

Spiliopoulos, Stavros, E-mail: stavspiliop@med.uoa.gr, E-mail: stavspiliop@upatras.gr; Karnabatidis, Dimitrios, E-mail: karnaby@med.upatras.gr [Patras University Hospital, Department of Interventional Radiology (Greece); Katsanos, Konstantinos, E-mail: katsanos@med.upatras.gr; Diamantopoulos, Athanasios, E-mail: adiamantopoulos@gmail.com [Guy’s and St Thomas’ Hospitals, NHS Foundation Trust, King’s Health Partners, Department of Interventional Radiology (United Kingdom); Ali, Tariq, E-mail: tariq.ali@addenbrookes.nhs.uk [Addenbrooke’s University Hospital, NHS Foundation Trust, Department of Interventional Radiology (United Kingdom); Kitrou, Panagiotis, E-mail: panoskitrou@gmail.com [Patras University Hospital, Department of Interventional Radiology (Greece); Cannavale, Alessandro, E-mail: alessandro.cannavale@hotmail.com; Krokidis, Miltiadis, E-mail: miltiadis.krokidis@addenbrookes.nhs.uk [Addenbrooke’s University Hospital, NHS Foundation Trust, Department of Interventional Radiology (United Kingdom)

2016-12-15

PurposeThe purpose of the study was to investigate safety and feasibility of day-case endovascular procedures for the management of peripheral arterial disease.Materials and MethodsThis was a multi-center, retrospective study including all patients treated over a 30-month period with endovascular angioplasty or stenting for intermittent claudication (IC) or critical limb ischemia (CLI) on a day-case basis, in Interventional Radiology (IR) departments of three European tertiary hospitals. Exclusion criteria were not related to the type of lesion and included unavailability of an adult able to take care of patient overnight; high bleeding risk and ASA score ≥4. Primary efficacy outcome was the rate of procedures performed on an outpatient basis requiring no further hospitalization and primary safety outcome was freedom from 30-day major complications’ rate.ResultsThe study included 652 patients (male 75 %; mean age 68 ± 10 years; range: 27–93), 24.6 % treated for CLI. In 53.3 % of the cases a 6Fr sheath was used. Technical success was 97.1 %. Haemostasis was obtained by manual compression in 52.4 % of the accesses. The primary efficacy outcome occurred in 95.4 % (622/652 patients) and primary safety outcome in 98.6 % (643/652 patients). Major complications included five (0.7 %) retroperitoneal hematomas requiring transfusion; one (0.1 %) common femoral artery pseudoaneurysm successfully treated with US-guided thrombin injection, two cases of intra-procedural distal embolization treated with catheter-directed local thrombolysis and one on-table cardiac arrest necessitating >24 h recovery. No major complication was noted after same-day discharge.ConclusionsDay-case endovascular procedures for the treatment of IC or CLI can be safely and efficiently performed in experienced IR departments of large tertiary hospitals.

Multi-criteria analysis for the detection of the most critical European UNESCO Heritage sites

Science.gov (United States)

Valagussa, Andrea; Frattini, Paolo; Berta, Nadia; Spizzichino, Daniele; Leoni, Gabriele; Margottini, Claudio; Battista Crosta, Giovanni

2017-04-01

A GIS-based multi-criteria analysis has been implemented to identify and to rank the most critical UNESCO Heritage sites at the European scale in the context of PROTHEGO JPI-Project. Two multi-criteria methods have been tested and applied to more than 300 European UNESCO Sites. First, the Analytic Hierarchy Procedure (AHP) was applied to the data of the UNESCO Periodic Report, in relation to 13 natural hazards that have affected or can potentially affect the Heritage sites. According to these reports, 22% of sites are without any documented hazard and 70% of the sites have at least one hazard affecting the site. The most important hazards on the European country are: fire (wildfire), storm, flooding, earthquake and erosion. For each UNESCO site, the potential risk was calculated as a weighed sum of the hazards that affect the site. The weighs of the 13 hazards were obtained by AHP procedure, which is a technique for multi-attribute decision making that enables the decomposition of a problem into hierarchy, based on the opinion of different experts about the dominance of risks. The weights are obtained by rescaling between 0 and 1 the eigenvectors relative to the maximum eigenvalue for the matrix of the coefficients. The internal coherence of the expert's attributions is defined through the calculation of the consistency ratio (Saaty, 1990). The result of the AHP method consists in a map of the UNESCO sites ranked according to the potential risk, where the site most at risk results to be the Geirangerfjord and Nærøyfjord in Norway. However, the quality of these results lies in the reliability of the Period Reports, which are produced by different experts with unknown level of scientific background. To test the reliability of these results, a comparison of the information of the periodic reports with available high-quality datasets (earthquake, volcano and landslide) at the Italian scale has been performed. Sites properly classified by the Period Reports range from

European network for promoting the physical health of residents in psychiatric and social care facilities (HELPS)

DEFF Research Database (Denmark)

Weiser, Prisca; Becker, Thomas; Losert, Carolin

2009-01-01

of defined health promoting interventions. The key methods are (a) stakeholder analysis, (b) international literature reviews, (c) Delphi rounds with experts from participating centres, and (d) focus groups with staff and residents of mental health care facilities.Meanwhile a multi-disciplinary network...... by promoting behaviour-based and/or environment-based interventions. METHODS AND DESIGN: HELPS is an interdisciplinary European network that aims at (i) gathering relevant knowledge on physical illness in people with mental illness, (ii) identifying health promotion initiatives in European countries that meet...... consisting of 15 European countries has been established and took up the work. As one main result of the project they expect that a widespread use of the HELPS toolkit could have a significant positive effect on the physical health status of residents of mental health and social care facilities, as well...

Dosimetric inter-institutional comparison in European radiotherapy centres: Results of IAEA supported treatment planning system audit.

Science.gov (United States)

Gershkevitsh, Eduard; Pesznyak, Csilla; Petrovic, Borislava; Grezdo, Joseph; Chelminski, Krzysztof; do Carmo Lopes, Maria; Izewska, Joanna; Van Dyk, Jacob

2014-05-01

One of the newer audit modalities operated by the International Atomic Energy Agency (IAEA) involves audits of treatment planning systems (TPS) in radiotherapy. The main focus of the audit is the dosimetry verification of the delivery of a radiation treatment plan for three-dimensional (3D) conformal radiotherapy using high energy photon beams. The audit has been carried out in eight European countries - Estonia, Hungary, Latvia, Lithuania, Serbia, Slovakia, Poland and Portugal. The corresponding results are presented. The TPS audit reviews the dosimetry, treatment planning and radiotherapy delivery processes using the 'end-to-end' approach, i.e. following the pathway similar to that of the patient, through imaging, treatment planning and dose delivery. The audit is implemented at the national level with IAEA assistance. The national counterparts conduct the TPS audit at local radiotherapy centres through on-site visits. TPS calculated doses are compared with ion chamber measurements performed in an anthropomorphic phantom for eight test cases per algorithm/beam. A set of pre-defined agreement criteria is used to analyse the performance of TPSs. TPS audit was carried out in 60 radiotherapy centres. In total, 190 data sets (combination of algorithm and beam quality) have been collected and reviewed. Dosimetry problems requiring interventions were discovered in about 10% of datasets. In addition, suboptimal beam modelling in TPSs was discovered in a number of cases. The TPS audit project using the IAEA methodology has verified the treatment planning system calculations for 3D conformal radiotherapy in a group of radiotherapy centres in Europe. It contributed to achieving better understanding of the performance of TPSs and helped to resolve issues related to imaging, dosimetry and treatment planning.

Exercise-based cardiac rehabilitation in twelve European countries results of the European cardiac rehabilitation registry

DEFF Research Database (Denmark)

Benzer, Werner; Rauch, Bernhard; Schmid, Jean-Paul

2017-01-01

AIM: Results from EuroCaReD study should serve as a benchmark to improve guideline adherence and treatment quality of cardiac rehabilitation (CR) in Europe. METHODS AND RESULTS: Data from 2.054 CR patients in 12 European countries were derived from 69 centres. 76% were male. Indication for CR...

Dietary practices in propionic acidemia: A European survey

Directory of Open Access Journals (Sweden)

A. Daly

2017-12-01

Conclusions: There was high use of PFAA with intakes of natural protein commonly below WHO/FAO/UNU (2007 safe levels. Optimal dietary management can only be determined by longitudinal, multi-centre, prospective case controlled studies. The metabolic instability of PA and small patient cohorts in each centre ensure that this is a challenging undertaking.

Current status of the European contribution to the Remote Data Access System of the ITER Remote Experimentation Centre

International Nuclear Information System (INIS)

De Tommasi, G.; Manduchi, G.; Muir, D.G.; Ide, S.; Naito, O.; Urano, H.; Clement-Lorenzo, S.; Nakajima, N.; Ozeki, T.; Sartori, F.

2015-01-01

The ITER Remote Experimentation Centre (REC) is one of the projects under implementation within the BA agreement. The final objective of the REC is to allow researchers to take part in the experimentation on ITER from a remote location. Before ITER first operations, the REC will be used to evaluate ITER-relevant technologies for remote participation. Among the different software tools needed for remote participation, an important one is the Remote Data Access System (RDA), which provides a single software infrastructure to access data stored at the remotely participating experiment, regardless of the geographical location of the users. This paper introduces the European contribution to the RDA system for the REC.

European multi-centre study of the Nucleus Hybrid L24 cochlear implant

NARCIS (Netherlands)

Lenarz, T.; James, C.; Cuda, D.; Fitzgerald O'Connor, A.; Frachet, B.; Frijns, J.H.M.; Klenzner, T.; Laszig, R.; Manrique, M.; Marx, M.; Merkus, P.; Mylanus, E.A.M.; Offeciers, E.; Pesch, J.; Ramos-Macias, A.; Robier, A.; Sterkers, O.; Uziel, A.

2013-01-01

Objectives: To investigate the preservation of residual hearing in subjects who received the Nucleus Hybrid L24 cochlear implant. To investigate the performance benefits up to one year post-implantation in terms of speech recognition, sound quality, and quality of life. Design: Prospective, with

A study of melanoma in Eastern European migrants in Italy.

Science.gov (United States)

Astrua, Chiara; Fava, Paolo; Brizio, Matteo; Savoia, Paola

2017-04-01

Cancer survival rates are lower in Eastern Europe. To describe, based on a single-centre database in northern Italy, clinical, histopathological, and prognostic features of melanoma in a migrant population from Eastern Europe. We retrospectively analysed data from 18,190 consecutive foreign patients who visited our institution, with 49 cases of melanoma from Eastern Europe. The control group was represented by 1,003 Italian melanoma patients diagnosed and followed at our centre during the same time period. Patients from Eastern Europe were mainly females with lower median age, without significant differences regarding primary melanoma site, relative to the control group. Diagnosis was made at the place of birth in 30.6% and in our centre for the remainder. Median Breslow thickness was greater (p = 0.0178), and aggressive histotypes (p = 0.0017) and ulcerated melanomas (p = 0.002) were significantly over-represented, particularly when diagnosed in the patients' native country. Disease was more advanced at diagnosis (p = 0.0001), regardless of the place of initial diagnosis (51% had a progressive disease within one year which rose to 80% if diagnosed before admission to our centre), and the percentage of patients who died within one year was significantly higher (p = 0.022), relative to the control group. Our study shows a poor prognosis for melanoma patients diagnosed in Eastern Europe. Moreover, for migrant populations moving from Eastern to Western European countries, financial difficulties, poor social integration, and language barriers, with consequent late access to healthcare facilities, may account for a worse prognosis.

A European Research Area

International Nuclear Information System (INIS)

Caro, R.

2001-01-01

This article is a summary of the presentation of the European Commissioner, Philippe Busquen, to the European Parliament (beginning of year 2000) with the proposal and method for a revival of the Research and Development in this wider sense in the European Union. The starting point of his thesis is that Europe performs less, and more disorderly, activities in this field that her main competitors. USA and Japan. His basic proposal is a larger coordination among the european research projects, with a previous phase of informatics intoxicator among the european research centres and the cross-linked participation, real of virtual in the experiments and projects. (Author)

Design and performance of a multi-centre randomised controlled trial and economic evaluation of joint tele-consultations [ISRCTN54264250

Directory of Open Access Journals (Sweden)

Thompson Simon

2002-01-01

Full Text Available Abstract Background Appropriate information flow is crucial to the care of patients, particularly at the interface between primary and secondary care. Communication problems can result from inadequate organisation and training, There is a major expectation that information and communication technologies may offer solutions, but little reliable evidence. This paper reports the design and performance of a multi-centre randomised controlled trial (RCT, unparalleled in telemedicine research in either scale or range of outcomes. The study investigated the effectiveness and cost implications in rural and inner-city settings of using videoconferencing to perform joint tele-consultations as an alternative to general practitioner referral to the hospital specialist in the outpatient clinic. Methods Joint tele-consultation services were established in both the Royal Free Hampstead NHS Trust in inner London, and the Royal Shrewsbury Hospitals Trust, in Shropshire. All the patients who gave consent to participate were randomised either to joint tele-consultation or to a routine outpatients appointment. The principal outcome measures included the frequency of decision by the specialist to offer a follow-up outpatient appointment, patient satisfaction (Ware Specific Questionnaire, wellbeing (SF12 and enablement (PEI, numbers of tests, investigations, procedures and treatments. Results A total of 134 general practitioners operating from 29 practices participated in the trial, referring a total of 3170 patients to 20 specialists in ENT medicine, general medicine (including endocrinology, and rheumatology, gastroenterology, orthopaedics, neurology and urology. Of these, 2094 patients consented to participate in the study and were correctly randomised. There was a 91% response rate to the initial assessment questionnaires, and analysis showed equivalence for all key characteristics between the treatment and control groups. Conclusion We have designed and

Involving older people in a multi-centre randomised trial of a complex intervention in pre-hospital emergency care: implementation of a collaborative model.

Science.gov (United States)

Koniotou, Marina; Evans, Bridie Angela; Chatters, Robin; Fothergill, Rachael; Garnsworthy, Christopher; Gaze, Sarah; Halter, Mary; Mason, Suzanne; Peconi, Julie; Porter, Alison; Siriwardena, A Niroshan; Toghill, Alun; Snooks, Helen

2015-07-10

Health services research is expected to involve service users as active partners in the research process, but few examples report how this has been achieved in practice in trials. We implemented a model to involve service users in a multi-centre randomised controlled trial in pre-hospital emergency care. We used the generic Standard Operating Procedure (SOP) from our Clinical Trials Unit (CTU) as the basis for creating a model to fit the context and population of the SAFER 2 trial. In our model, we planned to involve service users at all stages in the trial through decision-making forums at 3 levels: 1) strategic; 2) site (e.g. Wales; London; East Midlands); 3) local. We linked with charities and community groups to recruit people with experience of our study population. We collected notes of meetings alongside other documentary evidence such as attendance records and study documentation to track how we implemented our model. We involved service users at strategic, site and local level. We also added additional strategic level forums (Task and Finish Groups and Writing Days) where we included service users. Service user involvement varied in frequency and type across meetings, research stages and locations but stabilised and increased as the trial progressed. Involving service users in the SAFER 2 trial showed how it is feasible and achievable for patients, carers and potential patients sharing the demographic characteristics of our study population to collaborate in a multi-centre trial at the level which suited their health, location, skills and expertise. A standard model of involvement can be tailored by adopting a flexible approach to take account of the context and complexities of a multi-site trial. Current Controlled Trials ISRCTN60481756. Registered: 13 March 2009.

Effects of a partially supervised conditioning programme in cystic fibrosis: an international multi-centre randomised controlled trial (ACTIVATE-CF): study protocol.

Science.gov (United States)

Hebestreit, Helge; Lands, Larry C; Alarie, Nancy; Schaeff, Jonathan; Karila, Chantal; Orenstein, David M; Urquhart, Don S; Hulzebos, Erik H J; Stein, Lothar; Schindler, Christian; Kriemler, Susi; Radtke, Thomas

2018-02-08

Physical activity (PA) and exercise have become an accepted and valued component of cystic fibrosis (CF) care. Regular PA and exercise can positively impact pulmonary function, improve physical fitness, and enhance health-related quality of life (HRQoL). However, motivating people to be more active is challenging. Supervised exercise programs are expensive and labour intensive, and adherence falls off significantly once supervision ends. Unsupervised or partially supervised programs are less costly and more flexible, but compliance can be more problematic. The primary objective of this study is to evaluate the effects of a partially supervised exercise intervention along with regular motivation on forced expiratory volume in 1 s (FEV 1 ) at 6 months in a large international group of CF patients. Secondary endpoints include patient reported HRQoL, as well as levels of anxiety and depression, and control of blood sugar. It is planned that a total of 292 patients with CF 12 years and older with a FEV 1  ≥ 35% predicted shall be randomised. Following baseline assessments (2 visits) patients are randomised into an intervention and a control group. Thereafter, they will be seen every 3 months for assessments in their centre for one year (4 follow-up visits). Along with individual counselling to increase vigorous PA by at least 3 h per week on each clinic visit, the intervention group documents daily PA and inactivity time and receives a step counter to record their progress within a web-based diary. They also receive monthly phone calls from the study staff during the first 6 months of the study. After 6 months, they continue with the step counter and web-based programme for a further 6 months. The control group receives standard care and keeps their PA level constant during the study period. Thereafter, they receive the intervention as well. This is the first large, international multi-centre study to investigate the effects of a PA intervention in CF with

Does it matter if clinicians recruiting for a trial don't understand what the trial is really about? Qualitative study of surgeons' experiences of participation in a pragmatic multi-centre RCT

Directory of Open Access Journals (Sweden)

Snowdon Claire

2007-01-01

Full Text Available Abstract Background Qualitative methods are increasingly used to study the process of clinical trials and patients understanding of the rationale for trials, randomisation and reasons for taking part or refusing. Patients' understandings are inevitably influenced by the recruiting clinician's understanding of the trial, yet relatively little qualitative work has explored clinicians' perceptions and understandings of trials. This study interviewed surgeons shortly after the multi-centre, pragmatic RCT in which they had participated had been completed. Methods We used in-depth interviews with surgeons who participated in the Spine Stabilisation Trial (a pragmatic RCT to explore their understanding of the trial purpose and how this understanding had influenced their recruitment procedures and interpretation of the results. A purposive sample of eleven participating surgeons was chosen from 8 of the 15 UK trial centres. Results Although the surgeons thought that the trial was addressing an important question there was little agreement about what this question was: although it was a trial of 'equivalent' treatments, some thought that it was a trial of surgery, others a trial of rehabilitation and others that it was exploring what to do with patients in whom all other treatment options had been unsuccessful. The surgeons we interviewed were not aware of the rationale for the pragmatic inclusion criteria and nearly all were completely baffled about the meaning of 'equipoise'. Misunderstandings about the entry criteria were an important source of confusion about the results and led to reluctance to apply the results to their own practice. Conclusion The study suggests several lessons for the conduct of future multi-centre trials. Recruiting surgeons (and other clinicians may not be familiar with the rationale for pragmatic designs and may need to be regularly reminded about the purpose during the study. Reassurance may be necessary that a pragmatic

A multi-centre clinical follow-up database as a systematic approach to the evaluation of mid- and long-term health consequences in Chernobyl acute radiation syndrome patients

International Nuclear Information System (INIS)

Fischer, B.; Weiss, M.; Fliedner, T.M.; Belyi, D.A.; Kovalenko, A.N.; Bebeshko, V.G.; Nadejina, N.M.; Galstian, I.A.

1996-01-01

This paper describes scope, design and first results of a multi-centre follow-up database that has been established for the evaluation of mid- and long-term health consequences of acute radiation syndrome (ARS) survivors. After the Chernobyl accident on 26 April 1986, 237 cases with suspected acute radiation syndrome have been reported. For 134 of these cases the diagnosis of ARS was confirmed in a consensus conference three years after the accident. Nearly all survivors underwent regular follow-up examinations in two specialized centres in Kiev and in Moscow. In collaboration with these centres we established a multi-centre clinical follow-up database that records the results of the follow-up examinations in a standardized schema. This database is an integral part of a five step approach to patient evaluation and aims at a comprehensive base for scientific analysis of the mid- and long-term consequences of accidental ionizing radiation. It will allow for a dynamic view on the development of the health status of individuals and groups of patients as well as the identification of critical organ systems that need early support, and an improvement of acute and follow-up treatment protocols for radiation accident victims

Cross-Cultural Issues of Intra- and Inter-Organisational Cooperation in Space Operations: A Survey Study with Ground Personnel of the European Space Agency

Science.gov (United States)

Mjeldheim Sandal, Gro; Mjeldheim Sandal, Gro; Manzey, Dietrich

Today's space operations often involve close co-working of people with different ethnical, professional and organizational backgrounds. The aim of the study was to examine the implications of cultural diversity for efficient collaboration within the European Space Agency (ESA), and between ESA employees and representatives from other agencies. Methods: A web-based survey was answered by 905 employees at the European Astronaut Centre and at the European Space Technology Centre. An adapted version of the Flight Management Attitude Questionnaire by Helmreich and Merrit was used. Personnel were also asked about interpersonal and operational issues that interfered with efficient co-working within ESA and in relation to other space agencies. Results: Collaboration within ESA: A descriptive analysis was conducted of the rank orders of challenges perceived by members of different nationalities (the Netherlands (N=68), German (N=138), Italian (N=135), French (N=124), British (N=84) and Scandinavian (27).Rank orders show a surprisingly uniformity across nationalities. Most respondents perceived differences in the preferred leadership style as the main challenge for co-working in multi-national groups followed by differences in dealing with conflicts and misunderstandings. In contrast communication problems due different languages and differences in non-verbal behaviour, as well as differences in gender stereotypes were among the lowest rated issues. However, Scandinavian respondents showed a different pattern from other nationalities. Collaboration between agencies: The most significant issues reported to interfere with the efficiency of inter-agency collaboration varied. Most difficulties were reported in relation to clarity of communication, insufficient sharing of task related information, understanding the process of decision making in partner organization, and authoritarian leadership style in the partner organization Conclusion: Cultural differences in leadership and

The diagnostic and therapeutic impact of MRI: an observational multi-centre study

International Nuclear Information System (INIS)

Hollingworth, William; Todd, Christopher J.; Bell, Matthew I.; Arafat, Qais; Girling, Simon; Karia, Kanti R.; Dixon, Adrian K.

2000-01-01

AIM: To provide information about the diagnostic and therapeutic impact of magnetic resonance imaging (MRI) and to compare the findings across diagnostic groups. MATERIALS AND METHODS: A prospective, observational study of 2017 consecutive referrals for MRI of the head, spine or knee at four imaging centres. Clinicians completed questionnaires before MRI stating initial diagnoses, diagnostic confidence and treatment plans. After imaging, a second questionnaire evaluated clinicians' revised diagnosis and treatment plans in the light of imaging findings. Patients were grouped into nine diagnostic categories for analysis. Comparison between pre- and post-imaging was used to assess the diagnostic and therapeutic impact of MRI. RESULTS: In seven of nine diagnostic groups MRI findings were associated with a diagnostic impact. Diagnoses were revised or discarded following normal MR findings and diagnostic confidence was increased by confirmative MR findings. There was no statistically significant diagnostic impact for suspected pituitary or cerebello-pontine angle lesions. In five of nine diagnostic groups (knee meniscus, knee ligament, multiple sclerosis, lumbar and cervical spine) MRI findings had a clear impact on treatment plans. CONCLUSION: This study demonstrates that in most diagnostic categories, MRI influences diagnosis and treatment. However, experimental studies are needed to prove that these diagnostic and therapeutic impacts lead to improved health. Hollingworth (2000)

The diagnostic and therapeutic impact of MRI: an observational multi-centre study

Energy Technology Data Exchange (ETDEWEB)

Hollingworth, William; Todd, Christopher J.; Bell, Matthew I.; Arafat, Qais; Girling, Simon; Karia, Kanti R.; Dixon, Adrian K

2000-11-01

AIM: To provide information about the diagnostic and therapeutic impact of magnetic resonance imaging (MRI) and to compare the findings across diagnostic groups. MATERIALS AND METHODS: A prospective, observational study of 2017 consecutive referrals for MRI of the head, spine or knee at four imaging centres. Clinicians completed questionnaires before MRI stating initial diagnoses, diagnostic confidence and treatment plans. After imaging, a second questionnaire evaluated clinicians' revised diagnosis and treatment plans in the light of imaging findings. Patients were grouped into nine diagnostic categories for analysis. Comparison between pre- and post-imaging was used to assess the diagnostic and therapeutic impact of MRI. RESULTS: In seven of nine diagnostic groups MRI findings were associated with a diagnostic impact. Diagnoses were revised or discarded following normal MR findings and diagnostic confidence was increased by confirmative MR findings. There was no statistically significant diagnostic impact for suspected pituitary or cerebello-pontine angle lesions. In five of nine diagnostic groups (knee meniscus, knee ligament, multiple sclerosis, lumbar and cervical spine) MRI findings had a clear impact on treatment plans. CONCLUSION: This study demonstrates that in most diagnostic categories, MRI influences diagnosis and treatment. However, experimental studies are needed to prove that these diagnostic and therapeutic impacts lead to improved health. Hollingworth (2000)

A case-control study of the relation between plasma selenium and asthma in European populations

DEFF Research Database (Denmark)

Burney, P; Potts, J; Makowska, J

2008-01-01

BACKGROUND: There is evidence that selenium levels are relatively low in Europe and may be falling. Low levels of selenium or low activity of some of the enzymes dependent on selenium have been associated with asthma. METHODS: The GA(2)LEN network has organized a multicentre case-control study...... in Europe to assess the relation of plasma selenium to asthma. The network compared 569 cases in 14 European centres with a diagnosis of asthma and reporting asthma symptoms in the last 12 months with 576 controls from the same centres with no diagnosis of asthma and no asthmatic symptoms in the last 12......-analysis of the results from the centres showed no overall association between asthma and plasma selenium [odds ratio (OR)/10 microg/l increase in plasma selenium: 1.04; 95% confidence interval (CI): 0.89-1.21] though there was a significantly protective effect in Lodz (OR: 0.48; 95% CI: 0.29-0.78) and a marginally...

Ophthalmological abnormalities in wild European hedgehogs ...

African Journals Online (AJOL)

In this study we aimed to examine wild European hedgehogs (Erinaceus europaeus) in rescue centres and to determine ocular abnormalities in this animal population. Three hundred animals varying in age from 2 months to 5 years were examined, 147 being male and 153 female. All animals were evaluated with direct ...

Benchmarking in European Higher Education: A Step beyond Current Quality Models

Science.gov (United States)

Burquel, Nadine; van Vught, Frans

2010-01-01

This paper presents the findings of a two-year EU-funded project (DG Education and Culture) "Benchmarking in European Higher Education", carried out from 2006 to 2008 by a consortium led by the European Centre for Strategic Management of Universities (ESMU), with the Centre for Higher Education Development, UNESCO-CEPES, and the…

Proposal for an ecoradiological centre model

International Nuclear Information System (INIS)

Perovic, S.M.; Zunic, Z.; Demajo, M.; Konjevic, N.

1998-01-01

The problem of establishing an optimal Ecoradiological Centre Model is studied in some detail for the town of Kotor which is under the protection of the World Cultural and Natural Heritage. The proposed structure of the Centre is analyzed from the view of Engineering, Education and Scientific parameters. This Model is suitable for implementation as a network Centre Model for the state of Montenegro. Further, the modelling strategy of the ecoradiological condition control of natural, construction, bio and technological systems is elaborated. The proposal includes the ecoradiological monitoring, radioactive and electromagnetic radiation processing and protection for different natural zones as well as their different geostructures, aerial and hydrogeological conditions. The programme also includes all housing objects (hotels, flats, houses, office premises etc.). Here will also be presented the radiation protection and recommendations for the implementation of Title VII of the European Basic Safety Standards Directive (BSS), concerning significant increase in exposure due to natural radiation sources. Also, the proposal of Local Radiation Protection for the town of Kotor is presented. Our proposal for an Ecoradiological Centre Model presented here is in a form of a pilot programme, applicable also for other towns and states. (author)

Patient-centred performance monitoring systems and multi-agency care provision: a case study using a stakeholder participative approach.

Science.gov (United States)

Connell, N A; Goddard, A R; Philp, I; Bray, J

1998-05-01

We describe the processes involved in the development of an information system which can assess how care given by a number of agencies could be monitored by those agencies. In particular, it addresses the problem of sharing information as the boundaries of each agency are crossed. It focuses on the care of one specific patient group--the rehabilitation of elderly patients in the community, which provided an ideal multi-agency setting. It also describes: how a stakeholder participative approach to information system development was undertaken, based in part on the Soft Systems Methodology (SSM) approach (Checkland, 1981, 1990); some of the difficulties encountered in using such an approach; and the ways in which these were addressed. The paper goes on to describe an assessment tool called SCARS (the Southampton Community Ability Rating Scale). It concludes by reflecting on the management lessons arising from this project. It also observes, inter alia, how stakeholders have a strong preference for simpler, non-IT based systems, and comments on the difficulties encountered by stakeholders in attempting to reconcile their perceptions of the needs of their discipline or specialty with a more patient-centred approach of an integrated system.

Quality control for diagnostic oral microbiology laboratories in European countries

Directory of Open Access Journals (Sweden)

Andrew J. Smith

2011-11-01

Full Text Available Participation in diagnostic microbiology internal and external quality control (QC processes is good laboratory practice and an essential component of a quality management system. However, no QC scheme for diagnostic oral microbiology existed until 2009 when the Clinical Oral Microbiology (COMB Network was created. At the European Oral Microbiology Workshop in 2008, 12 laboratories processing clinical oral microbiological samples were identified. All these were recruited to participate into the study and six laboratories from six European countries completed both the online survey and the first QC round. Three additional laboratories participated in the second round. Based on the survey, European oral microbiology laboratories process a significant (mean per laboratory 4,135 number of diagnostic samples from the oral cavity annually. A majority of the laboratories did not participate in any internal or external QC programme and nearly half of the laboratories did not have standard operating procedures for the tests they performed. In both QC rounds, there was a large variation in the results, interpretation and reporting of antibiotic susceptibility testing among the laboratories. In conclusion, the results of this study demonstrate the need for harmonisation of laboratory processing methods and interpretation of results for oral microbiology specimens. The QC rounds highlighted the value of external QC in evaluating the efficacy and safety of processes, materials and methods used in the laboratory. The use of standardised methods is also a prerequisite for multi-centre epidemiological studies that can provide important information on emerging microbes and trends in anti-microbial susceptibility for empirical prescribing in oro-facial infections.

Reproducibility of a semi-automatic method for 6-point vertebral morphometry in a multi-centre trial

International Nuclear Information System (INIS)

Guglielmi, Giuseppe; Stoppino, Luca Pio; Placentino, Maria Grazia; D'Errico, Francesco; Palmieri, Francesco

2009-01-01

Purpose: To evaluate the reproducibility of a semi-automated system for vertebral morphometry (MorphoXpress) in a large multi-centre trial. Materials and methods: The study involved 132 clinicians (no radiologist) with different levels of experience across 20 osteo-centres in Italy. All have received training in using MorphoXpress. An expert radiologist was also involved providing data used as standard of reference. The test image originate from normal clinical activity and represent a variety of normal, under and over exposed films, indicating both normal anatomy and vertebral deformities. The image was represented twice to the clinicians in a random order. Using the software, the clinicians initially marked the midpoints of the upper and lower vertebrae to include as many of the vertebrae (T5-L4) as practical within each given image. MorphoXpress performs the localisation of all morphometric points based on statistical model-based vision system. Intra-operator as well inter-operator measurement of agreement was calculated using the coefficient of variation and the mean and standard deviation of the difference of two measurements to check their agreement. Results: The overall intra-operator mean differences in vertebral heights is 1.61 ± 4.27% (1 S.D.). The overall intra-operator coefficient of variation is 3.95%. The overall inter-operator mean differences in vertebral heights is 2.93 ± 5.38% (1 S.D.). The overall inter-operator coefficient of variation is 6.89%. Conclusions: The technology tested here can facilitate reproducible quantitative morphometry suitable for large studies of vertebral deformities

Project Based Learning in Multi-Grade Class

Science.gov (United States)

Ciftci, Sabahattin; Baykan, Ayse Aysun

2013-01-01

The purpose of this study is to evaluate project based learning in multi-grade classes. This study, based on a student-centered learning approach, aims to analyze students' and parents' interpretations. The study was done in a primary village school belonging to the Centre of Batman, already adapting multi-grade classes in their education system,…

RTEMS Centre - Support and Maintenance Centre to RTEMS Operating System

Science.gov (United States)

Silva, H.; Constantino, A.; Freitas, D.; Coutinho, M.; Faustino, S.; Mota, M.; Colaço, P.; Sousa, J.; Dias, L.; Damjanovic, B.; Zulianello, M.; Rufino, J.

2009-05-01

RTEMS CENTRE - Support and Maintenance Centre to RTEMS Operating System is a joint ESA/Portuguese Task Force initiative to develop a support and maintenance centre to the Real-Time Executive for Multiprocessor Systems (RTEMS). This paper gives a high level visibility of the progress, the results obtained and the future work in the RTEMS CENTRE [6] and in the RTEMS Improvement [7] projects. RTEMS CENTRE started officially in November 2006, with the RTEMS 4.6.99.2 version. A full analysis of RTEMS operating system was produced. The architecture was analysed in terms of conceptual, organizational and operational concepts. The original objectives [1] of the centre were primarily to create and maintain technical expertise and competences in this RTOS, to develop a website to provide the European Space Community an entry point for obtaining support (http://rtemscentre.edisoft.pt), to design, develop, maintain and integrate some RTEMS support tools (Timeline Tool, Configuration and Management Tools), to maintain flight libraries and Board Support Packages, to develop a strong relationship with the World RTEMS Community and finally to produce some considerations in ARINC-653, DO-178B and ECSS E-40 standards. RTEMS Improvement is the continuation of the RTEMS CENTRE. Currently the RTEMS, version 4.8.0, is being facilitated for a future qualification. In this work, the validation material is being produced following the Galileo Software Standards Development Assurance Level B [5]. RTEMS is being completely tested, errors analysed, dead and deactivated code removed and tests produced to achieve 100% statement and decision coverage of source code [2]. The SW to exploit the LEON Memory Management Unit (MMU) hardware will be also added. A brief description of the expected implementations will be given.

Interaction Control Protocols for Distributed Multi-user Multi-camera Environments

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Gareth W Daniel

2003-10-01

Full Text Available Video-centred communication (e.g., video conferencing, multimedia online learning, traffic monitoring, and surveillance is becoming a customary activity in our lives. The management of interactions in such an environment is a complicated HCI issue. In this paper, we present our study on a collection of interaction control protocols for distributed multiuser multi-camera environments. These protocols facilitate different approaches to managing a user's entitlement for controlling a particular camera. We describe a web-based system that allows multiple users to manipulate multiple cameras in varying remote locations. The system was developed using the Java framework, and all protocols discussed have been incorporated into the system. Experiments were designed and conducted to evaluate the effectiveness of these protocols, and to enable the identification of various human factors in a distributed multi-user and multi-camera environment. This work provides an insight into the complexity associated with the interaction management in video-centred communication. It can also serve as a conceptual and experimental framework for further research in this area.

Dietary Habits and Supplement Use in Relation to National Pregnancy Recommendations: Data from the EuroPrevall Birth Cohort

NARCIS (Netherlands)

Oliver, E. M.; Grimshaw, K. E. C.; Schoemaker, A. A.; Keil, T.; McBride, D.; Sprikkelman, A. B.; Ragnarsdottir, H. S.; Trendelenburg, V.; Emmanouil, E.; Reche, M.; Fiocchi, A.; Fiandor, A.; Stanczyk-Przyluska, A.; Wilczynski, J.; Busacca, M.; Sigurdardottir, S. T.; Dubakiene, R.; Rudzeviciene, O.; Vlaxos, G. D.; Beyer, K.; Roberts, G.

2014-01-01

Assessing maternal dietary habits across Europe during pregnancy in relation to their national pregnancy recommendations. A collaborative, multi-centre, birth cohort study in nine European countries was conducted as part of European Union funded EuroPrevall project. Standardised baseline

A multi-centre cohort study shows no association between experienced violence and labour dystocia in nulliparous women at term

Science.gov (United States)

2011-01-01

Background Although both labour dystocia and domestic violence during pregnancy are associated with adverse maternal and fetal outcome, evidence in support of a possible association between experiences of domestic violence and labour dystocia is sparse. The aim of this study was to investigate whether self-reported history of violence or experienced violence during pregnancy is associated with increased risk of labour dystocia in nulliparous women at term. Methods A population-based multi-centre cohort study. A self-administrated questionnaire collected at 37 weeks of gestation from nine obstetric departments in Denmark. The total cohort comprised 2652 nulliparous women, among whom 985 (37.1%) met the protocol criteria for dystocia. Results Among the total cohort, 940 (35.4%) women reported experience of violence, and among these, 66 (2.5%) women reported exposure to violence during their first pregnancy. Further, 39.5% (n = 26) of those had never been exposed to violence before. Univariate logistic regression analysis showed no association between history of violence or experienced violence during pregnancy and labour dystocia at term, crude OR 0.91, 95% CI (0.77-1.08), OR 0.90, 95% CI (0.54-1.50), respectively. However, violence exposed women consuming alcoholic beverages during late pregnancy had increased odds of labour dystocia, crude OR 1.45, 95% CI (1.07-1.96). Conclusions Our findings indicate that nulliparous women who have a history of violence or experienced violence during pregnancy do not appear to have a higher risk of labour dystocia at term, according to the definition of labour dystocia in this study. Additional research on this topic would be beneficial, including further evaluation of the criteria for labour dystocia. PMID:21338523

A multi-centre cohort study shows no association between experienced violence and labour dystocia in nulliparous women at term.

Science.gov (United States)

Finnbogadóttir, Hafrún; Dejin-Karlsson, Elisabeth; Dykes, Anna-Karin

2011-02-21

Although both labour dystocia and domestic violence during pregnancy are associated with adverse maternal and fetal outcome, evidence in support of a possible association between experiences of domestic violence and labour dystocia is sparse. The aim of this study was to investigate whether self-reported history of violence or experienced violence during pregnancy is associated with increased risk of labour dystocia in nulliparous women at term. A population-based multi-centre cohort study. A self-administrated questionnaire collected at 37 weeks of gestation from nine obstetric departments in Denmark. The total cohort comprised 2652 nulliparous women, among whom 985 (37.1%) met the protocol criteria for dystocia. Among the total cohort, 940 (35.4%) women reported experience of violence, and among these, 66 (2.5%) women reported exposure to violence during their first pregnancy. Further, 39.5% (n = 26) of those had never been exposed to violence before. Univariate logistic regression analysis showed no association between history of violence or experienced violence during pregnancy and labour dystocia at term, crude OR 0.91, 95% CI (0.77-1.08), OR 0.90, 95% CI (0.54-1.50), respectively. However, violence exposed women consuming alcoholic beverages during late pregnancy had increased odds of labour dystocia, crude OR 1.45, 95% CI (1.07-1.96). Our findings indicate that nulliparous women who have a history of violence or experienced violence during pregnancy do not appear to have a higher risk of labour dystocia at term, according to the definition of labour dystocia in this study. Additional research on this topic would be beneficial, including further evaluation of the criteria for labour dystocia.

Managing Pan-European mammography images and data using a service oriented architecture

CERN Document Server

Amendolia, S R; McClatchey, R; Rogulin, D; Solomonides, T

2004-01-01

Medical conditions such as breast cancer, and mammograms as images, are extremely complex with many degrees of variability across the population. An effective solution for the management of disparate mammogram data sources that provides sufficient statistics for complex epidemiological study is a federation of autonomous multi- centre sites which transcends national boundaries. Grid-based technologies are emerging as open-source standards-based solutions for managing and collaborating distributed resources. In the light of these new computing solutions, the MammoGrid project, as one example of a HealthGrid, is developing a Grid-aware medical application which manages a European-wide database of mammograms. The MammoGrid solution utilizes the grid technologies in seamlessly integrating distributed data sets and is investigating the potential of the Grid to support effective co-working among mammogram analysts throughout the EU.

Multi-parameter analysis for the technical and economic assessment of photovoltaic systems in the main European Union countries

International Nuclear Information System (INIS)

Bortolini, Marco; Gamberi, Mauro; Graziani, Alessandro; Mora, Cristina; Regattieri, Alberto

2013-01-01

Highlights: • Performance cost model assesses the feasibility and profitability of PV systems. • Multi-country and multi-parameter analysis of PV systems in the European Union area. • The impact of key technical, environmental, economic and financial data is assessed. • Germany, Italy and Spain present the most effective PV sector support strategies. • The rated power and energy self-consumption ratio affect PV plant profitability. - Abstract: In the last decades, the attention to solar energy as a renewable and nonpolluting energy source increased a lot through scientists, private and public institutions. Several efforts are made to increase the diffusion of such a source and to create the conditions making it competitive for the energy market. Particularly, for the photovoltaic (PV) sector, the module efficiency increase, manufacturing cost reduction and a strong public support, through favorable incentive schemes, generates a significant rise in the installed power, exceeding 40 GWp in 2010. Although the global trend of the PV sector is positive, differences among countries arise out of local peculiarities and evolutions in the national support policies. This paper investigates such issues focusing on the feasibility analysis of PV solar systems for eight relevant countries in the European Union area, i.e. France, Germany, Greece, Italy, Spain, The Netherlands, Turkey and United Kingdom. A multi-country and multi-parameter comparative analysis, based on the net present value and payback capital budget indices, allows to highlight the conditions most affecting the economic feasibility of PV systems. The national support strategies, along with the most relevant technical, environmental, economic and financial parameters, are the key features included and compared in the analysis. The major results deal with the conditions which make PV systems potentially profitable for each country and installation feature. The national support strategies to the PV

A Critical Assessment of a Eurosceptic Party Group on European Integration: A Case Study of the European Conservatives and Reformists Group

Directory of Open Access Journals (Sweden)

Akbaba Sertan

2014-06-01

Full Text Available The article explores Euroscepticism and the way it is utilized within the politics of Europe, analyzed upon evidence from a Eurosceptic Euro-party located in the European Parliament, namely the European Conservatives and Reformists Group (ECR. The aim of this article is to clarify that the selected party> disproves the argument of EU- criticism being an unfavourable condition, and, more importantly, its contribution to the political contestation in the EU. For such an assessment, a survey of the party> manifesto, party working documents, as well as the discourses of the Member of the European Parliament (MEPs will be analyzed, and the concept of Euroscepticism will be once again in the centre of this analysis. This argument is evaluated based on the transnational-level analysis of the aforementioned party, focusing primarily on three specific issues-the democratic deficit, the issue of sovereignty! and anti-immigration rhetoric.

ENES the European Network for Earth System modelling and its infrastructure projects IS-ENES

Science.gov (United States)

Guglielmo, Francesca; Joussaume, Sylvie; Parinet, Marie

2016-04-01

The scientific community working on climate modelling is organized within the European Network for Earth System modelling (ENES). In the past decade, several European university departments, research centres, meteorological services, computer centres, and industrial partners engaged in the creation of ENES with the purpose of working together and cooperating towards the further development of the network, by signing a Memorandum of Understanding. As of 2015, the consortium counts 47 partners. The climate modelling community, and thus ENES, faces challenges which are both science-driven, i.e. analysing of the full complexity of the Earth System to improve our understanding and prediction of climate changes, and have multi-faceted societal implications, as a better representation of climate change on regional scales leads to improved understanding and prediction of impacts and to the development and provision of climate services. ENES, promoting and endorsing projects and initiatives, helps in developing and evaluating of state-of-the-art climate and Earth system models, facilitates model inter-comparison studies, encourages exchanges of software and model results, and fosters the use of high performance computing facilities dedicated to high-resolution multi-model experiments. ENES brings together public and private partners, integrates countries underrepresented in climate modelling studies, and reaches out to different user communities, thus enhancing European expertise and competitiveness. In this need of sophisticated models, world-class, high-performance computers, and state-of-the-art software solutions to make efficient use of models, data and hardware, a key role is played by the constitution and maintenance of a solid infrastructure, developing and providing services to the different user communities. ENES has investigated the infrastructural needs and has received funding from the EU FP7 program for the IS-ENES (InfraStructure for ENES) phase I and II

Flexible Processes in Project-Centred Learning

NARCIS (Netherlands)

Ceri, Stefano; Matera, Maristella; Raffio, Alessandro; Spoelstra, Howard

2007-01-01

Ceri, S., Matera, M., Raffio, A. & Spoelstra, H. (2007). Flexible Processes in Project-Centred Learning. In E. Duval, R. Klamma, and M. Wolpers (Eds.), European Conference on Technology Enhanced Learning, Lecture Notes in Computer Science, Vol. 4753, pp. 463-468. Berlin Heidelberg: Springer-Verlag

Maximising value from a United Kingdom Biomedical Research Centre: study protocol.

