A Better Signpost, Not a Better Walking Stick: How to Evaluate the European Consensus Doctrine

Author(s):  
Andreas Follesdal
VASA ◽  
2015 ◽  
Vol 44 (3) ◽  
pp. 0220-0228 ◽  
Author(s):  
Marion Vircoulon ◽  
Carine Boulon ◽  
Ileana Desormais ◽  
Philippe Lacroix ◽  
Victor Aboyans ◽  
...  

Background: We compared one-year amputation and survival rates in patients fulfilling 1991 European consensus critical limb ischaemia (CLI) definition to those clas, sified as CLI by TASC II but not European consensus (EC) definition. Patients and methods: Patients were selected from the COPART cohort of hospitalized patients with peripheral occlusive arterial disease suffering from lower extremity rest pain or ulcer and who completed one-year follow-up. Ankle and toe systolic pressures and transcutaneous oxygen pressure were measured. The patients were classified into two groups: those who could benefit from revascularization and those who could not (medical group). Within these groups, patients were separated into those who had CLI according to the European consensus definition (EC + TASC II: group A if revascularization, group C if medical treatment) and those who had no CLI by the European definition but who had CLI according to the TASC II definition (TASC: group B if revascularization and D if medical treatment). Results: 471 patients were included in the study (236 in the surgical group, 235 in the medical group). There was no difference according to the CLI definition for survival or cardiovascular event-free survival. However, major amputations were more frequent in group A than in group B (25 vs 12 %, p = 0.046) and in group C than in group D (38 vs 20 %, p = 0.004). Conclusions: Major amputation is twice as frequent in patients with CLI according to the historical European consensus definition than in those classified to the TASC II definition but not the EC. Caution is required when comparing results of recent series to historical controls. The TASC II definition of CLI is too wide to compare patients from clinical trials so we suggest separating these patients into two different stages: permanent (TASC II but not EC definition) and critical ischaemia (TASC II and EC definition).


Nowadays, Thailand is stepping into an aging society. This research purposes developing the intelligence walking stick for the elderly in terms of the health care system by applied the IoT devices and biometric sensors in a real-time system. The heart rate, blood pressure, oxygen saturation, and temperature were measured at the finger of the elderly that holding the intelligence walking stick. All data can monitor and display on mobile devices. The intelligence walking stick system was evaluated by twenty users who are five experts and fifteen elderly in Ratchaburi province. As a result of the mean value at 4.88 and 4.85 by experts and elderly, respectively. It could be said that the development of intelligence walking stick by using IoT can help and improve the daily living of the elderly at the highest level.


Author(s):  
Janne Rothmar Herrmann

This chapter discusses the right to avoid procreation and the regulation of pregnancy from a European perspective. The legal basis for a right to avoid procreation can be said to fall within the scope of several provisions of the European Convention on Human Rights (ECHR), an instrument that is binding for all European countries. Here, Article 12 of the ECHR gives men and women of marriageable age the right to marry and found a family in accordance with the national laws governing this right. However, Article 12 protects some elements of the right not to procreate, but for couples only. The lack of common European consensus in this area highlights how matters relating to the right to decide on the number and spacing of children touch on aspects that differ from country to country even in what could appear to be a homogenous region. In fact, the cultural, moral, and historical milieus that surround these rights differ considerably with diverse national perceptions of the role of the family, gender equality, religious and moral obligations, and so on.


2019 ◽  
Vol 150 ◽  
pp. 161-164 ◽  
Author(s):  
Robert Niven ◽  
Michel Aubier ◽  
Peter Bonta ◽  
Luis Puente-Maestu ◽  
Nicola Facciolongo ◽  
...  

Author(s):  
Yassin Eddahchouri ◽  
◽  
Frans van Workum ◽  
Frits J. H. van den Wildenberg ◽  
Mark I. van Berge Henegouwen ◽  
...  

Abstract Background Minimally invasive esophagectomy (MIE) is a complex and technically demanding procedure with a long learning curve, which is associated with increased morbidity and mortality. To master MIE, training in essential steps is crucial. Yet, no consensus on essential steps of MIE is available. The aim of this study was to achieve expert consensus on essential steps in Ivor Lewis and McKeown MIE through Delphi methodology. Methods Based on expert opinion and peer-reviewed literature, essential steps were defined for Ivor Lewis (IL) and McKeown (McK) MIE. In a round table discussion, experts finalized the lists of steps and an online Delphi questionnaire was sent to an international expert panel (7 European countries) of minimally invasive upper GI surgeons. Based on replies and comments, steps were adjusted and rephrased and sent in iterative fashion until consensus was achieved. Results Two Delphi rounds were conducted and response rates were 74% (23 out of 31 experts) for the first and 81% (27 out of 33 experts) for the second round. Consensus was achieved on 106 essential steps for both the IL and McK approach. Cronbach’s alpha in the first round was 0.78 (IL) and 0.78 (McK) and in the second round 0.92 (IL) and 0.88 (McK). Conclusions Consensus among European experts was achieved on essential surgical steps for both Ivor Lewis and McKeown minimally invasive esophagectomy.


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