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Abstract: Purpose: Systematic verifications of patient''s specific intensity-modulated radiation treatments are usually performed with absolute and relative measurements. The results constitute a database which allows the identification of potential systematic errors. Material and methods: We analyzed 1270 beams distributed in 232 treatment plans. Step-and-shoot intensity-modulated radiation treatments were performed with a Clinac (6 and 23 MV) and sliding window intensity-modulated radiation treatments with a Novalis (6 MV). Results: The distributions obtained do not show systematic error and all the control meet specified tolerances. Conclusion: These results allow us to reduce controls specific patients for treatments performed under identical conditions (location, optimization and segmentation parameters of treatment planning system, etc.). [Copyright &y& Elsevier]

Abstract: While Hippocrates recognized that health is influenced by the external environment, it is only recently that the relationship between health and climate has become a focus of community and public health services. Advances in understanding of weather and climate sciences on the one hand and human health on the other are providing new opportunities for early detection, prediction and prevention of the adverse health effects of hazards as diverse as tropical cyclones, floods, heatwaves and cold spells, air quality, wildfires, droughts and disease epidemics. Early warning of disease outbreaks and a timely response makes prevention possible. For some climate-sensitive diseases, our understanding is sufficient to make health forecasting possible; for others, the relationship between the disease and any causal environmental effect remains unclear, and the focus of active research programs. Institutional changes are also taking place to improve operational and research cooperation between the health sector and the weather and climate communities, ranging from joint service delivery platforms to combined research and development programs. [ABSTRACT FROM AUTHOR]

Résumé Introduction La maltraitance des enfants constitue une problématique complexe qui nécessite une approche pluridisciplinaire encore non systématique en France. Le centre d’accueil en urgence des victimes d’agression (CAUVA) du centre hospitalier universitaire (CHU) de Bordeaux a pu rassembler dès création différents acteurs médicaux, paramédicaux et sociaux. Il a ainsi été établi une procédure d’évaluation psychosociale standardisée, qui est systématiquement diligentée en cas de suspicion de maltraitance sur mineurs. Méthode Nous avons étudié les 74 dossiers non judiciarisés de sujets mineurs (45 filles) ayant bénéficié d’une évaluation pour suspicion de violences entre le 1 er juillet 2014 et le 30 juin 2015. Résultats Ils étaient âgés en moyenne de 7 ans, nous avaient été adressés par des partenaires internes ( n = 15) ou externes au CHU ( n = 37), 22 s’étant présentés spontanément et alléguaient principalement (75 %) des faits de violences sexuelles. Trente-cinq ont pu rentrer au domicile, 17 fait l’objet d’un dépôt de plainte, 19 d’un signalement au Procureur de la République et 3 d’une information préoccupante au Conseil départemental. Conclusion En l’absence de consensus national sur la méthodologie d’évaluation des cas de suspicion de violences sur mineur, nous proposons une évaluation psychosociale comportant un regard collégial qui permet non seulement de faciliter le travail des professionnels mais également le dépistage et la judiciarisation des cas de maltraitance. Summary Introduction Maltreatment is a complex issue and therefore, requires a multidisciplinary approach, which has been commonly used in North America since the 1980s but remains unsystematic in France. Since 1999, the Centre d’Accueil en Urgence des Victimes d’Agression (emergency unit for victims of assault) of the Bordeaux University Hospital has brought together various medical, paramedical, and social actors on this issue. A standardized psychosocial assessment procedure has been introduced and is detailed in this paper, and was consistently conducted in all cases of suspicion of abuse on a minor. Method The authors studied 74 cases of minors having undergone a psychosocial assessment following suspicions of maltreatment between 1 July 2014 and 30 June 2015 that were not referred to the courts. Results Forty-five girls and 29 boys, mean age 7 years, claiming mainly (75 %) to have been subjected to sexual violence, were addressed to us by internal partners ( n = 15) and external partners ( n = 37) and 22 who came to our unit by self-referral. Following our assessment, 35 returned to their home and 36 went to court following a police complaint ( n = 17) and a report filed to the public prosecutor of the Republic ( n = 19). Three of these cases were subjected to a report on matters of concern sent to the departmental council. Conclusion Given the absence of a national consensus on the methodology used for assessing suspicions of maltreatment on minors, our psychosocial assessment can facilitate the task with its peer review as well as the detection and judicialization of the maltreatment. The authors also highlight the recent modification of article 226-14 of the Penal Code, which aims at protecting professionals reporting matters to legal authorities from any legal proceeding, except if it is established that the individual did not act in good faith. [ABSTRACT FROM AUTHOR]