Science.gov (United States)

Greenhalgh, Trisha; Ovseiko, Pavel V; Fahy, Nick; Shaw, Sara; Kerr, Polly; Rushforth, Alexander D; Channon, Keith M; Kiparoglou, Vasiliki

2017-08-14

Biomedical Research Centres (BRCs) are partnerships between healthcare organisations and universities in England. Their mission is to generate novel treatments, technologies, diagnostics and other interventions that increase the country's international competitiveness, to rapidly translate these innovations into benefits for patients, and to improve efficiency and reduce waste in healthcare. As NIHR Oxford BRC (Oxford BRC) enters its third 5-year funding period, we seek to (1) apply the evidence base on how best to support the various partnerships in this large, multi-stakeholder research system and (2) research how these partnerships play out in a new, ambitious programme of translational research. Organisational case study, informed by the principles of action research. A cross-cutting theme, 'Partnerships for Health, Wealth and Innovation' has been established with multiple sub-themes (drug development, device development, business support and commercialisation, research methodology and statistics, health economics, bioethics, patient and public involvement and engagement, knowledge translation, and education and training) to support individual BRC research themes and generate cross-theme learning. The 'Partnerships' theme will support the BRC's goals by facilitating six types of partnership (with patients and citizens, clinical services, industry, across the NIHR infrastructure, across academic disciplines, and with policymakers and payers) through a range of engagement platforms and activities. We will develop a longitudinal progress narrative centred around exemplar case studies, and apply theoretical models from innovation studies (Triple Helix), sociology of science (Mode 2 knowledge production) and business studies (Value Co-creation). Data sources will be the empirical research studies within individual BRC research themes (who will apply separately for NHS ethics approval), plus documentary analysis and interviews and ethnography with research

STUDY ON THE PROBLEMS IN THE STAGES OF FILLING OUT THE APPLICATION FORM AND TECHNICAL-FINANCIAL REPORTING ENCOUNTERED BY THE PUBLIC INSTITUTIONS IN THE CENTRE REGION IN ACCESSING EUROPEAN FUNDS

Directory of Open Access Journals (Sweden)

DUMITRASCU DANUT

2012-07-01

Full Text Available The article has as main field the project management, specifically, identifying the negative factors on European projects. The article assumes that there is a connection between the absorption of European funds and the maturity of the Romanian society in terms of project management. The main objective of the research is to identify the problems faced by public institutions from Centre Region in accessing European funds. The purpose of the research is to identify the causes that led to the low absorption of European funds, with devastating effects on the current economic situation. The present research is based on a preliminary analysis performed by the author on the rate of accessing European funds published in an article entitled “The current state of European funds absorption through funding programmes – measure of the Romanian performances in the project management practice”. The small degree of absorption of European funds resulting from the analysis shows a poor practice of the theory on project management. To identify the causes of this problem, a research was carried out to recognise the issues that led to this situation. The investigation included two successive surveys, the first one qualitative, exploratory type, interview-based, meant to demonstrate the qualitative aspects of the investigated phenomena and the other one, quantitative, based on a questionnaire in the form of occasional surveys. The qualitative and quantitative research methods are used in combination; this approach has become necessary especially due to the very complex reality whose trueness cannot be captured through one method. The investigation has however a highly quantitative character, the purpose of the qualitative research being to provide the prerequisites for achieving the quantitative research. The qualitative research revealed the existence of some problems faced by institutions in relation to accessing and developing projects that focus

Differences in care burden of patients undergoing dialysis in different centres in the netherlands.

Science.gov (United States)

de Kleijn, Ria; Uyl-de Groot, Carin; Hagen, Chris; Diepenbroek, Adry; Pasker-de Jong, Pieternel; Ter Wee, Piet

2017-06-01

A classification model was developed to simplify planning of personnel at dialysis centres. This model predicted the care burden based on dialysis characteristics. However, patient characteristics and different dialysis centre categories might also influence the amount of care time required. To determine if there is a difference in care burden between different categories of dialysis centres and if specific patient characteristics predict nursing time needed for patient treatment. An observational study. Two hundred and forty-two patients from 12 dialysis centres. In 12 dialysis centres, nurses filled out the classification list per patient and completed a form with patient characteristics. Nephrologists filled out the Charlson Comorbidity Index. Independent observers clocked the time nurses spent on separate steps of the dialysis for each patient. Dialysis centres were categorised into four types. Data were analysed using regression models. In contrast to other dialysis centres, academic centres needed 14 minutes more care time per patient per dialysis treatment than predicted in the classification model. No patient characteristics were found that influenced this difference. The only patient characteristic that predicted the time required was gender, with more time required to treat women. Gender did not affect the difference between measured and predicted care time. Differences in care burden were observed between academic and other centres, with more time required for treatment in academic centres. Contribution of patient characteristics to the time difference was minimal. The only patient characteristics that predicted care time were previous transplantation, which reduced the time required, and gender, with women requiring more care time. © 2017 European Dialysis and Transplant Nurses Association/European Renal Care Association.

Centre for urban ecotechnology in ''Oeksnehallen''. [Copenhagen, Denmark

Energy Technology Data Exchange (ETDEWEB)

1992-03-01

The Lord Mayor's Department of the municipality of Copenhagen, Denmark, has with support from this project made a proposal for the establishment of the Centre for Urban Ecotechnology in ''Oeksnehallen'', located in the Vesterbro area of the city. The centre should contribute to the dissemination of knowledge on ecological techniques (regarding passive solar energy etc.) to the inhabitants of Vesterbro and other citizens of Copenhagen, and also serve as a centre in an European context. The ecological demonstration centre will cover an area of two thousand square meters and will also include a cafe, a room for showing coloured slides, facilities for exhibitions created by the center and interested firms etc. The centre should play an important role as part of the ecological concept of urban renewal in Vesterbro. (author).

Health status of children with cerebral palsy living in Europe: a multi-centre study

DEFF Research Database (Denmark)

Beckung, E; White-Koning, M; Marcelli, M

2008-01-01

AIM: The aim of this report is to describe the health status of 8-12-year-old children with cerebral palsy (CP) of all severities in Europe using the Child Health Questionnaire (CHQ). METHOD: A total of 818 children with CP from nine centres in defined geographical areas participated. CP type...

A qualitative study into the perceived barriers of accessing healthcare among a vulnerable population involved with a community centre in Romania.

Science.gov (United States)

George, Siân; Daniels, Katy; Fioratou, Evridiki

2018-04-03

Minority vulnerable communities, such as the European Roma, often face numerous barriers to accessing healthcare services, resulting in negative health outcomes. Both these barriers and outcomes have been reported extensively in the literature. However, reports on barriers faced by European non-Roma native communities are limited. The "Health Care Access Barriers" (HCAB) model identifies pertinent financial, structural and cognitive barriers that can be measured and potentially modified. The present study thus aims to explore the barriers to accessing healthcare for a vulnerable population of mixed ethnicity from a charity community centre in Romania, as perceived by the centre's family users and staff members, and assess whether these reflect the barriers identified from the HCAB model. Eleven community members whose children attend the centre and seven staff members working at the centre participated in face-to-face semi-structured interviews, exploring personal experiences and views on accessing healthcare. The interviews were transcribed and analysed using an initial deductive and secondary inductive approach to identify HCAB themes and other emerging themes and subthemes. Identified themes from both groups aligned with HCAB's themes of financial, structural and cognitive barriers and emergent subthemes important to the specific population were identified. Specifically, financial barriers related mostly to health insurance and bribery issues, structural barriers related mostly to service availability and accessibility, and cognitive barriers related mostly to healthcare professionals' attitudes and discrimination and the vulnerable population's lack of education and health literacy. A unique theme of psychological barriers emerged from both groups with associated subthemes of mistrust, hopelessness, fear and anxiety of this vulnerable population. The current study highlights healthcare access barriers to a vulnerable non-Roma native population involved with a

Allocation of substance use disorder patients to appropriate levels of care: feasibility of matching guidelines in routine practice in Dutch treatment centres

NARCIS (Netherlands)

Merkx, Maarten J. M.; Schippers, Gerard M.; Koeter, Maarten J. W.; Vuijk, Pieter Jelle; Oudejans, Suzan; de Vries, Carlijn C. Q.; van den Brink, Wim

2007-01-01

AIMS: To examine the feasibility of implementing evidence-based guidelines for patient-treatment-matching to levels of care in two Dutch substance abuse treatment centres. DESIGN: Multi-centre observational follow-up study. SETTING: Two large substance abuse treatment centres (SATCs). PARTICIPANTS:

Introduction to Special Issue "Gender, Culture and Alcohol Problems: A Multi-national Study

DEFF Research Database (Denmark)

Bloomfield, Kim; Gmel, Gerhard; Wilsnack, Sharon

2006-01-01

and global level. Country surveys were independently conducted and then centralized at one institution for further data standardization and processing. Several results indicated that the greater the societal gender equality in a country, the smaller the gender differences in drinking behavior. In most...... analyses the smallest gender differences in drinking behaviour were found in Nordic countries, followed by western and central European countries, with the largest gender differences in countries with developing economies.......This paper provides an introduction to a series of articles reporting results from the EU concerted action "Gender, Culture and Alcohol Problems: A Multi-national Study" which examined differences in drinking among women and men in 13 European and two non-European countries. The gender gap...

Physical activity and asthma: A longitudinal and multi-country study.

Science.gov (United States)

Russell, Melissa A; Janson, Christer; Real, Francisco Gómez; Johannessen, Ane; Waatevik, Marie; Benediktsdóttir, Bryndis; Holm, Mathias; Lindberg, Eva; Schlünssen, Vivi; Raza, Wasif; Dharmage, Shyamali C; Svanes, Cecilie

2017-11-01

To investigate the impact of physical activity on asthma in middle-aged adults, in one longitudinal analysis, and one multi-centre cross-sectional analysis. The Respiratory Health in Northern Europe (RHINE) is a population-based postal questionnaire cohort study. Physical activity, height and weight were self-reported in Bergen, Norway, at RHINE II (1999-2001) and all centres at RHINE III (2010-2012). A longitudinal analysis of Bergen data investigated the association of baseline physical activity with follow-up asthma, incident asthma and symptoms, using logistic and zero-inflated Poisson regression (n = 1782). A cross-sectional analysis of all RHINE III centres investigated the association of physical activity with concurrent asthma and symptoms (n = 13,542) using mixed-effects models. Body mass index (BMI) was categorised (asthma (odds ratio [OR] 0.44, 95% confidence interval [CI] 0.22, 0.89), whilst an effect from undertaking vigorous activity 3+ times/week was not detected (OR 1.22, 95% CI 0.44, 2.76). The associations were attenuated with BMI adjustment. In the all-centre cross-sectional analysis an interaction was found, with the association between physical activity and asthma varying across BMI categories. These findings suggest potential longer-term benefit from lighter physical activity, whilst improvement in asthma outcomes from increasing activity intensity was not evident. Additionally, it appears the benefit from physical activity may differ according to BMI.

The European standard series in 9 European countries, 2002/2003 -- first results of the European Surveillance System on Contact Allergies

DEFF Research Database (Denmark)

Uter, W; Hegewald, J; Aberer, W

2005-01-01

Since January 2001, the European Surveillance System on Contact Allergies (ESSCA), supported by European Union funding (contract QLK4-CT-2001-00343), has started to collect patch-test data. This comprises a standardized clinical history and the patch-test results using the European standard series...... observed. The prevalence of contact allergy to Myroxylon pereirae resin (balsam of Peru) (5.8%) is coming close to the frequency found with the fragrance mix (6.4%). Regarding contact allergy to chromium compounds, different frequencies were noted in the 2 centres focused on occupational dermatitis (2......-marketing surveillance in the field of contact allergy, ESSCA will meet its objective of increased consumer safety across Europe....

A pragmatic multi-centre randomised controlled trial of fluid loading and level of dependency in high-risk surgical patients undergoing major elective surgery: trial protocol

Directory of Open Access Journals (Sweden)

Norrie John

2010-04-01

Full Text Available Abstract Background Patients undergoing major elective or urgent surgery are at high risk of death or significant morbidity. Measures to reduce this morbidity and mortality include pre-operative optimisation and use of higher levels of dependency care after surgery. We propose a pragmatic multi-centre randomised controlled trial of level of dependency and pre-operative fluid therapy in high-risk surgical patients undergoing major elective surgery. Methods/Design A multi-centre randomised controlled trial with a 2 * 2 factorial design. The first randomisation is to pre-operative fluid therapy or standard regimen and the second randomisation is to routine intensive care versus high dependency care during the early post-operative period. We intend to recruit 204 patients undergoing major elective and urgent abdominal and thoraco-abdominal surgery who fulfil high-risk surgical criteria. The primary outcome for the comparison of level of care is cost-effectiveness at six months and for the comparison of fluid optimisation is the number of hospital days after surgery. Discussion We believe that the results of this study will be invaluable in determining the future care and clinical resource utilisation for this group of patients and thus will have a major impact on clinical practice. Trial Registration Trial registration number - ISRCTN32188676

Feasibility and Preliminary Efficacy of Visual Cue Training to Improve Adaptability of Walking after Stroke: Multi-Centre, Single-Blind Randomised Control Pilot Trial

Science.gov (United States)

Hollands, Kristen L.; Pelton, Trudy A.; Wimperis, Andrew; Whitham, Diane; Tan, Wei; Jowett, Sue; Sackley, Catherine M.; Wing, Alan M.; Tyson, Sarah F.; Mathias, Jonathan; Hensman, Marianne; van Vliet, Paulette M.

2015-01-01

Objectives Given the importance of vision in the control of walking and evidence indicating varied practice of walking improves mobility outcomes, this study sought to examine the feasibility and preliminary efficacy of varied walking practice in response to visual cues, for the rehabilitation of walking following stroke. Design This 3 arm parallel, multi-centre, assessor blind, randomised control trial was conducted within outpatient neurorehabilitation services Participants Community dwelling stroke survivors with walking speed adaptability practice using visual cues are feasible and may improve mobility and balance. Future studies should continue a carefully phased approach using identified methods to improve retention. Trial Registration Clinicaltrials.gov NCT01600391 PMID:26445137

Virtual patients design and its effect on clinical reasoning and student experience: a protocol for a randomised factorial multi-centre study

Directory of Open Access Journals (Sweden)

Bateman James

2012-08-01

Full Text Available Abstract Background Virtual Patients (VPs are web-based representations of realistic clinical cases. They are proposed as being an optimal method for teaching clinical reasoning skills. International standards exist which define precisely what constitutes a VP. There are multiple design possibilities for VPs, however there is little formal evidence to support individual design features. The purpose of this trial is to explore the effect of two different potentially important design features on clinical reasoning skills and the student experience. These are the branching case pathways (present or absent and structured clinical reasoning feedback (present or absent. Methods/Design This is a multi-centre randomised 2x2 factorial design study evaluating two independent variables of VP design, branching (present or absent, and structured clinical reasoning feedback (present or absent.The study will be carried out in medical student volunteers in one year group from three university medical schools in the United Kingdom, Warwick, Keele and Birmingham. There are four core musculoskeletal topics. Each case can be designed in four different ways, equating to 16 VPs required for the research. Students will be randomised to four groups, completing the four VP topics in the same order, but with each group exposed to a different VP design sequentially. All students will be exposed to the four designs. Primary outcomes are performance for each case design in a standardized fifteen item clinical reasoning assessment, integrated into each VP, which is identical for each topic. Additionally a 15-item self-reported evaluation is completed for each VP, based on a widely used EViP tool. Student patterns of use of the VPs will be recorded. In one centre, formative clinical and examination performance will be recorded, along with a self reported pre and post-intervention reasoning score, the DTI. Our power calculations indicate a sample size of 112 is required for

A multi-centre cohort study shows no association between experienced violence and labour dystocia in nulliparous women at term

Directory of Open Access Journals (Sweden)

Dykes Anna-Karin

2011-02-01

Full Text Available Abstract Background Although both labour dystocia and domestic violence during pregnancy are associated with adverse maternal and fetal outcome, evidence in support of a possible association between experiences of domestic violence and labour dystocia is sparse. The aim of this study was to investigate whether self-reported history of violence or experienced violence during pregnancy is associated with increased risk of labour dystocia in nulliparous women at term. Methods A population-based multi-centre cohort study. A self-administrated questionnaire collected at 37 weeks of gestation from nine obstetric departments in Denmark. The total cohort comprised 2652 nulliparous women, among whom 985 (37.1% met the protocol criteria for dystocia. Results Among the total cohort, 940 (35.4% women reported experience of violence, and among these, 66 (2.5% women reported exposure to violence during their first pregnancy. Further, 39.5% (n = 26 of those had never been exposed to violence before. Univariate logistic regression analysis showed no association between history of violence or experienced violence during pregnancy and labour dystocia at term, crude OR 0.91, 95% CI (0.77-1.08, OR 0.90, 95% CI (0.54-1.50, respectively. However, violence exposed women consuming alcoholic beverages during late pregnancy had increased odds of labour dystocia, crude OR 1.45, 95% CI (1.07-1.96. Conclusions Our findings indicate that nulliparous women who have a history of violence or experienced violence during pregnancy do not appear to have a higher risk of labour dystocia at term, according to the definition of labour dystocia in this study. Additional research on this topic would be beneficial, including further evaluation of the criteria for labour dystocia.

Persistent multi-scale fluctuations shift European hydroclimate to its millennial boundaries.

Science.gov (United States)

Markonis, Y; Hanel, M; Máca, P; Kyselý, J; Cook, E R

2018-05-02

In recent years, there has been growing concern about the effect of global warming on water resources, especially at regional and continental scales. The last IPCC report on extremes states that there is medium confidence about an increase on European drought frequency during twentieth century. Here we use the Old World Drought Atlas palaeoclimatic reconstruction to show that when Europe's hydroclimate is examined under a millennial, multi-scale perspective, a significant decrease in dryness can be observed since 1920 over most of central and northern Europe. On the contrary, in the south, drying conditions have prevailed, creating an intense north-to-south dipole. In both cases, hydroclimatic conditions have shifted to, and in some regions exceeded, their millennial boundaries, remaining at these extreme levels for the longest period of the 1000-year-long record.

Agenda Responsiveness in the European Council

DEFF Research Database (Denmark)

Alexandrova, Petya; Rasmussen, Anne; Toshkov, Dimiter

2016-01-01

The existence of political responsiveness in multi-level systems like the EU remains an open question despite significant recent research on the topic. This article studies whether the European Council responds to the shifting policy priorities of European citizens. More specifically, it explores......, a detailed examination of the shifts in prioritisation of single issues over time reveals little evidence for dynamic issue responsiveness. Recently the European Council has paid more attention to the issues that the public considered the most pressing problems but the convergence could possibly be driven...

Evaluating Partnerships to Enhance Disaster Risk Management using Multi-Criteria Analysis: An Application at the Pan-European Level

Science.gov (United States)

Hochrainer-Stigler, Stefan; Lorant, Anna

2018-01-01

Disaster risk is increasingly recognized as a major development challenge. Recent calls emphasize the need to proactively engage in disaster risk reduction, as well as to establish new partnerships between private and public sector entities in order to decrease current and future risks. Very often such potential partnerships have to meet different objectives reflecting on the priorities of stakeholders involved. Consequently, potential partnerships need to be assessed on multiple criteria to determine weakest links and greatest threats in collaboration. This paper takes a supranational multi-sector partnership perspective, and considers possible ways to enhance disaster risk management in the European Union by better coordination between the European Union Solidarity Fund, risk reduction efforts, and insurance mechanisms. Based on flood risk estimates we employ a risk-layer approach to determine set of options for new partnerships and test them in a high-level workshop via a novel cardinal ranking based multi-criteria approach. Whilst transformative changes receive good overall scores, we also find that the incorporation of risk into budget planning is an essential condition for successful partnerships.

Hypertension control in a large multi-ethnic cohort in Amsterdam, The Netherlands: the HELIUS study

NARCIS (Netherlands)

Agyemang, Charles; Kieft, Suzanne; Snijder, Marieke B.; Beune, Erik J.; van den Born, Bert-Jan; Brewster, Lizzy M.; Ujcic-Voortman, Joanne J.; Bindraban, Navin; van Montfrans, Gert; Peters, Ron J.; Stronks, Karien

2015-01-01

Hypertension is a major problem among European ethnic minority groups. We assessed the current situation of hypertension prevalence and its management among a multi-ethnic population in Amsterdam, The Netherlands. Data from the HELIUS study were used including 12,974 participants (1871 Ghanaian,

In vitro predictions of skin absorption of caffeine, testosterone, and benzoic acid: A multi-centre comparison study

NARCIS (Netherlands)

Sandt, J.J.M. van de; Burgsteden, J.A. van; Cage, S.; Carmichael, P.L.; Dick, I.; Kenyon, S.; Korinth, G.; Larese, F.; Limasset, J.C.; Maas, W.J.M.; Montomoli, L.; Nielsen, J.B.; Payan, J.-P.; Robinson, E.; Sartorelli, P.; Schaller, K.H.; Wilkinson, S.C.; Williams, F.M.

2004-01-01

To obtain better insight into the robustness of in vitro percutaneous absorption methodology, the intra- and inter-laboratory variation in this type of study was investigated in 10 European laboratories. To this purpose, the in vitro absorption of three compounds through human skin (9 laboratories)

The European Nuclear Education Network Association - ENEN

International Nuclear Information System (INIS)

De Regge, P.P.

2005-01-01

The temporary network, established through the European 5 th Framework Programme project ENEN, was given a more permanent character by the foundation of the European Nuclear Education Network Association, a non-profit-making association according to the French law of 1901, pursuing a pedagogic and scientific aim. Its main objective is the preservation and the further development of higher nuclear education and expertise. This objective is realized through the co-operation between the European universities, involved in education and research in the nuclear engineering field, the nuclear research centres and the nuclear industry. The membership of the ENEN Association now consists of 35 universities members and 6 research centres. The paper briefly describes the history and structure of the ENEN Association and elaborates on the objectives and activities of its five committees during its first two years of operation. Supported by the 5 th and 6 th Framework Programme of the European Community, the ENEN Association established the delivery of the European Master of Science in Nuclear Engineering certificate. In particular, education and training courses have been developed and offered to materialise the core curricula and optional fields of study in a European exchange structure. Pilot editions of those courses and try-outs of training programmes have been successfully organised with a satisfying interest, attendance and performance by the students and the support of nuclear industries and international organisations. The involvement of ENEN in the 6 th EC Framework project EUROTRANS will further enlarge its field of activities into a realm of nuclear disciplines. The ENEN Association further contributes to the management of nuclear knowledge within the European Union as well as on a world-wide level, through contacts with its sister Network ANENT in Asia, and by its participation to activities of the World Nuclear University. (author)

The European Nuclear Education Network Association - ENEN

International Nuclear Information System (INIS)

Gentile, D.

2006-01-01

The temporary network, established through the European 5. Framework Programme project ENEN, was given a more permanent character by the foundation of the European Nuclear Education Network Association, a non-profit-making association according to the French law of 1901, pursuing a pedagogic and scientific aim. Its main objective is the preservation and the further development of higher nuclear education and expertise. This objective is realized through the co-operation between the European universities, involved in education and research in the nuclear engineering field, the nuclear research centres and the nuclear industry. The membership of the ENEN Association now consists of 35 universities members and 6 research centres. The paper briefly describes the history and structure of the ENEN Association and elaborates on the objectives and activities of its five committees during its first two years of operation. Supported by the 5. and 6. Framework Programme of the European Community, the ENEN Association established the delivery of the European Master of Science in Nuclear Engineering certificate. In particular, education and training courses have been developed and offered to materialize the core curricula and optional fields of study in a European exchange structure. Pilot editions of those courses and try-outs of training programmes have been successfully organised with a satisfying interest, attendance and performance by the students and the support of nuclear industries and international organisations. The involvement of ENEN in the 6. EC Framework project EUROTRANS will further enlarge its field of activities into a realm of nuclear disciplines. The ENEN Association further contributes to the management of nuclear knowledge within the European Union as well as on a world-wide level, through contacts with its sister Network ANENT in Asia, and by its participation to activities of the World Nuclear University. (author)

The European Nuclear Education Network Association - ENEN

Energy Technology Data Exchange (ETDEWEB)

Gentile, D. [Institut des Sciences et Techniques Nucleaires, CEA - Centre de Saclay, Bat. 395, F-91191 Gif-sur-Yvette (France)

2006-07-01

The temporary network, established through the European 5. Framework Programme project ENEN, was given a more permanent character by the foundation of the European Nuclear Education Network Association, a non-profit-making association according to the French law of 1901, pursuing a pedagogic and scientific aim. Its main objective is the preservation and the further development of higher nuclear education and expertise. This objective is realized through the co-operation between the European universities, involved in education and research in the nuclear engineering field, the nuclear research centres and the nuclear industry. The membership of the ENEN Association now consists of 35 universities members and 6 research centres. The paper briefly describes the history and structure of the ENEN Association and elaborates on the objectives and activities of its five committees during its first two years of operation. Supported by the 5. and 6. Framework Programme of the European Community, the ENEN Association established the delivery of the European Master of Science in Nuclear Engineering certificate. In particular, education and training courses have been developed and offered to materialize the core curricula and optional fields of study in a European exchange structure. Pilot editions of those courses and try-outs of training programmes have been successfully organised with a satisfying interest, attendance and performance by the students and the support of nuclear industries and international organisations. The involvement of ENEN in the 6. EC Framework project EUROTRANS will further enlarge its field of activities into a realm of nuclear disciplines. The ENEN Association further contributes to the management of nuclear knowledge within the European Union as well as on a world-wide level, through contacts with its sister Network ANENT in Asia, and by its participation to activities of the World Nuclear University. (author)

The importance of dietary change for men diagnosed with and at risk of prostate cancer: a multi-centre interview study with men, their partners and health professionals.

Science.gov (United States)

Avery, Kerry N L; Donovan, Jenny L; Horwood, Jeremy; Neal, David E; Hamdy, Freddie C; Parker, Chris; Wade, Julia; Lane, Athene

2014-05-03

The diagnosis of prostate cancer (PC) can provide a trigger for dietary change, and there is evidence that healthier diets may improve quality of life and clinical outcomes. However, men's views about dietary change in PC survivorship are largely unknown. This multi-centre qualitative interview study explored men's views about dietary change in PC survivorship, to better understand motivations for, and barriers to, achieving desired changes. The role of radical and active surveillance treatments on dietary change and the influence of men's partners were examined. Focus groups also evaluated stakeholder opinion, including healthcare professionals, about the provision of dietary advice to PC patients. A multi-centre interview study explored views about diet and motivations for, and barriers to, dietary change in men at elevated risk or diagnosed with PC following prostate specific antigen (PSA) testing. 58 men and 11 partners were interviewed. Interviews and focus groups were undertaken with 11 healthcare professionals, 5 patients and 4 partners to evaluate stakeholders' opinions about the feasibility and acceptability of providing dietary advice to PC patients. Data were analysed using methods of constant comparison and thematic analysis. Over half of diagnosed men reported making dietary changes, primarily to promote general or prostate health or facilitate coping, despite their uncertainty about diet-PC links. Interest in dietary advice was high. Information needs varied depending on treatment received, with men on active surveillance more frequently modifying their diet and regarding this as an adjunct therapy. Men considered their partners integral to implementing changes. Provision of dietary advice to men diagnosed with PC was considered by healthcare professionals and men to be feasible and appropriate in the context of a holistic 'care package'. Many men make positive dietary changes after PC diagnosis, which are perceived by men and their partners to bring

A longitudinal, multi-level comparative study of quality and safety in European hospitals

DEFF Research Database (Denmark)

Robert, Glenn B; Anderson, Janet E; Burnett, Susan J

2011-01-01

makers in the European Union. Throughout the study we will adopt a mixed methods approach, including qualitative (in-depth, narrative-based, ethnographic case studies using interviews, and direct non-participant observation of organisational processes) and quantitative research (secondary analysis......, patient safety and patient experience • a conceptualisation of quality as a human, social, technical and organisational accomplishment • an emphasis on translational research that is evidence-based and seeks to provide strategic and practical guidance for hospital practitioners and health care policy...... by Research' (QUASER) study will investigate how hospitals implement, spread and sustain quality improvement, including the difficulties they face and how they overcome them. The overall aim of the study is to explore relationships between the organisational and cultural characteristics of hospitals and how...

ASAP ECMO: Antibiotic, Sedative and Analgesic Pharmacokinetics during Extracorporeal Membrane Oxygenation: a multi-centre study to optimise drug therapy during ECMO

Directory of Open Access Journals (Sweden)

Shekar Kiran

2012-11-01

Full Text Available Abstract Background Given the expanding scope of extracorporeal membrane oxygenation (ECMO and its variable impact on drug pharmacokinetics as observed in neonatal studies, it is imperative that the effects of the device on the drugs commonly prescribed in the intensive care unit (ICU are further investigated. Currently, there are no data to confirm the appropriateness of standard drug dosing in adult patients on ECMO. Ineffective drug regimens in these critically ill patients can seriously worsen patient outcomes. This study was designed to describe the pharmacokinetics of the commonly used antibiotic, analgesic and sedative drugs in adult patients receiving ECMO. Methods/Design This is a multi-centre, open-label, descriptive pharmacokinetic (PK study. Eligible patients will be adults treated with ECMO for severe cardiac and/or respiratory failure at five Intensive Care Units in Australia and New Zealand. Patients will receive the study drugs as part of their routine management. Blood samples will be taken from indwelling catheters to investigate plasma concentrations of several antibiotics (ceftriaxone, meropenem, vancomycin, ciprofloxacin, gentamicin, piperacillin-tazobactum, ticarcillin-clavulunate, linezolid, fluconazole, voriconazole, caspofungin, oseltamivir, sedatives and analgesics (midazolam, morphine, fentanyl, propofol, dexmedetomidine, thiopentone. The PK of each drug will be characterised to determine the variability of PK in these patients and to develop dosing guidelines for prescription during ECMO. Discussion The evidence-based dosing algorithms generated from this analysis can be evaluated in later clinical studies. This knowledge is vitally important for optimising pharmacotherapy in these most severely ill patients to maximise the opportunity for therapeutic success and minimise the risk of therapeutic failure. Trial registration ACTRN12612000559819

European commission research activities on iodine

Energy Technology Data Exchange (ETDEWEB)

Loggia, E della [European Commission, Brussels (Belgium)

1996-12-01

The research on iodine, as on other important fission products which would be released during a severe accident, carried out directly or organized by the European Commission stems from the Euratom Treaty, namely from Chapter III of the treaty which deals with the protection of the health of the population against radiations and from Chapter I which deals with research. In this paper we do not consider the Commission radiological protection programme: we limit ourselves to the presentation of the research carried out on Iodine as part of the most recent source term studies within the framework Programmes as are called the research programme of the European Commission, usually valid for a 4 year periods. The research activities are carried out by the European Commission either directly through the Joint Research Centres (JRC) or indirectly through collaboration with research organizations of Member States. Concerning the iodine research carried out as Direct Action in the Joint Research Centres, are mentioned here the most relevant activities carried out in this field at the JRC of Ispra and Karlsruhe (TUI). As Indirect Action, we present here the results of some studies allocated by the European Commission to experts of research organizations of Member Countries, followed by a short description of the main results achieved by the Reinforced Concerted Action, within the III Framework Programme (1992-1995). At the end of the paper are described the research on iodine being carried out or proposed within the IV Framework Programme (1995-1998). Mention is also done of the Commission participation, relevant in terms of financial and human efforts, to the PHEBUS FP Project. (author) refs.

European commission research activities on iodine

International Nuclear Information System (INIS)

Loggia, E. della

1996-01-01

The research on iodine, as on other important fission products which would be released during a severe accident, carried out directly or organized by the European Commission stems from the Euratom Treaty, namely from Chapter III of the treaty which deals with the protection of the health of the population against radiations and from Chapter I which deals with research. In this paper we do not consider the Commission radiological protection programme: we limit ourselves to the presentation of the research carried out on Iodine as part of the most recent source term studies within the framework Programmes as are called the research programme of the European Commission, usually valid for a 4 year periods. The research activities are carried out by the European Commission either directly through the Joint Research Centres (JRC) or indirectly through collaboration with research organizations of Member States. Concerning the iodine research carried out as Direct Action in the Joint Research Centres, are mentioned here the most relevant activities carried out in this field at the JRC of Ispra and Karlsruhe (TUI). As Indirect Action, we present here the results of some studies allocated by the European Commission to experts of research organizations of Member Countries, followed by a short description of the main results achieved by the Reinforced Concerted Action, within the III Framework Programme (1992-1995). At the end of the paper are described the research on iodine being carried out or proposed within the IV Framework Programme (1995-1998). Mention is also done of the Commission participation, relevant in terms of financial and human efforts, to the PHEBUS FP Project. (author) refs

Scientific centres in Europe: An analysis of research strength and patterns of specialisation based on bibliometric indicators

DEFF Research Database (Denmark)

Matthiessen, C. W.; Schwarz, Annette Winkel

1999-01-01

This paper presents the first analysis of scientific strength by output (papers in the Science Citation Index 1994-96) produced by authors from the 'greater' urban regions of Europe, Top lists of European centres are indicated, Four agglomerations constitute the European super-league of science......: London, Paris, Moscow and the Dutch urban agglomeration of Amsterdam, the Hague, Rotterdam and Utrecht, The next layer could be named the primary league and comprises 19 large research centres, A third group of 16 cities forms a secondary league of 16 smaller research centres, These upper-level research...

European Scientists prepare to test the limits of Physics

CERN Multimedia

2007-01-01

"European Scientists are gearing up for a series of experiments that will probe deeper into the nature of matter than ever before. At the end of August the Scientific Information Port (PIC), a centre for technology based at the Universitat Autonoma de Barcelona (UAB) began work on the first stage of the European project Large Hadron Collider (LHC). The aim of the project is to study the origins of mater by reproducing conditions similar to those produced during the Big Bang." (1 page)

Factors associated with success in the oral part of the European Diploma in Intensive Care.

Science.gov (United States)

Waldauf, Petr; Rubulotta, Francesca; Sitzwohl, Christian; Elbers, Paul; Girbes, Armand; Saha, Rajnish; Marsh, Brian; Kumar, Ravindra; Maggiorini, Marco; Duška, František

2017-11-01

missing candidates' data are the main limitations of this study. Younger age, English as native language, better results in written part of the exam, working at a European country and the use of PACT for preparation, were factors associated with success in the oral part of the European Diploma in Intensive Care exam. Despite the limitations of this study, the differences in outcome among the exam centres will need further investigation.

Surgical timing after chemoradiotherapy for rectal cancer, analysis of technique (STARRCAT): results of a feasibility multi-centre randomized controlled trial.

Science.gov (United States)

Foster, J D; Ewings, P; Falk, S; Cooper, E J; Roach, H; West, N P; Williams-Yesson, B A; Hanna, G B; Francis, N K

2016-10-01

The optimal time of rectal resection after long-course chemoradiotherapy (CRT) remains unclear. A feasibility study was undertaken for a multi-centre randomized controlled trial evaluating the impact of the interval after chemoradiotherapy on the technical complexity of surgery. Patients with rectal cancer were randomized to either a 6- or 12-week interval between CRT and surgery between June 2012 and May 2014 (ISRCTN registration number: 88843062). For blinded technical complexity assessment, the Observational Clinical Human Reliability Analysis technique was used to quantify technical errors enacted within video recordings of operations. Other measured outcomes included resection completeness, specimen quality, radiological down-staging, tumour cell density down-staging and surgeon-reported technical complexity. Thirty-one patients were enrolled: 15 were randomized to 6 and 16-12 weeks across 7 centres. Fewer eligible patients were identified than had been predicted. Of 23 patients who underwent resection, mean 12.3 errors were observed per case at 6 weeks vs. 10.7 at 12 weeks (p = 0.401). Other measured outcomes were similar between groups. The feasibility of measurement of operative performance of rectal cancer surgery as an endpoint was confirmed in this exploratory study. Recruitment of sufficient numbers of patients represented a challenge, and a proportion of patients did not proceed to resection surgery. These results suggest that interval after CRT may not substantially impact upon surgical technical performance.

The Australian centre for RF bioeffects research (ACRBR) - an NHMRC centre of research excellence

International Nuclear Information System (INIS)

Wood, A.; Croft, R.; Abramson, M.; Anderson, V.; Cosic, I.; Finnie, J.; McKenzie, R.

2004-01-01

Full text: The Australian Centre for Radiofrequency Bioeffects Research (ACRBR) is a newly established multi-institutional research centre which seeks to research questions pertaining to possible health effects of exposure to radiofrequency devices, such as mobile phones and which is funded under the Australian National Health and Medical Research Council (NHMRC) Centres of Research Excellence funding program. The Centre of Research Excellence in Electromagnetic Energy is combining the efforts of engineers, epidemiologists, physicists, psychophysiologists and veterinary pathologists from RMIT University, the Institute of Medical and Veterinary Science in South Australia (IMVS), Monash University, Swinburne University of Technology and Telstra Research Laboratories (TRL). The centre is funded at $2.5 M over five years and will undertake a program of research to address the issue of exposure to radiofrequency (RF) devices and health. It will also train new scientists, keep the community informed of ongoing developments and help the development of government policies in this area of considerable public concern. The 5-year program has the following components: Neurobiology: One important area where there is a perceived research gap is in the area of potential neurological effects, which will hence be a major focus of this Centre. The proposed studies range from in vitro and in vivo research studies of RF effects on neuron and neural system functioning in rodents, to that of RF effects on simple neural function, cognition and subjective report in humans. The latter series of studies have been developed to account for the consensus view that more emphasis needs to be placed on possible differences in RF population sensitivity (e.g. youth versus aged, and ' electromagnetic hypersensitives'). Epidemiological studies are an important tool in studying the impact on public health from exposure of whole populations to modern radio technologies. Cancer outcomes in this area of

Community Documentation Centre on Industrial Risk. Bulletin no. 8

International Nuclear Information System (INIS)

Masera, M.; Rasmussen, K.

1993-01-01

The Directorate-General for Environment, Nuclear Safety and Civil Protection of the Commission of the European Communities is responsible for the effective and harmonized implementation of the Directive 82/501/EEC on the major-accident hazards of certain industrial activities. To this end, the Commission, in collaboration with the Committee of Competent Authorities responsible for the implementation of this Directive in the twelve Member States, carries out a whole range of activities. One of the most essential areas for action identified was the need for a systematic diffusion of information concerning the practical implementation of the Directive in the Member States, including the technical rules and guidelines applied, the safety practices and the lessons learnt from major accidents. Therefore, the Commission decided to set up a Community Documentation Centre on Industrial Risks (CDCIR). This Documentation Centre is run by the European Commission, Joint Research Centre, Institute for Systems Engineering and Informatics (ISEI), at Ispra, Italy, among its support activities on the implementation of the Directive. The Documentation Centre will collect, classify and review technical rules, guidelines and documents concerning the requirements of the Directive, as well as the safety of industrial installations produced by governments, administrative, scientific or technical bodies, national or international organizations and industrial or professional associations. Documents on major accidents in the form of reports, videotapes will also be collected and reviewed. The Centre is accessible to interested visitors, documents which are not covered by copyright and are not restricted can be obtained from the Documentation Centre on request. Periodical volumes which will feature the inventory, including abstracts, of the collected material will be published and made available to all interested parties. The Centre will also publish documents devoted to compare existing

Community Documentation Centre on Industrial Risk. Bulletin no. 4

International Nuclear Information System (INIS)

Gow, H.B.F.

1991-01-01

The Directorate-General for Environment, Nuclear Safety and Civil Protection of the Commission of the European Communities is responsible for the effective and harmonized implementation of the Directive 82/501/EEC on the major-accident hazards of certain industrial activities. To this end, the Commission, in collaboration with the Committee of Competent Authorities responsible for the implementation of this Directive in the twelve Member States, carries out a whole range of activities. One of the most essential areas for action identified was the need for a systematic diffusion of information concerning the practical implementation of the Directive in the Member States, including the technical rules and guidelines applied, the safety practices and the lessons learnt from major accidents. Therefore, the Commission decided to set up a Community Documentation Centre on Industrial Risks (CDCIR). This Documentation Centre is run by the European Commission, Joint Research Centre, Institute for Systems Engineering and Informatics (ISEI), at Ispra, Italy, among its support activities on the implementation of the Directive. The Documentation Centre will collect, classify and review technical rules, guidelines and documents concerning the requirements of the Directive, as well as the safety of industrial installations produced by governments, administrative, scientific or technical bodies, national or international organizations and industrial or professional associations. Documents on major accidents in the form of reports, videotapes will also be collected and reviewed. The Centre is accessible to interested visitors, documents which are not covered by copyright and are not restricted can be obtained from the Documentation Centre on request. Periodical volumes which will feature the inventory, including abstracts, of the collected material will be published and made available to all interested parties. The Centre will also publish documents devoted to compare existing

Community Documentation Centre on Industrial Risk. Bulletin no. 10

International Nuclear Information System (INIS)

Perschke, A.; Kirchsteiger, C.

1996-01-01

The Directorate-General for Environment, Nuclear Safety and Civil Protection of the Commission of the European Communities is responsible for the effective and harmonized implementation of the Directive 82/501/EEC on the major-accident hazards of certain industrial activities. To this end, the Commission, in collaboration with the Committee of Competent Authorities responsible for the implementation of this Directive in the twelve Member States, carries out a whole range of activities. One of the most essential areas for action identified was the need for a systematic diffusion of information concerning the practical implementation of the Directive in the Member States, including the technical rules and guidelines applied, the safety practices and the lessons learnt from major accidents. Therefore, the Commission decided to set up a Community Documentation Centre on Industrial Risks (CDCIR). This Documentation Centre is run by the European Commission, Joint Research Centre, Institute for Systems Engineering and Informatics (ISEI), at Ispra, Italy, among its support activities on the implementation of the Directive. The Documentation Centre will collect, classify and review technical rules, guidelines and documents concerning the requirements of the Directive, as well as the safety of industrial installations produced by governments, administrative, scientific or technical bodies, national or international organizations and industrial or professional associations. Documents on major accidents in the form of reports, videotapes will also be collected and reviewed. The Centre is accessible to interested visitors, documents which are not covered by copyright and are not restricted can be obtained from the Documentation Centre on request. Periodical volumes which will feature the inventory, including abstracts, of the collected material will be published and made available to all interested parties. The Centre will also publish documents devoted to compare existing

Community Documentation Centre on Industrial Risk. Bulletin no. 5

International Nuclear Information System (INIS)

Gow, H.B.F.

