941 resultados para Improvement Plan


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This article examines recent developments in the Cyprus negotiations and suggests a number of changes to the proposed electoral system. Specifically, cross-voting and other electoral methods that encourage coalition-building across ethnic communities might add significantly to the functionality of the Annan Plan. Combined with other innovative mechanisms already in the plan, cross-voting could force political parties to seriously take into account the interests and concerns of the two Cypriot communities, an element that is currently missing from both the Turkish Cypriot (TC) and Greek Cypriot (GC) political systems. Special conditions on the island, as well as the way most political parties operated in the critical pre-April 2004 referendum period, suggest the need for this amendment. Although this study respects the consociational logic of the Annan Plan, it supplements consociationalism with elements that foster integration and inter-dependence between the two communities and their voters. The article also reviews the postreferendum developments in Cyprus which might have worrisome future implications, not only for its two communities, but also for EU enlargement in general. Cyprus both holds one of the keys to Turkey's entrance into the EU and is a litmus test for the Euro-Atlantic nexus and its capacity to pacify and integrate ethnically divided societies in Europe and elsewhere.

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Background and purpose: To investigate the potential of intensity-modulated radiotherapy (IMRT) to reduce lung irradiation in the treatment of oesophageal carcinoma with radical radiotherapy.Materials and methods: A treatment planning study was performed to compare two-phase conformal radiotherapy (CFRT) with IMRT in five patients. The CFRT plans consisted of anterior, posterior and bilateral posterior oblique fields, while the IMRT plans consisted of either nine equispaced fields (9F), or four fields (4F) with orientations equal to the CFRT plans. IMRT plans with seven, five or three equispaced fields were also investigated in one patient. Treatment plans were compared using dose-volume histograms and normal tissue complication probabilities.Results: The 9F IMRT plan was unable to improve on the homogeneity of dose to the planning target volume (PTV), compared with the CFRT plan (dose range, 16.9+/-4.5 (1 SD) vs. 12.4+/-3.9%; P=0.06). Similarly, the 9F IMRT plan was unable to reduce the mean lung dose (11.7+/-3.2 vs. 11.0+/-2.9 Gy; P=0.2). Similar results were obtained for seven, five and three equispaced fields in the single patient studied. The 4F IMRT plan provided comparable PTV dose homogeneity with the CFRT plan (11.8+/-3.3 vs. 12.4+/-3.9%; P=0.6), with reduced mean lung dose (9.5+/-2.3 vs 11.0+/-2.9 Gy; P=0.001).Conclusions: IMRT using nine equispaced fields provided no improvement over CFRT. This was because the larger number of fields in the IMRT plan distributed a low dose over the entire lung. In contrast, IMRT using four fields equal to the CFRT fields offered an improvement in lung sparing. Thus, IMRT with a few carefully chosen field directions may lead to a modest reduction in pneumonitis, or allow tumour dose escalation within the currently accepted lung toxicity.