1991-11-01

The Directorate-General for Environment, Nuclear Safety and Civil Protection of the Commission of the European Communities is responsible for the effective and harmonized implementation of the Directive 82/501/EEC on the major-accident hazards of certain industrial activities. To this end, the Commission, in collaboration with the Committee of Competent Authorities responsible for the implementation of this Directive in the twelve Member States, carries out a whole range of activities. One of the most essential areas for action identified was the need for a systematic diffusion of information concerning the practical implementation of the Directive in the Member States, including the technical rules and guidelines applied, the safety practices and the lessons learnt from major accidents. Therefore, the Commission decided to set up a Community Documentation Centre on Industrial Risks (CDCIR). This Documentation Centre is run by the European Commission, Joint Research Centre, Institute for Systems Engineering and Informatics (ISEI), at Ispra, Italy, among its support activities on the implementation of the Directive. The Documentation Centre will collect, classify and review technical rules, guidelines and documents concerning the requirements of the Directive, as well as the safety of industrial installations produced by governments, administrative, scientific or technical bodies, national or international organizations and industrial or professional associations. Documents on major accidents in the form of reports, videotapes will also be collected and reviewed. The Centre is accessible to interested visitors, documents which are not covered by copyright and are not restricted can be obtained from the Documentation Centre on request. Periodical volumes which will feature the inventory, including abstracts, of the collected material will be published and made available to all interested parties. The Centre will also publish documents devoted to compare existing

Community Documentation Centre on Industrial Risk. Bulletin no. 7

International Nuclear Information System (INIS)

Gow, H.B.F.; Carditello, I.

1993-04-01

The Directorate-General for Environment, Nuclear Safety and Civil Protection of the Commission of the European Communities is responsible for the effective and harmonized implementation of the Directive 82/501/EEC on the major-accident hazards of certain industrial activities. To this end, the Commission, in collaboration with the Committee of Competent Authorities responsible for the implementation of this Directive in the twelve Member States, carries out a whole range of activities. One of the most essential areas for action identified was the need for a systematic diffusion of information concerning the practical implementation of the Directive in the Member States, including the technical rules and guidelines applied, the safety practices and the lessons learnt from major accidents. Therefore, the Commission decided to set up a Community Documentation Centre on Industrial Risks (CDCIR). This Documentation Centre is run by the European Commission, Joint Research Centre, Institute for Systems Engineering and Informatics (ISEI), at Ispra, Italy, among its support activities on the implementation of the Directive. The Documentation Centre will collect, classify and review technical rules, guidelines and documents concerning the requirements of the Directive, as well as the safety of industrial installations produced by governments, administrative, scientific or technical bodies, national or international organizations and industrial or professional associations. Documents on major accidents in the form of reports, videotapes will also be collected and reviewed. The Centre is accessible to interested visitors, documents which are not covered by copyright and are not restricted can be obtained from the Documentation Centre on request. Periodical volumes which will feature the inventory, including abstracts, of the collected material will be published and made available to all interested parties. The Centre will also publish documents devoted to compare existing

Community Documentation Centre on Industrial Risk. Bulletin no. 9

International Nuclear Information System (INIS)

Perschke, A.

1995-01-01

The Directorate-General for Environment, Nuclear Safety and Civil Protection of the Commission of the European Communities is responsible for the effective and harmonized implementation of the Directive 82/501/EEC on the major-accident hazards of certain industrial activities. To this end, the Commission, in collaboration with the Committee of Competent Authorities responsible for the implementation of this Directive in the twelve Member States, carries out a whole range of activities. One of the most essential areas for action identified was the need for a systematic diffusion of information concerning the practical implementation of the Directive in the Member States, including the technical rules and guidelines applied, the safety practices and the lessons learnt from major accidents. Therefore, the Commission decided to set up a Community Documentation Centre on Industrial Risks (CDCIR). This Documentation Centre is run by the European Commission, Joint Research Centre, Institute for Systems Engineering and Informatics (ISEI), at Ispra, Italy, among its support activities on the implementation of the Directive. The Documentation Centre will collect, classify and review technical rules, guidelines and documents concerning the requirements of the Directive, as well as the safety of industrial installations produced by governments, administrative, scientific or technical bodies, national or international organizations and industrial or professional associations. Documents on major accidents in the form of reports, videotapes will also be collected and reviewed. The Centre is accessible to interested visitors, documents which are not covered by copyright and are not restricted can be obtained from the Documentation Centre on request. Periodical volumes which will feature the inventory, including abstracts, of the collected material will be published and made available to all interested parties. The Centre will also publish documents devoted to compare existing

Community Documentation Centre on Industrial Risk. Bulletin no. 6

International Nuclear Information System (INIS)

Gow, H.B.F.

1992-06-01

The Directorate-General for Environment, Nuclear Safety and Civil Protection of the Commission of the European Communities is responsible for the effective and harmonized implementation of the Directive 82/501/EEC on the major-accident hazards of certain industrial activities. To this end, the Commission, in collaboration with the Committee of Competent Authorities responsible for the implementation of this Directive in the twelve Member States, carries out a whole range of activities. One of the most essential areas for action identified was the need for a systematic diffusion of information concerning the practical implementation of the Directive in the Member States, including the technical rules and guidelines applied, the safety practices and the lessons learnt from major accidents. Therefore, the Commission decided to set up a Community Documentation Centre on Industrial Risks (CDCIR). This Documentation Centre is run by the European Commission, Joint Research Centre, Institute for Systems Engineering and Informatics (ISEI), at Ispra, Italy, among its support activities on the implementation of the Directive. The Documentation Centre will collect, classify and review technical rules, guidelines and documents concerning the requirements of the Directive, as well as the safety of industrial installations produced by governments, administrative, scientific or technical bodies, national or international organizations and industrial or professional associations. Documents on major accidents in the form of reports, videotapes will also be collected and reviewed. The Centre is accessible to interested visitors, documents which are not covered by copyright and are not restricted can be obtained from the Documentation Centre on request. Periodical volumes which will feature the inventory, including abstracts, of the collected material will be published and made available to all interested parties. The Centre will also publish documents devoted to compare existing

Community Documentation Centre on Industrial Risk. Bulletin no. 11

International Nuclear Information System (INIS)

Perschke, A.; Kirchsteiger, C.; Carnevali, C.

1997-01-01

The Directorate-General for Environment, Nuclear Safety and Civil Protection of the Commission of the European Communities is responsible for the effective and harmonized implementation of the Directive 82/501/EEC on the major-accident hazards of certain industrial activities. To this end, the Commission, in collaboration with the Committee of Competent Authorities responsible for the implementation of this Directive in the twelve Member States, carries out a whole range of activities. One of the most essential areas for action identified was the need for a systematic diffusion of information concerning the practical implementation of the Directive in the Member States, including the technical rules and guidelines applied, the safety practices and the lessons learnt from major accidents. Therefore, the Commission decided to set up a Community Documentation Centre on Industrial Risks (CDCIR). This Documentation Centre is run by the European Commission, Joint Research Centre, Institute for Systems Engineering and Informatics (ISEI), at Ispra, Italy, among its support activities on the implementation of the Directive. The Documentation Centre will collect, classify and review technical rules, guidelines and documents concerning the requirements of the Directive, as well as the safety of industrial installations produced by governments, administrative, scientific or technical bodies, national or international organizations and industrial or professional associations. Documents on major accidents in the form of reports, videotapes will also be collected and reviewed. The Centre is accessible to interested visitors, documents which are not covered by copyright and are not restricted can be obtained from the Documentation Centre on request. Periodical volumes which will feature the inventory, including abstracts, of the collected material will be published and made available to all interested parties. The Centre will also publish documents devoted to compare existing

Dietary practices in isovaleric acidemia: A European survey

Directory of Open Access Journals (Sweden)

A. Pinto

2017-09-01

Conclusions: This survey demonstrates wide differences in dietary practice in the management of IVA across European centres. It provides unique dietary data collectively representing European practices in IVA which can be used as a foundation to compare dietary management changes as a consequence of the first E-IMD IVA guidelines availability.

International research centre launched

International Nuclear Information System (INIS)

1965-01-01

Full text: The first scientific research and educational institution to be set up on a completely international basis was officially inaugurated in Trieste on 5 October 1964 by the Director General of IAEA, Dr. Sigvard Eklund, when he opened the first seminar of the International Centre for Theoretical Physics. As evidence of the international nature of the institution he noted that the scientists who would work and teach there during the first year represented sixteen different countries. By the end of 1964, the Centre building was nearing completion and three of the five floors were occupied. A successful symposium had been held on the subject of plasma physics, and a score of professors and fellows were at work, from Bulgaria, Czechoslovakia, Greece, India, Japan, Jordan, the Netherlands, Norway, Pakistan, Poland, the United Kingdom, and the United States. A dozen scientific papers had been issued as preprints. The main purpose of the Centre is to foster the advancement of theoretical physics through training and research; at first the chief subject will be high-energy and elementary particle physics. Plasma physics, low energy physics and solid-state physics will also be dealt with. Special attention is paid to the needs of the developing countries. Of the 25 fellows selected for the academic year 1964-65, more than half are from South America, Africa and Asia. In conjunction with the Research Centre, there is an Advanced School for theoretical Physics to provide graduate training for fellows who need such preparation before they embark upon research. The Centre works under the guidance of a Scientific Council comprising the president, Prof. M. Sandoval-Vallarta (Nuclear Energy Commission of Mexico); Prof. A. Abragam (Saclay, France); Prof. R. Oppenheimer (Institute for Advanced Study, Princeton, USA); Dr. V. Soloviev (Dubna, USSR); Prof V.F. Weiskopf (Director General, CERN) ; Prof Abdus Salam (Imperial College, London) ; Prof. P. Budini (University of Trieste

University career centres – venues of non-formal learning for students

Directory of Open Access Journals (Sweden)

Sabina Žnidaršič Žagar

2015-04-01

Full Text Available Incorporation of young people, including tertiary graduates, into the labour market is facing stagnation in Slovenia. Besides external factors that are beyond the control of an individual, good employability also depends on personal characteristics of the employment seeker. Awareness of the importance of good employability means empowering and strengthening individuals through process of lifelong learning, thus enabling them to find and retain sustainable employment within the labour market. This consequently enables them to fulfil their career goals and creatively contribute to their own personal satisfaction and success, as well as that of society as a whole. Universities in Slovenia have established careers centres. The University of Ljubljana opened its first careers centre years ago (in 2008, and we are now beginning to see the results, which are similar to those achieved by careers centres of other European universities. This confirms that promotion and facilitation of good employability is more effective when careers centres are closely involved in the study process.

Discussion: European Commission policy

International Nuclear Information System (INIS)

Coldwell, R.

1993-01-01

This paper documents the debate which arose following two papers presented to a seminar run by the Centre for the Study of Regulated Industries, on 11th November 1992, on European Commission (EC) energy policies. The issues raised cover how an internal market for electricity and natural gas will be implemented under a proposed EC directive, bearing in mind the level of opposition from a number of Member States. How this Directive will apply to vertically integrated structures, such as Scottish Electricity Industry, is also considered. (UK)

Globalized Trade, Logistics and Intermodality: European Perspectives

NARCIS (Netherlands)

Henstra, D.; Ruijgrok, C.J.; Tavasszy, L.A.; Capineri, C.; Leinbach, T.; Black, W.

2007-01-01

This chapter describes megatrends that are shaping international trade, logistics organization and (multi)modal transport in Europe. It focuses on impacts on the European context, both from the peculiarities arising from the European uni?cation process and the European transport policies but also

A study of goiter among female adolescents referred to centre for nuclear medicine, Lahore

International Nuclear Information System (INIS)

Elahi, S; Hassan, M.; Syed, Z.; Hyder, S.W.; Nazeer, L.; Nagra, S.A.

2005-01-01

Objective: To study goiter and thyroid dysfunction in female adolescents residing in Lahore referred to Centre for Nuclear Medicine (CENUM), Mayo Hospital for thyroid scanning and thyroid function tests. Design: Retrospective study of thyroid size, thyroid scan patterns and serum FT/sub 4/ and TSH levels. Setting: Centre for Nuclear Medicine (CENUM), Mayo Hospital, Lahore. Patients: 350 female adolescent referred during September 2002 to April 2003. Main outcome measures: adolescent goiter, thyroid nodules, hyperthyroidism, hypothyroidism, Graves' disease, toxic multi nodular goiter. Results: Among 350 adolescents 212(60.6%) had goiter of various grades mostly visible. Among goiterous patients 136(64.2%) had diffuse and 76 (35.8%) had nodular presentation. The number of patients with solitary nodular goiter (20.7%) was more than multi nodular goiter (15.1%) and number of patients with solitary cold nodule (16.5%) was more than functioning nodule (4.2%). The incidence of biochemical thyroid dysfunction, both overt and subclinical, was detected in 42(19.8%) patients and was significantly more frequent in patients with nodular than diffuse presentation (29% VS 14.7%; p<0.001) and in multinodular than solitary nodular goiter (p<0.005). More than 80% of the patients with solitary nodular goiter were euthyroid. Simple goiter was detected in 116(54.7%), Graves' disease in 5(2.4%) and toxic multinodular goiter in 4(1.9%) patients. Overall incidence of hypothyroidism was more than double as compared to hyperthyroidism. Incidence of nodularity and hypothyroidism was more in large goiter but duration of goiter was not significant in promoting nodularity. Conclusion: Goiterous adolescents need urgent attention because they don't have just diffuse hypertrophy with normal thyroid function. Many are afflicted with dysfunction and nodularity, particularly solitary cold nodule bearing risk of thyroid malignancy. (author)

Validation of the 24-item recovery assessment scale-revised (RAS-R) in the Norwegian language and context: a multi-centre study.

Science.gov (United States)

Biringer, Eva; Tjoflåt, Marit

2018-01-25

The Recovery Assessment Scale-revised (RAS-R) is a self-report instrument measuring mental health recovery. The purpose of the present study was to translate and adapt the RAS-R into the Norwegian language and to investigate its psychometric properties in terms of factor structure, convergent and discriminant validity and reliability in the Norwegian context. The present study is a cross-sectional multi-centre study. After a pilot test, the Norwegian version of the RAS-R was distributed to 231 service users in mental health specialist and community services. The factor structure of the instrument was investigated by a confirmatory factor analysis (CFA), and internal consistency was assessed by Cronbach's alpha. The RAS-R was found to be acceptable and feasible for service users. The original five-factor structure was confirmed. All model fit indices, including the standardised root mean square residual (SRMR), which is independent of the χ 2 -test, met the criteria for an acceptable model fit. Internal consistencies within sub-scales as measured by Cronbach's alpha ranged from 0.65 to 0.85. Cronbach's alpha for the total scale was 0.90. As expected, some redundancy between factors existed (in particular among the factors Personal confidence and hope, Goal and success orientation and Not dominated by symptoms). The Norwegian RAS-R showed acceptable psychometric properties in terms of convergent validity and reliability, and fit indices from the CFA confirmed the original factor structure. We recommend the Norwegian RAS-R as a tool in service users' and health professionals' collaborative work towards the service users' recovery goals and as an outcome measure in larger evaluations.

The role of the sexual assault centre.

LENUS (Irish Health Repository)

Eogan, Maeve

2013-02-01

Sexual Assault Centres provide multidisciplinary care for men and women who have experienced sexual crime. These centres enable provision of medical, forensic, psychological support and follow-up care, even if patients chose not to report the incident to the police service. Sexual Support Centres need to provide a ring-fenced, forensically clean environment. They need to be appropriately staffed and available 24 hours a day, 7 days a week to allow prompt provision of medical and supportive care and collection of forensic evidence. Sexual Assault Centres work best within the context of a core agreed model of care, which includes defined multi-agency guidelines and care pathways, close links with forensic science and police services, and designated and sustainable funding arrangements. Additionally, Sexual Assault Centres also participate in patient, staff and community education and risk reduction. Furthermore, they contribute to the development, evaluation and implementation of national strategies on domestic, sexual and gender-based violence.

Tuberculosis among migrant populations in the European Union and the European Economic Area.

Science.gov (United States)

Odone, Anna; Tillmann, Taavi; Sandgren, Andreas; Williams, Gemma; Rechel, Bernd; Ingleby, David; Noori, Teymur; Mladovsky, Philipa; McKee, Martin

2015-06-01

Although tuberculosis (TB) incidence has been decreasing in the European Union/European Economic Area (EU/EEA) in the last decades, specific subgroups of the population, such as migrants, remain at high risk of TB. This study is based on the report 'Key Infectious Diseases in Migrant Populations in the EU/EEA' commissioned by The European Centre for Disease Prevention and Control. We collected, critically appraised and summarized the available evidence on the TB burden in migrants in the EU/EEA. Data were collected through: (i) a comprehensive literature review; (ii) analysis of data from The European Surveillance System (TESSy) and (iii) evidence provided by TB experts during an infectious disease workshop in 2012. In 2010, of the 73,996 TB cases notified in the EU/EEA, 25% were of foreign origin. The overall decrease of TB cases observed in recent years has not been reflected in migrant populations. Foreign-born people with TB exhibit different socioeconomic and clinical characteristics than native sufferers. This is one of the first studies to use multiple data sources, including the largest available European database on infectious disease notifications, to assess the burden and provide a comprehensive description and analysis of specific TB features in migrants in the EU/EEA. Strengthened information about health determinants and factors for migrants' vulnerability is needed to plan, implement and evaluate targeted TB care and control interventions for migrants in the EU/EEA. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association.

Predicting Species Distributions Using Record Centre Data: Multi-Scale Modelling of Habitat Suitability for Bat Roosts.

Science.gov (United States)

Bellamy, Chloe; Altringham, John

2015-01-01

Conservation increasingly operates at the landscape scale. For this to be effective, we need landscape scale information on species distributions and the environmental factors that underpin them. Species records are becoming increasingly available via data centres and online portals, but they are often patchy and biased. We demonstrate how such data can yield useful habitat suitability models, using bat roost records as an example. We analysed the effects of environmental variables at eight spatial scales (500 m - 6 km) on roost selection by eight bat species (Pipistrellus pipistrellus, P. pygmaeus, Nyctalus noctula, Myotis mystacinus, M. brandtii, M. nattereri, M. daubentonii, and Plecotus auritus) using the presence-only modelling software MaxEnt. Modelling was carried out on a selection of 418 data centre roost records from the Lake District National Park, UK. Target group pseudoabsences were selected to reduce the impact of sampling bias. Multi-scale models, combining variables measured at their best performing spatial scales, were used to predict roosting habitat suitability, yielding models with useful predictive abilities. Small areas of deciduous woodland consistently increased roosting habitat suitability, but other habitat associations varied between species and scales. Pipistrellus were positively related to built environments at small scales, and depended on large-scale woodland availability. The other, more specialist, species were highly sensitive to human-altered landscapes, avoiding even small rural towns. The strength of many relationships at large scales suggests that bats are sensitive to habitat modifications far from the roost itself. The fine resolution, large extent maps will aid targeted decision-making by conservationists and planners. We have made available an ArcGIS toolbox that automates the production of multi-scale variables, to facilitate the application of our methods to other taxa and locations. Habitat suitability modelling has the

Exploring health, safety and environment in central and Eastern Europe: an introduction to the European Centre for Occupational Health, Safety and the Environment (ECOHSE).

Science.gov (United States)

Beck, M; Robson, M; Watterson, A; Woolfson, C

2001-01-01

This article traces the development of the European Centre for Occupational Health, Safety and the Environment (ECOHSE) at the University of Glasgow. ECOHSE recently has been designated a Thematic Network by the European Union which is providing administrative support through 2004. The de facto de-regulation that accompanied emergent capitalism in Eastern Europe created opportunities for exploitation of the work force. Voluntary efforts of a loose network of occupational and environmental health academics led to a series of yearly conferences to discuss these problems and the lack of research about them. Then, in 1999, a more formal organization was established at Glasgow to pursue continuity and funding. The first occupational and environmental health conference under ECOHSE was held last year in Lithuania, and selected presentations of that meeting are offered in this journal. A second ECOHSE conference will be held this fall in Romania.

Study of multi-pixel Geiger-mode avalanche photodiodes as a read-out for PET

CERN Document Server

Musienko, Yuri; Lecoq, Paul; Reucroft, Stephen; Swain, John; Trummer, Julia

2007-01-01

We have studied the performance of two multi-pixel Geiger-mode APDs (recently developed by the Centre of Perspective Technologies and Apparatus (CPTA) in Moscow) with 1×1 mm2 and 3×3 mm2 sensitive area as a readout for LSO and LYSO scintillator crystals. Energy and timing spectra were measured using a 22Na γ-source. The results of this study allow us to conclude that this photodetector is a very promising candidate for PET applications.

Fast neutrons in the treatment of head and neck cancers: the results of a multi-centre randomly controlled trial

International Nuclear Information System (INIS)

Duncan, W.; Arnott, S.J.; Orr, J.A.; Kerr, G.R.; Schmitt, G.

1984-01-01

The results are presented of a multi-centre randomly controlled trial of fast neutron irradiation and mega-voltage X-rays in the treatment of patients with locally advanced squamous cell carcinoma of the head and neck region. No significant difference was observed in local tumour control rates. Salvage surgery was performed in a similar number of patients in the two groups. Late morbidity was also similar in the two treatment groups. Patients in a subgroup with cancer of the larynx treated by photons had a significantly better survival than those in the neutron treated group. (Auth.)

An Expanded Genome-Wide Association Study of Type 2 Diabetes in Europeans

NARCIS (Netherlands)

Scott, Robert A; Scott, Laura J; Mägi, Reedik; Marullo, Letizia; Gaulton, Kyle J; Kaakinen, Marika; Pervjakova, Natalia; Pers, Tune H; Johnson, Andrew D; Eicher, John D; Jackson, Anne U; Ferreira, Teresa; Lee, Yeji; Ma, Clement; Steinthorsdottir, Valgerdur; Thorleifsson, Gudmar; Qi, Lu; Van Zuydam, Natalie R; Mahajan, Anubha; Chen, Han; Almgren, Peter; Voight, Ben F; Grallert, Harald; Müller-Nurasyid, Martina; Ried, Janina S; Rayner, William N; Robertson, Neil; Karssen, Lennart C; van Leeuwen, Elisabeth M; Willems, Sara M; Fuchsberger, Christian; Kwan, Phoenix; Teslovich, Tanya M; Chanda, Pritam; Li, Man; Lu, Yingchang; Dina, Christian; Thuillier, Dorothee; Yengo, Loic; Jiang, Longda; Sparso, Thomas; Kestler, Hans A; Chheda, Himanshu; Eisele, Lewin; Gustafsson, Stefan; Frånberg, Mattias; Strawbridge, Rona J; Benediktsson, Rafn; Hreidarsson, Astradur B; Kong, Augustine; Sigurðsson, Gunnar; Kerrison, Nicola D; Luan, Jian'an; Liang, Liming; Meitinger, Thomas; Roden, Michael; Thorand, Barbara; Esko, Tõnu; Mihailov, Evelin; Fox, Caroline; Liu, Ching-Ti; Rybin, Denis; Isomaa, Bo; Lyssenko, Valeriya; Tuomi, Tiinamaija; Couper, David J; Pankow, James S; Grarup, Niels; Have, Christian T; Jørgensen, Marit E; Jørgensen, Torben; Linneberg, Allan; Cornelis, Marilyn C; van Dam, Rob M; Hunter, David J; Kraft, Peter; Sun, Qi; Edkins, Sarah; Owen, Katharine R; Perry, John Rb; Wood, Andrew R; Zeggini, Eleftheria; Tajes-Fernandes, Juan; Abecasis, Goncalo R; Bonnycastle, Lori L; Chines, Peter S; Stringham, Heather M; Koistinen, Heikki A; Kinnunen, Leena; Sennblad, Bengt; Mühleisen, Thomas W; Nöthen, Markus M; Pechlivanis, Sonali; Baldassarre, Damiano; Gertow, Karl; Humphries, Steve E; Tremoli, Elena; Klopp, Norman; Meyer, Julia; Steinbach, Gerald; Wennauer, Roman; Eriksson, Johan G; Mӓnnistö, Satu; Peltonen, Leena; Tikkanen, Emmi; Charpentier, Guillaume; Eury, Elodie; Lobbens, Stéphane; Gigante, Bruna; Leander, Karin; McLeod, Olga; Bottinger, Erwin P; Gottesman, Omri; Ruderfer, Douglas; Blüher, Matthias; Kovacs, Peter; Tonjes, Anke; Maruthur, Nisa M; Scapoli, Chiara; Erbel, Raimund; Jöckel, Karl-Heinz; Moebus, Susanne; de Faire, Ulf; Hamsten, Anders; Stumvoll, Michael; Deloukas, Panagiotis; Donnelly, Peter J; Frayling, Timothy M; Hattersley, Andrew T; Ripatti, Samuli; Salomaa, Veikko; Pedersen, Nancy L; Boehm, Bernhard O; Bergman, Richard N; Collins, Francis S; Mohlke, Karen L; Tuomilehto, Jaakko; Hansen, Torben; Pedersen, Oluf; Barroso, Inês; Lannfelt, Lars; Ingelsson, Erik; Lind, Lars; Lindgren, Cecilia M; Cauchi, Stephane; Froguel, Philippe; Loos, Ruth Jf; Balkau, Beverley; Boeing, Heiner; Franks, Paul W; Gurrea, Aurelio Barricarte; Palli, Domenico; van der Schouw, Yvonne T; Altshuler, David; Groop, Leif C; Langenberg, Claudia; Wareham, Nicholas J; Sijbrands, Eric; van Duijn, Cornelia M; Florez, Jose C; Meigs, James B; Boerwinkle, Eric; Gieger, Christian; Strauch, Konstantin; Metspalu, Andres; Morris, Andrew D; Palmer, Colin Na; Hu, Frank B; Thorsteinsdottir, Unnur; Stefansson, Kari; Dupuis, Josée; Morris, Andrew P; Boehnke, Michael; McCarthy, Mark I; Prokopenko, Inga

2017-01-01

To characterise type 2 diabetes (T2D) associated variation across the allele frequency spectrum, we conducted a meta-analysis of genome-wide association data from 26,676 T2D cases and 132,532 controls of European ancestry after imputation using the 1000 Genomes multi-ethnic reference panel.

European rating of drug harms

NARCIS (Netherlands)

van Amsterdam, Jan; Nutt, David; Phillips, Lawrence; van den Brink, Wim

2015-01-01

The present paper describes the results of a rating study performed by a group of European Union (EU) drug experts using the multi-criteria decision analysis model for evaluating drug harms. Forty drug experts from throughout the EU scored 20 drugs on 16 harm criteria. The expert group also assessed

Variability of fish consumption within the 10 European countries participating in the European Investigation into Cancer and Nutrition (EPIC) study

DEFF Research Database (Denmark)

Welch, A.A.; Lund, E.; Amiano, P.

2002-01-01

was in the coastal areas of northern Europe (Denmark, Sweden and Norway) and in Germany. Consumption of fish products was greater in northern than in southern Europe, with white fish products predominating in centres in France, Italy, Spain, The Netherlands and Norway. Intake of roe and roe products was low......OBJECTIVE: To describe and compare the consumption of total fish (marine foods) and the fish sub-groups - white fish, fatty fish, very fatty fish, fish products and crustacea, in participants from the European Investigation into Cancer and Nutrition (EPIC) study. DESIGN: Cross-sectional analysis...... study. SUBJECTS: In total, 35 955 subjects (13 031 men and 22 924 women), aged 35-74 years, selected from the main EPIC cohort. RESULTS: A six- to sevenfold variation in total fish consumption exists in women and men, between the lowest consumption in Germany and the highest in Spain. Overall, white...

CoDuSe group exercise programme improves balance and reduces falls in people with multiple sclerosis: A multi-centre, randomized, controlled pilot study.

Science.gov (United States)

Carling, Anna; Forsberg, Anette; Gunnarsson, Martin; Nilsagård, Ylva

2017-09-01

Imbalance leading to falls is common in people with multiple sclerosis (PwMS). To evaluate the effects of a balance group exercise programme (CoDuSe) on balance and walking in PwMS (Expanded Disability Status Scale, 4.0-7.5). A multi-centre, randomized, controlled single-blinded pilot study with random allocation to early or late start of exercise, with the latter group serving as control group for the physical function measures. In total, 14 supervised 60-minute exercise sessions were delivered over 7 weeks. Pretest-posttest analyses were conducted for self-reported near falls and falls in the group starting late. Primary outcome was Berg Balance Scale (BBS). A total of 51 participants were initially enrolled; three were lost to follow-up. Post-intervention, the exercise group showed statistically significant improvement ( p = 0.015) in BBS and borderline significant improvement in MS Walking Scale ( p = 0.051), both with large effect sizes (3.66; -2.89). No other significant differences were found between groups. In the group starting late, numbers of falls and near falls were statistically significantly reduced after exercise compared to before ( p balance and reduced perceived walking limitations, compared to no exercise. The intervention reduced falls and near falls frequency.

European union standards for tuberculosis care.

Science.gov (United States)

Migliori, G B; Zellweger, J P; Abubakar, I; Ibraim, E; Caminero, J A; De Vries, G; D'Ambrosio, L; Centis, R; Sotgiu, G; Menegale, O; Kliiman, K; Aksamit, T; Cirillo, D M; Danilovits, M; Dara, M; Dheda, K; Dinh-Xuan, A T; Kluge, H; Lange, C; Leimane, V; Loddenkemper, R; Nicod, L P; Raviglione, M C; Spanevello, A; Thomsen, V Ø; Villar, M; Wanlin, M; Wedzicha, J A; Zumla, A; Blasi, F; Huitric, E; Sandgren, A; Manissero, D

2012-04-01

The European Centre for Disease Prevention and Control (ECDC) and the European Respiratory Society (ERS) jointly developed European Union Standards for Tuberculosis Care (ESTC) aimed at providing European Union (EU)-tailored standards for the diagnosis, treatment and prevention of tuberculosis (TB). The International Standards for TB Care (ISTC) were developed in the global context and are not always adapted to the EU setting and practices. The majority of EU countries have the resources and capacity to implement higher standards to further secure quality TB diagnosis, treatment and prevention. On this basis, the ESTC were developed as standards specifically tailored to the EU setting. A panel of 30 international experts, led by a writing group and the ERS and ECDC, identified and developed the 21 ESTC in the areas of diagnosis, treatment, HIV and comorbid conditions, and public health and prevention. The ISTCs formed the basis for the 21 standards, upon which additional EU adaptations and supplements were developed. These patient-centred standards are targeted to clinicians and public health workers, providing an easy-to-use resource, guiding through all required activities to ensure optimal diagnosis, treatment and prevention of TB. These will support EU health programmes to identify and develop optimal procedures for TB care, control and elimination.

The European EUCCLID pilot study on care and complications in an unselected sample of people with type 2 diabetes in primary care

DEFF Research Database (Denmark)

Gorter, K.J.; Wens, J.; Khunti, K.

2010-01-01

indicators, UKPDS-risk engine, psychological and general well-being. RESULTS: We included 103 participants from 22 GPs in 11 countries. Central data and laboratory samples were successfully collected. Of the participants 54% were female, mean age was 66 years and mean duration of diabetes was 9.6 years......BACKGROUND: European studies on quality of diabetes care in an unselected primary care diabetes population are scarce. RESEARCH QUESTION: To test the feasibility of the set-up and logistics of a cross-sectional EUropean study on Care and Complications in patients with type 2 diabetes (T2DM......) in Primary Care (EUCCLID) in 12 European countries. METHOD: One rural and one urban practice from each country participated. The central coordinating centre randomly selected five patients from each practice. Patient characteristics were assessed including medical history, anthropometric measures, quality...

The European Microwave Week 2008 and its Microwave Conferences

NARCIS (Netherlands)

Hoogeboom, P.; Van Vliet, F.

2009-01-01

Under the auspices of the European Microwave Association (EuMA) the 11th annual European Microwave Week was organized in the Amsterdam RAI Congress Centre, The Netherlands, 27-31 October 2008. This major event consisted this year of five conferences, an exhibition, and various side events. The 38th

Multi-Omics Research Trends in Sepsis: A Bibliometric, Comparative Analysis Between the United States, the European Union 28 Member States, and China.

Science.gov (United States)

Evangelatos, Nikolaos; Satyamoorthy, Kapaettu; Levidou, Georgia; Bauer, Pia; Brand, Helmut; Kouskouti, Christina; Lehrach, Hans; Brand, Angela

2018-03-01

"-Omics" research is in transition with the recent rise of multi-omics technology platforms. Integration of "-omics" and multi-omics research is of high priority in sepsis, a heterogeneous syndrome that is widely recognized as a global health burden and a priority biomedical funding field. We report here an original study on bibliometric trends in the use of "-omics" technologies, and multi-omics approaches in particular, in sepsis research in three (supra)national settings, the United States, the European Union 28 Member States (EU-28), and China. Using a 5-year longitudinal bibliometric study design from 2011 to 2015, we analyzed the sepsis-related research articles in English language that included at least one or multi-omics technologies in publicly available form in Medline (free full texts). We found that the United States has had the lead (almost one-third of publications) in the inclusion of an "-omics" or multi-omics technology in sepsis within the study period. However, both China and the EU-28 displayed a significant increase in the number of publications that employed one or more types of "-omics" research (p < 0.005), while the EU-28 displayed a significant increase especially in multi-omics research articles in sepsis (p < 0.05). Notably, more than half of the multi-omics research studies in the sepsis knowledge domain had a university or government/state funding source. Among the multi-omics research publications in sepsis, the combination of genomics and transcriptomics was the most frequent (40.5%), followed by genomics and proteomics (20.4%). We suggest that the lead of the United States in the field of "-omics" and multi-omics research in sepsis is likely at stake, with both the EU-28 and China rapidly increasing their research capacity. Moreover, "triple omics" that combine genomics, proteomics, and metabolomics analyses appear to be uncommon in sepsis, and yet much needed for triangulation of systems science data. These observations

The effect of TCM acupuncture on hot flushes among menopausal women (ACUFLASH study: A study protocol of an ongoing multi-centre randomised controlled clinical trial

Directory of Open Access Journals (Sweden)

Borud Einar K

2007-02-01

Full Text Available Abstract Background After menopause, 10–20% of all women have nearly intolerable hot flushes. Long term use of hormone replacement therapy involves a health risk, and many women seek alternative strategies to relieve climacteric complaints. Acupuncture is one of the most frequently used complementary therapies in Norway. We designed a study to evaluate whether Traditional Chinese Medicine acupuncture-care together with self-care is more effective than self-care alone to relieve climacteric complaints. Methods/Design The study is a multi-centre pragmatic randomised controlled trial with two parallel arms. Participants are postmenopausal women who document ≥7 flushes/24 hours and who are not using hormone replacement therapy or other medication that may influence flushes. According to power calculations 200 women are needed to detect a 50% reduction in flushes, and altogether 286 women will be recruited to allow for a 30% dropout rate. The treatment group receives 10 sessions of Traditional Chinese Medicine acupuncture-care and self-care; the control group will engage in self-care only. A team of experienced Traditional Chinese Medicine acupuncturists give acupuncture treatments. Discussion The study tests acupuncture as a complete treatment package including the therapeutic relationship and expectation. The intervention period lasts for 12 weeks, with follow up at 6 and 12 months. Primary endpoint is change in daily hot flush frequency in the two groups from baseline to 12 weeks; secondary endpoint is health related quality of life, assessed by the Women's Health Questionnaire. We also collect data on Traditional Chinese Medicine diagnoses, and we examine treatment experiences using a qualitative approach. Finally we measure biological variables, to examine potential mechanisms for the effect of acupuncture. The study is funded by The Research Council of Norway.

European neonatal intensive care nursing research priorities: an e-Delphi study.

Science.gov (United States)

Wielenga, Joke M; Tume, Lyvonne N; Latour, Jos M; van den Hoogen, Agnes

2015-01-01

This study aimed to identify and prioritise neonatal intensive care nursing research topics across Europe using an e-Delphi technique. An e-Delphi technique with three questionnaire rounds was performed. Qualitative responses of round one were analysed by content analysis and research statements were generated to be ranged on importance on a scale of 1-6 (not important to most important). Neonatal intensive care units (NICUs) in 17 European countries. NICU clinical nurses, managers, educators and researchers (n=75). None. A list of 43 research statements in eight domains. The six highest ranking statements (≥5.0 mean score) were related to prevention and reduction of pain (mean 5.49; SD 1.07), medication errors (mean 5.20; SD 1.13), end-of-life care (mean 5.05; SD 1.18), needs of parents and family (mean 5.04; SD 1.23), implementing evidence into nursing practice (mean 5.02; SD 1.03), and pain assessment (mean 5.02; SD 1.11). The research domains were prioritised and ranked: (1) pain and stress; (2) family centred care; (3) clinical nursing care practices; (4) quality and safety; (5) ethics; (6) respiratory and ventilation; (7) infection and inflammation; and (8) professional issues in neonatal intensive care nursing. The results of this study might support developing a nursing research strategy for the nursing section of the European Society of Paediatric and Neonatal Intensive Care. In addition, this may promote more European researcher collaboratives for neonatal nursing research. 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.

Pilates based core stability training in ambulant individuals with multiple sclerosis: protocol for a multi-centre randomised controlled trial.

Science.gov (United States)

Freeman, Jennifer; Fox, Esther; Gear, Margaret; Hough, Alan

2012-04-05

People with Multiple Sclerosis (MS) frequently experience balance and mobility impairments, including reduced trunk stability. Pilates-based core stability training, which is aimed at improving control of the body's stabilising muscles, is popular as a form of exercise with people with MS and therapists. A replicated single case series study facilitated by the Therapists in MS Group in the United Kingdom (UK) provides preliminary evidence that this approach can improve balance and mobility in ambulant people with MS; further evidence is needed to substantiate these findings to ensure that limited time, energy, finances and resources are used to best effect.This study builds upon the pilot work undertaken in the case series study by implementing a powered randomised controlled study, with the aims of: 1 Establishing the effectiveness of core stability training; 2 Comparing core stability training with standardised physiotherapy exercise; 3 Exploring underlying mechanisms of change associated with this intervention This is a multi-centre, double blind, block randomised, controlled trial. Eligible participants will be recruited from 4 UK centres. Participants will be randomly allocated to one of three groups: Pilates based core stability training, standardised physiotherapy exercise or contract-relax relaxation sessions (placebo control). All will receive face to face training sessions over a 12 week period; together with a 15 minute daily home programme. All will be assessed by a blinded assessor before training, at the end of the 12 week programme and at 4 week follow-up. The primary outcome measure is the 10 metre timed walk. Secondary outcome measures are the MS walking Scale (MSWS-12), the Functional Reach (forwards and lateral), a 10 point Numerical Rating Scale to determine "Difficulty in carrying a drink when walking", and the Activities-specific Balance Confidence (ABC) Scale. In addition, ultrasound imaging of the abdominal muscles will be performed before

Pilates based core stability training in ambulant individuals with multiple sclerosis: protocol for a multi-centre randomised controlled trial

Directory of Open Access Journals (Sweden)

Freeman Jennifer

2012-04-01

Full Text Available Abstract Background People with Multiple Sclerosis (MS frequently experience balance and mobility impairments, including reduced trunk stability. Pilates-based core stability training, which is aimed at improving control of the body's stabilising muscles, is popular as a form of exercise with people with MS and therapists. A replicated single case series study facilitated by the Therapists in MS Group in the United Kingdom (UK provides preliminary evidence that this approach can improve balance and mobility in ambulant people with MS; further evidence is needed to substantiate these findings to ensure that limited time, energy, finances and resources are used to best effect. This study builds upon the pilot work undertaken in the case series study by implementing a powered randomised controlled study, with the aims of: 1 Establishing the effectiveness of core stability training 2 Comparing core stability training with standardised physiotherapy exercise 3 Exploring underlying mechanisms of change associated with this intervention Methods This is a multi-centre, double blind, block randomised, controlled trial. Eligible participants will be recruited from 4 UK centres. Participants will be randomly allocated to one of three groups: Pilates based core stability training, standardised physiotherapy exercise or contract-relax relaxation sessions (placebo control. All will receive face to face training sessions over a 12 week period; together with a 15 minute daily home programme. All will be assessed by a blinded assessor before training, at the end of the 12 week programme and at 4 week follow-up. The primary outcome measure is the 10 metre timed walk. Secondary outcome measures are the MS walking Scale (MSWS-12, the Functional Reach (forwards and lateral, a 10 point Numerical Rating Scale to determine "Difficulty in carrying a drink when walking", and the Activities-specific Balance Confidence (ABC Scale. In addition, ultrasound imaging of the

The prognostic value of pimonidazole and tumour pO2 in human cervix carcinomas after radiation therapy: a prospective international multi-center study

DEFF Research Database (Denmark)

Nordsmark, Marianne; Loncaster, Julie; Aquino-Parsons, Christina

2006-01-01

BACKGROUND AND PURPOSE: Hypoxia adversely affects treatment outcome in human uterine cervical cancer. Here, we present the results of a prospective international multi-centre study evaluating the prognostic value of pre-treatment tumour oxygen partial pressure (pO(2)) and the hypoxia marker pimon...... pimonidazole (pimo). MATERIALS AND METHODS: One hundred and twenty-seven patients with primary cervix cancer were entered. Pre-treatment tumour pO(2) measurements were obtained, and reported by the median tumour pO(2), the fraction of pO(2) values......BACKGROUND AND PURPOSE: Hypoxia adversely affects treatment outcome in human uterine cervical cancer. Here, we present the results of a prospective international multi-centre study evaluating the prognostic value of pre-treatment tumour oxygen partial pressure (pO(2)) and the hypoxia marker...

Fusion research in the European Community

International Nuclear Information System (INIS)

Wolf, G.H.

1988-01-01

Centering around the European joint project Joint European Torus (JET), in the framework of which hot fusion plasmas are already brought close to thermonuclear ignition, the individual research centres in Europe have taken over different special tasks. In Germany research concentrates above all on the development of super-conductive magnets, the stage of plasma-physical fundamentals or the investigation of the interaction between the plasma boundary layer and the material of the vessel wall. On this basis the development stage following JET, the Next European Torus (NET), is planned, with its main aim being the production and maintenance of a thermonuclear burning plasma, i.e. a plasma which maintains its active state from the gain of energy of its own fusion reactions. In the framework of a contractually agreed cooperation between the European Community, Japan, the USSR and the USA, the establishment of an international study group (with seat in Garching) was decided upon, which is to develop the concept of an 'International Thermonuclear Experimental Reactor (ITER)' jointly supported by these countries. The results of the studies presented show that the differences in the design data of ITER and NET are negligible. (orig./DG) [de

Quality assurance in clinical trials : a multi-disciplinary approach

International Nuclear Information System (INIS)

Cornes, D.

2001-01-01

Full text: Multi-disciplinary groups, such as medical physicists and radiation therapists, which work effectively together, can ensure continued improvements in radiation therapy quality. The same is also true for clinical trials, which have the added complication of requiring multi-institutional participation to collate sufficient data to effectively assess treatment benefits. It can be difficult to manage quality across all aspects of a multi-disciplinary and multi-institutional trial. A planned system of quality assurance is necessary to provide support for participating centres and facilitate a collaborative approach. To ensure protocol compliance a good relationship between the clinical trial group and treatment centre is idea with definition of mutual goals and objectives before and during the trial, and ongoing consultation and feedback throughout the trial process. To ensure good quality data and maximise the validity of results the study protocol must be strictly adhered to. Because of the need for meticulous attention to detail, both in treatment delivery and standards of documentation, clinical trials are often seen to further complicate the process of delivery of radiation therapy treatment. The Declaration of Helsinki and Good Clinical Practise Guidelines (adopted in May 1996, ICH) provide 'international ethical and scientific standards for designing, conducting, recording and reporting clinical research' and multi-disciplinary groups in each participating centre should also adhere to these guidelines. Copyright (2001) Australasian College of Physical Scientists and Engineers in Medicine

Coerced hospital admission and symptom change--a prospective observational multi-centre study.

Directory of Open Access Journals (Sweden)

Thomas W Kallert

Full Text Available INTRODUCTION: Coerced admission to psychiatric hospitals, defined by legal status or patient's subjective experience, is common. Evidence on clinical outcomes however is limited. This study aimed to assess symptom change over a three month period following coerced admission and identify patient characteristics associated with outcomes. METHOD: At study sites in 11 European countries consecutive legally involuntary patients and patients with a legally voluntary admission who however felt coerced, were recruited and assessed by independent researchers within the first week after admission. Symptoms were assessed on the Brief Psychiatric Rating Scale. Patients were re-assessed after one and three months. RESULTS: The total sample consisted of 2326 legally coerced patients and 764 patients with a legally voluntary admission who felt coerced. Symptom levels significantly improved over time. In a multivariable analysis, higher baseline symptoms, being unemployed, living alone, repeated hospitalisation, being legally a voluntary patient but feeling coerced, and being initially less satisfied with treatment were all associated with less symptom improvement after one month and, other than initial treatment satisfaction, also after three months. The diagnostic group was not linked with outcomes. DISCUSSION: On average patients show significant but limited symptom improvements after coerced hospital admission, possibly reflecting the severity of the underlying illnesses. Social factors, but not the psychiatric diagnosis, appear important predictors of outcomes. Legally voluntary patients who feel coerced may have a poorer prognosis than legally involuntary patients and deserve attention in research and clinical practice.

ENEN - European Nuclear Educational Network Association

International Nuclear Information System (INIS)

De Regge, P.

2006-01-01

After the pioneering initiative of BNEN, the Belgian Nuclear higher Education Network, other countries, e.g. Italy, United Kingdom, Germany, Switzerland, etc., created their own pool of education. At the European level the ENEN Association (European Nuclear Education Network) is a sustainable product generated by an FP5 project. The main objective of the ENEN Association is the preservation and the further development of higher nuclear education and expertise. This objective is realized through the co-operation between European universities, involved in education and research in the nuclear engineering field, nuclear research centres and nuclear industry

European Conference on Molecular Biology EMBO

CERN Multimedia

1967-01-01

European Conference on Molecular Biology, which eventually led to the setting up of EMBO, was held at CERN in April. Olivier Reverdin is adressing the delegates. Bernard Gregory is on the left and Willy Spuhler in the centre.

Use of platelet rich plasma to treat plantar fasciitis: design of a multi centre randomized controlled trial

Directory of Open Access Journals (Sweden)

Peerbooms Joost C

2010-04-01

Full Text Available Abstract Background If conservative treatment for chronic plantar fasciitis fails, often a corticosteroid injection is given. Corticosteroid injection gives temporarily pain reduction, but no healing. Blood platelets initiate the natural healing rate. GPS® gives an eightfold concentrate platelets of patients own blood. Injection of these platelets in the attachment of the fascia to the os calcis might induce a healing rate. Methods and design A randomized controlled multi centre trial will be performed. The study population consists of 120 patients of 18 years and older. Patients with chronic plantar fasciitis will be allocated randomly to have a steroid injection or an autologous platelet concentrate injections. Data will be collected before the procedure, 4,8,12,26 weeks and 1 year after the procedure. The main outcome measures of this study are pain and function measured with questionnaires. Conclusion Recent literature show positive effects for the treatment of tendinosis with autologous platelet injections. The forthcoming trial will compare treatment for chronic plantar fasciitis with a steroid injection versus an autologous platelet injection. Our results will be published as soon as they become available. Trial Registration Trial registration number: http://www.clinicaltrials.gov NCT00758641.

Cardiovascular safety of vildagliptin in patients with type 2 diabetes: A European multi-database, non-interventional post-authorization safety study.

Science.gov (United States)

Williams, Rachael; de Vries, Frank; Kothny, Wolfgang; Serban, Carmen; Lopez-Leon, Sandra; Chu, Changan; Schlienger, Raymond

2017-10-01

The aim of this non-interventional, multi-database, analytical cohort study was to assess the cardiovascular (CV) safety of vildagliptin vs other non-insulin antidiabetic drugs (NIADs) using real-world data from 5 European electronic healthcare databases. Patients with type 2 diabetes aged ≥18 years on NIAD treatment were enrolled. Adjusted incidence rate ratios (IRRs) and 95% confidence intervals (CIs) for the outcomes of interest (myocardial infarction [MI], acute coronary syndrome [ACS], stroke, congestive heart failure [CHF], individually and as a composite) were estimated using negative binomial regression. Approximately 2.8% of the enrolled patients (n = 738 054) used vildagliptin at any time during the study, with an average follow-up time of 1.4 years, resulting in a cumulative current vildagliptin exposure of 28 330 person-years. The adjusted IRRs (vildagliptin [±other NIADs] vs other NIADs) were in the range of 0.61 to 0.97 (MI), 0.55 to 1.60 (ACS), 0.02 to 0.77 (stroke), 0.49 to 1.03 (CHF), and 0.22 to 1.02 (composite CV outcomes). The IRRs and their 95% CIs were close to 1, demonstrating no increased risk of adverse CV events, including the risk of CHF, with vildagliptin vs other NIADs in real-world conditions. © 2017 Crown copyright. Diabetes, Obesity and Metabolism © 2017 John Wiley & Sons Ltd.

A new European plan to attack cancer

Energy Technology Data Exchange (ETDEWEB)

Hegarty, Seamus

1989-01-15

While cancer remains the scourge of mankind, a large proportion of cases these days are amenable to treatment by irradiation. Bringing new irradiation centres to large concentrations of population is thus a vital task. This was highlighted at the first three-day workshop of the European Light Ion Medical Accelerator (EULIMA) project to assess the potential value of light ion beam therapy. Held in November at the Antoine-Lacassagne Centre, Nice, one of twenty cancer centres in France, the workshop was attended by some 60 delegates from Europe, USA, Canada and Japan, representing the fields of physics, radiobiology, radiotherapy and medicine.

The European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP)--a sentinel approach in the European Union (EU)/European Economic Area (EEA).

Science.gov (United States)

Spiteri, Gianfranco; Cole, Michelle; Unemo, Magnus; Hoffmann, Steen; Ison, Catherine; van de Laar, Marita

2013-12-01

Antimicrobial resistance in Neisseria gonorrhoeae is monitored in the European Union/European Economic Area through the European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP) coordinated by the European Centre for Disease Prevention and Control. Euro-GASP includes a sentinel surveillance programme which aims to detect in a timely manner changes in resistance patterns and inform treatment guidelines. The programme aims to test a representative number of isolates from each European Union/European Economic Area member state per year for a range of therapeutically relevant antimicrobials through a biannual hybrid centralised/decentralised system. Testing is supported by an External Quality Assurance programme and a laboratory training programme. Participation in the programme has increased to 21 countries in 2012. Euro-GASP has been able to detect the rapid spread of isolates with decreased susceptibility to cefixime across Europe in 2010 and 2011. Results from the programme have informed changes in European treatment guidelines for gonorrhoea and led to the development of the 'Response plan to control and manage the threat of multidrug resistant gonorrhoea in Europe'. Future challenges for Euro-GASP include supporting countries to participate in Euro-GASP through decentralised testing, improving timeliness and epidemiological data quality, and increasing participation from Eastern Europe.

Cooling solutions in an operational data centre: A case study

International Nuclear Information System (INIS)

Fakhim, B.; Behnia, M.; Armfield, S.W.; Srinarayana, N.

2011-01-01

The rapid growth in data centres - large computing infrastructures containing vast quantities of data processing and storage equipment - has resulted in their consumption of up to 100 times more energy per square metre than office accommodation. The decrease in processing server sizes and the more efficient use of space and server processing are challenging data centre facilities to provide more power and cooling, significantly increasing energy demands. Energy consumption of data centres can be severely and unnecessarily high due to inadequate localised cooling and densely packed server rack layouts. However, as heat dissipation in data centres rises by orders of magnitude, inefficiencies such as air recirculation causing hot spots and flow short-circuiting will have a significant impact on the thermal manageability and energy efficiency of the cooling infrastructure. Therefore, an efficient thermal management of high-powered electronic equipment is a significant challenge for cooling of data centres. To highlight the importance of some of these issues, in this project, an operational data centre has been studied. Field measurements of temperature have been performed. Numerical analysis of flow and temperature fields is conducted in order to evaluate the thermal behaviour of the data centre. A number of undesirable hot spots have been identified. To rectify the problem, a few practical design and remedial solutions to improve the cooling effectiveness have been proposed and examined to allow a reduced air-conditioning power requirement. The findings lead to a better understanding of the cooling issues and the respective proposed solutions allow an improved design for future data centres. - Highlights: → Study of flow and temperature distribution in an operational data centre. → Both field measurements and numerical simulations are conducted. → Numerical simulations are validated by field measurements. → Various modifications to improve the thermal

Oxygen titration after resuscitation from out-of-hospital cardiac arrest: a multi-centre, randomised controlled pilot study (the EXACT pilot trial).

Science.gov (United States)

Bray, Janet E; Hein, Cindy; Smith, Karen; Stephenson, Michael; Grantham, Hugh; Finn, Judith; Stub, Dion; Cameron, Peter

2018-04-20

Recent studies suggest the administration of 100% oxygen to hyperoxic levels following return-of-spontaneous-circulation (ROSC) post-cardiac arrest may be harmful. However, the feasibility and safety of oxygen titration in the prehospital setting is unknown. We conducted a multi-centre, phase-2 study testing whether prehospital titration of oxygen results in an equivalent number of patients arriving at hospital with oxygen saturations SpO2 ≥ 94%. We enrolled unconscious adults with: sustained ROSC; initial shockable rhythm; an advanced airway; and an SpO2 ≥ 95%. Initially (Sept 2015-March 2016) patients were randomised 1:1 to either 2 litres/minute (L/min) oxygen (titrated) or >10 L/min oxygen (control) via a bag-valve reservoir. However, one site experienced a high number of desaturations (SpO2 titrated arm and this arm was changed (April 2016) to an initial reduction of oxygen to 4 L/min then, if tolerated, to 2 L/min, and the desaturation limit was decreased to titrated (n = 37: 2L/min = 20 and 2-4 L/min = 17) oxygen or control (n = 24). Patients allocated to titrated oxygen were more likely to desaturate compared to controls ((SpO2 titrated: 90% vs. control: 100%) and all patients had a SpO2 ≥ 90%. One patient (control) re-arrested. Survival to hospital discharge was similar. Oxygen titration post-ROSC is feasible in the prehospital environment, but incremental titration commencing at 4L/min oxygen flow may be needed to maintain an oxygen saturation >90% (NCT02499042). Copyright © 2018. Published by Elsevier B.V.

The PHARE Multi-country Energy Program an efficient tool for European integration of the partner countries

International Nuclear Information System (INIS)

Votruba, J.; Milev, N.; Kostrzewa, J.; Binig, A.V.

1996-01-01

The present paper intends to demonstrate the financial, geographical and qualitative dimensions of the PHARE transfer of know-how in the energy field. Also it emphasizes the efforts made to improve the international cooperation, to ensure the realization of certain objectives of continental interest and for the harmonization of the national interests in a common European policy in the energy sector. Since its inception the efforts of the PHARE Multi-country Energy Program (MEP) aimed at three strategic targets: development of energy supply, improvement of energy efficiency and environment protection. (author). 4 tabs., 3 refs

Recruiting ENT and Audiology patients into pharmaceutical trials: evaluating the multi-centre experience in the UK and USA.

Science.gov (United States)

Sanchez, Victoria A; Hall, Deborah A; Millar, Bonnie; Escabi, Celia D; Sharman, Alice; Watson, Jeannette; Thasma, Sornaraja; Harris, Peter

2018-01-21

Recruiting into clinical trials on time and on target is a major challenge and yet often goes unreported. This study evaluated the adjustment to procedures, recruitment and screening methods in two multi-centre pharmaceutical randomised controlled trials (RCTs) for hearing-related problems in adults. Recruitment monitoring and subsequent adjustment of various study procedures (e.g. eligibility criteria, increasing recruiting sites and recruitment methods) are reported. Participants were recruited through eight overarching methods: trial registration, posters/flyers, print publications, Internet, social media, radio, databases and referrals. The efficiency of the recruitment was measured by determining the number of people: (1) eligible for screening as a percentage of those who underwent telephone pre-screening and (2) randomised as a percentage of those screened. A total of 584 participants completed the pre-screening steps, 491 screened and 169 participants were randomised. Both RCTs completed adjustments to the participant eligibility, added new study sites and additional recruitment methods. No single recruitment method was efficient enough to serve as the only route to enrolment. A diverse portfolio of methods, continuous monitoring, mitigation strategy and adequate resourcing were essential for achieving our recruitment goals.

Use of antibiotics and the prevalence of antibiotic-associated diarrhoea in patients with spinal cord injuries: an international, multi-centre study.

Science.gov (United States)

Wong, S; Santullo, P; Hirani, S P; Kumar, N; Chowdhury, J R; García-Forcada, A; Recio, M; Paz, F; Zobina, I; Kolli, S; Kiekens, C; Draulans, N; Roels, E; Martens-Bijlsma, J; O'Driscoll, J; Jamous, A; Saif, M

2017-10-01

Little is known about the use of antibiotics and the extent of antibiotic-associated diarrhoea (AAD) in patients with spinal cord injuries (SCIs). To record the use of antibiotics, establish the prevalence of AAD and Clostridium difficile infection (CDI), and assess if there was any seasonal variation in antibiotic use and incidence of AAD in patients with SCIs. A retrospective study was conducted in six European SCI centres between October 2014 and June 2015. AAD was defined as two or more watery stools (Bristol Stool Scale type 5, 6 or 7) over 24 h. In total, 1267 adults (median age 54 years, 30.7% female) with SCIs (52.7% tetraplegia, 59% complete SCI) were included in this study. Among the 215 (17%) patients on antibiotics, the top three indications for antibiotics were urinary tract infections (UTIs), infected pressure ulcers and other skin infections. Thirty-two of these 215 (14.9%) patients developed AAD and two patients out of the total study population (2/1267; 0.16%) developed CDI. AAD was more common in summer than in spring, autumn or winter (30.3% vs 3.8%, 7.4% and 16.9%, respectively; Pantibiotic use and high-risk antibiotic use. Summer and winter seasons and male sex were identified as independent predictors for the development of AAD. This survey found that AAD is common in patients with SCIs, and UTI is the most common cause of infection. Summer and winter seasons and male sex are unique predictors for AAD. Both AAD and UTIs are potentially preventable; therefore, further work should focus on preventing the over-use of antibiotics, and developing strategies to improve hospital infection control measures. Copyright © 2017 The Healthcare Infection Society. All rights reserved.

The study of the European Union from outside: European integration studies in Norway and Iceland 1990-2010

OpenAIRE

Eliassen, Kjell; Marino, Marit Sjøvaag; Bergmann, Eirikur

2012-01-01

This is a working paper version of a paper written for SENT - The Network of European Studies. The aim of this chapter is to map the research on European integration carried out by Norwegian and Icelandic researchers and research institutions in the period 1990–2010. This study covers research of central aspects of the European Union itself: institutions, decision-making processes, policies, actors and the relationship to other countries, global and regional institutions and local and regiona...

Multi-centre point prevalence survey of hospital-acquired infections in Ghana.

Science.gov (United States)

Labi, Appiah-Korang; Obeng-Nkrumah, Noah; Owusu, Enid; Bjerrum, Stephanie; Bediako-Bowan, Antoinette; Sunkwa-Mills, Gifty; Akuffo, Christiana; Fenny, Ama Pokua; Opintan, Japheth Awuletey; Enweronu-Laryea, Christabel; Debrah, Samuel; Damale, Nelson; Bannerman, Cynthia; Newman, Mercy Jemima

2018-05-03

There is a paucity of data describing hospital acquired infections (HAIs) in Africa. To describe the prevalence and distribution of HAIs in acute care hospitals in Ghana. Between September and December 2016, point prevalence surveys were conducted in participating hospitals using protocols of the European Centre for Disease Prevention and Control. We reviewed medical records of eligible inpatients at or before 8am on the day of survey to identify HAIs present at the time of survey. Ten hospitals were surveyed, representing 32.9% of all acute care beds in government hospitals. Of 2107 inpatients surveyed, 184 HAIs were identified among 172 patients, corresponding to an overall prevalence of 8.2%. The prevalence values in hospitals ranged from 3.5 to 14.4% with higher proportion of infections in secondary and tertiary care facilities. The most frequent HAIs were surgical site infections (32.6%), bloodstream infections (19.5%), urinary tract infections (18.5%), and respiratory tract infections (16.3%). Device-associated infections accounted for 7.1% of HAIs. For 12.5% of HAIs, a microorganism was reported; the most isolated microorganism was Escherichia coli. Approximately 61% of all patients surveyed were on antibiotics; 89.5% of patients with an HAI received at least one antimicrobial agent on the day of survey. The strongest independent predictors for HAI were the presence of invasive device before onset of infection and duration of hospital stay. We recorded a low HAI burden compared to findings from other low and middle income countries. Copyright © 2018. Published by Elsevier Ltd.

The role of science centres and museums in the dialogue between science and society

Directory of Open Access Journals (Sweden)

Paola Rodari

2007-06-01

Full Text Available In a meta-analysis carried out in 2002, the two main associations of science centres and museums (ASTC, mainly US-centered, and ECSITE, mainly European gathered all studies analysing the impact of science centres and museums on their local communities1. Four types of impact were identified: personal, social, political and economical. It was noticed that the vast majority of studies concentrated on the personal impact (that is, learning outcome, visitor satisfaction, etc., while the latter three were largely neglected. The very fact of pointing this out, and many recent experiences - some of which are included in this commentary - show that there is now a shift of attention.

Lifestyle and risk factor management in people at high risk of cardiovascular disease. A report from the European Society of Cardiology European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) IV cross-sectional survey in 14 European regions

OpenAIRE

Kotseva, Kornelia; De Bacquer, Dirk; De Backer, Guy; Ryden, Lars; Jennings, Catriona; Gyberg, Viveca; Abreu, Ana; Aguiar, Carlos; Conde, Almudena C.; Davletov, Kairat; Dilic, Mirza; Dolzhenko, Maryna; Gaita, Dan; Georgiev, Borislav; Gotcheva, Nina

2016-01-01

BACKGROUND: European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) IV in primary care was a cross-sectional survey carried out by the European Society of Cardiology, EURObservational Research Programme in 2014-2015 in 71 centres from 14 European countries. The main objective was to determine whether the 2012 Joint European Societies' guidelines on cardiovascular disease (CVD) prevention in people at high CVD risk have been followed in clinical practi...

Underpricing and Firm’s Distance from Financial Centre: Evidence from three European Countries

OpenAIRE

Antonio Acconcia; Alfredo Del Monte; Luca Pennacchio

2011-01-01

We provide international evidence on the relationship between the extent of underpricing related to initial public offerings (IPOs) and the distance of the issuing firm from the financial centre of a country: for France, Germany and Italy, the higher the distance, the higher the level of underpricing. Under the maintained assumption that headquarters of institutional investors and underwriters are part of a financial centre, our evidence is consistent with the hypothesis that ex ante uncertai...

Logistic centres in the Hungarian traffic network -A Current Smvey

Directory of Open Access Journals (Sweden)

Geza Schubert

2003-07-01

Full Text Available As Europe's economic integration proceeds, Hungary- situatedin the continent's geometric centre - is called upon to accommodatea huge volume of transit traffic. Congestion on thecountry's highways, already a serious problem, makes it desirableto shift transit freight traffic onto railways. For this purpose,and also to make transportation generally more efficient,the so-called logistic service centres are being established. Theseare expected to play a decisive role in the European freight trafficnetwork. An expeditious extension of their services is urgentlyneeded.

Geographical variation in DXA bone mineral density in young European men and women. Results from the Network in Europe on Male Osteoporosis (NEMO) study

DEFF Research Database (Denmark)

Kaptoge, S.; Silva, J.A. da; Brixen, K.

2008-01-01

We collected population-based young normal hip and spine BMD data from 17 centres across Europe to assess between centre differences and to compare reference values with the US NHANES-III data. There was strong evidence of between country heterogeneity, but not between centres within countries. Hip...... values specific to an American population can be validly used for T-score calculation in Europeans. METHODS: We collected population based BMD data from 1163 men and 329 women aged 19-29 years from 17 centres across Europe to compare mean and SD values with the NHANES-III study USA results. BMD(g/cm2......, the cross-calibrated BMD values were converted using the ESP equations to Hologic QDR 1000 units. RESULTS: In men, the overall mean(SD) BMD values expressed in Hologic-QDR1000 units of measurement, were: femoral neck 0.912(0.132); trochanter 0.793(0.124); and L2-L4 spine 1.027(0.123). The respective...

Defining and describing birth centres in the Netherlands - a component study of the Dutch Birth Centre Study.

NARCIS (Netherlands)

Hermus, M.A.A.; Boesveld, I.C.; Hilzert, M.; Franx, A.; Graaf, J.P. de; Steegers, E.A.P.; Wiegers, T.A.; Pal-de Bruin, K.M. van der

2017-01-01

Background: During the last decade, a rapid increase of birth locations for low-risk births, other than conventional obstetric units, has been seen in the Netherlands. Internationally some of such locations are called birth centres. The varying international definitions for birth centres are not

Defining and describing birth centres in the Netherlands - a component study of the Dutch Birth Centre Study

NARCIS (Netherlands)

Hermus, Marieke A. A.; Boesveld, I. C.; Hitzert, Marrit M; Franx, A.; de Graaf, J. P.; Steegers, E. A P; Wiegers, Therese A.; van der Pal-de Bruin, Karin M.

2017-01-01

Background: During the last decade, a rapid increase of birth locations for low-risk births, other than conventional obstetric units, has been seen in the Netherlands. Internationally some of such locations are called birth centres. The varying international definitions for birth centres are not

Cardiac patients' perception of patient-centred care: a qualitative study.

Science.gov (United States)

Esmaeili, Maryam; Cheraghi, Mohammad A; Salsali, Mahvash

2016-03-01

The aim of this study was to explore cardiac patients' perception of patient-centred care. Despite patient's importance in the process of care, less attention has been paid to experiences and expectations of patients in definitions of patient-centred care. As patients are an important element in process of patient-centred care, organizing care programs according to their perceptions and expectations will lead to enhanced quality of care and greater patient satisfaction. This study is a descriptive qualitative study. Content analysis approach was performed for data analysis. Participants were 18 cardiac patients (10 women and 8 men) hospitalized in coronary care units of teaching hospitals affiliated to Tehran University of Medical Sciences. We collected the study data through conducting personal face-to-face semi-structured interviews. The participants' perceptions of patient-centred care fell into three main themes including managing patients uncertainty, providing care with more flexibility and establishing a therapeutic communication. The second theme consisted of two sub-themes: empathizing with patients and having the right to make independent decisions. Receiving patient-centred care is essential for cardiac patients. Attention to priorities and preferences of cardiac patients and making decisions accordingly is among effective strategies for achieving patient-centred care. Cardiac care unit nurses ought to be aware that in spite of technological developments and advances, it is still important to pay attention to patients' needs and expectations in order to achieve patient satisfaction. In planning care programs, they should consider accountability towards patients' needs, flexibility in process of care and establishing medical interactions as an effective strategy for improving quality of care. © 2014 British Association of Critical Care Nurses.

[Structured care in an ISO certified centre for patients with cystic fibrosis and their families].

Science.gov (United States)

Ellemunter, H; Eder, J; Steinkamp, G

2011-10-01

Cystic fibrosis (CF) is a chronic, life-shortening disease of multiple organ systems. Guidelines recommend that patients should be treated in specialised CF centres with multi-professional teams. We describe the organisation of medical care at the CF centre of Innsbruck University as well as results of treatment. Procedures and delivery of multi-professional care have been elaborated and structured. Since 2006 the Centre has been repeatedly certified according to DIN ISO 9001:2000. The patient database is being used during the doctor's consultation and for the continuous monitoring of treatment results. In 2010, 71 of the 148 patients (48%) were between 18 and 56 years old. The total number of patients has doubled and the proportion of adults tripled since 1995. Nevertheless, median FEV1 remained stable (>80% of predicted) during the last 15 years. Compared with 18 CF centres of the German Benchmarking Group, patients treated in Innsbruck had favourable FEV1 values: 52% of adults had a normal FEV1 (>80% pred.) and only 23% an FEV1 <50% of predicted. A structured programme of multi-professional care was associated with favourable treatment results, both longitudinally and in comparison to other CF centres. © Georg Thieme Verlag KG Stuttgart · New York.

Assessment of Diet, Physical Activity and Biological, Social and Environmental Factors in a Multi-centre European Project on Diet- and Lifestyle-related Disorders in Children (IDEFICS)

DEFF Research Database (Denmark)

Bammann, Karin; Peplies, Jenny; Sjöström, Michael

2006-01-01

Obesity is a major public health problem in developed countries. We present a European project, called Identification and Prevention of Dietary and Lifestyle-induced Health Effects in Children and Infants (IDEFICS), that focuses on diet- and lifestyle-related diseases in children. This paper...... outlines methodological aspects and means of quality control in IDEFICS. IDEFICS will use a multicentre survey design of a population-based cohort of about 17,000 2- to 10-year-old children in nine European countries (Belgium, Cyprus, Estonia, Germany, Greece, Hungary, Italy, Spain and Sweden). The project...... will investigate the impact of dietary factors such as food intake and food preferences, lifestyle factors such as physical activity, psychosocial factors and genetic factors on the development of obesity and other selected diet- and lifestyle-related disorders. An intervention study will be set up in pre...

Multi-hazard assessment using GIS in the urban areas: Case study - Banja Luka municipality, B&H

Directory of Open Access Journals (Sweden)

Tošić Radislav

2013-01-01

Full Text Available The research presents a techniques for natural hazard assessment using GIS and cartographic approaches with multi-hazard mapping in urban communities, because natural hazards are a multi-dimensional phenomena which have a spatial component. Therefore the use of Remote Sensing and GIS has an important function and become essential in urban multi-hazard assessment. The first aim of this research was to determine the geographical distributions of the major types of natural hazards in the study area. Seismic hazards, landslides, rockfalls, floods, torrential floods, and excessive erosion are the most significant natural hazards within the territory of Banja Luka Municipality. Areas vulnerable to some of these natural hazards were singled out using analytical maps. Based on these analyses, an integral map of the natural hazards of the study area was created using multi-hazard assessment and the total vulnerability was determined by overlapping the results. The detailed analysis, through the focused research within the most vulnerable areas in the study area will highlight the administrative units (urban centres and communes that are vulnerable to various types of natural hazard. The results presented in this article are the first multi-hazard assessment and the first version of the integral map of natural hazards in the Republic of Srpska.

Segmentation of age-related white matter changes in a clinical multi-center study

DEFF Research Database (Denmark)

Dyrby, Tim B.; Rostrup, E.; Baare, W.F.C.

2008-01-01

Age-related white matter changes (WMC) are thought to be a marker of vascular pathology, and have been associated with motor and cognitive deficits. In the present study, an optimized artificial neural network was used as an automatic segmentation method to produce probabilistic maps of WMC...... in a clinical multi-center study. The neural network uses information from T1- and T2-weighted and fluid attenuation inversion recovery (FLAIR) magnetic resonance (MR) scans, neighboring voxels and spatial location. Generalizability of the neural network was optimized by including the Optimal Brain Damage (OBD......) pruning method in the training stage. Six optimized neural networks were produced to investigate the impact of different input information on WMC segmentation. The automatic segmentation method was applied to MR scans of 362 non-demented elderly subjects from 11 centers in the European multi-center study...

A multi-centre randomised controlled trial of rehabilitation aimed at improving outdoor mobility for people after stroke: Study protocol for a randomised controlled trial

Directory of Open Access Journals (Sweden)

Logan Pip A

2012-06-01

Full Text Available Abstract Background Up to 42% of all stroke patients do not get out of the house as much as they would like. This can impede a person’s quality of life. This study is testing the clinical effectiveness and cost effectiveness of a new outdoor mobility rehabilitation intervention by comparing it to usual care. Methods/design This is a multi-centre parallel group individually randomised, controlled trial. At least 506 participants will be recruited through 15 primary and secondary care settings and will be eligible if they are over 18 years of age, have had a stroke and wish to get out of the house more often. Participants are being randomly allocated to either the intervention group or the control group. Intervention group participants receive up to 12 rehabilitation outdoor mobility sessions over up to four months. The main component of the intervention is repeated practice of outdoor mobility with a therapist. Control group participants are receiving the usual intervention for outdoor mobility limitations: verbal advice and provision of leaflets provided over one session. Outcome measures are being collected using postal questionnaires, travel calendars and by independent assessors. The primary outcome measure is the Social Function domain of the SF36v2 quality of life assessment six months after recruitment. The secondary outcome measures include: functional ability, mobility, the number of journeys (monthly travel diaries, satisfaction with outdoor mobility, mood, health-related quality of life, resource use of health and social care. Carer mood information is also being collected. The mean Social Function score of the SF-36v2 will be compared between treatment arms using a multiple membership form of mixed effects multiple regression analysis adjusting for centre (as a fixed effect, age and baseline Social Function score as covariates and therapist as a multiple membership random effect. Regression coefficients and 95% confidence

Shaping Place Identity through Interaction on the Example of the European Solidarity Centre in Gdansk

Science.gov (United States)

Targowski, Wojciech; Piotr, Czyż

2017-10-01

The article presents process of shaping place identity on the example of an important for Pomerania region investment - European Solidarity Centre. The idea of a Solidarity social movement is strongly associated with the formation of post-socialist national identity of Poland as well as local identity of Pomerania, from which movement originates. The realization of the European Solidarity Centre aims to be one of the essential elements of shaping Gdańsk’s identity of space. The article is an attempt to analyse how the presence of realization gradually affects the formation of the place identity of new urban space. Analysis of this realization will allow on the one hand to verify design assumptions made by authors, on the other provides the opportunity to search for best description of still vague notion of local identity. This concept, though intuitively close to everyone still seems to elude conceptual apparatus of theory of architecture. The intention of this article is to explore the notion of identity based on the observations of the newly realized significant cultural space. This analysis approaches the concept of identity from two perspectives. The first approach draws from the concept of identity of Christian Norberg-Schulz. Here, local identity is seen as a unique set of characteristics of space. So seen the concept of place identity is a correlate of concept of personal identity. In this analysis, methods of description of personal identity were transferred to the identity of the place. In the second approach, the identity of place is understood as a unique for that place way of being in space, way to spend time and development of the site-specific urban rituals. Such a concept of identity, draws from the concept of place of Kim Dovey. Both presented approaches seems to complement each other but they also emphasize different qualities. The now-traditional concept of Genius Loci sees architecture as a structural system of meanings. Meaningful elements

Preventing work-related stress among staff working in children's cancer Principal Treatment Centres in the UK: a brief survey of staff support systems and practices.

Science.gov (United States)

Beresford, B; Gibson, F; Bayliss, J; Mukherjee, S

2018-03-01

Growing evidence of the association between health professionals' well-being and patient and organisational outcomes points to the need for effective staff support. This paper reports a brief survey of the UK's children's cancer Principal Treatment Centres (PTCs) regarding staff support systems and practices. A short on-line questionnaire, administered in 2012-2013, collected information about the availability of staff support interventions which seek to prevent work-related stress among different members of the multi-disciplinary team (MDT). It was completed by a member of staff with, where required, assistance from colleagues. All PTCs (n = 19) participated. Debriefs following a patient death was the most frequently reported staff support practice. Support groups were infrequently mentioned. There was wide variability between PTCs, and between professional groups, regarding the number and type of interventions available. Doctors appear to be least likely to have access to support. A few Centres routinely addressed work-related stress in wider staff management strategies. Two Centres had developed a bespoke intervention. Very few Centres were reported to actively raise awareness of support available from their hospital's Occupational Health department. A minority of PTCs had expert input regarding staff support from clinical psychology/liaison psychiatry. © 2016 The Authors. European Journal of Cancer Care Published by John Wiley & Sons Ltd.

Undergraduate nursing students' performance in recognising and responding to sudden patient deterioration in high psychological fidelity simulated environments: an Australian multi-centre study.

Science.gov (United States)

Bogossian, Fiona; Cooper, Simon; Cant, Robyn; Beauchamp, Alison; Porter, Joanne; Kain, Victoria; Bucknall, Tracey; Phillips, Nicole M

2014-05-01

Early recognition and situation awareness of sudden patient deterioration, a timely appropriate clinical response, and teamwork are critical to patient outcomes. High fidelity simulated environments provide the opportunity for undergraduate nursing students to develop and refine recognition and response skills. This paper reports the quantitative findings of the first phase of a larger program of ongoing research: Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends (FIRST2ACTTM). It specifically aims to identify the characteristics that may predict primary outcome measures of clinical performance, teamwork and situation awareness in the management of deteriorating patients. Mixed-method multi-centre study. High fidelity simulated acute clinical environment in three Australian universities. A convenience sample of 97 final year nursing students enrolled in an undergraduate Bachelor of Nursing or combined Bachelor of Nursing degree were included in the study. In groups of three, participants proceeded through three phases: (i) pre-briefing and completion of a multi-choice question test, (ii) three video-recorded simulated clinical scenarios where actors substituted real patients with deteriorating conditions, and (iii) post-scenario debriefing. Clinical performance, teamwork and situation awareness were evaluated, using a validated standard checklist (OSCE), Team Emergency Assessment Measure (TEAM) score sheet and Situation Awareness Global Assessment Technique (SAGAT). A Modified Angoff technique was used to establish cut points for clinical performance. Student teams engaged in 97 simulation experiences across the three scenarios and achieved a level of clinical performance consistent with the experts' identified pass level point in only 9 (1%) of the simulation experiences. Knowledge was significantly associated with overall teamwork (p=.034), overall situation awareness (p=.05) and clinical performance in two of the three scenarios

Characterization of female breast lesions from multi-wavelength time-resolved optical mammography

International Nuclear Information System (INIS)

Spinelli, Lorenzo; Torricelli, Alessandro; Pifferi, Antonio; Taroni, Paola; Danesini, Gianmaria; Cubeddu, Rinaldo

2005-01-01

Characterization of both malignant and benign lesions in the female breast is presented as the result of a clinical study that involved more than 190 subjects in the framework of the OPTIMAMM European project. All the subjects underwent optical mammography, by means of a multi-wavelength time-resolved mammograph, in the range 637-985 nm. Optical images were processed by applying a perturbation model, relying on a nonlinear approximation of time-resolved transmittance curves in the presence of an inclusion, with the aim of estimating the major tissue constituents (i.e. oxy- and deoxy-haemoglobin, lipid and water) and structural parameters (linked to dimension and density of the scatterer centres) for both the lesion area and the surrounding tissue. The critical factors for the application of the perturbation model on in vivo data are also discussed. Forty-six malignant and 68 benign lesions were analysed. A subset of 32 cancers, 40 cysts and 14 fibroadenomas were found reliable for the perturbation analysis. For cancers, we show a higher blood content with respect to the surrounding tissue, while cysts are characterized by a lower concentration of scattering centres with respect to the surrounding tissue. For fibroadenomas, the low number of cases does not allow any definite conclusions

Clinical features of dysthyroid optic neuropathy: a European Group on Graves' Orbitopathy (EUGOGO) survey

NARCIS (Netherlands)

McKeag, David; Lane, Carol; Lazarus, John H.; Baldeschi, Lelio; Boboridis, Kostas; Dickinson, A. Jane; Hullo, A. Iain; Kahaly, George; Krassas, Gerry; Marcocci, Claudio; Marinò, Michele; Mourits, Maarten P.; Nardi, Marco; Neoh, Christopher; Orgiazzi, Jacques; Perros, Petros; Pinchera, Aldo; Pitz, Susanne; Prummel, Mark F.; Sartini, Maria S.; Wiersinga, Wilmar M.

2007-01-01

BACKGROUND: This study was performed to determine clinical features of dysthyroid optic neuropathy (DON) across Europe. METHODS: Forty seven patients with DON presented to seven European centres during one year. Local protocols for thyroid status, ophthalmic examination and further investigation

Development of European urban tourist systems

Directory of Open Access Journals (Sweden)

Jerković Senta

2009-01-01

Full Text Available Relationship between urban development and tourism is a significant process in Europe today. Development of tourism has caused many organizational changes in urban environment. In the middle of the 20th century cultural and historical heritage in the cities was impetus of development of tourism in European cities. Nowadays, in many European cities tourism is recognized as a mean of further economic development. Strategy of polycentricity, outlined in European spatial development perspective is supporting that process, too. Many tourist centres and metropolitan tourist areas have been developed. In the period from 1996. to 2007. number of visitors in European cultural capitals was growing continuously by rate of 25,6%. In the same period, the number of international tourist arrivals increased by rate of only 7%.

Standardised surveillance of Clostridium difficile infection in European acute care hospitals: a pilot study, 2013.

Science.gov (United States)

van Dorp, Sofie M; Kinross, Pete; Gastmeier, Petra; Behnke, Michael; Kola, Axel; Delmée, Michel; Pavelkovich, Anastasia; Mentula, Silja; Barbut, Frédéric; Hajdu, Agnes; Ingebretsen, André; Pituch, Hanna; Macovei, Ioana S; Jovanović, Milica; Wiuff, Camilla; Schmid, Daniela; Olsen, Katharina Ep; Wilcox, Mark H; Suetens, Carl; Kuijper, Ed J

2016-07-21

Clostridium difficile infection (CDI) remains poorly controlled in many European countries, of which several have not yet implemented national CDI surveillance. In 2013, experts from the European CDI Surveillance Network project and from the European Centre for Disease Prevention and Control developed a protocol with three options of CDI surveillance for acute care hospitals: a 'minimal' option (aggregated hospital data), a 'light' option (including patient data for CDI cases) and an 'enhanced' option (including microbiological data on the first 10 CDI episodes per hospital). A total of 37 hospitals in 14 European countries tested these options for a three-month period (between 13 May and 1 November 2013). All 37 hospitals successfully completed the minimal surveillance option (for 1,152 patients). Clinical data were submitted for 94% (1,078/1,152) of the patients in the light option; information on CDI origin and outcome was complete for 94% (1,016/1,078) and 98% (294/300) of the patients in the light and enhanced options, respectively. The workload of the options was 1.1, 2.0 and 3.0 person-days per 10,000 hospital discharges, respectively. Enhanced surveillance was tested and was successful in 32 of the hospitals, showing that C. difficile PCR ribotype 027 was predominant (30% (79/267)). This study showed that standardised multicountry surveillance, with the option of integrating clinical and molecular data, is a feasible strategy for monitoring CDI in Europe. This article is copyright of The Authors, 2016.

Zoonoses in the European Union: origin, distribution and dynamics

DEFF Research Database (Denmark)

Lahuerta, A.; Westrell, T.; Takkinen, J.

2011-01-01

We present a summary of the main findings of the latest report of the European Food Safety Authority and European Centre for Disease Prevention and Control on zoonoses, zoonotic agents and food-borne outbreaks in the European Union (EU), based on data from 2009. Zoonoses are prevalent and widely...... distributed across several countries in the EU. The most important highlight of this report was the continuous decrease of human salmonellosis since 2005, probably due to effective control programmes in livestock....

The European Centre for Disease Prevention and Control (ECDC) pilot point prevalence survey of healthcare-associated infections and antimicrobial use.

Science.gov (United States)

Zarb, P; Coignard, B; Griskeviciene, J; Muller, A; Vankerckhoven, V; Weist, K; Goossens, Mm; Vaerenberg, S; Hopkins, S; Catry, B; Monnet, Dl; Goossens, H; Suetens, C

2012-11-15

A standardised methodology for a combined point prevalence survey (PPS) on healthcare-associated infections (HAIs) and antimicrobial use in European acute care hospitals developed by the European Centre for Disease Prevention and Control was piloted across Europe. Variables were collected at national, hospital and patient level in 66 hospitals from 23 countries. A patient-based and a unit-based protocol were available. Feasibility was assessed via national and hospital questionnaires. Of 19,888 surveyed patients, 7.1% had an HAI and 34.6% were receiving at least one antimicrobial agent. Prevalence results were highest in intensive care units, with 28.1% patients with HAI, and 61.4% patients with antimicrobial use. Pneumonia and other lower respiratory tract infections (2.0% of patients; 95% confidence interval (CI): 1.8–2.2%) represented the most common type (25.7%) of HAI. Surgical prophylaxis was the indication for 17.3% of used antimicrobials and exceeded one day in 60.7% of cases. Risk factors in the patient-based protocol were provided for 98% or more of the included patients and all were independently associated with both presence of HAI and receiving an antimicrobial agent. The patient-based protocol required more work than the unit-based protocol, but allowed collecting detailed data and analysis of risk factors for HAI and antimicrobial use.

European „C” quest: community, competitiveness, convergence, cohesion. what should the “eu new comer romanians” aim for?

Directory of Open Access Journals (Sweden)

Jora Octavian-Dragomir

2008-04-01

Full Text Available The analyses carried out both at the centre (Brussels and at the destination (member states (abuse of the principle that in public expenditure terms “spent money means well-spent money” and consider that absorption capacity equals economic performance (equated quite disputably with disparity reduction. The aggregate Keynesian perspective provides the main argument in favour of this interpretation: EU funds lead to GDP growth (economic growth. This vision overlooks the crucial importance of resource allocation micro-processes, private property and business activity. Therewith, the process of making European funds profitable and, consequently, the EU convergence feasible depends on the extent to which the absorption environment is structurally reformed. The “cohesion paradox,” which can be formulated like “least underdeveloped regions have relatively higher chances to attract European funds, while disparities compared to relatively less developed regions might even intensify”, can be broken only through multi-dimensional reform, immaterial to whether we speak about Romania, or Ireland, or Portugal, or Spain, or Greece.

Plant Poisonings According to the Czech Toxicological Information Centre from 2005 to 2008

Czech Academy of Sciences Publication Activity Database

Říčařová, B.; Rakovcová, H.; Pelclová, D.; Navrátil, Tomáš

2009-01-01

Roč. 47, č. 5 (2009), s. 473-473 ISSN 1556-3650. [The International Congress of the European Association of Poison Centres and Clinical Toxicologists /29./. 12.05.2009-15.05.2009, Stockholm] R&D Projects: GA AV ČR IAA400400806 Institutional research plan: CEZ:AV0Z40400503 Keywords : Czech Toxicological Information Centre * plant poison ings according Subject RIV: CF - Physical ; Theoretical Chemistry

Luteinizing hormone-releasing hormone analogue (Buserelin) treatment for central precocious puberty: a multi-centre trial.

Science.gov (United States)

Werther, G A; Warne, G L; Ennis, G; Gold, H; Silink, M; Cowell, C T; Quigley, C; Howard, N; Antony, G; Byrne, G C

1990-02-01

A multi-centre open trial of Buserelin, a luteinizing hormone-releasing hormone (LHRH) analogue, was conducted in 13 children with central precocious puberty. Eleven children (eight girls and three boys), aged 3.4-10.2 years at commencement, completed the required 12 month period of treatment. Initially all patients received the drug by intranasal spray in a dose of 1200 micrograms/day, but by the end of the 12 month period two were having daily subcutaneous injections and three were receiving an increased dose intranasally. The first month of treatment was associated in one boy with increased aggression and masturbation, and in the girls with an increase in the prevalence of vaginal bleeding. Thereafter, however, both behavioural abnormalities and menstruation were suppressed. Median bone age increased significantly during the study, but without any significant change in the ratio of height age to bone age. The median predicted adult height for the group therefore did not alter significantly over the twelve months of the study. Buserelin treatment caused a reduction in the peak luteinizing hormone and follicle-stimulating hormone (FSH) responses to LHRH, mostly to prepubertal levels, and also suppressed basal FSH. In the first weeks of treatment, the girls' serum oestradiol levels rose significantly and then fell to prepubertal or early pubertal levels. A similar pattern was seen for serum testosterone levels. Serum somatomedin-C levels, however, showed little fluctuation over the course of the study. Buserelin treatment was safe and well accepted, and offers the promise of improved linear growth potential in precocious puberty.

Multi-model ensemble projections of European river floods and high flows at 1.5, 2, and 3 degrees global warming

Science.gov (United States)

Thober, Stephan; Kumar, Rohini; Wanders, Niko; Marx, Andreas; Pan, Ming; Rakovec, Oldrich; Samaniego, Luis; Sheffield, Justin; Wood, Eric F.; Zink, Matthias

2018-01-01

Severe river floods often result in huge economic losses and fatalities. Since 1980, almost 1500 such events have been reported in Europe. This study investigates climate change impacts on European floods under 1.5, 2, and 3 K global warming. The impacts are assessed employing a multi-model ensemble containing three hydrologic models (HMs: mHM, Noah-MP, PCR-GLOBWB) forced by five CMIP5 general circulation models (GCMs) under three Representative Concentration Pathways (RCPs 2.6, 6.0, and 8.5). This multi-model ensemble is unprecedented with respect to the combination of its size (45 realisations) and its spatial resolution, which is 5 km over the entirety of Europe. Climate change impacts are quantified for high flows and flood events, represented by 10% exceedance probability and annual maxima of daily streamflow, respectively. The multi-model ensemble points to the Mediterranean region as a hotspot of changes with significant decrements in high flows from -11% at 1.5 K up to -30% at 3 K global warming mainly resulting from reduced precipitation. Small changes (impacts of global warming could be similar under 1.5 K and 2 K global warming, but have to account for significantly higher changes under 3 K global warming.

Multi-morbidities of allergic rhinitis in adults: European Academy of Allergy and Clinical Immunology Task Force Report.

Science.gov (United States)

Cingi, C; Gevaert, P; Mösges, R; Rondon, C; Hox, V; Rudenko, M; Muluk, N B; Scadding, G; Manole, F; Hupin, C; Fokkens, W J; Akdis, C; Bachert, C; Demoly, P; Mullol, J; Muraro, A; Papadopoulos, N; Pawankar, R; Rombaux, P; Toskala, E; Kalogjera, L; Prokopakis, E; Hellings, P W; Bousquet, J

2017-01-01

This report has been prepared by the European Academy of Allergy and Clinical Immunology Task Force on Allergic Rhinitis (AR) comorbidities. The aim of this multidisciplinary European consensus document is to highlight the role of multimorbidities in the definition, classification, mechanisms, recommendations for diagnosis and treatment of AR, and to define the needs in this neglected area by a literature review. AR is a systemic allergic disease and is generally associated with numerous multi-morbid disorders, including asthma, eczema, food allergies, eosinophilic oesophagitis (EoE), conjunctivitis, chronic middle ear effusions, rhinosinusitis, adenoid hypertrophy, olfaction disorders, obstructive sleep apnea, disordered sleep and consequent behavioural and educational effects. This report provides up-to-date usable information to: (1) improve the knowledge and skills of allergists, so as to ultimately improve the overall quality of patient care; (2) to increase interest in this area; and (3) to present a unique contribution to the field of upper inflammatory disease.

Science communication in European projects

International Nuclear Information System (INIS)

Vachev, Boyko; Stamenov, Jordan

2009-01-01

Science communication in several resent successful projects of Institute for Nuclear Research and Nuclear Energy, Bulgarian Academy of Sciences (INRNE, BAS) from the 5th and 6th Framework Programmes of EC is presented: the joint INRNE, BAS project with JRC of EC (FP5 NUSES) and two subsequent Centre of Excellence projects (FP5 HIMONTONET and FP6 BEOBAL) are considered. Innovations and traditional forms development and application are discussed. An overview of presentation and communication of INRNE, BAS contribution to Bulgarian European Project is made. Good practices have been derived. Keywords: Science communication, European projects, Innovations

EPERC: The European Pressure Equipment Research Council

International Nuclear Information System (INIS)

Darlaston, J.; McAllister, S.

1998-01-01

The European Pressure Equipment Research Council (EPERC) is a European Network of industries, research laboratories, inspection bodies and governmental institutions set up to foster co-operative research for the greater benefit of the European industry. The concept of a European Research Council originated at the PVRC meeting in Cannes in 1989 and since this time volunteers from the industry, research laboratories and of the European Commission Joint Research Centre, Petten have worked together to create a Statute for EPERC. In the context of the pressure equipment industry, the creation of EPERC is extremely pertinent, since in the near future, a Council directive on pressure equipment will replace the existing national regulations. In parallel to this, work is in progress for the elaboration of European Standards. It is useful to recall that ''Harmonised Standards'' will be the privileged means of complying with the Essential Safety Requirements of the directive. (author)

Phlebitis risk varies by peripheral venous catheter site and increases after 96 hours: a large multi-centre prospective study.

Science.gov (United States)

Cicolini, Giancarlo; Manzoli, Lamberto; Simonetti, Valentina; Flacco, Maria Elena; Comparcini, Dania; Capasso, Lorenzo; Di Baldassarre, Angela; Eltaji Elfarouki, Ghaleb

2014-11-01

This multi-centre prospective field study evaluated whether peripheral venous catheter site of insertion influences the risk of catheter-related phlebitis. Potential predictors of phlebitis were also investigated. Millions of patients worldwide use peripheral venous catheters, which frequently cause local complications including phlebitis, infection and obstruction. Although phlebitis predictors have been broadly investigated, uncertainties remain on the potential effect of cannulation anatomical site, duration and the appropriate time for catheter removal. A prospective cohort design was carried out from January-June 2012. The clinical course of each patient who received a new peripheral venous catheter for any cause in five Italian hospitals was followed by trained nurses until catheter removal. The presence of phlebitis was assessed every 24 hours using the Visual Infusion Phlebitis score. Analyses were based upon multilevel mixed-effects regression. The final sample consisted of 1498 patients. The average time for catheters in situ was 65·6 hours and 23·6% of the catheters were in place beyond 96 hours. Overall phlebitis incidence was 15·4%, 94·4% of which were grade 1. The likelihood of phlebitis independently increased with increasing catheter duration, being highest after 96 hours. Compared with patients with catheter placed in the dorsum of the hand (22·8% of the sample), those with the catheter located in the antecubital fossa (34·1%) or forearm were less likely to have a phlebitis of any grade. Antecubital fossa and forearm veins may be preferential sites for peripheral venous cannulation. Our results support Centers for Disease Control and Prevention recommendations to replace catheters in adults no later than 96 hours. A relevant proportion of healthcare personnel did not adhere to such guidelines - more attention to this issue is required. © 2014 John Wiley & Sons Ltd.

Design and analysis of the location of an online resale business distribution centre in Japan

Directory of Open Access Journals (Sweden)

K. Suzuki

2016-01-01

Full Text Available The location of distribution centres for online retailers has become an important issue for many companies. The operation of the distribution centre for e-commerce seems to be different from the traditional concept of distribution centres. This study considers how the location of distribution centres are designed and operated for online retailing using a computer simulation with actual data. This paper analyses current issues in order to propose an effective location for e-commerce distribution centres. An effective location for a multi-distribution system over a wide geographical area is required. This paper clearly points out the importance of locating e-commerce distribution centres over a wide geographical area by performing a computer simulation using actual data on the assumption that online resale business customers live in a metropolitan area. The study created a business model in which a buffer warehouse, which primarily handled commodities with high-frequency shipments, was located near a large consumption area and was used in addition to a large-scale distribution centre. The validity of the created business model was verified by performing a simulation based on actual data. The result revealed that these recommended improvement measures for the location of e-commerce distribution centres can function effectively.

Headache service quality: evaluation of quality indicators in 14 specialist-care centres.

Science.gov (United States)

Schramm, Sara; Uluduz, Derya; Gouveia, Raquel Gil; Jensen, Rigmor; Siva, Aksel; Uygunoglu, Ugur; Gvantsa, Giorgadze; Mania, Maka; Braschinsky, Mark; Filatova, Elena; Latysheva, Nina; Osipova, Vera; Skorobogatykh, Kirill; Azimova, Julia; Straube, Andreas; Eren, Ozan Emre; Martelletti, Paolo; De Angelis, Valerio; Negro, Andrea; Linde, Mattias; Hagen, Knut; Radojicic, Aleksandra; Zidverc-Trajkovic, Jasna; Podgorac, Ana; Paemeleire, Koen; De Pue, Annelien; Lampl, Christian; Steiner, Timothy J; Katsarava, Zaza

2016-12-01

The study was a collaboration between Lifting The Burden (LTB) and the European Headache Federation (EHF). Its aim was to evaluate the implementation of quality indicators for headache care Europe-wide in specialist headache centres (level-3 according to the EHF/LTB standard). Employing previously-developed instruments in 14 such centres, we made enquiries, in each, of health-care providers (doctors, nurses, psychologists, physiotherapists) and 50 patients, and analysed the medical records of 50 other patients. Enquiries were in 9 domains: diagnostic accuracy, individualized management, referral pathways, patient's education and reassurance, convenience and comfort, patient's satisfaction, equity and efficiency of the headache care, outcome assessment and safety. Our study showed that highly experienced headache centres treated their patients in general very well. The centres were content with their work and their patients were content with their treatment. Including disability and quality-of-life evaluations in clinical assessments, and protocols regarding safety, proved problematic: better standards for these are needed. Some centres had problems with follow-up: many specialised centres operated in one-touch systems, without possibility of controlling long-term management or the success of treatments dependent on this. This first Europe-wide quality study showed that the quality indicators were workable in specialist care. They demonstrated common trends, producing evidence of what is majority practice. They also uncovered deficits that might be remedied in order to improve quality. They offer the means of setting benchmarks against which service quality may be judged. The next step is to take the evaluation process into non-specialist care (EHF/LTB levels 1 and 2).

Implementation of preventive strength training in residential geriatric care: a multi-centre study protocol with one year of interventions on multiple levels.

Science.gov (United States)

Brach, Michael; Nieder, Frank; Nieder, Ulrike; Mechling, Heinz

2009-11-24

There is scientific evidence that preventive physical exercise is effective even in high age. In contrast, there are few opportunities of preventive exercise for highly aged people endangered by or actually in need of care. For example, they would not be able to easily go to training facilities; standard exercises may be too intensive and therefore be harmful to them; orientation disorders like dementia would exacerbate individuals and groups in following instructions and keeping exercises going. In order to develop appropriate interventions, these and other issues were assigned to different levels: the individual-social level (ISL), the organisational-institutional level (OIL) and the political-cultural level (PCL). Consequently, this conceptional framework was utilised for development, implementation and evaluation of a new strength and balance exercise programme for old people endangered by or actually in need of daily care. The present paper contains the development of this programme labeled "fit for 100", and a study protocol of an interventional single-arm multi-centre trial. The intervention consisted of (a) two group training sessions every week over one year, mainly resistance exercises, accompanied by sensorimotor and communicative group exercises and games (ISL), (b) a sustainable implementation concept, starting new groups by instructors belonging to the project, followed by training and supervision of local staff, who stepwise take over the group (OIL), (c) informing and convincing activities in professional, administrative and governmental contexts, public relation activities, and establishing an advisory council with renowned experts and public figures (PCL). Participating institutions of geriatric care were selected through several steps of quality criteria assessment. Primary outcome measures were continuous documentation of individual participation (ISL), number of groups continued without external financial support (at the end of the project, and

Implementation of preventive strength training in residential geriatric care: a multi-centre study protocol with one year of interventions on multiple levels

Directory of Open Access Journals (Sweden)

Nieder Ulrike

2009-11-01

Full Text Available Abstract Background There is scientific evidence that preventive physical exercise is effective even in high age. In contrast, there are few opportunities of preventive exercise for highly aged people endangered by or actually in need of care. For example, they would not be able to easily go to training facilities; standard exercises may be too intensive and therefore be harmful to them; orientation disorders like dementia would exacerbate individuals and groups in following instructions and keeping exercises going. In order to develop appropriate interventions, these and other issues were assigned to different levels: the individual-social level (ISL, the organisational-institutional level (OIL and the political-cultural level (PCL. Consequently, this conceptional framework was utilised for development, implementation and evaluation of a new strength and balance exercise programme for old people endangered by or actually in need of daily care. The present paper contains the development of this programme labeled "fit for 100", and a study protocol of an interventional single-arm multi-centre trial. Methods The intervention consisted of (a two group training sessions every week over one year, mainly resistance exercises, accompanied by sensorimotor and communicative group exercises and games (ISL, (b a sustainable implementation concept, starting new groups by instructors belonging to the project, followed by training and supervision of local staff, who stepwise take over the group (OIL, (c informing and convincing activities in professional, administrative and governmental contexts, public relation activities, and establishing an advisory council with renowned experts and public figures (PCL. Participating institutions of geriatric care were selected through several steps of quality criteria assessment. Primary outcome measures were continuous documentation of individual participation (ISL, number of groups continued without external financial

The Europeanization of Politics: Building a Terminology for European Studies

Directory of Open Access Journals (Sweden)

Damir Grubiša

2005-01-01

Full Text Available The article discusses the problem of Europeanisation, one of the key concepts developed within the European Studies in the last ten years or so, since the adoption and entry into force of the Maastricht Treaty. The fi rst part of the article deals with various models of Europeanisation in a context extending beyond the conceptual framework of the European Union, within which the phenomenon of Europeanisation arises. Therefore, the author attempts to develop a typology of broader approaches to the identifi cation of the phenomenon and process of Europeanisation, which includes six conceptions thereof: the fi rst approach is a geographical-political one, where Europeanisation is seen as a change in outer borders of Europe, from the reduction of Europe to the countries of Western Europe and Central Europe, to the extension of the concept of Europe to marginal countries; the second approach links the concept of Europeanisation with the development of political institutions on the European level. The third defi nition identifi es Europeanisation as an export of various forms of political organisation, a process which proceeds from the experience of European colonisation to the diff usion of European values as a role model for other continents; the fourth model of Europeanisation is the identifi cation with the project of European unifi cation, i. e. the process of integration which ends up in a federal, unifi ed Europe; the fi fth subtype is the penetration of national systems of governance by the European model of multilevel governance, which becomes manifest in the adaptation, convergence and harmonisation of the political and legal systems of member nations. The author elaborates on this classic typology by adding the sixth approach, which he calls “retrospective Europeanisation”. It involves Europeanisation as identifi cation with traditional European values that existed before EC and EU, primarily with the preintegration traditional

Progress and Results from the 4DH Research Centre

DEFF Research Database (Denmark)

Werner, Sven; Lund, Henrik; Mathiesen, Brian Vad

2014-01-01

With lower and more flexible distribution temperatures, fourth generation district heating systems can utilize renewable energy sources, while meeting the requirements of low-energy buildings and energy conservation measures in the existing building stock. 4DH is an international strategic research...... centre located at Aalborg University, which develops 4th generation district heating technologies and systems (4GDH). This technology is fundamental to the implementation of the Danish objective of being fossil fuel-free by 2050 and the European 2020 goals. The research centre is working between 2012...... and 2017, with The Danish Council for Strategic Research as main financier and the participating 31 Danish and international companies and universities as cofinanciers. Thirteen PhD student projects constitute a vital part of the research centre. In 4GDH systems, synergies are created between three areas...

SU-C-BRD-01: Multi-Centre Collaborative Quality Assurance Program for IMRT Planning and Delivery: Year 3 Results

Energy Technology Data Exchange (ETDEWEB)

McNiven, A; Jaffray, D; Letourneau, D [Princess Margaret Cancer Centre and Department of Radiation Oncology, University of Toronto, Toronto, ON (Canada)

2015-06-15

Purpose: A multi-centre quality assurance program was developed to enable quality improvement by coupling measurement of intensity modulated radiotherapy (IMRT) planning and delivery performance for site-specific planning exercises with diagnostic testing. The third year of the program specifically assessed the quality of spine stereotactic body radiotherapy (SBRT) planning and delivery amongst the participating centres. Methods: A spine SBRT planning exercise (24 Gy in 2 fractions) was created and completed by participants prior to an on-site visit. The delivery portion of the on-site visit included spine SBRT plan delivery and diagnostic testing, which included portal image acquisition for quantification of phantom positioning error and multi-leaf collimator (MLC) calibration accuracy. The measured dose was compared to that calculated in the treatment planning system (TPS) using 3%/2mm composite analysis and 3%/3mm gamma analysis. Results: Fourteen institutions participated, creating 17 spine SBRT plans (15 VMAT and 2 IMRT). Three different TPS, two beam energies (6 MV and 6 MV FFF), and four MLC designs from two linac vendors were tested. Large variation in total monitor units (MU) per plan (2494–6462 MU) and dose-volume parameters was observed. The maximum point dose in the plans ranged from 116–149% and was dependent upon the TPS used. Pass rates for measured to planned dose comparison ranged from 89.4–100% and 97.3–100% for 3%/2mm and 3%/3mm criteria respectively. The largest measured MLC error did Result in one of the poorer pass rates. No direct correlation between phantom positioning error and pass rates overall. Conclusion: Significant differences were observed in the planning exercise for some plan and dose-volume parameters based on the TPS used. Standard evaluation criteria showed good agreement between planned and measured dose for all participants, however on an individual plan basis, diagnostic tests were able to identify contributing

SU-C-BRD-01: Multi-Centre Collaborative Quality Assurance Program for IMRT Planning and Delivery: Year 3 Results

International Nuclear Information System (INIS)

McNiven, A; Jaffray, D; Letourneau, D

2015-01-01

Purpose: A multi-centre quality assurance program was developed to enable quality improvement by coupling measurement of intensity modulated radiotherapy (IMRT) planning and delivery performance for site-specific planning exercises with diagnostic testing. The third year of the program specifically assessed the quality of spine stereotactic body radiotherapy (SBRT) planning and delivery amongst the participating centres. Methods: A spine SBRT planning exercise (24 Gy in 2 fractions) was created and completed by participants prior to an on-site visit. The delivery portion of the on-site visit included spine SBRT plan delivery and diagnostic testing, which included portal image acquisition for quantification of phantom positioning error and multi-leaf collimator (MLC) calibration accuracy. The measured dose was compared to that calculated in the treatment planning system (TPS) using 3%/2mm composite analysis and 3%/3mm gamma analysis. Results: Fourteen institutions participated, creating 17 spine SBRT plans (15 VMAT and 2 IMRT). Three different TPS, two beam energies (6 MV and 6 MV FFF), and four MLC designs from two linac vendors were tested. Large variation in total monitor units (MU) per plan (2494–6462 MU) and dose-volume parameters was observed. The maximum point dose in the plans ranged from 116–149% and was dependent upon the TPS used. Pass rates for measured to planned dose comparison ranged from 89.4–100% and 97.3–100% for 3%/2mm and 3%/3mm criteria respectively. The largest measured MLC error did Result in one of the poorer pass rates. No direct correlation between phantom positioning error and pass rates overall. Conclusion: Significant differences were observed in the planning exercise for some plan and dose-volume parameters based on the TPS used. Standard evaluation criteria showed good agreement between planned and measured dose for all participants, however on an individual plan basis, diagnostic tests were able to identify contributing

Minimum ten-year follow-up of acetabular fracture fixation from the Irish tertiary referral centre.

LENUS (Irish Health Repository)

Magill, Paul

2012-04-01

Successful outcome from acetabular fracture fixation is multi-factorial. Long-term results are not frequently reported. Pooling such data from high output centres will help progress acetabular fixation. This paper presents the first ten-year data from the Irish tertiary referral centre.

Is patient-centredness in European hospitals related to existing quality improvement strategies? Analysis of a cross-sectional survey (MARQuIS study)

NARCIS (Netherlands)

Groene, O.; Lombarts, M. J. M. H.; Klazinga, N.; Alonso, J.; Thompson, A.; Suñol, R.

2009-01-01

Background: There is growing recognition of patients' contributions to setting objectives for their own care, improving health outcomes and evaluating care. Objective: To quantify the extent to which European hospitals have implemented strategies to promote a patient-centred approach, and to assess

Liver melanomacrophage centres and CYP1A expression as response biomarkers to environmental pollution in European anchovy (Engraulis encrasicolus) from the western Mediterranean Sea.

Science.gov (United States)

Basilone, Gualtiero; Gargano, Antonella; Corriero, Aldo; Zupa, Rosa; Santamaria, Nicoletta; Mangano, Salvatore; Ferreri, Rosalia; Pulizzi, Maurizio; Mazzola, Salvatore; Bonanno, Angelo; Passantino, Letizia

2018-06-01

The goal of the present study was to verify the suitability of using melanomacrophage centres (MMCs) as response biomarkers of marine pollution in European anchovy, which are short-lived, migratory, small pelagic fish. This suitability was verified by analysing the MMC density and cytochrome P450 monooxygenase 1A (CYP1A) expression in livers of anchovies from four areas of southern Italy. Age 2 anchovies sampled from three areas exposed to pollutants of industrial/agricultural origin (Gulf of Gela, Mazara del Vallo and Gulf of Naples) showed liver areas occupied by MMCs and numbers of MMCs that were significantly higher than those in the anchovies from Pozzallo, which is a marine area not subjected to any source of pollution. Anti-CYP1A immunoreactivity was observed in the hepatocytes of all specimens sampled from the Gulf of Gela. These findings suggest the utility of liver MMCs as biomarkers of exposure to pollutants in this small pelagic fish. Copyright © 2018 Elsevier Ltd. All rights reserved.

Overview of the Nuresafe European Project

Energy Technology Data Exchange (ETDEWEB)

Chanaron, B.

2016-08-01

Since some years, there is a worldwide trend to move towards higher fidelity simulation techniques in reactor analysis. Then main objectives of the research in this area to develop more predictive physical models and implement the dynamic 3D coupling of the codes simulating the different physics of the problem into a common multi-physic simulation scheme. In this context, the NURESIM road map (2006-2015) aimed at delivering to the European Stake holders an advanced and reliable software capacity usable for safety analysis needs of LWR reactors including uncertainty assessment to quantify the margins toward feared phenomena occurring during an accident. This software capacity is the Nuresium European simulation platform. It includes fully integrated advanced core physics, two-phase thermal-hydraulics, fuel modeling and multi-scale and multi-physics features together with sensitivity and uncertainty tools. (Author)

Historical centres: changing definitions

Directory of Open Access Journals (Sweden)

Roberta Lazzarotti

2014-02-01

Full Text Available Since the end of the Second World War, the architectural and planning culture has been showing a fluctuating attention to the theme of historical centres and their enhancement. First of all this uneven progress explains the difficulty to reach a homogeneous definition and this is still lacking. During a long phase of this period, the historical parts of the town were considered as objects to be preserved in an integral way, as urban monuments. This is mostly due to the high symbolic value of these settlements, that represent fundamental landmarks. Identity building and empowerment of local communities are indispensable conditions for any development programme, especially in the case of centres or other historic environments at risk of abandonment. The progressive evolution of this concept brings awareness of the impossibility of separating – either in analytical or in planning terms ­ historical centres from their urban and territorial contexts, which are linked by mutual, deep relationships. This article attempts to retrace the steps signaled by the publication of international documents and conventions, from the Charter of Gubbio (1960 to the Charter of Krakow and the European Landscape Convention (2000; they obviously represent particular points of view, not exhaustive of the richness of the positions in the debate, but extremely significant in terms of diffusion and consensus.

A hard lesson for Europeans: the ASEAN CDC.

Science.gov (United States)

Tibayrenc, Michel

2005-06-01

Despite the growing threat of major pandemics, the European Union is planning no more than a meager surveillance agency staffed with 70 people on the 2007 horizon: the new European Centre for Disease Control. I argue that an effective structure should be much larger and include a strong research activity. Asian countries, inspired by the US CDC, are now taking this concept in hand and creating an ASEAN Center For Disease Control, with sophisticated laboratory facilities to be included. This is a tough lesson for us Europeans, and our avarice in this domain could have tragic consequences in the future.

Combining Mass Spectrometry and Toxicology for a Multi-Country European Epidemiologic Study on Drinking Water Disinfection By-Products

Science.gov (United States)

The HiWATE (Health Impacts of long-term exposure to disinfection by-products in drinking WATEr) project is the first systematic analysis that combines the epidemiology on adverse pregnancy outcomes with analytical chemistry and analytical biology in the European Union. This study...

Outcome of physiotherapy after surgery for cervical disc disease: a prospective randomised multi-centre trial

Science.gov (United States)

2014-01-01

Background Many patients with cervical disc disease require leave from work, due to long-lasting, complex symptoms, including chronic pain and reduced levels of physical and psychological function. Surgery on a few segmental levels might be expected to resolve disc-specific pain and reduce neurological deficits, but not the non-specific neck pain and the frequent illness. No study has investigated whether post-surgery physiotherapy might improve the outcome of surgery. The main purpose of this study was to evaluate whether a well-structured rehabilitation programme might add benefit to the customary post-surgical treatment for cervical disc disease, with respect to function, disability, work capability, and cost effectiveness. Methods/Design This study was designed as a prospective, randomised, controlled, multi-centre study. An independent, blinded investigator will compare two alternatives of rehabilitation. We will include 200 patients of working age, with cervical disc disease confirmed by clinical findings and symptoms of cervical nerve root compression. After providing informed consent, study participants will be randomised to one of two alternative physiotherapy regimes; (A) customary treatment (information and advice on a specialist clinic); or (B) customary treatment plus active physiotherapy. Physiotherapy will follow a standardised, structured programme of neck-specific exercises combined with a behavioural approach. All patients will be evaluated both clinically and subjectively (with questionnaires) before surgery and at 6 weeks, 3 months, 6 months, 12 months, and 24 months after surgery. The main outcome variable will be neck-specific disability. Cost-effectiveness will also be calculated. Discussion We anticipate that the results of this study will provide evidence to support physiotherapeutic rehabilitation applied after surgery for cervical radiculopathy due to cervical disc disease. Trial registration ClinicalTrials.gov identifier: NCT01547611

EUROPEAN CULTURE: A REASSESSMENT OF THE IDENTITY

Directory of Open Access Journals (Sweden)

LAZĂR LUDMILA

2017-12-01

Full Text Available Massive migration to the EU, violent challenges in European capitals and internal conflicts raise not only political, but also cultural issues. The values of the European civilization are challenged by the new communication and informational technologies, at the EU level, as well as at the national and individual level. Europe is deeply marked by the globalization phenomenon and its consequences require to be addressed from a new perspective. West European vulnerabilities appear in the foreground and some people try to doubt the fundamental identity marks of the European society. In fact, as far back as the end of the last century, Edgar Morin proposed the dialogic principle to conceive Europe, merely because the dialogic ‘is at the heart of European identity, and not one or another of its elements or moments’. Under the current conditions, the European identity becomes fluid, ever-changing, whilst preserving the ‘hard core’ of values centred on the cultural dimension, characterized by diversity and openness for intercultural dialogue.

Natural Water Retention Measures (NWRM): from Design to Implementation through European Projects

International Nuclear Information System (INIS)

Magdaleno Mas, F.; Dalacamara Andres, G.

2015-01-01

The Centre for Applied Technique Studies (CETA) of CEDEX has been working over the last few years in different European projects related with the design and development of natural water retention measures (NWRM). These are a number of measures, boosted by the Water Unit of the Environment Directorate-General of the European Commission. with close links to green infrastructures, which try to integrate, from a multifunctional approach, different legal and technical requirements aimed at a better adaptation to extreme hydro meteorological events, environmental protection and conservation, and maintenance of ecosystem services. This paper reviews the underpinning foundations of the concept and the mechanisms for designing and implementing NWRM. It also shows the way they can be applied, by presenting different initiatives developed by CETA since 2008 in Navarra (Arga-Aragon rivers system). For fulfilling those works, CETA has collaborated with environmental and hydraulic authorities of Navarra. It has also actively cooperated with research centres, such as the Institute IMDEA Water. specifically in a European project devoted to the diffusion, assessment, and presentation of NWRM within the context of the EU River Basin Districts. (Author)

Presentations to the Emergency Department Following Cannabis use--a Multi-Centre Case Series from Ten European Countries.

Science.gov (United States)

Dines, Alison M; Wood, David M; Galicia, Miguel; Yates, Christopher M; Heyerdahl, Fridtjof; Hovda, Knut Erik; Giraudon, Isabelle; Sedefov, Roumen; Dargan, Paul I

2015-12-01

Cannabis is the most commonly used illicit drug in Europe, and is generally regarded as having low acute toxicity. We present the findings of the first 6 months of data collection from the Euro-DEN project on presentations related to cannabis use to further understand the acute toxicity related to the use of cannabis. Data was extracted on clinical features, treatment and outcome from the Euro-DEN minimum dataset for all cases of acute recreational drug toxicity reported 1st October 2013 to 31st March 2014 for all cannabis-related presentations. Of 2198 presentations reported by 14 of the 16 Euro-DEN centres, 356 (16.2 %) involved cannabis either alone or together with other drugs/alcohol. There were 36 that involved lone use of cannabis (1.6 % of all presentations). Of the 35 non-fatal lone cannabis presentations, the most commonly reported features were neuro-behavioural (agitation/aggression 8 (22.9 %), psychosis 7 (20.0 %), anxiety 7 (20.0 %)) and vomiting 6 (17.1 %). Most patients (25, 71.4 %) received no treatment and 30 (85.7 %) were discharged/self-discharged from the ED. There was one fatality amongst these lone-cannabis cases: an 18-year-old male collapsed with an asystolic cardiac arrest whilst smoking cannabis and suffered hypoxic brain injury related to prolonged cardiac arrest. THC was detected in a urine sample taken at ED arrival; no other drugs were detected. Lone acute cannabis toxicity was typically associated with neuro-behavioural symptoms and vomiting. Although uncommon, severe toxicity including cardiovascular toxicity and death may be under-recognised, and it is important that Emergency Physicians are aware of this.

Conceptual design of an ALICE Tier-2 centre. Integrated into a multi-purpose computing facility

Energy Technology Data Exchange (ETDEWEB)

Zynovyev, Mykhaylo

2012-06-29

This thesis discusses the issues and challenges associated with the design and operation of a data analysis facility for a high-energy physics experiment at a multi-purpose computing centre. At the spotlight is a Tier-2 centre of the distributed computing model of the ALICE experiment at the Large Hadron Collider at CERN in Geneva, Switzerland. The design steps, examined in the thesis, include analysis and optimization of the I/O access patterns of the user workload, integration of the storage resources, and development of the techniques for effective system administration and operation of the facility in a shared computing environment. A number of I/O access performance issues on multiple levels of the I/O subsystem, introduced by utilization of hard disks for data storage, have been addressed by the means of exhaustive benchmarking and thorough analysis of the I/O of the user applications in the ALICE software framework. Defining the set of requirements to the storage system, describing the potential performance bottlenecks and single points of failure and examining possible ways to avoid them allows one to develop guidelines for selecting the way how to integrate the storage resources. The solution, how to preserve a specific software stack for the experiment in a shared environment, is presented along with its effects on the user workload performance. The proposal for a flexible model to deploy and operate the ALICE Tier-2 infrastructure and applications in a virtual environment through adoption of the cloud computing technology and the 'Infrastructure as Code' concept completes the thesis. Scientific software applications can be efficiently computed in a virtual environment, and there is an urgent need to adapt the infrastructure for effective usage of cloud resources.

Conceptual design of an ALICE Tier-2 centre. Integrated into a multi-purpose computing facility

International Nuclear Information System (INIS)

Zynovyev, Mykhaylo

2012-01-01

This thesis discusses the issues and challenges associated with the design and operation of a data analysis facility for a high-energy physics experiment at a multi-purpose computing centre. At the spotlight is a Tier-2 centre of the distributed computing model of the ALICE experiment at the Large Hadron Collider at CERN in Geneva, Switzerland. The design steps, examined in the thesis, include analysis and optimization of the I/O access patterns of the user workload, integration of the storage resources, and development of the techniques for effective system administration and operation of the facility in a shared computing environment. A number of I/O access performance issues on multiple levels of the I/O subsystem, introduced by utilization of hard disks for data storage, have been addressed by the means of exhaustive benchmarking and thorough analysis of the I/O of the user applications in the ALICE software framework. Defining the set of requirements to the storage system, describing the potential performance bottlenecks and single points of failure and examining possible ways to avoid them allows one to develop guidelines for selecting the way how to integrate the storage resources. The solution, how to preserve a specific software stack for the experiment in a shared environment, is presented along with its effects on the user workload performance. The proposal for a flexible model to deploy and operate the ALICE Tier-2 infrastructure and applications in a virtual environment through adoption of the cloud computing technology and the 'Infrastructure as Code' concept completes the thesis. Scientific software applications can be efficiently computed in a virtual environment, and there is an urgent need to adapt the infrastructure for effective usage of cloud resources.

Evaluation of the fusion technology and safety programme of the Joint Research Centre (1980-85)

International Nuclear Information System (INIS)

Haines, M.; Cabibbo, N.; Crocker, J.G.; Lecomte, M.; Merz, E.

1986-01-01

The Joint Research Centre, Ispra, has been involved in fusion research since 1973. In July 1985 the Commission of European Communities - DG XII, following a policy of systematically evaluating its RandD activities, appointed a panel of external experts to evaluate the fusion technology and safety programme carried out at the Joint Research Centre. This report describes the work of the panel in evaluating the research performed by the JRC within the framework of its 1984-87 programme. The achievements of the previous programme, 1980-83, were also taken into consideration. The different research areas covered in the programme, i.e.: reactor studies, breeding blanket technology, structural materials studies, risk assessment and tritium laboratory studies, are described and a draft proposal for the period 1987-90 presented. The evaluation panel has been asked to assess the following aspects: the scientific and technical achievements of the programme, the contribution of the programme to the development of other Community policies, the role played by the JRC in the European fusion research (including NET) and in international collaborations such as INTOR. From its assessment the evaluation panel has made a series of recommendations for the current programme and for future work

Adherence to MRI protocol consensus guidelines in multiple sclerosis: an Australian multi-centre study

International Nuclear Information System (INIS)

Curley, Michael; Josey, Lawrence; Lucas, Robyn; Dear, Keith; Taylor, Bruce V.; Coulthard, Alan; Ausimmune Investigator Group

2012-01-01

Multiple sclerosis (MS) is a debilitating disease that causes significant morbidity within a young demographic. Diagnostic guidelines for MS have evolved, and imaging has played an increasingly important role in diagnosis over the last two decades. For imaging to contribute to diagnosis in a meaningful way, it must be reproducible. Consensus guidelines for MRI in MS exist to define correct sequence type and imaging technique, but it is not clear to what extent they are followed. This study reviewed MRI studies performed on Australian individuals presenting with a first clinical diagnosis of central nervous system demyelination (FCD) for adherence to published guidelines and discussed practical implementation of MS guidelines in light of recent updates. The Ausimmune study was a prospective case control study of Australian participants presenting with FCD from 2003 to 2006. Baseline cranial and spinal cord MRI studies of 226 case participants from four separate Australian regions were reviewed. MRI sequences were classified according to anatomical location, slice plane, tissue weighting and use of gadolinium-containing contrast media. Results were compared with the 2003 Consortium of Multiple Sclerosis Centres MRI protocol for the diagnosis of MS. The composition of core cranial MRI sequences performed varied across the 226 scans. Of the studies, 91% included sagittal fluid attenuated inversion recovery (FLAIR) sequences. Cranial axial T2-weighted, axial FLAIR and axial proton density-weighted sequences were performed in 88%, 60% and 16% (respectively) of scans. Only 25% of the studies included a T1-weighted contrast-enhanced sequence. Concordance with the guidelines in all sequences was very low (2). Only a small number of MRI investigations performed included all of the sequences stipulated by consensus guidelines. This is likely due to poor awareness in the imaging community of the guidelines and the rationale behind certain sequences. Radiologists with a sub

PATIENT-CENTRED SCREENING FOR PRIMARY IMMUNODEFICIENCY, A MULTI-STAGE DIAGNOSTIC PROTOCOL DESIGNED FOR NONIMMUNOLOGISTS: 2011 UPDATE

Directory of Open Access Journals (Sweden)

E. de Vries

2013-01-01

Full Text Available Abstract. Members of the European Society for Immunodeficiencies (ESID and other colleagues have updated themulti-stage expert-opinion-based diagnostic protocol for non-immunologists incorporating newly defined primary immunodeficiency diseases (PIDs. The protocol presented here aims to increase the awareness of PIDs among doctors working in different fields. Prompt identification of PID is important for prognosis, but this may not be an easy task. The protocol therefore starts from the clinical presentation of the patient. Because PIDs may present at all ages, this protocol is aimed at both adult and paediatric physicians. The multi-stage design allows cost-effective screening for PID of the large number of potential cases in the early phases, with more expensive tests reserved for definitive classification in collaboration with a specialist in the field of immunodeficiency at a later stage.

Soft X-ray excited colour-centre luminescence and XANES studies of calcium oxide

International Nuclear Information System (INIS)

Ko, J.Y.P.; Heigl, F.; Yiu, Y.M.; Zhou, X.-T.; Regier, T.; Blyth, R.I.R.; Sham, T.-K.

2007-01-01

In this study, we show that colour centres can be produced by irradiating calcium oxide with soft X-rays from a synchrotron radiation source. Using the X-ray excited optical Iuminescence (XEOL) technique, two colour centres, F-centre, and F + -centre can be identified. These colour centres emit photons at characteristic wavelengths. In addition, by performing time-resolved XEOL (TRXEOL), we are able to reveal timing and decay characteristics of the colour centres. We also present X-ray absorption near-edge structure (XANES) spectra collected across oxygen K-edge, calcium L 3,2 -edge, and calcium K-edge. Experimental results are compared with density functional theory (DFT) calculations. (author)

European Studies and Public Engagement: A Conceptual Toolbox

Directory of Open Access Journals (Sweden)

Andreas Müllerleile

2014-11-01

Full Text Available Journal of Contemporary European Research User Username Password Remember me Subscribe... Sign up for issue alerts Follow JCER on Twitter Font Size Make font size smaller Make font size default Make font size larger Journal Content Search Search Scope Browse By Issue By Author By Title Information For Readers For Authors For Librarians Journal Help Keywords CFSP Communication ESDP EU EU enlargement EU trade policy Energy, EU, External Policy Europe European Commission European Parliament European Union European integration Europeanisation First Enlargement Germany Liberty Lisbon Treaty Poland Russia Security teaching European studies The UACES Blog The Commission after the 2014 EP... Power shift? The EU’s pivot to Asia 100 Books on Europe to be Remembered For a Global European Studies? EU Member State Building in the... Open Journal Systems Home About Login Register Search Current Archives Announcements UACES Home > Vol 10, No 4 (2014 > Müllerleile European Studies and Public Engagement: A Conceptual Toolbox Andreas Müllerleile Abstract This article examines public engagement strategies for academics working in the field of European Studies. Should academics engage with the public? What are the most effective outreach strategies? And what are the implications for universities and departments? The article argues that engaging with the public should be considered an integral part for academics working on topics that relate to the European Union or European politics. The article has a theoretical and a practical dimension. The first part of the paper deals with the nature of public engagement, explaining why it is an important issue and how it differs from the mainstream understanding of public engagement. The practical part of the paper presents the idea of building an online presence through which academics can engage with the public debate both during periods of low issue salience and high issue salience. The final section includes a toolbox

Distance to invasive heart centre, performance of acute coronary angiography, and angioplasty and associated outcome in out-of-hospital cardiac arrest: a nationwide study.

Science.gov (United States)

Tranberg, Tinne; Lippert, Freddy K; Christensen, Erika F; Stengaard, Carsten; Hjort, Jakob; Lassen, Jens Flensted; Petersen, Frants; Jensen, Jan Skov; Bäck, Caroline; Jensen, Lisette Okkels; Ravkilde, Jan; Bøtker, Hans Erik; Terkelsen, Christian Juhl

2017-06-01

To evaluate whether the distance from the site of event to an invasive heart centre, acute coronary angiography (CAG)/percutaneous coronary intervention (PCI) and hospital-level of care (invasive heart centre vs. local hospital) is associated with survival in out-of-hospital cardiac arrest (OHCA) patients. Nationwide historical follow-up study of 41 186 unselected OHCA patients, in whom resuscitation was attempted between 2001 and 2013, identified through the Danish Cardiac Arrest Registry. We observed an increase in the proportion of patients receiving bystander CPR (18% in 2001, 60% in 2013, P acute CAG/PCI (5% in 2001, 27% in 2013, P acute CAG/PCI annually in each region was defined as the CAG/PCI index. The following variables were associated with lower mortality in multivariable analyses: direct admission to invasive heart centre (HR 0.91, 95% CI: 0.89-0.93), CAG/PCI index (HR 0.33, 95% CI: 0.25-0.45), population density above 2000 per square kilometre (HR 0.94, 95% CI: 0.89-0.98), bystander CPR (HR 0.97, 95% CI: 0.95-0.99) and witnessed OHCA (HR 0.87, 95% CI: 0.85-0.89), whereas distance to the nearest invasive centre was not associated with survival. Admission to an invasive heart centre and regional performance of acute CAG/PCI were associated with improved survival in OHCA patients, whereas distance to the invasive centre was not. These results support a centralized strategy for immediate post-resuscitation care in OHCA patients. © The Author 2017. Published on behalf of the European Society of Cardiology.

ENLIGHT: European network for Light ion hadron therapy.

Science.gov (United States)

Dosanjh, Manjit; Amaldi, Ugo; Mayer, Ramona; Poetter, Richard

2018-04-03

The European Network for Light Ion Hadron Therapy (ENLIGHT) was established in 2002 following various European particle therapy network initiatives during the 1980s and 1990s (e.g. EORTC task group, EULIMA/PIMMS accelerator design). ENLIGHT started its work on major topics related to hadron therapy (HT), such as patient selection, clinical trials, technology, radiobiology, imaging and health economics. It was initiated through CERN and ESTRO and dealt with various disciplines such as (medical) physics and engineering, radiation biology and radiation oncology. ENLIGHT was funded until 2005 through the EC FP5 programme. A regular annual meeting structure was started in 2002 and continues until today bringing together the various disciplines and projects and institutions in the field of HT at different European places for regular exchange of information on best practices and research and development. Starting in 2006 ENLIGHT coordination was continued through CERN in collaboration with ESTRO and other partners involved in HT. Major projects within the EC FP7 programme (2008-2014) were launched for R&D and transnational access (ULICE, ENVISION) and education and training networks (Marie Curie ITNs: PARTNER, ENTERVISION). These projects were instrumental for the strengthening of the field of hadron therapy. With the start of 4 European carbon ion and proton centres and the upcoming numerous European proton therapy centres, the future scope of ENLIGHT will focus on strengthening current and developing European particle therapy research, multidisciplinary education and training and general R&D in technology and biology with annual meetings and a continuously strong CERN support. Collaboration with the European Particle Therapy Network (EPTN) and other similar networks will be pursued. Copyright © 2018 CERN. Published by Elsevier B.V. All rights reserved.

ENLIGHT at its second European appointment

CERN Multimedia

2006-01-01

CERN hosts the preparatory meeting of ENLIGHT++ to focus European efforts in light-ion hadron therapy. On Friday, 24 March, CERN hosted the preparatory meeting of ENLIGHT++, which continues the vision started by the European Network for Research in Light-Ion Hadron Therapy (ENLIGHT). Clinicians, oncologists, physicists, radiobiologists, information and communication technology experts and engineers from around Europe came for the one-day workshop to coordinate European efforts in radiation therapy using light-ion beams for cancer therapy. Following a welcome from CERN's Chief Scientific Officer Jos Engelen, key note presentations began with Jean-Pierre Gérard, Director-General of the Centre Antoine-Lacassagne and former chairman of the European Society for Therapeutic Radiology and Oncology (ESTRO), who illustrated the compelling reasons why ion therapy is needed. The following talks were given by Germaine Heeren, manager of the original ENLIGHT project (Belgium), and Thomas Haberer from the Heidelberg Io...

Measurement equivalence of the CES-D 8 depression-scale among the ageing population in eleven European countries.

Science.gov (United States)

Missinne, Sarah; Vandeviver, Christophe; Van de Velde, Sarah; Bracke, Piet

2014-07-01

Depression is one of the most prevalent mental disorders in later life. However, despite considerable research attention, great confusion remains regarding the association between ageing and depression. There is doubt as to whether a depression scale performs identically for different age groups and countries. Although measurement equivalence is a crucial prerequisite for valid comparisons across age groups and countries, it has not been established for the eight-item version of the Centre for Epidemiological Studies Depression Scale (CES-D8). Using multi-group confirmatory factor analysis, we assess configural, metric, and scalar measurement equivalence across two age groups (50-64 years of age and 65 or older) in eleven European countries, employing data from the Survey of Health, Ageing, and Retirement (SHARE). Results indicate that the construct of depression is comparable across age and country groups, allowing the substantive interpretation of correlates and mean levels of depressive symptoms. Copyright © 2014 Elsevier Inc. All rights reserved.

Ready-to-eat cereals improve nutrient, milk and fruit intake at breakfast in European adolescents.

Science.gov (United States)

Michels, Nathalie; De Henauw, Stefaan; Beghin, Laurent; Cuenca-García, Magdalena; Gonzalez-Gross, Marcela; Hallstrom, Lena; Kafatos, Anthony; Kersting, Mathilde; Manios, Yannis; Marcos, Ascensión; Molnar, Denes; Roccaldo, Romana; Santaliestra-Pasías, Alba M; Sjostrom, Michael; Reye, Béatrice; Thielecke, Frank; Widhalm, Kurt; Claessens, Mandy

2016-03-01

Breakfast consumption has been recommended as part of a healthy diet. Recently, ready-to-eat cereals (RTEC) became more popular as a breakfast item. Our aim was to analyse the dietary characteristics of an RTEC breakfast in European adolescents and to compare them with other breakfast options. From the European multi-centre HELENA study, two 24-h dietary recalls of 3137 adolescents were available. Food items (RTEC or bread, milk/yoghurt, fruit) and macro- and micronutrient intakes at breakfast were calculated. Cross-sectional regression analyses were adjusted for gender, age, socio-economic status and city. Compared to bread breakfasts (39 %) and all other breakfasts (41.5 %), RTEC breakfast (19.5 %) was associated with improved nutrient intake (less fat and less sucrose; more fibre, protein and some micronutrients like vitamin B, calcium, magnesium and phosphorus) at the breakfast occasion. Exceptions were more simple sugars in RTEC breakfast consumers: more lactose and galactose due to increased milk consumption, but also higher glucose and fructose than bread consumers. RTEC consumers had a significantly higher frequency (92.5 vs. 50.4 and 60.2 %) and quantity of milk/yoghurt intake and a slightly higher frequency of fruit intake (13.4 vs. 10.9 and 8.0 %) at breakfast. Among European adolescents, RTEC consumers showed a more favourable nutrient intake than consumers of bread or other breakfasts, except for simple sugars. Therefore, RTEC may be regarded as a good breakfast option as part of a varied and balanced diet. Nevertheless, more research is warranted concerning the role of different RTEC types in nutrient intake, especially for simple sugars.

Recommendations for centres of expertise in rare anaemias. The ENERCA White Book

OpenAIRE

Joan-Lluis Vives Corrons; María del Mar Mañú Pereira; Carlos Romeo-Casabona; Pilar Nicolás; Béatrice Gulbis; Androulla Eleftheriou; Michael Angastiniotis; Patricia Aguilar Martínez; Paola Bianchi; Richard Van Wijk; Hermann Heimpel; Barbara De la Salle; Andrea Mosca

2014-01-01

The Community added value of Centres of Expertise (CoE) and European Reference Networks (ERN) is particularly high for rare diseases (RD) due to the rarity of these conditions, which implies both a small number of patients and scarcity of expertise within a single country. Gathering expertise at the European level is therefore, paramount in order to ensure equal access to accurate information, appropriate and timely diagnosis and high quality clinical care and follow up for patients with rare...

Communication in Health Professions: A European consensus on inter- and multi-professional learning objectives in German.

Science.gov (United States)

Bachmann, Cadja; Kiessling, Claudia; Härtl, Anja; Haak, Rainer

2016-01-01

Communication is object of increasing attention in the health professions. Teaching communication competencies should already begin in undergraduate education or pre-registration training. The aim of this project was to translate the Health Professions Core Communication Curriculum (HPCCC), an English catalogue of learning objectives, into German to make its content widely accessible in the German-speaking countries. This catalogue lists 61 educational objectives and was agreed on by 121 international communication experts. A European reference framework for inter- and multi-professional curriculum development for communication in the health professions in German-speaking countries should be provided. The German version of the HPCCC was drafted by six academics and went through multiple revisions until consensus was reached. The learning objectives were paired with appropriate teaching and assessment tools drawn from the database of the teaching Committee of the European Association for Communication Health Care (tEACH). The HPCCC learning objectives are now available in German and can be applied for curriculum planning and development in the different German-speaking health professions, the educational objectives can also be used for inter-professional purposes. Examples for teaching methods and assessment tools are given for using and implementing the objectives. The German version of the HPCCC with learning objectives for communication in health professions can contribute significantly to inter- and multi-professional curriculum development in the health care professions in the German-speaking countries. Examples for teaching methods and assessment tools from the materials compiled by tEACH supplement the curricular content and provide suggestions for practical implementation of the learning objectives in teaching and assessment. The relevance of the German HPCCC to the processes of curriculum development for the various health professions and inter

A novel SDN enabled hybrid oiptical packet/circuit switched data centre network - The LIGHTNESS approach

NARCIS (Netherlands)

Peng, S.; Simeonidou, D.; Zervas, G.; Nejabati, R.; Yan, Y; Shu, Yi; Spadaro, S.; Perelló, J.; Agraz, F.; Careglio, D.; Dorren, H.J.S.; Miao, W.; Calabretta, N.; Bernini, G.; Ciulli, N.; Sancho, J.C.; Iordache, S.; Becerra, Y.; Farreras, M.; Biancani, M.; Predieri, A.; Proietti, R.; Cao, Z.; Liu, L.; Yoo, S.J.B.

2014-01-01

Current over-provisioned and multi-tier data centre networks (DCN) deploy rigid control and management platforms, which are not able to accommodate the ever-growing workload driven by the increasing demand of high-performance data centre (DC) and cloud applications. In response to this, the EC FP7

The Governance of Multi-Use Platforms at Sea for Energy Production and Aquaculture: Challenges for Policy Makers in European Seas

Directory of Open Access Journals (Sweden)

Marian Stuiver

2016-04-01

Full Text Available European seas are encountering an upsurge in competing marine activities and infrastructures. Traditional exploitation such as fisheries, tourism, transportation, and oil production are accompanied by new sustainable economic activities such as offshore windfarms, aquaculture, and tidal and wave energy. One proposed solution to overcome possible competing claims at sea lies in combining these economic activities as part of Multi-Use Platforms at Sea (MUPS. MUPS can be understood as areas at sea, designated for a combination of activities, either completely integrated in a platform or in shared marine space. MUPS can potentially benefit from each other in terms of infrastructure, maintenance, etc. Developing MUPS in the marine environment demands adequate governance. In this article, we investigate four European sites to find out how governance arrangements may facilitate or complicate MUPs. In particular, we apply a framework specifying policy, economic, social, technical, environmental, and legal (PESTEL factors to explore governance arrangements in four case study sites in different sea basins around Europe (the Mediterranean Sea, the Atlantic Ocean, the North Sea, and the Baltic Sea. The article concludes with policy recommendations on a governance regime for facilitating the development of MUPS in the future.

European Cosmoscapes. The case of the Festival of Europe in Florence

Directory of Open Access Journals (Sweden)

Dario Verderame

2015-01-01

Full Text Available The aim of this essay is to offer an empirical contribution to the understanding of cosmopolita-nization processes, centred on Europe. Specifically, the subject of my study is the Festival of Europe, an event dedicated to European themes that is held every two years in the city of Florence (Italy. By means of this case study I intend to analyse those elements that enable or constrain the formation of a European cosmopolitan imaginary within a concrete situational context. This analysis will also permit the formulation of some observations with regard to the role that such organizational and social forms – festivals – can play in the construction of a cosmopolitan social space.

A European network for nuclear medicine and radiotherapy. EMIR

International Nuclear Information System (INIS)

Jehenson, P.; Lartigau, E.; Guidez, J.

2003-01-01

Nuclear medicine and radiotherapy make a vital contribution to the diagnosis and treatment of major disease. This role is likely to expand with new developments including availability of new medical isotopes. A European network (EMIR) was initiated in 2001 by the Joint Research Centre (JRC) of the European Commission, to identify and solve difficulties that constrain nuclear medicine and radiotherapy development in Europe and facilitate closer interdisciplinary collaboration. Participating organisations include the main European associations of medical radiation specialists, radiopharmaceutical/radioisotope producers, nuclear research reactor institutions, research organizations and the JRC. The steering committee established task groups focusing on eight key areas for development. Liaison with non-European organizations will be encouraged. (author)

Complementary and alternative medicine for cancer patients: results of the EPAAC survey on integrative oncology centres in Europe.

Science.gov (United States)

Rossi, Elio; Vita, Alessandra; Baccetti, Sonia; Di Stefano, Mariella; Voller, Fabio; Zanobini, Alberto

2015-06-01

The Region of Tuscany Health Department was included as an associated member in WP7 "Healthcare" of the European Partnership for Action Against Cancer (EPAAC), initiated by the EU Commission in 2009. The principal aim was to map centres across Europe prioritizing those that provide public health services and operating within the national health system in integrative oncology (IO). A cross-sectional descriptive survey design was used to collect data. A questionnaire was elaborated concerning integrative oncology therapies to be administered to all the national health system oncology centres or hospitals in each European country. These institutes were identified by convenience sampling, searching on oncology websites and forums. The official websites of these structures were analysed to obtain more information about their activities and contacts. Information was received from 123 (52.1 %) out of the 236 centres contacted until 31 December 2013. Forty-seven out of 99 responding centres meeting inclusion criteria (47.5 %) provided integrative oncology treatments, 24 from Italy and 23 from other European countries. The number of patients seen per year was on average 301.2 ± 337. Among the centres providing these kinds of therapies, 33 (70.2 %) use fixed protocols and 35 (74.5 %) use systems for the evaluation of results. Thirty-two centres (68.1 %) had research in progress or carried out until the deadline of the survey. The complementary and alternative medicines (CAMs) more frequently provided to cancer patients were acupuncture 26 (55.3 %), homeopathy 19 (40.4 %), herbal medicine 18 (38.3 %) and traditional Chinese medicine 17 (36.2 %); anthroposophic medicine 10 (21.3 %); homotoxicology 6 (12.8 %); and other therapies 30 (63.8 %). Treatments are mainly directed to reduce adverse reactions to chemo-radiotherapy (23.9 %), in particular nausea and vomiting (13.4 %) and leucopenia (5 %). The CAMs were also used to reduce pain and fatigue (10.9�

Integration of Composite Structures in Modern Day Architecture: Case Study of City Business Centre, Timisoara, Romania

Science.gov (United States)

Vataman, Adina; Gaivoronschi, Vlad; Mosoarca, Marius

2017-10-01

In current day structural design the use of composite steel-concrete structures has become the norm; because of the advantages that each of these materials has to offer. Composite structures also have the benefit of a faster execution at a lower cost, compared to traditional structures. While the arguments in favour of designing composite structures are well-known and appreciated by civil engineers; there remains a question of integrating these structures in modern-day urban landscapes. Eastern European countries are welcoming a blossoming of culture, arts, economy and industry, which unavoidably and necessarily will lead to a change in urban landscapes. With an increasing amount of foreign companies opening offices in these areas, the need for modern office solutions has arisen. The current paper presents a case study of an office building complex situated in the western part of Romania, in the city of Timişoara. The complex consists of 5 office buildings; all designed in composite steel-concrete structure, an underground parking lot, multiple terraces and adjacent promenade areas. Within the context of rapid growth and development of the city, the City Business Centre has offered high quality office spaces in the heart of the city, while considering the needs of the community. A very important aspect in the successful completion of the project was the efficient and professional collaboration between the separate project teams, between the owner, represented by the project management team, the architect, the structural designer and the building company. The successful joining of seismic structural solutions with modern architectural aesthetics has led to a dynamic, vibrant environment, making the City Business Centre the core of the region’s business life, at the same time redefining Timisoara’s architectural landscape. A testimony to the success of the project was the Civil Engineering Structural Designers Associations’ (AICPS) 3rd Prize awarded for great

Mineral metabolism in European children living with a renal transplant: a European society for paediatric nephrology/european renal association-European dialysis and transplant association registry study

NARCIS (Netherlands)

Bonthuis, Marjolein; Busutti, Marco; van Stralen, Karlijn J.; Jager, Kitty J.; Baiko, Sergey; Bakkaloğlu, Sevcan; Battelino, Nina; Gaydarova, Maria; Gianoglio, Bruno; Parvex, Paloma; Gomes, Clara; Heaf, James G.; Podracka, Ludmila; Kuzmanovska, Dafina; Molchanova, Maria S.; Pankratenko, Tatiana E.; Papachristou, Fotios; Reusz, György; Sanahuja, Maria José; Shroff, Rukshana; Groothoff, Jaap W.; Schaefer, Franz; Verrina, Enrico

2015-01-01

Data on mineral metabolism in pediatric renal transplant recipients largely arise from small single-center studies. In adult patients, abnormal mineral levels are related to a higher risk of graft failure. This study used data from the European Society for Paediatric Nephrology/European Renal

European surveillance for enterovirus D68 during the emerging North-American outbreak in 2014

DEFF Research Database (Denmark)

Poelman, Randy; Schuffenecker, Isabelle; Van Leer-Buter, Coretta

2015-01-01

BACKGROUND: In August and September 2014, unexpected clusters of enterovirus-D68 (EV-D68) infections associated with severe respiratory disease emerged from North-America. In September, the European Centre for Disease Prevention and Control (ECDC) asked European countries to strengthen respiratory...... sample screening for enterovirus detection and typing in cases with severe respiratory presentations. OBJECTIVES: To provide a detailed picture of EV-D68 epidemiology in Europe by conducting a retrospective and prospective laboratory analysis of clinical specimens. STUDY DESIGN: An initiative supported...

The relationship between Prostate CAncer gene 3 (PCA3) and prostate cancer significance

NARCIS (Netherlands)

van Poppel, Hein; Haese, Alexander; Graefen, Markus; de la Taille, Alexandre; Irani, Jacques; de Reijke, Theo; Remzi, Mesut; Marberger, Michael

2012-01-01

OBJECTIVE To evaluate the relationship between Prostate CAncer gene 3 (PCA3) and prostate cancer significance. PATIENTS AND METHODS Clinical data from two multi-centre European open-label, prospective studies evaluating the clinical utility of the PCA3 assay in guiding initial and repeat biopsy

MUPBED: A Pan-European Prototype for Multi-Domain Research Networks

DEFF Research Database (Denmark)

Spaeth, Jan; Cavazzoni, Carlo; Foisel, Hans-Martin

2009-01-01

Integration and full interoperability are challenging areas of research in wide-area networks today. A European project, MUPBED, has recently concluded and achieved the main result of integrating and demonstrating technologies and network solutions that enable the operation of future European res...

Use of selective digestive tract decontamination in European intensive cares

DEFF Research Database (Denmark)

Reis Miranda, D; Citerio, G; Perner, A

2015-01-01

BACKGROUND: Several studies have shown that the use of selective digestive tract decontamination (SDD) reduces mortality. However, fear for increasing multi drug resistance might prevent wide acceptance. A survey was performed among the units registered in the European Registry for Intensive Care...

Designation of the European Working Group on Legionella Infection (EWGLI) amplified fragment length polymorphism types of Legionella pneumophila serogroup 1 and results of intercentre proficiency testing Using a standard protocol

DEFF Research Database (Denmark)

Fry, N K; Bangsborg, Jette Marie; Bergmans, A

2002-01-01

The utility of amplified fragment length polymorphism (AFLP) analysis as a genotyping method for the epidemiological typing of Legionella pneumophila serogroup 1 has been previously demonstrated. This study (i). reports recommendations for the designation of the European Working Group on Legionella...... centres), and 92% (7 centres) to 100% (7 centres). The AFLP method as described is robust and rapid and allows the genotypic comparison of isolates of Legionella pneumophila between different testing centres without the need for exchange of the strains studied....

Dietary management of urea cycle disorders: European practice.

Science.gov (United States)

Adam, S; Almeida, M F; Assoun, M; Baruteau, J; Bernabei, S M; Bigot, S; Champion, H; Daly, A; Dassy, M; Dawson, S; Dixon, M; Dokoupil, K; Dubois, S; Dunlop, C; Evans, S; Eyskens, F; Faria, A; Favre, E; Ferguson, C; Goncalves, C; Gribben, J; Heddrich-Ellerbrok, M; Jankowski, C; Janssen-Regelink, R; Jouault, C; Laguerre, C; Le Verge, S; Link, R; Lowry, S; Luyten, K; Macdonald, A; Maritz, C; McDowell, S; Meyer, U; Micciche, A; Robert, M; Robertson, L V; Rocha, J C; Rohde, C; Saruggia, I; Sjoqvist, E; Stafford, J; Terry, A; Thom, R; Vande Kerckhove, K; van Rijn, M; van Teeffelen-Heithoff, A; Wegberg, A van; van Wyk, K; Vasconcelos, C; Vestergaard, H; Webster, D; White, F J; Wildgoose, J; Zweers, H

2013-12-01

There is no published data comparing dietary management of urea cycle disorders (UCD) in different countries. Cross-sectional data from 41 European Inherited Metabolic Disorder (IMD) centres (17 UK, 6 France, 5 Germany, 4 Belgium, 4 Portugal, 2 Netherlands, 1 Denmark, 1 Italy, 1 Sweden) was collected by questionnaire describing management of patients with UCD on prescribed protein restricted diets. Data for 464 patients: N-acetylglutamate synthase (NAGS) deficiency, n=10; carbamoyl phosphate synthetase (CPS1) deficiency, n=29; ornithine transcarbamoylase (OTC) deficiency, n=214; citrullinaemia, n=108; argininosuccinic aciduria (ASA), n=80; arginase deficiency, n=23 was reported. The majority of patients (70%; n=327) were aged 0-16y and 30% (n=137) >16y. Prescribed median protein intake/kg body weight decreased with age with little variation between disorders. The UK tended to give more total protein than other European countries particularly in infancy. Supplements of essential amino acids (EAA) were prescribed for 38% [n=174] of the patients overall, but were given more commonly in arginase deficiency (74%), CPS (48%) and citrullinaemia (46%). Patients in Germany (64%), Portugal (67%) and Sweden (100%) were the most frequent users of EAA. Only 18% [n=84] of patients were prescribed tube feeds, most commonly for CPS (41%); and 21% [n=97] were prescribed oral energy supplements. Dietary treatment for UCD varies significantly between different conditions, and between and within European IMD centres. Further studies examining the outcome of treatment compared with the type of dietary therapy and nutritional support received are required. © 2013 Elsevier Inc. All rights reserved.

PREGO (presentation of Graves' orbitopathy) study

DEFF Research Database (Denmark)

Perros, Petros; Žarković, Miloš; Azzolini, Claudio

2015-01-01

BACKGROUND/AIMS: The epidemiology of Graves' orbitopathy (GO) may be changing. The aim of the study was to identify trends in presentation of GO to tertiary centres and initial management over time. METHODS: Prospective observational study of European Group On Graves' Orbitopathy (EUGOGO) centres...

Analysis of multi-functional ventilated facades. An European joule project

Energy Technology Data Exchange (ETDEWEB)

Costa, M; Perez Segarra, C.D; A Oliva; Aceves, O; Sen F [Barcelona (Spain)] (and others)

2000-07-01

The name Multi-Functional Ventilated Facade (MFVF) has been used in the project as a generic name to refer to a facade characterized by an inner ventilated air layer along with the incorporation of some additional technological elements. The elements here studied have been the following: the use of phase change materials (PCM) in the opaque walls to provide thermal inertia, the use of transparent insulation (TI) to reduce the connective losses in the semi-transparent areas and, finally the incorporation of photovoltaic cells (PV) at the skin of the building to provide electrical power. The flux air developed in the channel provides not only an additional thermal resistance but a heat flux which can be driven outdoors or indoors conveniently according to the buildings energetic load. Different MFVF prototypes adapted to the different European climates have been experimentally tested in cabin test cells under real outdoor conditions and for long time periods. Also, an specific computing code has been adapted to analyze the thermal behavior of this kind of facades. The code has been partially validated with the experimental information provided by the prototypes. Finally, the code is been used to optimize the main design variables of these facades. [Spanish] El nombre de fachadas ventiladas multi-funcionales (MFVF) ha sido usado en el proyecto como un nombre generico para referirse a una fachada caracterizada por una capa interior ventilada con aire juntamente con la incorporacion de algunos elementos tecnologicos adicionales. Los elementos aqui estudiados han sido los siguientes: el uso de materiales de cambio de fase (PCM) en las paredes opacas para proporcionar inercia termica, el uso de aislamiento transparente (TI) para reducir las perdidas conectivas en las areas semitransparentes, y finalmente la incorporacion de celdas fotovoltaica (PV) y el recubrimiento del edificio para proporcionar energia electrica. El flujo del aire desarrollado en el canal proporciona

Dietary management of urea cycle disorders : European practice

NARCIS (Netherlands)

Adam, S.; Almeida, M. F.; Assoun, M.; Baruteau, J.; Bernabei, S. M.; Bigot, S.; Champion, H.; Daly, A.; Dassy, M.; Dawson, S.; Dixon, M.; Dokoupil, K.; Dubois, S.; Dunlop, C.; Evans, S.; Eyskens, F.; Faria, A.; Favre, E.; Ferguson, C.; Goncalves, C.; Gribben, J.; Heddrich-Ellerbrok, M.; Jankowski, C.; Janssen-Regelink, R.; Jouault, C.; Laguerre, C.; Le Verge, S.; Link, R.; Lowry, S.; Luyten, K.; MacDonald, A.; Maritz, C.; McDowell, S.; Meyer, U.; Micciche, A.; Robertson, L. V.; Rocha, J. C.; Rohde, C.; Saruggia, I.; Sjoqvist, E.; Stafford, J.; Terry, A.; Thom, R.; Vande Kerckhove, K.; van Rijn, M.; van Teeffelen-Heithoff, A.; van Wegberg, A.; van Wyk, K.; Vasconcelos, C.; Vestergaard, H.; Webster, D.; White, F. J.; Wildgoose, J.; Zweers, H.; Robert, M.

2013-01-01

Background: There is no published data comparing dietary management of urea cycle disorders (UCD) in different countries. Methods: Cross-sectional data from 41 European Inherited Metabolic Disorder (IMD) centres (17 UK, 6 France, 5 Germany, 4 Belgium, 4 Portugal, 2 Netherlands, 1 Denmark, 1 Italy, 1

Dietary management of urea cycle disorders: European practice.

NARCIS (Netherlands)

Adam, S.; Almeida, M.F.; Assoun, M.; Baruteau, J.; Bernabei, S.M.; Bigot, S.; Champion, H.; Daly, A.; Dassy, M.; Dawson, S.; Dixon, M.; Dokoupil, K.; Dubois, S.; Dunlop, C.; Evans, S.; Eyskens, F.; Faria, A.; Favre, E.; Ferguson, C.; Goncalves, C.; Gribben, J.; Heddrich-Ellerbrok, M.; Jankowski, C.; Janssen-Regelink, R.G.; Jouault, C.; Laguerre, C.; Verge, S. Le; Link, R.; Lowry, S.; Luyten, K.; Macdonald, A.; Maritz, C.; McDowell, S.; Meyer, U.; Micciche, A.; Robert, M.; Robertson, L.V.; Rocha, J.C.; Rohde, C.; Saruggia, I.; Sjoqvist, E.; Stafford, J.; Terry, A.; Thom, R.; nde Kerckhove, K. Va; Rijn, M. van de; Teeffelen-Heithoff, A. van; Wegberg, A.M.J. van; Wyk, K. van; Vasconcelos, C.; Vestergaard, H.; Webster, D.; White, F.J.; Wildgoose, J.; Zweers, H.

2013-01-01

BACKGROUND: There is no published data comparing dietary management of urea cycle disorders (UCD) in different countries. METHODS: Cross-sectional data from 41 European Inherited Metabolic Disorder (IMD) centres (17 UK, 6 France, 5 Germany, 4 Belgium, 4 Portugal, 2 Netherlands, 1 Denmark, 1 Italy, 1

Health-related quality of life among colorectal cancer patients in Malaysia: a study protocol

Directory of Open Access Journals (Sweden)

Magaji Bello

2012-09-01

Full Text Available Abstract Background Colorectal cancer is a major public health problem in Malaysia. However, it is also one of the most treatable cancers, resulting in significant numbers of survivors. Therefore, the impact of surviving treatment for colorectal cancer on health related quality of life is important for the patients, clinicians and policy makers, and may differ in different cultures and populations. The aim of this study was to validate the Malaysian versions of the European Organization for Research and Treatment of Cancer quality of life instruments among colorectal cancers patients. Methods/design This is a cross sectional multi centre study. Three hospitals were included, the University of Malaya Medical Centre, the Universiti Kebangsaan Malaysia Medical Centre and Hospital Tuanku Jaafar Seremban. Malaysian citizens and permanent residence were studied and demographic and clinical information obtained from hospital records. The European Organization for Research and Treatment of Cancer Quality of life Core 30, colorectal cancer CR29, and the colorectal cancer liver metastasis LMC 21 were used and an observer assessment of performance obtained with the Karnofsky Performance Scale. Questionnaires were translated into three most commonly spoken languages in Malaysia (Bahasa Malaysia, Chinese and Tamil, then administered, scored and analyzed following the developers’ guidelines. Ethical approval was obtained from the participating centres. Tests of reliability and validity were performed to examine the validity of these instruments. Conclusion The result of pilot testing shows that the use of the Malaysian versions of EORTC QLQ C30, CR29 instruments is feasible in our sample of colorectal cancer patients. Instructions for completion as well as questions were well understood except the questions on the overall quality of life, overall health status and sexual activity. Thus we anticipate obtaining good psychometric properties for the instruments

Health-related quality of life among colorectal cancer patients in Malaysia: a study protocol.

Science.gov (United States)

Magaji, Bello Arkilla; Moy, Foong Ming; Roslani, April Camilla; Sagap, Ismail; Zakaria, Jasiah; Blazeby, Jane M; Law, Chee Wei

2012-09-03

Colorectal cancer is a major public health problem in Malaysia. However, it is also one of the most treatable cancers, resulting in significant numbers of survivors. Therefore, the impact of surviving treatment for colorectal cancer on health related quality of life is important for the patients, clinicians and policy makers, and may differ in different cultures and populations. The aim of this study was to validate the Malaysian versions of the European Organization for Research and Treatment of Cancer quality of life instruments among colorectal cancers patients. This is a cross sectional multi centre study. Three hospitals were included, the University of Malaya Medical Centre, the Universiti Kebangsaan Malaysia Medical Centre and Hospital Tuanku Jaafar Seremban. Malaysian citizens and permanent residence were studied and demographic and clinical information obtained from hospital records. The European Organization for Research and Treatment of Cancer Quality of life Core 30, colorectal cancer CR29, and the colorectal cancer liver metastasis LMC 21 were used and an observer assessment of performance obtained with the Karnofsky Performance Scale. Questionnaires were translated into three most commonly spoken languages in Malaysia (Bahasa Malaysia, Chinese and Tamil), then administered, scored and analyzed following the developers' guidelines. Ethical approval was obtained from the participating centres. Tests of reliability and validity were performed to examine the validity of these instruments. The result of pilot testing shows that the use of the Malaysian versions of EORTC QLQ C30, CR29 instruments is feasible in our sample of colorectal cancer patients. Instructions for completion as well as questions were well understood except the questions on the overall quality of life, overall health status and sexual activity. Thus we anticipate obtaining good psychometric properties for the instruments at the end of the study.

The impact of PET-CT in suspected recurrent ovarian cancer: A prospective multi-centre study as part of the Australian PET Data Collection Project.

Science.gov (United States)

Fulham, M J; Carter, J; Baldey, A; Hicks, R J; Ramshaw, J E; Gibson, M

2009-03-01

To assess the impact of FDG PET-CT on the management of patients with suspected recurrent ovarian cancer and to determine the incremental information provided by PET-CT. This was a prospective, multi-centre, cohort study. Ninety women (mean age 59.9 years; age range 35-85 years) with a previous history of treated epithelial ovarian carcinoma and suspected recurrence based on elevated CA-125, anatomical imaging or clinical symptoms were studied with FDG PET-CT across two States. Referring doctors were asked to specify a management plan pre-PET, if management was altered after PET-CT and, the impact (rated - none, low, medium, high) of PET-CT on patient management. The pre-PET management plan could include radiotherapy, chemotherapy, surgery, and 'other' including observation. Patients were followed at 6 and 12 months and clinical status, evidence of recurrence and progression were recorded. Patients were referred by 34 individual specialists. At least 168 additional sites of disease in 61 patients (68%), not identified by conventional imaging were identified by PET-CT. In 77% the additional lesions were located below the diaphragm and most were nodal or peritoneal. PET-CT affected management in 60% (49% high, 11% medium impact). Patients where more disease was detected with PET-CT were more likely to progress in the following 12 months. For women with previously treated ovarian carcinoma with recurrent disease, PET-CT can: a) alter management in close to 60% of patients, b) detect more sites of disease than abdominal and pelvic CT, c) is superior in the detection of nodal, peritoneal and subcapsular liver disease and d) offers the opportunity for technology replacement in this setting.

European Master of Science in Nuclear Engineering

International Nuclear Information System (INIS)

Moons, F.; Safieh, J.; Giot, M.; Mavko, B.; Sehgal, B.R.; Schaefer, A.; Goethem, G. van; D'haeseleer, W.

2004-01-01

The need to preserve, enhance or strengthen nuclear knowledge is worldwide recognised since a couple of years. It appears that within the European university education and training network, nuclear engineering is presently sufficiently covered, although somewhat fragmented. To take up the challenges of offering top quality, new, attractive and relevant curricula, higher education institutions should cooperate with industry, regulatory bodies and research centres, and more appropriate funding a.o. from public and private is to be re-established. More, European nuclear education and training should benefit from links with international organisations like IAEA, OECD-NEA and others, and should include world-wide cooperation with academic institutions and research centres. The European master in nuclear engineering guarantees a high quality nuclear education in Europe by means of stimulating student and instructor exchange, through mutual checks of the quality of the programmes offered, by close collaboration with renowned nuclear-research groups at universities and laboratories. The concept for a nuclear master programme consists of a solid basket of recommended basic nuclear science and engineering courses, but also contains advanced courses as well as practical training. Some of the advanced courses also serve as part of the curricula for doctoral programmes. A second important issue identified is Continued Professional Development. In order to achieve the objectives and practical goals described above, the ENEN association was formed. This international, non-profit association is be considered as a step towards a virtual European Nuclear University symbolising the active collaboration between various national institutions pursuing nuclear education. (author)

European oil product supply modelling

International Nuclear Information System (INIS)

Saint-Antonin, V.

1998-01-01

Over the last few years, trends in European oil product consumption (in terms of level as structure and quality) has important implications of the refining industry. In this context, the purpose of this thesis consists in building a mathematical programming model applied to the European refineries in order to determine oil product supply prices, European refining industry investments and oil product exchanges of the European Union. The first part presents the reason for our choice for a long-term aggregate multi-refineries linear programming model, based on European refineries characteristics and the objectives of our model. Its dual properties are studied in detail and we focus particularly on the European exchange modelling. In the second part, an analysis of the European refining trends leads us to identify parameters and variables of the model that are essential to the aggregate representation of the European oil product supply. The third part is devoted to the use of this model, regarding two scenarios of increasingly stringent specifications for gasoline and diesel oil. Our interest for these products is due to their important share of the European oil product consumption and the not insignificant responsibility of the transport sector for atmospheric pollution. Finally, in order to have the use of an overall picture of the European refining industry, we build a regression model summarizing, though a few equations, the main relations between the major endogenous and exogenous variables o the LP model. Based on pseudo-data, this kind of model provides a simple and robust representation of the oil product supply. But a more specialized analysis of the refining industry operations, turning on a technical assessment of processing units, is reliant on the use of an optimization model such as the model we have built. (author)

Konference European Studies: between Globalisation and Regionalism

Czech Academy of Sciences Publication Activity Database

Laštovková, Jitka

2006-01-01

Roč. 42, č. 5 (2006), s. 1009-1010 ISSN 0038-0288. [European Studies: between Globalisation and Regionalism. Šiauliai, 12.05.2006-03.05.2006] Institutional research plan: CEZ:AV0Z70280505 Keywords : conference * European identitiy * globalization Subject RIV: AO - Sociology, Demography Impact factor: 0.128, year: 2006

Measuring Implicit European and Mediterranean Landscape Identity: A Tool Proposal

Science.gov (United States)

Fornara, Ferdinando; Dentale, Francesco; Troffa, Renato; Piras, Simona

2016-01-01

This study presents a tool – the Landscape Identity Implicit Association Test (LI-IAT) – devoted to measure the implicit identification with European and Mediterranean landscapes. To this aim, a series of prototypical landscapes was selected as stimulus, following an accurate multi-step procedure. Participants (N = 174), recruited in two Italian cities, performed two LI-IATs devoted to assess their identification with European vs. Not-European and Mediterranean vs. Not-Mediterranean prototypical landscapes. Psychometric properties and criterion validity of these measures were investigated. Two self-report measures, assessing, respectively, European and Mediterranean place identity and pleasantness of the target landscapes, were also administered. Results showed: (1) an adequate level of internal consistency for both LI-IATs; (2) a higher identification with European and Mediterranean landscapes than, respectively, with Not-European and Not-Mediterranean ones; and (3) a significant positive relationship between the European and Mediterranean LI-IATs and the corresponding place identity scores, also when pleasantness of landscapes was controlled for. Overall, these findings provide a first evidence supporting the reliability and criterion validity of the European and Mediterranean LI-IATs. PMID:27642284

Total dietary carbohydrate, sugar, starch and fibre intakes in the European Prospective Investigation into Cancer and Nutrition

NARCIS (Netherlands)

Cust, A. E.; Skilton, M. R.; van Bakel, M. M. E.; Halkjaer, J.; Olsen, A.; Agnoli, C.; Psaltopoulou, T.; Buurma, E.; Sonestedt, E.; Chirlaque, M. D.; Rinaldi, S.; Tjonneland, A.; Jensen, M. K.; Clavel-Chapelon, F.; Boutron-Ruault, M. C.; Kaaks, R.; Noethlings, U.; Chloptsios, Y.; Zylis, D.; Mattiello, A.; Caini, S.; Ocke, M. C.; van der Schouw, Y. T.; Skeie, G.; Parr, C. L.; Molina-Montes, E.; Manjer, J.; Johansson, I.; McTaggart, A.; Key, T. J.; Bingham, S.; Riboli, E.; Slimani, N.

2009-01-01

Objective: To describe dietary carbohydrate intakes and their food sources among 27 centres in 10 countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Methods: Between 1995 and 2000, 36 034 subjects, aged between 35-74 years, were administered a

Predictors of weight loss and maintenance during 2 years of treatment by sibutramine in obesity. Results from the European multi-centre STORM trial. Sibutramine Trial of Obesity Reduction and Maintenance

DEFF Research Database (Denmark)

Hansen, D; Astrup, A; Toubro, S

2001-01-01

In this report we assess pre-treatment determinants of weight loss and maintenance outcome in The Sibutramine Trial of Obesity Reduction and Maintenance (STORM), a 2 y randomized, double-blind, placebo-controlled, European multicenter study examining the effect of sibutramine (Sib) on inducing...

Linking Public Administration and Law Studies within European Union

Directory of Open Access Journals (Sweden)

Mihaela V. Cărăuşan

2012-05-01

Full Text Available The year 1987 represented for us, scholars, the turning point for the Europeanization of highdegree studies. The European Region Action Scheme for the Mobility of University Students (ERASMUS isa European Union student exchange program which has proved its utility in the last two decade. The publicadministration and law studies are two of the fields of studies which have benefited from the ERASMUSProgramme. In this respect we will try to learn the lesson of internationalization from the European contactthrough ERASMUS programme. The ‘win win’ for students is not just in the increase of knowledge in thearea of administrative sciences and law, but also in the share of cultures. The ERASMUS gives students abetter sense of what it means to be a European citizen. In addition, many employers highly value such aperiod abroad, which increases the students’ employability and job prospects.

A qualitative study of the role of workplace and interpersonal trust in shaping service quality and responsiveness in Zambian primary health centres.

Science.gov (United States)

Topp, Stephanie M; Chipukuma, Julien M

2016-03-01

Human decisions, actions and relationships that invoke trust are at the core of functional and productive health systems. Although widely studied in high-income settings, comparatively few studies have explored the influence of trust on health system performance in low- and middle-income countries. This study examines how workplace and inter-personal trust impact service quality and responsiveness in primary health services in Zambia. This multi-case study included four health centres selected for urban, peri-urban and rural characteristics. Case data included provider interviews (60); patient interviews (180); direct observation of facility operations (two weeks/centre) and key informant interviews (14) that were recorded and transcribed verbatim. Case-based thematic analysis incorporated inductive and deductive coding. Findings demonstrated that providers had weak workplace trust influenced by a combination of poor working conditions, perceptions of low pay and experiences of inequitable or inefficient health centre management. Weak trust in health centre managers' organizational capacity and fairness contributed to resentment amongst many providers and promoted a culture of blame-shifting and one-upmanship that undermined teamwork and enabled disrespectful treatment of patients. Although patients expressed a high degree of trust in health workers' clinical capacity, repeated experiences of disrespectful or unresponsive care undermined patients' trust in health workers' service values and professionalism. Lack of patient-provider trust prompted some patients to circumvent clinic systems in an attempt to secure better or more timely care. Lack of resourcing and poor leadership were key factors leading to providers' weak workplace trust and contributed to often-poor quality services, driving a perverse cycle of negative patient-provider relations across the four sites. Findings highlight the importance of investing in both structural factors and organizational

A qualitative study of the role of workplace and interpersonal trust in shaping service quality and responsiveness in Zambian primary health centres

Science.gov (United States)

Topp, Stephanie M; Chipukuma, Julien M

2016-01-01

Background: Human decisions, actions and relationships that invoke trust are at the core of functional and productive health systems. Although widely studied in high-income settings, comparatively few studies have explored the influence of trust on health system performance in low- and middle-income countries. This study examines how workplace and inter-personal trust impact service quality and responsiveness in primary health services in Zambia. Methods: This multi-case study included four health centres selected for urban, peri-urban and rural characteristics. Case data included provider interviews (60); patient interviews (180); direct observation of facility operations (two weeks/centre) and key informant interviews (14) that were recorded and transcribed verbatim. Case-based thematic analysis incorporated inductive and deductive coding. Results: Findings demonstrated that providers had weak workplace trust influenced by a combination of poor working conditions, perceptions of low pay and experiences of inequitable or inefficient health centre management. Weak trust in health centre managers’ organizational capacity and fairness contributed to resentment amongst many providers and promoted a culture of blame-shifting and one-upmanship that undermined teamwork and enabled disrespectful treatment of patients. Although patients expressed a high degree of trust in health workers’ clinical capacity, repeated experiences of disrespectful or unresponsive care undermined patients’ trust in health workers’ service values and professionalism. Lack of patient–provider trust prompted some patients to circumvent clinic systems in an attempt to secure better or more timely care. Conclusion: Lack of resourcing and poor leadership were key factors leading to providers’ weak workplace trust and contributed to often-poor quality services, driving a perverse cycle of negative patient–provider relations across the four sites. Findings highlight the importance

European synchrotron radiation facility at Risoe

International Nuclear Information System (INIS)

1981-07-01

The results of the feasibility study on a potential European Synchrotron Radiation Facility site at Risoe, Denmark, can be summarized as follows: The site is located in a geologically stable area. The ground is fairly flat, free from vibrations and earth movements, and the foundation properties are considered generally good. The study is based upon the machine concept and main geometry as presented in the ESF feasibility study of May 1979. However, the proposed site could accomodate a larger machine (e.g. 900 m of circumference) or a multi-facility centre. The site is located in the vicinity of Risoe National Laboratory, a R and D establishment with 850 employees and a well-developed technical and scientific infrastructure, which can provide support to the ESRF during the plant construction and operation. In particular the possible combination of synchrotron radiation with the existing neutron scattering facilities in DR 3 is emphasized. The site is located 35 km west of Copenhagen with easy access to the scientific, technological and industrial organizations in the metropolitan area. The regional infrastructure ensures easy and fast communication between the ESRF and locations in the host country as well as abroad. The site is located 35 minutes drive from Copenhagen International Airport and on a main communication route out of Copenhagen. The estimated time duration for the design, construction and commissioning of ESRF phase 1 - taking into account national regulatory procedures - is consistent with that of the ESF feasibility study, i.e. approx. 6 years. The estimated captal costs associated with site-specific structures are consistent with those of the ESF feasibility study, taking into account price increase between 1979 and 1981. It should be emphasized that the study is based upon technical and scientific assessments only, and does not reflect any official position or approval from appropriate authorities. (author)

4th European Turbulence Conference

CERN Document Server

1993-01-01

The European Turbulence Conferences have been organized under the auspices of the European Mechanics Committee (Euromech) to provide a forum for discussion and exchange of recent and new results in the field of turbulence. The first conference was organized in Lyon in 1986 with 152 participants. The second and third conferences were held in Berlin (1988) and Stockholm (1990) with 165 and 172 participants respectively. The fourth was organized in Delft from 30 June to 3 July 1992 by the J.M. Burgers Centre. There were 214 participants from 22 countries. This steadily growing number of participants demonstrates both the success and need for this type of conference. The main topics of the Fourth European Turbulence Conference were: Dynamical Systems and Transition; Statistical Physics and Turbulence; Experiments and Novel Experimental Techniques; Particles and Bubbles in Turbulence; Simulation Methods; Coherent Structures; Turbulence Modelling and Compressibility Effects. In addition a special session was held o...

Cervical cancer screening in women referred to healthcare centres in Tabriz, Iran.

Science.gov (United States)

Farshbaf-Khalili, Azizeh; Salehi-Pourmehr, Hanieh; Shahnazi, Mahnaz; Yaghoubi, Sina; Gahremani-Nasab, Parvaneh

2015-01-01

Cervical cancer is the second most common cancer among Iranian women and among the few cancers that could be easily diagnosed in the pre-malignant stage. We aimed to assess the status of cervical cancer screening in women referred to health care centres in Tabriz, northwest Iran. This descriptive-analytical study was done on 441 women referred to health care centres of Tabriz, northwest Iran. The centres were selected using the multi-stage cluster sampling method. The participants were selected from the active records of those centres. A questionnaire regarding the socio-demographic characteristics and cervical cancer screening and reasons for referring or not referring for screening was completed by the participants A P marriage or having sexual intercourse at a young age, history of obvious cervical infection, cautery, cryotherapy or repeated curettage), age and type of family planning] in screening was controlled. Suitable and continuous educational programmes especially for high risk women should be implemented through the health care services. Preparing educational brochures and pamphlets and providing adequate training on the necessity of early referral and marriage counseling could also be effective in improving woman's awareness and performance.

A multi-centre, prospective, clinical in-market evaluation to assess the performance of Opsite™ Post-Op Visible dressings.

LENUS (Irish Health Repository)

O'Brien, Gillian

2010-10-01

The aim of this study was to assess the performance of Opsite™ Post-Op Visible as a post-surgical dressing in a typical clinical setting. In this multi-centre clinical evaluation, patients who underwent clean surgery were treated with Opsite Post-Op Visible dressing. Duration of dressing wear, visibility through the dressing and ability to handle exudate were assessed and the product was rated in comparison with those normally used. A total of 64 patients were recruited. Mean wear time was 4·5 days. Exudate management was rated very good or good at 96% of assessments. Visibility of the incision site was rated as very good or good at 72%, and as acceptable at 24%, of assessments. Patient comfort was rated very comfortable (63%) or comfortable (37%) at all assessments. Dressings were generally rated as satisfactory or exceeding expectations with clinicians stating that the Opsite Post-Op Visible dressing was better than the dressing they routinely used for 92% of patients. Opsite Post-Op Visible dressing is an innovative dressing combining good visibility with exudate management and patient comfort. It was found to have adequate wear time, visibility and exudate management properties making it suitable for use on a variety of surgical incision sites.

Blood phenylalanine control in phenylketonuria : a survey of 10 European centres

NARCIS (Netherlands)

Ahring, K.; Belanger-Quintana, A.; Dokoupil, K.; Gokmen-Ozel, H.; Lammardo, A. M.; MacDonald, A.; Motzfeldt, K.; Nowacka, M.; van Rijn, M.; Robert, M.

Background: Only limited data are available on the blood phenylalanine (Phe) concentrations achieved in European patients with phenylketonuria (PKU) on a low-Phe diet. Objective: A survey was conducted to compare blood Phe control achieved in diet-treated patients with PKU of different age groups in

Diagnosis and treatment of melanoma. European consensus-based interdisciplinary guideline - Update 2016

DEFF Research Database (Denmark)

Garbe, Claus; Peris, Ketty; Hauschild, Axel

2016-01-01

Cutaneous melanoma (CM) is potentially the most dangerous form of skin tumour and causes 90% of skin cancer mortality. A unique collaboration of multi-disciplinary experts from the European Dermatology Forum, the European Association of Dermato-Oncology and the European Organisation of Research a...

Fasting Glucose GWAS Candidate Region Analysis across Ethnic Groups in the Multi-Ethnic Study of Atherosclerosis (MESA)

OpenAIRE

Rasmussen-Torvik, L. J.; Guo, X.; Bowden, D. W.; Bertoni, A. G.; Sale, M. M.; Yao, J.; Bluemke, D. A.; Goodarzi, M. O.; Chen, Y. I.; Vaidya, D.; Raffel, L. J.; Papanicolaou, G.J.; Meigs, J. B.; Pankow, J. S.

2012-01-01

Genetic variants associated with fasting glucose in European ancestry populations are increasingly well understood. However, the nature of the associations between these SNPs and fasting glucose in other racial and ethnic groups is unclear. We sought to examine regions previously identified to be associated with fasting glucose in Caucasian GWAS across multiple ethnicities in the Multi-Ethnic Study of Atherosclerosis (MESA). Non-diabetic MESA participants with fasting glucose measured at the ...

Patients' views of patient-centred care: a phenomenological case study in one surgical unit.

Science.gov (United States)

Marshall, Amy; Kitson, Alison; Zeitz, Kathryn

2012-12-01

To report a study of patients' views of patient-centred care. The study aimed to explore patients' understanding and conceptualization of patient-centred care and link it to existing literature on the topic. Patient-centred care currently lacks a widely accepted definition, with much of the literature based on definitions formulated by health professionals and researchers. Qualitative research study grounded in phenomenology. Interpersonal interviews were conducted with ten participants who were patients in a surgical ward in a large metropolitan hospital in South Australia in 2010. Participants were unfamiliar with the concept of patient-centred care, but despite this, were able to describe what the term meant to them and what they wanted from their care. Patients equated the type and quality of care they received with the staff that provided it and themes of connectedness, involvement and attentiveness were prevalent in their descriptions of what they wanted from their care. Ensuring that patients have a voice in the definition and conceptualization of patient-centred care is essential and further and regular consultation with patients about their needs and priorities will ensure an integrated approach to patient-centred care. © 2012 Blackwell Publishing Ltd.

A pragmatic multi-centre randomised controlled trial of fluid loading in high-risk surgical patients undergoing major elective surgery--the FOCCUS study.

Science.gov (United States)

Cuthbertson, Brian H; Campbell, Marion K; Stott, Stephen A; Elders, Andrew; Hernández, Rodolfo; Boyers, Dwayne; Norrie, John; Kinsella, John; Brittenden, Julie; Cook, Jonathan; Rae, Daniela; Cotton, Seonaidh C; Alcorn, David; Addison, Jennifer; Grant, Adrian

2011-01-01

Fluid strategies may impact on patient outcomes in major elective surgery. We aimed to study the effectiveness and cost-effectiveness of pre-operative fluid loading in high-risk surgical patients undergoing major elective surgery. This was a pragmatic, non-blinded, multi-centre, randomised, controlled trial. We sought to recruit 128 consecutive high-risk surgical patients undergoing major abdominal surgery. The patients underwent pre-operative fluid loading with 25 ml/kg of Ringer's solution in the six hours before surgery. The control group had no pre-operative fluid loading. The primary outcome was the number of hospital days after surgery with cost-effectiveness as a secondary outcome. A total of 111 patients were recruited within the study time frame in agreement with the funder. The median pre-operative fluid loading volume was 1,875 ml (IQR 1,375 to 2,025) in the fluid group compared to 0 (IQR 0 to 0) in controls with days in hospital after surgery 12.2 (SD 11.5) days compared to 17.4 (SD 20.0) and an adjusted mean difference of 5.5 days (median 2.2 days; 95% CI -0.44 to 11.44; P = 0.07). There was a reduction in adverse events in the fluid intervention group (P = 0.048) and no increase in fluid based complications. The intervention was less costly and more effective (adjusted average cost saving: £2,047; adjusted average gain in benefit: 0.0431 quality adjusted life year (QALY)) and has a high probability of being cost-effective. Pre-operative intravenous fluid loading leads to a non-significant reduction in hospital length of stay after high-risk major surgery and is likely to be cost-effective. Confirmatory work is required to determine whether these effects are reproducible, and to confirm whether this simple intervention could allow more cost-effective delivery of care. Prospective Clinical Trials, ISRCTN32188676.

Multi-Centre Study on Cardiovascular Risk Management on Patients Undergoing AAA Surveillance.

Science.gov (United States)

Saratzis, A; Dattani, N; Brown, A; Shalhoub, J; Bosanquet, D; Sidloff, D; Stather, P

2017-07-01

The risk of cardiovascular events and death in patients with abdominal aortic aneurysms (AAA) is high. Screening has been introduced to reduce AAA related mortality; however, after AAA diagnosis, cardiovascular modification may be as important to patient outcomes as surveillance. The aim of this study was to assess cardiovascular risk reduction in patients with small AAA. Institutional approval was granted for The Vascular and Endovascular Research Network (VERN) to retrospectively collect data pertaining to cardiovascular risk reduction from four tertiary vascular units in England. Patients with small AAA (January 2013-December 2015) were included. Demographic details, postcode, current medications, and smoking status were recorded using a bespoke electronic database and analysed. In a secondary analysis VERN contacted all AAA screening units in England and Wales to assess their current protocols relating to CV protection. In total, 1053 patients were included (mean age 74 ± 9 years, all men). Of these, 745 patients (70.8%) had been prescribed an antiplatelet agent and 787 (74.7%) a statin. Overall, only 666 patients (63.2%) were prescribed both a statin and antiplatelet. Two hundred and sixty eight patients (32.1%) were current smokers and the proportion of patients who continued to smoke decreased with age. Overall, only 401 patients (48.1%) were prescribed a statin, antiplatelet, and had stopped smoking. In the secondary analysis 38 AAA screening units (84% national coverage) replied. Thirty-one units (82%) suggest changes to the patient's prescription; however, none monitor compliance with these recommendations or assess whether the general practitioner has been made aware of the AAA diagnosis or prescription advice. Many patients with small AAA are not prescribed an antiplatelet/statin, and still smoke cigarettes, and therefore remain at high risk of cardiovascular morbidity and mortality. National guidance to ensure this high risk group of patients is

Socio-demographic and fertility-related characteristics and motivations of oocyte donors in eleven European countries.

Science.gov (United States)

Pennings, G; de Mouzon, J; Shenfield, F; Ferraretti, A P; Mardesic, T; Ruiz, A; Goossens, V

2014-05-01

Do the socio-demographic and fertility-related characteristics and motivations of oocyte donors differ in European countries? The socio-demographic and fertility-related characteristics and motivations of oocyte donors differ considerably across countries. There have been no other international studies comparing the characteristics of oocyte donors. Regarding their motivations, most studies indicate mixed motives. The proposed study was a transversal epidemiological study. Data were collected from 63 voluntarily participating assisted reproduction technology centres practising oocyte donation in 11 European countries (Belgium, Czech Republic, Finland, France, Greece, Poland, Portugal, Russia, Spain, UK and Ukraine). The survey was conducted between September 2011 and June 2012 and ran for 1-6 calendar months depending on the number of cycles of oocyte donation performed at the centre. The sample size was computed in order to allow an estimate of the percentage of a relatively rare characteristic (∼2%) with a precision (95% confidence interval) of 1%. The calculation gave 1118 donors. In total, 1423 forms were obtained from oocyte donors. All consecutive donors in these centres filled out an anonymous questionnaire when they started their hormonal stimulation, asking for their socio-demographic and fertility-related characteristics, their motivations and compensation. Population characteristics were described and compared by country of donation. Motives for donation and mean amount of money were compared between countries and according to the donors characteristics. The socio-demographic and fertility-related characteristics and motivations of oocyte donors varied enormously across European countries. The number of received forms corresponded with a participation rate of 61.9% of the cycles performed by the participating centres. Mean age was 27.4 years. About 49% of donors were fully employed, 16% unemployed and 15% student. The motivation in the total group of

Multi-centre, multi-database studies with common protocols

DEFF Research Database (Denmark)

Klungel, Olaf H.; Kurz, Xavier; de Groot, Mark C.H.

2016-01-01

was observed depending on design, exposure and outcome definitions, but none of the differences were statistically significant. The association between anti-epileptics and suicidality was inconsistent across the UK CPRD, Danish National registries and the French PGRx system. Calcium channel blockers were...

Interest Organisations and European Integration

DEFF Research Database (Denmark)

Pedersen, Ove K.

This paper examines the influence of European integration on the relationship between state administration and private interests in the four Nordic countries - Sweden, Denmark, Norway and Finland. By private interests I mean interest organizations, private corporations and independent experts....... The paper focuses exclusively on the national policy processes that are involved with managing European Union (EU) issues. More specifically, this paper discusses two aspects of multi-level governance. First is the important role of private interests in the coordination of decision making at the national...... level preceding their government's representation of national interests in the European Council of Ministers and other EU organizations. Second is the effect of all this on national democratic systems....

CADC and CANFAR: Extending the role of the data centre

Science.gov (United States)

Gaudet, Severin

2015-12-01

Over the past six years, the CADC has moved beyond the astronomy archive data centre to a multi-service system for the community. This evolution is based on two major initiatives. The first is the adoption of International Virtual Observatory Alliance (IVOA) standards in both the system and data architecture of the CADC, including a common characterization data model. The second is the Canadian Advanced Network for Astronomical Research (CANFAR), a digital infrastructure combining the Canadian national research network (CANARIE), cloud processing and storage resources (Compute Canada) and a data centre (Canadian Astronomy Data Centre) into a unified ecosystem for storage and processing for the astronomy community. This talk will describe the architecture and integration of IVOA and CANFAR services into CADC operations, the operational experiences, the lessons learned and future directions

A cross-sectional study on person-centred communication in the care of older people: the COMHOME study protocol.

NARCIS (Netherlands)

Hafskjold, L.; Sundler, A.J.; Holmström, I.K.; Sundling, V.; Dulmen, S. van; Eide, H.

2015-01-01

Introduction: This paper presents an international cross-sectional study on person-centred communication with older people receiving healthcare (COMHOME). Person-centred care relies on effective communication, but few studies have explored this with a specific focus on older people. The main aim of

A cross-sectional study on person-centred communication in the care of older people: the COMHOME study protocol

NARCIS (Netherlands)

Hafskjold, L.; Sundler, A.J.; Holmstrom, I.K.; Sundling, V.; Dulmen, S. van; Eide, H.

2015-01-01

INTRODUCTION: This paper presents an international cross-sectional study on person-centred communication with older people receiving healthcare (COMHOME). Person-centred care relies on effective communication, but few studies have explored this with a specific focus on older people. The main aim of

Inter-observer agreement for Crohn's disease sub-phenotypes using the Montreal Classification: How good are we? A multi-centre Australasian study.

Science.gov (United States)

Krishnaprasad, Krupa; Andrews, Jane M; Lawrance, Ian C; Florin, Timothy; Gearry, Richard B; Leong, Rupert W L; Mahy, Gillian; Bampton, Peter; Prosser, Ruth; Leach, Peta; Chitti, Laurie; Cock, Charles; Grafton, Rachel; Croft, Anthony R; Cooke, Sharon; Doecke, James D; Radford-Smith, Graham L

2012-04-01

Crohn's disease (CD) exhibits significant clinical heterogeneity. Classification systems attempt to describe this; however, their utility and reliability depends on inter-observer agreement (IOA). We therefore sought to evaluate IOA using the Montreal Classification (MC). De-identified clinical records of 35 CD patients from 6 Australian IBD centres were presented to 13 expert practitioners from 8 Australia and New Zealand Inflammatory Bowel Disease Consortium (ANZIBDC) centres. Practitioners classified the cases using MC and forwarded data for central blinded analysis. IOA on smoking and medications was also tested. Kappa statistics, with pre-specified outcomes of κ>0.8 excellent; 0.61-0.8 good; 0.41-0.6 moderate and ≤0.4 poor, were used. 97% of study cases had colonoscopy reports, however, only 31% had undergone a complete set of diagnostic investigations (colonoscopy, histology, SB imaging). At diagnosis, IOA was excellent for age, κ=0.84; good for disease location, κ=0.73; only moderate for upper GI disease (κ=0.57) and disease behaviour, κ=0.54; and good for the presence of perianal disease, κ=0.6. At last follow-up, IOA was good for location, κ=0.68; only moderate for upper GI disease (κ=0.43) and disease behaviour, κ=0.46; but excellent for the presence/absence of perianal disease, κ=0.88. IOA for immunosuppressant use ever and presence of stricture were both good (κ=0.79 and 0.64 respectively). IOA using MC is generally good; however some areas are less consistent than others. Omissions and inaccuracies reduce the value of clinical data when comparing cohorts across different centres, and may impair the ability to translate genetic discoveries into clinical practice. Crown Copyright © 2011. Published by Elsevier B.V. All rights reserved.

Novõi jevropeiskii tsentr transportnõhh issledovanii = The new european research centre / Igor Kabashkin

Index Scriptorium Estoniae

Kabashkin, Igor

2004-01-01

Veebruaris 2004 OECD ja transpordiministrite Euroopa Komitee poolt asutatud Euroopa ühendatud transpordiuuringute keskuse (The joint OECD/ECMT Transport Research Centre) ülesannetest, uurimisvaldkondadest ja -projektidest

Psychological problems in children with cerebral palsy: a cross-sectional European study.

Science.gov (United States)

Parkes, Jackie; White-Koning, Melanie; Dickinson, Heather O; Thyen, Ute; Arnaud, Catherine; Beckung, Eva; Fauconnier, Jerome; Marcelli, Marco; McManus, Vicki; Michelsen, Susan I; Parkinson, Kathryn; Colver, Allan

2008-04-01

To describe psychological symptoms in 8-12-year-old children with cerebral palsy; to investigate predictors of these symptoms and their impact on the child and family. A cross-sectional multi-centre survey. Eight hundred and eighteen children with cerebral palsy, aged 8-12 years, identified from population-based registers of cerebral palsy in eight European regions and from multiple sources in one further region. The Strengths and Difficulties Questionnaire (SDQ)(P4-16) and the Total Difficulties Score (TDS) dichotomised into normal/borderline (TDS abnormal (TDS > 16). Multilevel, multivariable logistic regression to relate the presence of psychological symptoms to child and family characteristics. About a quarter of the children had TDS > 16 indicating significant psychological symptoms, most commonly in the domain Peer Problems. Better gross motor function, poorer intellect, more pain, having a disabled or ill sibling and living in a town were independently associated with TDS > 16. The risk of TDS > 16 was odds ratio (OR) = .2 (95% CI: .1 to .3) comparing children with the most and least severe functional limitations; OR = 3.2 (95%CI: 2.1 to 4.8) comparing children with IQ psychological problems, 95% said they had lasted over a year, 37% said they distressed their child and 42% said they burdened the family at least 'quite a lot'. A significant proportion of children with cerebral palsy have psychological symptoms or social impairment sufficiently severe to warrant referral to specialist services. Care must be taken in the assessment and management of children with cerebral palsy to ensure psychological problems are not overlooked and potentially preventable risk factors like pain are treated effectively. The validity of the SDQ for children with severe disability warrants further assessment.

European clearinghouse on nuclear power plants operational experience feedback

International Nuclear Information System (INIS)

Ranguelova, Vesselina; Bruynooghe, Christiane; Noel, Marc

2010-01-01

Learning from operational experience and applying this knowledge promptly and intelligently is one of the ways to improve the safety of Nuclear Power Plant (NPP). Recent reviews of the effectiveness of Operational Experience Feedback (OEF) systems have pointed to the need for further improvement, with importance being placed on tailoring the information to the needs of the regulators. In 2007, at the request of a number of nuclear safety regulatory authorities in Europe, the Institute for Energy of the European Commission's Joint Research Centre (EC JRC) initiated a project on Nuclear Power Plant operational experience feedback, which adopts an integrated approach to the research needed to strengthen the European capabilities for assessment of NPP operational events and to promote the development of tools and mechanisms for the improved application of the lessons learned. Consequently, a so-called ''European Clearinghouse'' on NPP OEF was established, which includes scientific officers from the EC JRC, a number of European nuclear safety regulatory authorities and some of their Technical Support Organizations (TSOs). The paper discusses the activities implemented in 2008 within the framework of the European Clearinghouse on NPP OEF (hereinafter called the European NPP Clearinghouse) and provides an overview of the main conclusions drawn from the safety studies performed. Outlook of the activities carried out in 2009 are given. (orig.)

An Expanded Genome-Wide Association Study of Type 2 Diabetes in Europeans

DEFF Research Database (Denmark)

Scott, Robert A; Scott, Laura J; Mägi, Reedik

2017-01-01

To characterise type 2 diabetes (T2D) associated variation across the allele frequency spectrum, we conducted a meta-analysis of genome-wide association data from 26,676 T2D cases and 132,532 controls of European ancestry after imputation using the 1000 Genomes multi-ethnic reference panel. Promi...... secretion, and in adipocytes, monocytes and hepatocytes for insulin action-associated loci. These findings highlight the predominant role played by common variants of modest effect and the diversity of biological mechanisms influencing T2D pathophysiology....

Low vitamin D and the risk of developing chronic widespread pain: results from the European male ageing study.

Science.gov (United States)

McCabe, Paul S; Pye, Stephen R; Beth, John Mc; Lee, David M; Tajar, Abdelouahid; Bartfai, Gyorgy; Boonen, Steven; Bouillon, Roger; Casanueva, Felipe; Finn, Joseph D; Forti, Gianni; Giwercman, Aleksander; Huhtaniemi, Ilpo T; Kula, Krzysztof; Pendleton, Neil; Punab, Margus; Vanderschueren, Dirk; Wu, Frederick C; O'Neill, Terence W

2016-01-16

The association between low levels of vitamin D and the occurrence of chronic widespread pain (CWP) remains unclear. The aim of our analysis was to determine the relationship between low vitamin D levels and the risk of developing CWP in a population sample of middle age and elderly men. Three thousand three hundred sixty nine men aged 40-79 were recruited from 8 European centres for a longitudinal study of male ageing, the European Male Ageing Study. At baseline participants underwent assessment of lifestyle, health factors, physical characteristics and gave a fasting blood sample. The occurrence of pain was assessed at baseline and follow up (a mean of 4.3 years later) by shading painful sites on a body manikin. The presence of CWP was determined using the ACR criteria for fibromyalgia. Serum 25-hydroxyvitamin D (25-(OH) D) was assessed by radioimmunoassay. Logistic regression was used to determine the relationship between baseline vitamin D levels and the new occurrence of CWP. Two thousand three hundred thirteen men, mean age 58.8 years (SD = 10.6), had complete pain and vitamin data available and contributed to this analysis. 151 (6.5%) developed new CWP at follow up and 577 (24.9%) were pain free at both time points, the comparator group. After adjustment for age and centre, physical performance and number of comorbidities, compared to those in upper quintile of 25-(OH) D ( ≥36.3 ng/mL), those in the lowest quintile (BMI (OR = 1.67; 95% CI = 0.93-3.02) or depression (OR = 1.77; 95% CI = 0.98-3.21), however rendered the association non-significant. Low vitamin D is linked with the new occurrence of CWP, although this may be explained by underlying adverse health factors, particularly obesity and depression.

Globalization and Europeanization. A Projection on a European Model of Public Administration

Directory of Open Access Journals (Sweden)

Ani Matei

2008-04-01

Full Text Available The specialized studies and literature present moreover and insistently the connection between globalization and Europeanization, more precisely between globalization and a European model of integration, whose features aim to set up a global-type European society. The development of the European model of integration starts with economic elements, it reveals nowadays the Economic and Monetary Union and in perspective it will be structured within a sui generis system of transnational governance. The values of the European model of integration become fundamental values of a social process, with powerful economic and political determinations, aiming the multi-causal interference between individual, community and European construction. This process, remarked increasingly in the specialized literature, being assigned with the name of Europeanization, has got original, functional features in the spectrum of significations of the globalization paradigm. As essential global-type formula, within Europeanization, we shall find models with economic, political or social finality, integrating also a model of administration among the latter ones. When we say administration, we refer to its up dated and adequate contents to the new European developments. This assertion derives from a less economic modality to conceptualize the relationship between globalization and Europeanization, presenting Europeanization more as a political adaptation to globalization and even a political expression of globalization. In this context, the development of a system for European governance on several levels (local, regional, national, intergovernmental and supranational suggests its evolution towards globalization. In fact, the literature specific for Europeanization asserts the fact that the European model has also features with integrative nature related to the supranational and trans-governmental dimensions, as well as features with normative nature in view of harmonization

Design-corrected variation by centre in mortality reduction in the ERSPC randomised prostate cancer screening trial.

Science.gov (United States)

Hakama, Matti; Moss, Sue M; Stenman, Ulf-Hakan; Roobol, Monique J; Zappa, Marco; Carlsson, Sigrid; Randazzo, Marco; Nelen, Vera; Hugosson, Jonas

2017-06-01

Objectives To calculate design-corrected estimates of the effect of screening on prostate cancer mortality by centre in the European Randomised Study of Screening for Prostate Cancer (ERSPC). Setting The ERSPC has shown a 21% reduction in prostate cancer mortality in men invited to screening with follow-up truncated at 13 years. Centres either used pre-consent randomisation (effectiveness design) or post-consent randomisation (efficacy design). Methods In six centres (three effectiveness design, three efficacy design) with follow-up until the end of 2010, or maximum 13 years, the effect of screening was estimated as both effectiveness (mortality reduction in the target population) and efficacy (reduction in those actually screened). Results The overall crude prostate cancer mortality risk ratio in the intervention arm vs control arm for the six centres was 0.79 ranging from a 14% increase to a 38% reduction. The risk ratio was 0.85 in centres with effectiveness design and 0.73 in those with efficacy design. After correcting for design, overall efficacy was 27%, 24% in pre-consent and 29% in post-consent centres, ranging between a 12% increase and a 52% reduction. Conclusion The estimated overall effect of screening in attenders (efficacy) was a 27% reduction in prostate cancer mortality at 13 years' follow-up. The variation in efficacy between centres was greater than the range in risk ratio without correction for design. The centre-specific variation in the mortality reduction could not be accounted for by the randomisation method.

Study Protocol. IDUS -- Instrumental delivery & ultrasound. A multi-centre randomised controlled trial of ultrasound assessment of the fetal head position versus standard care as an approach to prevent morbidity at instrumental delivery

LENUS (Irish Health Repository)

Murphy, Deirdre J

2012-09-13

AbstractBackgroundInstrumental deliveries are commonly performed in the United Kingdom and Ireland, with rates of 12 – 17% in most centres. Knowing the exact position of the fetal head is a pre-requisite for safe instrumental delivery. Traditionally, diagnosis of the fetal head position is made on transvaginal digital examination by delineating the suture lines of the fetal skull and the fontanelles. However, the accuracy of transvaginal digital examination can be unreliable and varies between 20% and 75%. Failure to identify the correct fetal head position increases the likelihood of failed instrumental delivery with the additional morbidity of sequential use of instruments or second stage caesarean section. The use of ultrasound in determining the position of the fetal head has been explored but is not part of routine clinical practice.Methods\\/DesignA multi-centre randomised controlled trial is proposed. The study will take place in two large maternity units in Ireland with a combined annual birth rate of 13,500 deliveries. It will involve 450 nulliparous women undergoing instrumental delivery after 37 weeks gestation. The main outcome measure will be incorrect diagnosis of the fetal head position. A study involving 450 women will have 80% power to detect a 10% difference in the incidence of inaccurate diagnosis of the fetal head position with two-sided 5% alpha.DiscussionIt is both important and timely to evaluate the use of ultrasound to diagnose the fetal head position prior to instrumental delivery before routine use can be advocated. The overall aim is to reduce the incidence of incorrect diagnosis of the fetal head position prior to instrumental delivery and improve the safety of instrumental deliveries.Trial registrationCurrent Controlled Trials ISRCTN72230496

EUROPEAN INTEGRATION: A MULTILEVEL PROCESS THAT REQUIRES A MULTILEVEL STATISTICAL ANALYSIS

Directory of Open Access Journals (Sweden)

Roxana-Otilia-Sonia HRITCU

2015-11-01

Full Text Available A process of market regulation and a system of multi-level governance and several supranational, national and subnational levels of decision making, European integration subscribes to being a multilevel phenomenon. The individual characteristics of citizens, as well as the environment where the integration process takes place, are important. To understand the European integration and its consequences it is important to develop and test multi-level theories that consider individual-level characteristics, as well as the overall context where individuals act and express their characteristics. A central argument of this paper is that support for European integration is influenced by factors operating at different levels. We review and present theories and related research on the use of multilevel analysis in the European area. This paper draws insights on various aspects and consequences of the European integration to take stock of what we know about how and why to use multilevel modeling.

A designated centre for people with disabilities operated by Muiríosa Foundation, Westmeath

LENUS (Irish Health Repository)

Nichol, Alistair

2015-02-08

Traumatic brain injury is a leading cause of death and disability worldwide. Laboratory and clinical studies demonstrate a possible beneficial effect of erythropoietin in improving outcomes in the traumatic brain injury cohort. However, there are concerns regarding the association of erythropoietin and thrombosis in the critically ill. A large-scale, multi-centre, blinded, parallel-group, placebo-controlled, randomised trial is currently underway to address this hypothesis.

Orchestrating French Music Conservatories: European Political Interventions and Local Governance

Directory of Open Access Journals (Sweden)

Elena Raevskikh

2017-03-01

Full Text Available Supported by the omnipresent State in the past, French music education leans increasingly towards a more liberal and competitive model. In the current context of a decentralized economy and European integration, music conservatories are called upon to contribute to regional and municipal development and enhance European student mobility. How do conservatories react to the restructuring of the competitive field? How do they affect European territorial cohesion? Are they managing adaptive or hybrid strategies with new conceptions of music education? Alternatively, do they gradually move away from the marketplace and become an obsolete and difficult heritage to maintain? To answer these questions, it is necessary to analyze the current balance of power among the different elements of the French multi-level system of conservatories, including communal, inter-communal, departmental, regional, national and European institutions. By combining different sources of spatial and statistical data, this paper contributes to constructing a comparative institutional geography of French multi-level territorial divisions. Extraction and treatment of the small data with SPSS statistical software allowed us to build a number of small-scale datasets that were merged to broader geographical databases from the French National Institute of Statistics and Economic Studies (INSEE. The geographical units that structure the INSEE databases (the zip and district codes, codes of regions, departments, GPS coordinates made possible the location of each conservatory within municipal, departmental, regional and national spaces. A cartographic approach to studying music conservatories allows the identification of problems that deserve further detailed qualitative and statistical study in the future.

Efficacy of night-time compression for breast cancer related lymphedema (LYNC): protocol for a multi-centre, randomized controlled efficacy trial

International Nuclear Information System (INIS)

McNeely, Margaret L.; Campbell, Kristin L.; Webster, Marc; Kuusk, Urve; Tracey, Karen; Mackey, John

2016-01-01

Lymphedema is a prevalent long-term effect of breast cancer treatment that is associated with reduced quality of life. More recent observational data suggest that the addition of night-time compression to day-time use of a compression garment results in better long-term control of arm lymphedema. The primary objectives of the randomized controlled phase of the trial are to determine the efficacy of night-time compression on arm lymphedema volume maintenance and quality of life in breast cancer survivors who have completed intensive reduction treatment for their lymphedema. The study will be a parallel 3-arm, multi-centre randomized fast-track trial. A total of 120 women with breast cancer related lymphedema will be recruited from 3 centres in Canada and randomized to group 1: Day-time compression garment alone or Group 2: Day-time compression garment + night-time compression bandaging or Group 3: Day-time compression garment + use of a night-time compression system garment. The duration of the primary intervention period will be 12 weeks. The follow-up period after the intervention (weeks 13 to 24) will follow a longitudinal observational design. The primary outcome variables: differences from baseline to week 12 in arm volume and quality of life (Lymphoedema Functioning, Disability and Health Questionnaire: Lymph-ICF). Secondary outcomes include bioimpedance analysis, sleep disturbance and self-efficacy. All measurements are standardized and will be performed prior to randomization, and at weeks 6, 12, 18 and 24. The use of night-time compression as a self-management strategy for chronic breast cancer related lymphedema is seen as an innovative approach to improve long-term control over the condition. This trial aims to advance the knowledge on self-management strategies for lymphedema

Imbalances in the development of European currency integration: key issues and recent trends

Directory of Open Access Journals (Sweden)

Cornelia Sahling

2017-12-01

Full Text Available The recent financial and sovereign debt crises affected the Eurozone countries in different ways. The centre-periphery divide of the national economies exacerbated existing problems in the euro area. In this article an empirical analysis of the development of intra-European imbalances is provided. The analysis shows that the problem of internal imbalances remains unsolved. High unemployment and high public debt in Eurozone’s periphery reflects the internal imbalances. In some Northern countries the public debt ratios are becoming higher, too. Significant current account imbalances provide an important indicator of external imbalances. The co-existence of large current account surpluses in Germany and the Netherlands and deficits in Greece challenges the possibilities of deeper European integration. The provided analysis shows a reduction in external imbalances because of better performance of periphery current accounts. A real solution of European problems needs deeper macroeconomic policy cooperation between national authorities and European institutions. The article highlights the limits of European institutions in promoting common economic policy. It is necessary to boost competitiveness by coordinated structural reforms in the euro area; fiscal austerity policies are not enough to restore pre-crisis internal balance. For sustainable economic growth European investment projects should be implemented in the euro area. The recovery of national economies should be used to reduce the high public debt levels in both centre and periphery countries. In the absence of economic adjustment through the exchange rate in the euro area further improvement in European current accounts convergence is important for European economic integration.

Training of nuclear power plant personnel in the member states of the European Community

International Nuclear Information System (INIS)

Misenta, R.; Matfield, R.S.; Volta, G.; Ancarani, A.; Lhoir, J.

1981-01-01

After the Three Mile Island accident the Commission of the European Communities undertook various actions in order to assess the status of the training of nuclear power plant personnel with particular attention to their training for incidents and accidents. This presentation attempts a review of the training situation in the six member states of the European Community together with some other European states, that are operating nuclear power plants. Schemes for the training of control room operators, shift leaders, major European training centres and simulator training will be described

European protocol for neutron dosimetry for external beam therapy

International Nuclear Information System (INIS)

Broerse, J.J.; Mijnheer, B.J.; Williams, J.R.

1981-01-01

The paper attempts to serve the needs of European centres participating in the High LET Therapy Project Group set up under the sponsorship of The European Organization for Research on Treatment of Cancer, to promote cooperation between physicists involved in fast neutron therapy and establish a common basis for neutron dosimetry. Differences in dosimetry procedures between European and American Groups are indicated if relevant. The subject is dealt with under the following main headings: principles of dosimetry of neutron fields, dosimetric methods, physical parameters, determination of absorbed dose at a reference point, determination of absorbed dose at any point, check of absorbed dose given to a patient, dosimetry intercomparisons between institutes. There is an ample bibliography. (U.K.)

The New European and/or EU Studies Curriculum

OpenAIRE

Brie, Mircea; Dolghi, Dorin; Pantea, Dana

2011-01-01

In this part we will present turn by turn the evolution of the curriculum in four domains which are developing in the area of European and/or EU Studies: EU Intercultural Dialogue Studies, EU International Relations and Diplomacy Studies, EU Communication and Information Studies, EU and Comparative Regionalism, from several points of view. First, we will take into consideration the perspective that each curriculum from the four domains has in the ensemble of European and/or EU Studies, t...

ERS/ECDC Statement: European Union standards for tuberculosis care, 2017 update.

Science.gov (United States)

Migliori, Giovanni Battista; Sotgiu, Giovanni; Rosales-Klintz, Senia; Centis, Rosella; D'Ambrosio, Lia; Abubakar, Ibrahim; Bothamley, Graham; Caminero, Jose Antonio; Cirillo, Daniela Maria; Dara, Masoud; de Vries, Gerard; Aliberti, Stefano; Dinh-Xuan, Anh Tuan; Duarte, Raquel; Midulla, Fabio; Solovic, Ivan; Subotic, Dragan R; Amicosante, Massimo; Correia, Ana Maria; Cirule, Andra; Gualano, Gina; Kunst, Heinke; Palmieri, Fabrizio; Riekstina, Vija; Tiberi, Simon; Verduin, Remi; van der Werf, Marieke J

2018-05-01

The International Standards for Tuberculosis Care define the essential level of care for managing patients who have or are presumed to have tuberculosis, or are at increased risk of developing the disease. The resources and capacity in the European Union (EU) and the European Economic Area permit higher standards of care to secure quality and timely TB diagnosis, prevention and treatment. On this basis, the European Union Standards for Tuberculosis Care (ESTC) were published in 2012 as standards specifically tailored to the EU setting. Since the publication of the ESTC, new scientific evidence has become available and, therefore, the standards were reviewed and updated.A panel of international experts, led by a writing group from the European Respiratory Society (ERS) and the European Centre for Disease Prevention and Control (ECDC), updated the ESTC on the basis of new published evidence. The underlying principles of these patient-centred standards remain unchanged. The second edition of the ESTC includes 21 standards in the areas of diagnosis, treatment, HIV and comorbidities, and public health and prevention.The ESTC target clinicians and public health workers, provide an easy-to-use resource and act as a guide through all the required activities to ensure optimal diagnosis, treatment and prevention of TB. The content of this work is copyright of the authors or their employers. Design and branding are copyright ©ERS 2018.

8 May 2013 - Swedish European Spallation Source Chief Executive Officer J. H. Yeck in the ATLAS visitor centre and experimental cavern with Collaboration Spokesperson D. Charlton (also present M. Nessi, R. Garoby and E. Tsesmelis); signing the guest book with International Relations Adviser E. Tsesmelis.

CERN Multimedia

Jean-Claude Gadmer

2013-01-01

8 May 2013 - Swedish European Spallation Source Chief Executive Officer J. H. Yeck in the ATLAS visitor centre and experimental cavern with Collaboration Spokesperson D. Charlton (also present M. Nessi, R. Garoby and E. Tsesmelis); signing the guest book with International Relations Adviser E. Tsesmelis.

Britain's delegation to CERN, the European Centre for Nuclear Research near Geneva, voted in favour of a project which take seven years to build, involve a 27 kilometre long tunnel, and cost 230 million pounds. Now LEP receives the go-ahead later this month

CERN Multimedia

Llewellyn Smith, Christopher Hubert

1981-01-01

Britain's delegation to CERN, the European Centre for Nuclear Research near Geneva, voted in favour of a project which take seven years to build, involve a 27 kilometre long tunnel, and cost 230 million pounds. Now LEP receives the go-ahead later this month

IAEA To Launch Centre On Ocean Acidification

International Nuclear Information System (INIS)

2012-01-01

Full text: The International Atomic Energy Agency (IAEA) is to launch a new centre this summer to address the growing problem of ocean acidification. Operated by the Agency's Monaco Environmental Laboratories, the Ocean Acidification International Coordination Centre will serve the scientific community - as well as policymakers, universities, media and the general public - by facilitating, promoting and communicating global actions on ocean acidification. Growing amounts of carbon dioxide in the Earth's atmosphere are being absorbed in the planet's oceans which increases their acidity. According to the experts, ocean acidification may render most regions of the ocean inhospitable to coral reefs by 2050 if atmospheric carbon dioxide levels continue to increase. This could lead to substantial changes in commercial fish stocks, threatening food security for millions of people as well as the multi-billion dollar fishing industry. International scientists have been studying the effect and possible responses, and the new centre will help coordinate their efforts. ''During the past five years, numerous multinational and national research projects on ocean acidification have emerged and significant research advances have been made,'' said Daud bin Mohamad, IAEA Deputy Director General for Nuclear Sciences and Applications. ''The time is now ripe to provide international coordination to gain the greatest value from national efforts and research investments.'' The centre will be supported by several IAEA Member States and through the Peaceful Uses Initiative, and it will be overseen by an Advisory Board consisting of leading institutions, including the U.N. Intergovernmental Oceanographic Commission, the U.S. National Oceanic and Atmospheric Administration, the U.N. Food and Agriculture Organization, the Fondation Prince Albert II de Monaco, the OA-Reference User Group, as well as leading scientists and economists in the field. The new centre will focus on international

The year 2013 in the European Heart Journal--Cardiovascular Imaging: Part II.

Science.gov (United States)

Plein, Sven; Edvardsen, Thor; Pierard, Luc A; Saraste, Antti; Knuuti, Juhani; Maurer, Gerald; Lancellotti, Patrizio

2014-08-01

The new multi-modality cardiovascular imaging journal, European Heart Journal - Cardiovascular Imaging, was created in 2012. Here we summarize the most important studies from the journal's second year in two articles. Part I of the review has summarized studies in myocardial function, myocardial ischaemia, and emerging techniques in cardiovascular imaging. Part II is focussed on valvular heart diseases, heart failure, cardiomyopathies, and congenital heart diseases. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

Pattern of intensive phase treatment outcomes of multi-drug resistant ...

African Journals Online (AJOL)

Pattern of intensive phase treatment outcomes of multi-drug resistant tuberculosis in University of Port Harcourt Treatment Centre: a review of records from ... Data on patients' age, sex, HIV status, treatment outcomes were extracted from the hospital book records into a computer data sheet at the UPTH treatment centre.

The ESTRO European assurance programme for radiation treatments (EQUAL Network)

International Nuclear Information System (INIS)

Ferreira, I.H.; Dutreix, A.; Bridier, A.; Svensson, H.

2002-01-01

The European Society for Therapeutic Radiology and Oncology (ESTRO) Quality Assurance network for radiotherapy (EQUAL) has been set up in 1998 for European countries. This TLD postal dose assurance service addresses to photon and electron beam checks in reference and non-reference conditions and is successful with more than 440 radiotherapy centres and 1,656 beams checked. Dosimetric problems in the beam calibration, errors in beam data used as input to the treatment planning system (TPS), or uncertainties in the algorithms used in the TPS can be detected in the EQUAL audit. The EQUAL reference dosimetry is linked to the IAEA dosimetry laboratory and to the Radiological Physics Center (RPC) dosimetry laboratory by periodic intercomparisons. The absorbed doses to water in photon and electron beams, measured with the ionization chambers, are determined following the procedure described in the new IAEA TRS-398 International Code of Practice for dosimetry based on standards of absorbed dose to water. The participating centres are instructed to irradiate the TLD (LiF) capsules to a dose of 2 Gy according to the calculations given by the Treatment Planning System used in clinical routine. For photon beams, the EQUAL checks four dosimetric parameters: the reference beam output, the percentage depth doses, the beam output variation for open and wedged fields and the wedge transmission factor. In electron TLD audits, beam outputs are checked for 4 different field sizes. EQUAL has checked 440 radiotherapy centres corresponding to 1,656 beams (1009 photon beams and 574 electrons beams and 73 photon beams shaped by multileaf collimators). The results from measurements at the reference point are very good both for photon and electron beams. For photons, the rates of deviation (vertical bar d vertical bar D measured- D stated ) x 100 / D stated ) larger than 5% which have been observed are respectively of 2.6% for the beam output variation and 3.5% for the wedge transmission

Proposal of a service delivery integration index of home care for older persons: application in several European cities.

NARCIS (Netherlands)

Henrard, J.C.; Ankri, J.; Frijters, D.; Carpenter, I.; Topinkova, E.; Garms-Homolova, V.; Finne-Soveri, H.; Wergeland Sorbye, L.; Jonsson, P.V.; Ljunggren, G.; Schroll, M.; Wagner, C.; Bernabei, R.

2006-01-01

PURPOSE: To propose an integration index of home care delivery to older persons, to study its validity and to apply it to home care services of European cities. THEORY: Home care delivery integration was based on two dimensions referring to process-centred integration and organisational structure

ENLIST 1: An International Multi-centre Cross-sectional Study of the Clinical Features of Erythema Nodosum Leprosum.

Directory of Open Access Journals (Sweden)

Stephen L Walker

Full Text Available Erythema nodosum leprosum (ENL is a severe multisystem immune mediated complication of borderline lepromatous leprosy and lepromatous leprosy. ENL is associated with skin lesions, neuritis, arthritis, dactylitis, eye inflammation, osteitis, orchitis, lymphadenitis and nephritis. The treatment of ENL requires immunosuppression, which is often required for prolonged periods of time and may lead to serious adverse effects. ENL and its treatment is associated with increased mortality and economic hardship. Improved, evidence-based treatments for ENL are needed; however, defining the severity of ENL and outcome measures for treatment studies is difficult because of the multiple organ systems involved. A cross-sectional study was performed, by the members of the Erythema Nodosum Leprosum International STudy (ENLIST Group, of patients with ENL attending seven leprosy referral centres in Brazil, Ethiopia, India, Nepal, the Philippines and the United Kingdom. We systematically documented the clinical features and type of ENL, its severity and the drugs used to treat it. Patients with chronic ENL were more likely to be assessed as having severe ENL. Pain, the most frequent symptom, assessed using a semi-quantitative scale was significantly worse in individuals with "severe" ENL. Our findings will determine the items to be included in a severity scale of ENL which we are developing and validating. The study also provides data on the clinical features of ENL, which can be incorporated into a definition of ENL and used for outcome measures in treatment studies.

A multi-centre study of interactional style in nurse specialist- and physician-led Rheumatology clinics in the UK.

Science.gov (United States)

Vinall-Collier, Karen; Madill, Anna; Firth, Jill

2016-07-01

Nurse-led care is well established in Rheumatology in the UK and provides follow-up care to people with inflammatory arthritis including treatment, monitoring, patient education and psychosocial support. The aim of this study is to compare and contrast interactional style with patients in physician-led and nurse-led Rheumatology clinics. A multi-centre mixed methods approach was adopted. Nine UK Rheumatology out-patient clinics were observed and audio-recorded May 2009-April 2010. Eighteen practitioners agreed to participate in clinic audio-recordings, researcher observations, and note-taking. Of 9 nurse specialists, 8 were female and 5 of 9 physicians were female. Eight practitioners in each group took part in audio-recorded post-clinic interviews. All patients on the clinic list for those practitioners were invited to participate and 107 were consented and observed. In the nurse specialist cohort 46% were female; 71% had a diagnosis of Rheumatoid Arthritis (RA). The physician cohort comprised 31% female; 40% with RA and 16% unconfirmed diagnosis. Nineteen (18%) of the patients observed were approached for an audio-recorded telephone interview and 15 participated (4 male, 11 female). Forty-four nurse specialist and 63 physician consultations with patients were recorded. Roter's Interactional Analysis System (RIAS) was used to code this data. Thirty-one semi-structured interviews were conducted (16 practitioner, 15 patients) within 24h of observed consultations and were analyzed using thematic analysis. RIAS results illuminated differences between practitioners that can be classified as 'socio-emotional' versus 'task-focussed'. Specifically, nurse specialists and their patients engaged significantly more in the socio-emotional activity of 'building a relationship'. Across practitioners, the greatest proportion of 'patient initiations' were in 'giving medical information' and reflected what patients wanted the practitioner to know rather than giving insight into

Environmental gamma radiation levels around various DAE research centres

International Nuclear Information System (INIS)

Takale, R.A.; Swarnakar, M.; Shetty, P.G.; Sahu, S.K.; Pandit, G.G.

2014-01-01

This paper presents the gamma radiation levels of four research centres viz. Bhabha Atomic Research Centre (BARC), Trombay; Indira Gandhi Centre for Atomic Research (IGCAR), Kalpakkam; Variable Energy Cyclotron Centre (VECC), Kolkata; Raja Ramanna Centre for Advanced Technology (RRCAT), Indore; and an industry Board of Radiation and Isotope Technology (BRIT), Vashi. BARC is India's premier nuclear research facility and is a multi-disciplinary research centre with extensive infrastructure for advanced research and development (R and D). IGCAR, Kalpakkam is engaged in scientific research and advanced engineering programme towards the development of Fast Breeder Reactor technology. VECC Kolkata is dedicated to carry out frontier R and D in the fields of Accelerator Science and Technology, Nuclear Science (Theoretical and Experimental), and Material Science etc. RRCAT, Indore has rapidly grown into a premier institute for R and D in lasers, accelerators and their applications. BRIT, Vashi unit is involved in production, development, and supply of radioisotope based products and provision of isotope applications, radiation processing, radio analytical services etc. With an objective to keep a watch on the prevailing environmental background gamma radiation level around all the DAE installations, routine monitoring programme are being carried out using the Thermo Luminescent Dosimeters (TLDs). TLDs provide the simple, inexpensive and precise measurement of small, integrated, external gamma radiation dose rate. The general practice of this programme is to observe the outdoor gamma radiation levels. This paper summarizes the methodology and gamma radiation levels of four research centres viz. BARC, IGCAR, VECC, RRCAT and an industry BRIT, Vashi

The carbon balance of European croplands: a Trans-European, cross-site, multi model simulation study

Science.gov (United States)

Wattenbach, Martin; Sus, Oliver; Vuichard, Nicolas; Lehuger, Simon; Leip, Adrian; Gottschalk, Pia; Smith, Pete

2010-05-01

Croplands cover approximately 45% of Europe and play a significant role in the overall carbon budget of the continent. However, the estimation of the regional carbon balance is still uncertain. Here, we present a multi-site model comparison for four cropland ecosystem models namely the DNDC, ORCHIDEE-STICS, CERES-EGC and SPA model. We compare the accuracy of the models in predicting net ecosystem exchange (NEE), gross primary production (GPP), ecosystem respiration (Reco) as well as actual evapo-transpiration (ETa) for winter wheat (Triticum aestivum L.), winter barley (Hordeum vulgare L.) and maize (Zea mays L.) derived from eddy covariance measurements on five sites of the CarboEurope IP network. The models are all able to simulate mean daily GPP. The simulation results for mean daily ETa and Reco are, however, less accurate. The resulting simulation of daily NEE is adequate beside some cases where models fail due to a lack in phase and amplitude alignment. ORCHIDEE-STICS and the SPA demonstrate the best performance, nevertheless, they are not able to simulate full crop rotations under consideration of multiple management. CERES-EGC and especially DNDC although exhibiting a lower level of model accuracy are able to simulate such conditions resulting in more accurate annual cumulative NEE.

Percutaneous Isolated Hepatic Perfusion as a Treatment for Isolated Hepatic Metastases of Uveal Melanoma: Patient Outcome and Safety in a Multi-centre Study

International Nuclear Information System (INIS)

Vogl, Thomas J.; Koch, Silvia A.; Lotz, Gösta; Gebauer, Bernhard; Willinek, Winfried; Engelke, Christoph; Brüning, Roland; Zeile, Martin; Wacker, Frank; Vogel, Arndt; Radeleff, Boris; Scholtz, Jan-Erik

2017-01-01

PurposePercutaneous isolated hepatic perfusion (PIHP) with Melphalan has been developed as a treatment for patients with isolated hepatic metastases of uveal melanoma. We discuss patient outcome and safety in a retrospective multi-centre study.Materials and MethodsBetween 2012 and 2016 18 patients with un-resectable isolated hepatic metastases of uveal melanoma received single or repeated PIHP with Melphalan (n = 35) at seven sites. Progression-free time, overall survival time (OS) and tumour response by means of RECIST 1.1 criteria were evaluated. Peri- and post-procedural adverse events (AE) were registered. Patients’ life quality was assessed using four-point scale questionnaires.ResultsOf 18 patients, initial PIHP treatment resulted in partial response (PR) in eight, stable disease (SD) in seven and progressive disease (PD) in three cases. Nine patients underwent second PIHP with PR in eight cases and PD in one case. Six patients were evaluated after third PIHP with PR in five patients and SD in one patient. Two patients received fourth PIHP with PD in both cases. Median OS was 9.6 months (range 1.6–41.0 months). Median progression-free survival time was 12.4 months (range 0.9–41.0 months) with 1-year survival of 44%. Most common post-procedural AE grade 3 and 4 were temporary leukopenia (n = 11) and thrombocytopenia (n = 8). Patients’ self-assessments showed good ratings for overall health and quality of life with only slight changes after PIHP, and a high degree of satisfaction with PIHP treatment.ConclusionPIHP with Melphalan proved to be a relatively safe, minimal-invasive and repeatable treatment for patients with non-resectable hepatic metastases of uveal melanoma.

Percutaneous Isolated Hepatic Perfusion as a Treatment for Isolated Hepatic Metastases of Uveal Melanoma: Patient Outcome and Safety in a Multi-centre Study

Energy Technology Data Exchange (ETDEWEB)

Vogl, Thomas J., E-mail: t.vogl@em.uni-frankfurt.de; Koch, Silvia A., E-mail: silvia.koch@web.de [University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology (Germany); Lotz, Gösta, E-mail: goesta.lotz@kgu.de [University Hospital Frankfurt, Department of Anesthesiology, Intensive-Care Medicine and Pain Therapy (Germany); Gebauer, Bernhard, E-mail: bernhard.gebauer@charite.de [Universitätsmedizin Berlin, Department of Diagnostic and Interventional Radiology, Campus Charité Mitte (Germany); Willinek, Winfried, E-mail: w.willinek@bk-trier.de [Brüderkrankenhaus Trier, Department of Diagnostic and Interventional Radiology (Germany); Engelke, Christoph, E-mail: engelke@ekweende.de [Evangelisches Krankenhaus Göttingen-Weende gGmbH, Department of Diagnostic and Interventional Radiology (Germany); Brüning, Roland, E-mail: r.bruening@asklepios.com; Zeile, Martin, E-mail: m.zeile@asklepios.com [Asklepios Klinik Barmbek, Department of Diagnostic and Interventional Radiology (Germany); Wacker, Frank, E-mail: wacker.frank@mh-hannover.de [Medizinische Hochschule Hannover, Department of Diagnostic and Interventional Radiology (Germany); Vogel, Arndt, E-mail: vogel.arndt@mh-hannover.de [Medizinische Hochschule Hannover, Department of Gastroenterology, Hepatology and Endocrinology (Germany); Radeleff, Boris, E-mail: boris.radeleff@med.uni-heidelberg.de [Heidelberg University Hospital, Department of Diagnostic and Interventional Radiology (Germany); Scholtz, Jan-Erik, E-mail: janerikscholtz@gmail.com [University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology (Germany)

2017-06-15

PurposePercutaneous isolated hepatic perfusion (PIHP) with Melphalan has been developed as a treatment for patients with isolated hepatic metastases of uveal melanoma. We discuss patient outcome and safety in a retrospective multi-centre study.Materials and MethodsBetween 2012 and 2016 18 patients with un-resectable isolated hepatic metastases of uveal melanoma received single or repeated PIHP with Melphalan (n = 35) at seven sites. Progression-free time, overall survival time (OS) and tumour response by means of RECIST 1.1 criteria were evaluated. Peri- and post-procedural adverse events (AE) were registered. Patients’ life quality was assessed using four-point scale questionnaires.ResultsOf 18 patients, initial PIHP treatment resulted in partial response (PR) in eight, stable disease (SD) in seven and progressive disease (PD) in three cases. Nine patients underwent second PIHP with PR in eight cases and PD in one case. Six patients were evaluated after third PIHP with PR in five patients and SD in one patient. Two patients received fourth PIHP with PD in both cases. Median OS was 9.6 months (range 1.6–41.0 months). Median progression-free survival time was 12.4 months (range 0.9–41.0 months) with 1-year survival of 44%. Most common post-procedural AE grade 3 and 4 were temporary leukopenia (n = 11) and thrombocytopenia (n = 8). Patients’ self-assessments showed good ratings for overall health and quality of life with only slight changes after PIHP, and a high degree of satisfaction with PIHP treatment.ConclusionPIHP with Melphalan proved to be a relatively safe, minimal-invasive and repeatable treatment for patients with non-resectable hepatic metastases of uveal melanoma.

Torwards a more patient-centred healthcare system and effective services

Directory of Open Access Journals (Sweden)

Philip Michael Chircop

2013-03-01

Full Text Available The European Patients’ Forum is a non-governmental, non-profit organisation set up in 2003 and based in Brussels. EPF is an umbrella body with currently 54 members - who are national coalitions of patients’ organisations, and disease-specific patients’ organisations active at European level. EPF’s raison d’être is to contribute a strong and united patients’ voice into EU-level policies that have an impact on patients’ lives. EPF works with the EU institutions and agencies, as well as a range of other stakeholders, on a number of health-related policy areas and projects. EPF’s vision is: high-quality, patient-centred, and equitable healthcare for all patients across the EU.

Multidisciplinary integrated Parent and Child Centres in Amsterdam: a qualitative study

Directory of Open Access Journals (Sweden)

Vincent Busch

2013-04-01

Full Text Available Background: In several countries centres for the integrated delivery of services to the parent and child have been established. In the Netherlands family health care service centres, called Parent and Child Centres (PCCs involve multidisciplinary teams. Here doctors, nurses, midwives, maternity help professionals and educationists are integrated into multidisciplinary teams in neighbourhood-based centres. To date there has been little research on the implementation of service delivery in these centres.Study Design: A SWOT analysis was performed by use of triangulation data; this took place by integrating all relevant published documents on the origin and organization of the PCCs and the results from interviews with PCC experts and with PCC professionals (N=91. Structured interviews were performed with PCC-professionals (health care professionals (N=67 and PCC managers N=12 and PCC-experts (N=12 in Amsterdam and qualitatively analysed thematically. The interview themes were based on a pre-set list of codes, derived from a prior documentation study and a focus group with PCC experts. Results: Perceived advantages of PCCs were more continuity of care, shorter communication lines, low-threshold contact between professionals and promising future perspectives. Perceived challenges included the absence of uniform multidisciplinary guidelines, delays in communication with hospitals and midwives, inappropriate accommodation for effective professional integration, differing expectations regarding the PCC-manager role among PCC-partners and the danger of professionals' needs dominating clients' needs.Conclusions: Professionals perceive PCCs as a promising development in the integration of services. Remaining challenges involved improvements at the managerial and organizational level. Quantitative research into the improvements in quality of care and child health is recommended.

Multidisciplinary integrated Parent and Child Centres in Amsterdam: a qualitative study

Directory of Open Access Journals (Sweden)

Vincent Busch

2013-04-01

Full Text Available Background: In several countries centres for the integrated delivery of services to the parent and child have been established. In the Netherlands family health care service centres, called Parent and Child Centres (PCCs involve multidisciplinary teams. Here doctors, nurses, midwives, maternity help professionals and educationists are integrated into multidisciplinary teams in neighbourhood-based centres. To date there has been little research on the implementation of service delivery in these centres. Study Design: A SWOT analysis was performed by use of triangulation data; this took place by integrating all relevant published documents on the origin and organization of the PCCs and the results from interviews with PCC experts and with PCC professionals (N=91. Structured interviews were performed with PCC-professionals (health care professionals (N=67 and PCC managers N=12 and PCC-experts (N=12 in Amsterdam and qualitatively analysed thematically. The interview themes were based on a pre-set list of codes, derived from a prior documentation study and a focus group with PCC experts.  Results: Perceived advantages of PCCs were more continuity of care, shorter communication lines, low-threshold contact between professionals and promising future perspectives. Perceived challenges included the absence of uniform multidisciplinary guidelines, delays in communication with hospitals and midwives, inappropriate accommodation for effective professional integration, differing expectations regarding the PCC-manager role among PCC-partners and the danger of professionals' needs dominating clients' needs. Conclusions: Professionals perceive PCCs as a promising development in the integration of services. Remaining challenges involved improvements at the managerial and organizational level. Quantitative research into the improvements in quality of care and child health is recommended.

Psychological and psychosocial functioning of children with burn scarring using cosmetic camouflage: a multi-centre prospective randomised controlled trial.

Science.gov (United States)

Maskell, Jessica; Newcombe, Peter; Martin, Graham; Kimble, Roy

2014-02-01

Burns leave patients with long-term physical scarring. Children with scarring are required to face challenges of reintegration into their community, including acceptance of an altered appearance and acceptance by others. This can be difficult given society's preoccupation with physical appearance. Limited research exists investigating validity of cosmetic camouflage as a psychosocial intervention for children with scarring. This study investigated whether using cosmetic camouflage (Microskin™) had a positive impact on health-related quality of life, self-concept and psychopathology for children and adolescents (8-17 years) with burn scarring. A prospective multi-centre randomised controlled trial was conducted across Australian and New Zealand paediatric hospitals. 63 participants (49 females, mean age 12.7 ± 2.1 years) were enrolled. Data points were baseline (Time 1) and at 8 weeks (Time 2) using reliable and valid psychometric measures. Findings indicate there were significant improvements in socialisation, school and appearance scales on the Paediatric Quality of Life Inventory and psychopathology scores particularly peer problems decreased. However self-concept remained stable from baseline throughout intervention use. Cosmetic camouflage appears to have a positive impact on quality of life particularly socialisation. Cosmetic camouflage is a valid tool to assist children with scarring to actively participate socially within their communities. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

The CRC Contribution to Research Training: Report of a Scoping Study for the Cooperative Research Centres Association

Science.gov (United States)

Palmer, Nigel

2012-01-01

This report summarises findings from a scoping study conducted for the Cooperative Research Centres Association (CRCA) by the Centre for the Study of Higher Education. The purpose of the scoping study is to inform the research training activities of Cooperative Research Centres (CRCs). While previous studies have focussed on the outcomes supported…

Factors that trigger emergency physicians to contact a poison centre: findings from a Swiss study.

Science.gov (United States)

Schurter, David; Rauber-Lüthy, Christine; Jahns, Maximilian; Haberkern, Monika; Kupferschmidt, Hugo; Exadaktylos, Aristomenis; Eriksson, Urs; Ceschi, Alessandro

2014-03-01

Poison centres offer rapid and comprehensive support for emergency physicians managing poisoned patients. This study investigates institutional, case-specific and poisoning-specific factors which influence the decision of emergency physicians to contact a poison centre. Retrospective, consecutive review of all poisoning-related admissions to the emergency departments (EDs) of a primary care hospital and a university hospital-based tertiary referral centre during 2007. Corresponding poison centre consultations were extracted from the poison centre database. Data were matched and analysed by logistic regression and generalised linear mixed models. 545 poisonings were treated in the participating EDs (350 (64.2%) in the tertiary care centre, 195 (35.8%) in the primary care hospital). The poison centre was consulted in 62 (11.4%) cases (38 (61.3%) by the tertiary care centre and 24 (38.7%) by the primary care hospital). Factors significantly associated with poison centre consultation included gender (female vs male) (OR 2.99; 95% CI 1.69 to 5.29; p1 vs 1) (OR 2.84; 95% CI 1.65 to 4.9; ppoison centre consultation. Poison centre consultation was significantly higher during the week, and significantly less during night shifts. The poison centre was consulted significantly more when patients were admitted to intensive care units (OR 5.81; 95% CI 3.25 to 10.37; ppoison centre consultation by emergency physicians. It appears that intensive care unit admission and other factors reflecting either complexity or uncertainty of the clinical situation are the strongest predictors for poison centre consultation. Hospital size did not influence referral behaviour.

Feasibility study for the Nuclear Research Centre of the Nuclear Energy Commission

International Nuclear Information System (INIS)

1985-01-01

The feasibility study was carried out in order to evaluate the possibility of building a Nuclear Research Centre in Uruguay, which would support a wide range of nuclear related technological activities. A market research was carried out, of the products to be manufactured at the Nuclear Centre, regarding the size of production. A detailed list of the main products considered is enclosed. The siting study was performed through the analysis of the incidental factors, such as environment, technical scope and socio-ecomonic factors. An engineering study for the main installations was done. The investment and financial sources were also studied

The Bloodgen Project of the European Union, 2003-2009.

Science.gov (United States)

Avent, Neil D; Martinez, Antonio; Flegel, Willy A; Olsson, Martin L; Scott, Marion L; Nogués, Núria; Písăcka, Martin; Daniels, Geoff L; Muñiz-Diaz, Eduardo; Madgett, Tracey E; Storry, Jill R; Beiboer, Sigrid; Maaskant-van Wijk, Petra M; von Zabern, Inge; Jiménez, Elisa; Tejedor, Diego; López, Monica; Camacho, Emma; Cheroutre, Goedele; Hacker, Anita; Jinoch, Pavel; Svobodova, Irena; van der Schoot, Ellen; de Haas, Masja

2009-01-01

The Bloodgen project was funded by the European Commission between 2003 and 2006, and involved academic blood centres, universities, and Progenika Biopharma S.A., a commercial supplier of genotyping platforms that incorporate glass arrays. The project has led to the development of a commercially available product, BLOODchip, that can be used to comprehensively genotype an individual for all clinically significant blood groups. The intention of making this system available is that blood services and perhaps even hospital blood banks would be able to obtain extended information concerning the blood group of routine blood donors and vulnerable patient groups. This may be of significant use in the current management of multi-transfused patients who become alloimmunised due to incomplete matching of blood groups. In the future it can be envisaged that better matching of donor-patient blood could be achieved by comprehensive genotyping of every blood donor, especially regular ones. This situation could even be extended to genotyping every individual at birth, which may prove to have significant long-term health economic benefits as it may be coupled with detection of inborn errors of metabolism.

Incidence of acute otitis media in children below 6 years of age seen in medical practices in five East European countries.

Science.gov (United States)

Usonis, Vytautas; Jackowska, Teresa; Petraitiene, Sigita; Sapala, Alicja; Neculau, Andrea; Stryjewska, Izabella; Devadiga, Raghavendra; Tafalla, Monica; Holl, Katsiaryna

2016-07-26

Although acute otitis media (AOM) remains a major public health problem worldwide and brings economic burden on health care system and caregivers, little information is available about its epidemiology in Eastern Europe. We conducted an epidemiological, prospective, observational, multi-centre cohort study (NCT01365390) in five East European countries (Estonia, Lithuania, Poland, Romania and Slovenia) between June 2011 and January 2013 to determine the incidence and clinical characteristics of AOM among children aged children and a higher risk in those attending school/childcare or with allergies. AOM required 521 visits to the doctor. Antibiotics were prescribed for 276 (74.8 %) episodes with the lowest prescription rate in Estonia (51.4 %) and the highest in Romania (83.7 %). Complications were rare and hospitalisations occurred in 2 % of the cases. The disease burden of AOM in Eastern Europe is relevant and public health initiatives to reduce it should be considered. ClinicalTrial.gov NCT01365390 .

A complexity analysis of the Gauss-Bessel quadrature as applied to the evaluation of multi-centre integrals over STFs

International Nuclear Information System (INIS)

Bouferguene, Ahmed; Safouhi, Hassan

2006-01-01

In a previous work (Bouferguene 2005 J. Phys. A: Math. Gen. 38 3923), we have shown that in the framework of the Gaussian integral transform, multi-centre integrals over Slater type functions can be evaluated to an acceptable accuracy using a tailored Gauss quadrature in which the weight function has the form W(σ, τ; z) = z ν exp(-σz - τ/z). To be considered a solution worth implementing within a software for routine use in ab initio molecular simulations, the method must also prove to be at least as efficient as those methods previously published in the literature. Two major results are provided in this paper. Firstly, an improvement of the procedure used to generate the roots and weights of the Gauss-Bessel quadrature is proposed. Secondly, a computational cost analysis of the present method and the SD-bar (Safouhi 2001 J. Phys. A: Math. Gen. 34 2801) based approach are compared, hence proving the equivalence of the two from a complexity point of view

Study Protocol. IDUS – Instrumental delivery & ultrasound. A multi-centre randomised controlled trial of ultrasound assessment of the fetal head position versus standard care as an approach to prevent morbidity at instrumental delivery

Directory of Open Access Journals (Sweden)

Murphy Deirdre J

2012-09-01

Full Text Available Abstract Background Instrumental deliveries are commonly performed in the United Kingdom and Ireland, with rates of 12 – 17% in most centres. Knowing the exact position of the fetal head is a pre-requisite for safe instrumental delivery. Traditionally, diagnosis of the fetal head position is made on transvaginal digital examination by delineating the suture lines of the fetal skull and the fontanelles. However, the accuracy of transvaginal digital examination can be unreliable and varies between 20% and 75%. Failure to identify the correct fetal head position increases the likelihood of failed instrumental delivery with the additional morbidity of sequential use of instruments or second stage caesarean section. The use of ultrasound in determining the position of the fetal head has been explored but is not part of routine clinical practice. Methods/Design A multi-centre randomised controlled trial is proposed. The study will take place in two large maternity units in Ireland with a combined annual birth rate of 13,500 deliveries. It will involve 450 nulliparous women undergoing instrumental delivery after 37 weeks gestation. The main outcome measure will be incorrect diagnosis of the fetal head position. A study involving 450 women will have 80% power to detect a 10% difference in the incidence of inaccurate diagnosis of the fetal head position with two-sided 5% alpha. Discussion It is both important and timely to evaluate the use of ultrasound to diagnose the fetal head position prior to instrumental delivery before routine use can be advocated. The overall aim is to reduce the incidence of incorrect diagnosis of the fetal head position prior to instrumental delivery and improve the safety of instrumental deliveries. Trial registration Current Controlled Trials ISRCTN72230496

A multi-centre cohort study evaluating the role of inflammatory markers in patient’s presenting with acute ureteric colic (MIMIC

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T.T. Shah

Full Text Available Background: Spontaneous Stone Passage (SSP rates in acute ureteric colic range from 47 to 75%. There is conflicting evidence on the role of raised inflammatory markers in acute ureteric colic. The use of an easily applicable biomarker that could predict SSP or need for intervention would improve the management of obstructing ureteric stones. Thus, there is a need to determine in an appropriately powered study, in patients who are initially managed conservatively, which factors at the time of acute admission can predict subsequent patient outcome such as SSP and the need for intervention. Particularly, establishing whether levels of white cell count (WBC at presentation are associated with likelihood of SSP or intervention may guide clinicians on the management of these patients’ stones. Design: Multi-center cohort study disseminated via the UK British Urology Researchers in Surgical Training (BURST and Australian Young Urology Researchers Organisation (YURO. Primary research question: What is the association between WBC and SSP in patients discharged from emergency department after initial conservative management? Patient population: Patients who have presented with acute renal colic with CT KUB evidence of a solitary ureteric stone. A minimum sample size of 720 patients across 15 centres will be needed. Hypothesis: A raised WBC is associated with decreased odds of spontaneous stone passage. Primary outcome: The occurrence of SSP within six months of presentation with acute ureteric colic (YES/NO. SSP was defined as absence of need for intervention to assist stone passage. Statistical analysis plan: A multivariable logistic regression model will be constructed, where the outcome of interest is SSP using data from patients who do not undergo intervention at presentation. A random effect will be used to account for clustering of patients within hospitals/institutions. The model will include adjustments for gender, age as control variables

A preliminary study of the impact of the ERS 1 C band scatterometer wind data on the European Centre for Medium-Range Weather Forecasts global data assimilation system

Science.gov (United States)

Hoffman, Ross N.

1993-01-01

A preliminary assessment of the impact of the ERS 1 scatterometer wind data on the current European Centre for Medium-Range Weather Forecasts analysis and forecast system has been carried out. Although the scatterometer data results in changes to the analyses and forecasts, there is no consistent improvement or degradation. Our results are based on comparing analyses and forecasts from assimilation cycles. The two sets of analyses are very similar except for the low level wind fields over the ocean. Impacts on the analyzed wind fields are greater over the southern ocean, where other data are scarce. For the most part the mass field increments are too small to balance the wind increments. The effect of the nonlinear normal mode initialization on the analysis differences is quite small, but we observe that the differences tend to wash out in the subsequent 6-hour forecast. In the Northern Hemisphere, analysis differences are very small, except directly at the scatterometer locations. Forecast comparisons reveal large differences in the Southern Hemisphere after 72 hours. Notable differences in the Northern Hemisphere do not appear until late in the forecast. Overall, however, the Southern Hemisphere impacts are neutral. The experiments described are preliminary in several respects. We expect these data to ultimately prove useful for global data assimilation.

How social policies can improve financial accessibility of healthcare: a multi-level analysis of unmet medical need in European countries.

Science.gov (United States)

Israel, Sabine

2016-03-05

The article explores in how far financial accessibility of healthcare (FAH) is restricted for low-income groups and identifies social protection policies that can supplement health policies in guaranteeing universal access to healthcare. The article is aimed to advance the literature on comparative European social epidemiology by focussing on income-related barriers of healthcare take-up. The research is carried out on the basis of multi-level cross-sectional analyses using 2012 EU-SILC data for 30 European countries. The social policy data stems from EU-SILC beneficiary information. It is argued that unmet medical needs are a reality for many individuals within Europe - not only due to direct user fees but also due to indirect costs such as waiting time, travel costs, time not spent working. Moreover, low FAH affects not only the lowest income quintile but also the lower middle income class. The study observes that social allowance increases the purchasing power of both household types, thereby helping them to overcome financial barriers to healthcare uptake. Alongside healthcare system reform aimed at improving the pro-poor availability of healthcare facilities and financing, policies directed at improving FAH should aim at providing a minimum income base to the low-income quintile. Moreover, categorical policies should address households exposed to debt which form the key vulnerable group within the low-income classes.

Development of the European activation system

Energy Technology Data Exchange (ETDEWEB)

Forrest, Robin [Euratom/UKAEA Fusion Association, Culham Science Centre, Abingdon, Oxfordshire (United Kingdom); Kopecky, Jiri [JUKO Research (Netherlands); Sublet, Jean-Christophe [CEA, Service de Physique des Reacteurs et du Cycle, Saint Paul Lez Durance (France)

2002-08-01

The ability to predict the effects of neutron irradiation on an arbitrary material is a fundamental need of fusion technology. The European Fusion Technology Programme has long recognised this fact, and has developed the European Activation System (EASY). This integrated package relies on research in several areas and can be described as an example of successful international co-operation. Modern software tools were used to produce a user-friendly application (SAFEPAQ-II) running under Windows-98 or NT in which all nuclear data are stored in relational databases. Cross section data from almost 50 sources are read and converted from standard formats to databases. By a series of manipulations these data are selected, modified and processed to yield SAFEPAQ-II databases. All reactions can be graphically displayed with experimental data and uncertainty estimates. Following internal validation and processing the data can then be written out in standard EAF (European Activation File) format (including a set of nine multi-group files) ready for use by the FISPACT inventory code. The various EAF data libraries have been extensively validated against integral measurements using fusion relevant materials and three complementary neutron spectra. Results from such studies have also been fed back to improve library development. New user tools allow the graphical viewing of all multi-group cross sections and decay data. User feedback on bugs and new options have been incorporated in EASY-2001 which is fully documented and provides a complete and reliable tool for prediction of activation in fusion and other applications. (J.P.N.)

WHEDA study: Effectiveness of occupational therapy at home for older people with dementia and their caregivers - the design of a pragmatic randomised controlled trial evaluating a Dutch programme in seven German centres

Directory of Open Access Journals (Sweden)

Vernooij-Dassen Myrra

2009-10-01

Full Text Available Abstract Background A recent Dutch mono-centre randomised controlled trial has shown that occupational therapy improves daily functioning in dementia. The aim of this present study is to compare the effects of the Dutch community occupational therapy programme with a community occupational therapy consultation on daily functioning in older people with mild or moderate dementia and their primary caregivers in a German multi-centre context. Methods/Design A multi-centre single blind randomised controlled trial design is being used in seven health care centres (neurological, psychiatric and for older people in urban regions. Patients are 1:1 randomised to treatment or control group. Assessors are blind to group assignment and perform measurements on both groups at baseline, directly after intervention at 6 weeks and at 16, 26 and 52 weeks follow-up. A sample of 140 community dwelling older people (aged >65 years with mild or moderate dementia and their primary caregivers is planned. The experimental intervention consists of an evidence-based community occupational therapy programme including 10 sessions occupational therapy at home. The control intervention consists of one community occupational therapy consultation based on information material of the Alzheimer Society. Providers of both interventions are occupational therapists experienced in treatment of cognitively impaired older people and trained in both programmes. 'Community' indicates that occupational therapy intervention occurs in the person's own home. The primary outcome is patients' daily functioning assessed with the performance scale of the Interview for Deterioration in Daily Living Activities in Dementia and video tapes of daily activities rated by external raters blind to group assignment using the Perceive, Recall, Plan and Perform System of Task Analysis. Secondary outcomes are patients' and caregivers' quality of life, mood and satisfaction with treatment; the caregiver

Brexit and the European Union

DEFF Research Database (Denmark)

Jensen, Mads Dagnis; Snaith, Holly

2018-01-01

When on 23 June 2016 a majority voted in favour of the United Kingdom (UK) leaving the European Union (EU), it generated a host of unknowns. Prior to the referendum, scholars had already started to anticipate the implications of a potential Brexit from different perspectives, including considering...... lie and suggesting where Britain’s exit will leave the greatest strategic vacuums. The subsequent analysis centres on the actors that will likely win and lose from the UK’s exit from the Union....

Conveying Sacred Knowledge through Contemporary Architectural Design: The Garma Cultural Knowledge Centre

Directory of Open Access Journals (Sweden)

Elizabeth Grant

2016-01-01

Full Text Available The Indigenous peoples of north east Arnhem Land in Australia (Yolngu overlay their culture with the customs and social behaviour of other societies to achieve positive outcomes and autonomy. Passing down cultural knowledge is intrinsic to the cultural identity of Yolngu. The paper discusses the recently completed Garma Cultural Knowledge Centre and examines the cultural knowledge conveyed through the medium of contemporary architecture design. The paper finds that the Garma Cultural Knowledge Centre combined aspects of non-Aboriginal and Aboriginal cultures to form a coherent whole with multi-facetted meanings.

Critical Care Health Informatics Collaborative (CCHIC): Data, tools and methods for reproducible research: A multi-centre UK intensive care database.

Science.gov (United States)

Harris, Steve; Shi, Sinan; Brealey, David; MacCallum, Niall S; Denaxas, Spiros; Perez-Suarez, David; Ercole, Ari; Watkinson, Peter; Jones, Andrew; Ashworth, Simon; Beale, Richard; Young, Duncan; Brett, Stephen; Singer, Mervyn

2018-04-01

To build and curate a linkable multi-centre database of high resolution longitudinal electronic health records (EHR) from adult Intensive Care Units (ICU). To develop a set of open-source tools to make these data 'research ready' while protecting patient's privacy with a particular focus on anonymisation. We developed a scalable EHR processing pipeline for extracting, linking, normalising and curating and anonymising EHR data. Patient and public involvement was sought from the outset, and approval to hold these data was granted by the NHS Health Research Authority's Confidentiality Advisory Group (CAG). The data are held in a certified Data Safe Haven. We followed sustainable software development principles throughout, and defined and populated a common data model that links to other clinical areas. Longitudinal EHR data were loaded into the CCHIC database from eleven adult ICUs at 5 UK teaching hospitals. From January 2014 to January 2017, this amounted to 21,930 and admissions (18,074 unique patients). Typical admissions have 70 data-items pertaining to admission and discharge, and a median of 1030 (IQR 481-2335) time-varying measures. Training datasets were made available through virtual machine images emulating the data processing environment. An open source R package, cleanEHR, was developed and released that transforms the data into a square table readily analysable by most statistical packages. A simple language agnostic configuration file will allow the user to select and clean variables, and impute missing data. An audit trail makes clear the provenance of the data at all times. Making health care data available for research is problematic. CCHIC is a unique multi-centre longitudinal and linkable resource that prioritises patient privacy through the highest standards of data security, but also provides tools to clean, organise, and anonymise the data. We believe the development of such tools are essential if we are to meet the twin requirements of

Links between North Atlantic atmospheric blocking and recent trends in European winter precipitation

Science.gov (United States)

Ummenhofer, Caroline; Seo, Hyodae; Kwon, Young-Oh; Joyce, Terrence

2015-04-01

European precipitation has sustained robust trends during wintertime (January - March) over recent decades. Central, western, and northern Europe have become wetter by an average 0.1-0.3% per annum for the period 1901-2010, while southern Europe, including the Iberian Peninsula, much of Italy and the Balkan States, has sustained drying of -0.2% per annum or more over the same period. The overall pattern is consistent across different observational precipitation products, while the magnitude of the precipitation trends varies amongst data sets. Using cluster analysis, which identifies recurrent states (or regimes) of European winter precipitation by grouping them according to an objective similarity criterion, changes in the frequency of dominant winter precipitation patterns over the past century are evaluated. Considerable multi-decadal variability exists in the frequency of dominant winter precipitation patterns: more recent decades are characterised by significantly fewer winters with anomalous wet conditions over southern, western, and central Europe. In contrast, winters with dry conditions in western and southern Europe, but above-average rainfall in western Scandinavia and the northern British Isles, have been more common recently. We evaluate the associated multi-decadal large-scale circulation changes across the broader extratropical North Atlantic region, which accompany the observed wintertime precipitation variability using the 20th Century reanalysis product. Some influence of the North Atlantic Oscillation (NAO) is apparent in modulating the frequency of dominant precipitation patterns. However, recent trends in the characteristics of atmospheric blocking across the North Atlantic sector indicate a change in the dominant blocking centres (near Greenland, the British Isles, and west of the Iberian Peninsula). Associated changes in sea level pressure, storm track position and strength, and oceanic heat fluxes across the North Atlantic region are also

Recommendations for centres of expertise in rare anaemias. The ENERCA White Book

Directory of Open Access Journals (Sweden)

Joan-Lluis Vives Corrons

2014-12-01

Full Text Available The Community added value of Centres of Expertise (CoE and European Reference Networks (ERN is particularly high for rare diseases (RD due to the rarity of these conditions, which implies both a small number of patients and scarcity of expertise within a single country. Gathering expertise at the European level is therefore, paramount in order to ensure equal access to accurate information, appropriate and timely diagnosis and high quality clinical care and follow up for patients with rare diseases. This applies particularly to rare anaemias due to the high number of different rare diseases that constitute this group. In this context, the European Network for Rare and Congenital Anaemias (ENERCA, co-financed by the European Commission, was created in 2002 with the aim of prevention and management of rare anaemias (RA and the development and promotion of policies to improve the well-being of European Union citizens. The ENERCA White Book is a position paper, developed as a deliverable of the ENERCA (phase 3 project that intends to contribute to the creation of a ERN in RA (ERN-RA by preparation of the recommendations and, in particular, the definition of the criteria that CoE, local centres (LC and their interrelations have to fulfil as healthcare providers. It has been nourished by all the activities that have been performed over the past ten years within the ENERCA framework. The White Book is addressed to authorities in charge of the identifying CoE, as an essential requirement for the official recognition of the ERN, to European and national health authorities, Healthcare centres and health professionals, as well as to all other stakeholders interested in RA. It is also addressed to the patients, as a way to empower their community in this process. One particular characteristic of the White Book is the integration of the three main aspects of a CoE: a ethical and legal frameworks to ensure the non-discrimination and non-stigmatisation of rare

Intermodal Logistics Centres and Freight Corridors – Concepts and Trends

Directory of Open Access Journals (Sweden)

Norbert Wagener

2017-09-01

Full Text Available . Background: The development of international freight corridors, as the Trans European Network and new rail and inland shipping corridors in Asia and Africa, require efficient logistics centres along these corridors which serve as intermodal interfaces and provide a variety of different logistics service functions. The definition of the term logistics centre differs between countries and implies different functionalities. Locations are often selected randomly and business models are opportunity driven, especially in highly dynamic and less regulated new emerging economies. In particular Freight Villages as a special form of logistics centres have a high impact on regional development and serve as cargo generator for freight corridors. Consideration of general principles how to establish Freight Villages could improve the effectiveness of these logistics centres along freight corridors. Methods: Based on a literature review a comprehensive and hierarchical definition of logistics centres will be discussed and applied. From experiences in the development of logistics centres in several countries, especially in Germany and Lithuania, challenges and concepts concerning regulatory framework, determination of location and business and financing models are discussed. Results: Concerning the definition of logistics centres a hierarchical definition is applied which comprises different levels of logistics centres depending on the scope of the value adding and the functionality. As general principles for the development of Freight Villages the active role of the state, master planning, objective location finding, participation and co-operation of different stakeholders in the business model and a stepwise scheme for financing are introduced. Major trends for the future development of Freight Villages are the digitalization of supply chains, the application of new intermodal technologies and of innovative telematics systems, solutions for low emission and

City Centres as Places for Strategic Cooperation through Active City Management – The Significance of Trade Entities

Directory of Open Access Journals (Sweden)

Brańka Sebastian

2016-03-01

Full Text Available This paper posits that the contemporary city should be viewed as a common space that needs the effort of many various stakeholders in order to satisfy the diverse (and changing needs of its stakeholders. Yet, achieving this effectively requires active management and coordination of a range of activities. This paper discusses three examples of recent activities in Cracow (Poland that reflect strategic approach. The first of these case studies focuses on identifying the factors encouraging students to remain in Cracow after completing their studies. The second case study corresponds to a shopping centre opened in 2006 and the last case study shows the recent application of the cultural park legal framework to the city centre of Cracow. This study also makes reference to recent research funded by the European Commission’s Life Long Learning programme on the professional competences of city managers across 6 countries.

Overview of Recent Activities on Safety Culture and Human and Organizational Factors Carried Out at the Joint Research Centre of the European Commission

International Nuclear Information System (INIS)

Stručić, M.; Manna, G.

2016-01-01

The Institute for Energy and Transport (IET) of the Joint Research Centre (JRC) of the European Commission (EC) is since more than ten years active in the field of Safety Culture (SC) and Human and Organizational Factors (HOF). Several activities related to SC and HOF have been and are carried out in the frame of the EU Nuclear Safety Clearinghouse for Operating Experience Feedback (Clearinghouse). The Clearinghouse was established in 2008 to enhance nuclear safety through the lessons learned from NPP events, and to provide help in Operational Experience Feedback (OEF) process primarily to nuclear safety Regulatory Authorities and to their Technical Support Organizations within the EU. Additionally to these activities, during the Fukushima accident, Clearinghouse has been regularly providing reports on the status and progress of the accident to the EU Regulatory Authorities. Moreover, experts, selected from the JRC staffing, were directly engaged in the EU-wide risk and safety assessments of nuclear power plants known as “the Stress Tests”.

Asymptomatic population reference values for three knee patient-reported outcomes measures: evaluation of an electronic data collection system and implications for future international, multi-centre cohort studies.

Science.gov (United States)

McLean, James M; Brumby-Rendell, Oscar; Lisle, Ryan; Brazier, Jacob; Dunn, Kieran; Gill, Tiffany; Hill, Catherine L; Mandziak, Daniel; Leith, Jordan

2018-05-01

The aim was to assess whether the Knee Society Score, Oxford Knee Score (OKS) and Knee Injury and Osteoarthritis Outcome Score (KOOS) were comparable in asymptomatic, healthy, individuals of different age, gender and ethnicity, across two remote continents. The purpose of this study was to establish normal population values for these scores using an electronic data collection system. There is no difference in clinical knee scores in an asymptomatic population when comparing age, gender and ethnicity, across two remote continents. 312 Australian and 314 Canadian citizens, aged 18-94 years, with no active knee pain, injury or pathology in the ipsilateral knee corresponding to their dominant arm, were evaluated. A knee examination was performed and participants completed an electronically administered questionnaire covering the subjective components of the knee scores. The cohorts were age- and gender-matched. Chi-square tests, Fisher's exact test and Poisson regression models were used where appropriate, to investigate the association between knee scores, age, gender, ethnicity and nationality. There was a significant inverse relationship between age and all assessment tools. OKS recorded a significant difference between gender with females scoring on average 1% lower score. There was no significant difference between international cohorts when comparing all assessment tools. An electronic, multi-centre data collection system can be effectively utilized to assess remote international cohorts. Differences in gender, age, ethnicity and nationality should be taken into consideration when using knee scores to compare to pathological patient scores. This study has established an electronic, normal control group for future studies using the Knee society, Oxford, and KOOS knee scores. Diagnostic Level II.

The European Narcolepsy Network (EU-NN) database

DEFF Research Database (Denmark)

Khatami, Ramin; Luca, Gianina; Baumann, Christian R

2016-01-01

Narcolepsy with cataplexy is a rare disease with an estimated prevalence of 0.02% in European populations. Narcolepsy shares many features of rare disorders, in particular the lack of awareness of the disease with serious consequences for healthcare supply. Similar to other rare diseases, only a ......, identification of post-marketing medication side-effects, and will contribute to improve clinical trial designs and provide facilities to further develop phase III trials....... Narcolepsy Network is introduced. The database structure, standardization of data acquisition and quality control procedures are described, and an overview provided of the first 1079 patients from 18 European specialized centres. Due to its standardization this continuously increasing data pool is most...

The Scandinavian Propaten(®) trial - 1-year patency of PTFE vascular prostheses with heparin-bonded luminal surfaces compared to ordinary pure PTFE vascular prostheses - a randomised clinical controlled multi-centre trial.

Science.gov (United States)

Lindholt, J S; Gottschalksen, B; Johannesen, N; Dueholm, D; Ravn, H; Christensen, E D; Viddal, B; Flørenes, T; Pedersen, G; Rasmussen, M; Carstensen, M; Grøndal, N; Fasting, H

2011-05-01

To compare 1-year potencies' of heparin-bonded PTFE [(Hb-PTFE) (Propaten(®))] grafts with those of ordinary polytetraflouroethylene (PTFE) grafts in a blinded, randomised, clinically controlled, multi-centre study. Eleven Scandinavian centres enrolled 569 patients with chronic functional or critical lower limb ischaemia who were scheduled to undergo femoro-femoral bypass or femoro-poplitaeal bypass. The patients were randomised 1:1 stratified by centre. Patency was assessed by duplex ultrasound scanning. A total of 546 patients (96%) completed the study with adequate follow-up. Perioperative bleeding was, on average, 370 ml with PTFE grafts and 399 ml with Heparin-bonded PTFE grafts (p = 0.32). Overall, primary patency after 1 year was 86.4% for Hb-PTFE grafts and 79.9% for PTFE grafts (OR = 0.627, 95% CI: 0.398; 0.989, p = 0.043). Secondary patency was 88% in Hb-PTFE grafts and 81% in PTFE grafts (OR = 0.569 (0.353; 0.917, p = 0.020)). Subgroup analyses revealed that significant reduction in risk (50%) was observed when Hb-PTFE was used for femoro-poplitaeal bypass (OR = 0.515 (0.281; 0.944, p = 0.030)), and a significant reduction in risk (50%) was observed with Hb-PTFE in cases with critical ischaemia (OR = 0.490 (0.249; 0.962, p = 0.036)). The Hb-PTFE graft significantly reduced the overall risk of primary graft failure by 37%. Risk reduction was 50% in femoro-poplitaeal bypass cases and in cases with critical ischaemia. Copyright © 2011. Published by Elsevier Ltd.