Time over the Life Course: Preferences, Options and Life Course Policy

This article has a twofold objective and addresses two central questions. Is there a gap between the preferences for and availability of various ways to make working patterns more flexible over the life course? What is the role of life course policy (LCP) in narrowing this gap? Using the Eurobarometer 2004 survey on time use over the life course, in the first part we map the preferences, options and attitudes of workers to several ways of modifying their, often standard, working biographies through sabbaticals, smoothing into early retirement, educational leave, palliative leave, part-time jobs or temporary unpaid leaves. As is clear from the empirical part, there is ample potential among the European workforce to arrange paid and unpaid work and leisure in different ways over the life course. In the second part, we discuss the potential of distinct LCP to effectuate more life cycle oriented choices made by workers themselves on how to spend their time and arrange it over the life course according to their own wishes.working hours, life course policy, labour force participation, early retirement

Creating social impact with side-events

All over the world, sport events are seen as significant tools for creating positive social impact. This is understandable, as sport events have the power to attract enthusiastic participants, volunteers and to reach large audiences of visitors and followers via (social) media. Outbursts of excitement, pleasure and feelings of camaraderie are experienced among millions of people in the case of mega events. Still, a fairly large section of the population does not care that much for sports. Some may experience road blocks, litter and noise disturbance from the events. Sport events generally require investments, often from local or national authorities. Concerned citizens rightfully point at alternative usage of public money (e.g. schools, health care). Thrills and excitement are good things, but does that warrant public money being spent on? Or is there a broader social significance of sport events? Can sport events help alleviate societal issues (like cohesion, inequality and non-participation), do they generate a social impact beyond what spectators experience during the event? In this report the authors have aimed to describe the state of play as regards the evidence for the occurrence of a social impact from sport events and the strategies that are required to enhance social impact from sport events. For the report, an extensive scan of the literature was performed and input was collected from a key group of international experts

Validation of Fully Automated Robust Multicriterial Treatment Planning for Head and Neck Cancer IMPT

Purpose: Our purpose was to compare robust intensity modulated proton therapy (IMPT) plans, automatically generated with wish-list–based multicriterial optimization as implemented in Erasmus-iCycle, with manually created robust clinical IMPT plans for patients with head and neck cancer. Methods and Materials: Thirty-three patients with head and neck cancer were retrospectively included. All patients were previously treated with a manually created IMPT plan with 7000 cGy dose prescription to the primary tumor (clinical target volume [CTV]7000) and 5425 cGy dose prescription to the bilateral elective volumes (CTV5425). Plans had a 4-beam field configuration and were generated with scenario-based robust optimization (21 scenarios, 3-mm setup error, and ±3% density uncertainty for the CTVs). Three clinical plans were used to configure the Erasmus-iCycle wish-list for automated generation of robust IMPT plans for the other 30 included patients, in line with clinical planning requirements. Automatically and manually generated IMPT plans were compared for (robust) target coverage, organ-at-risk (OAR) doses, and normal tissue complication probabilities (NTCP). No manual fine-tuning of automatically generated plans was performed. Results: For all automatically generated plans, voxel-wise minimum D98% values for the CTVs were within clinical constraints and similar to manual plans. All investigated OAR parameters were favorable in the automatically generated plans (all P &lt; .001). Median reductions in mean dose to OARs went up to 667 cGy for the inferior pharyngeal constrictor muscle, and median reductions in D0.03cm3 in serial OARs ranged up to 1795 cGy for the spinal cord surface. The observed lower mean dose in parallel OARs resulted in statistically significant lower NTCP for xerostomia (grade ≥2: 34.4% vs 38.0%; grade ≥3: 9.0% vs 10.2%) and dysphagia (grade ≥2: 11.8% vs 15.0%; grade ≥3: 1.8% vs 2.8%). Conclusions: Erasmus-iCycle was able to produce IMPT dose distributions fully automatically with similar (robust) target coverage and improved OAR doses and NTCPs compared with clinical manual planning, with negligible hands-on planning workload.</p

Validation of Fully Automated Robust Multicriterial Treatment Planning for Head and Neck Cancer IMPT

Purpose: Our purpose was to compare robust intensity modulated proton therapy (IMPT) plans, automatically generated with wish-list–based multicriterial optimization as implemented in Erasmus-iCycle, with manually created robust clinical IMPT plans for patients with head and neck cancer. Methods and Materials: Thirty-three patients with head and neck cancer were retrospectively included. All patients were previously treated with a manually created IMPT plan with 7000 cGy dose prescription to the primary tumor (clinical target volume [CTV]7000) and 5425 cGy dose prescription to the bilateral elective volumes (CTV5425). Plans had a 4-beam field configuration and were generated with scenario-based robust optimization (21 scenarios, 3-mm setup error, and ±3% density uncertainty for the CTVs). Three clinical plans were used to configure the Erasmus-iCycle wish-list for automated generation of robust IMPT plans for the other 30 included patients, in line with clinical planning requirements. Automatically and manually generated IMPT plans were compared for (robust) target coverage, organ-at-risk (OAR) doses, and normal tissue complication probabilities (NTCP). No manual fine-tuning of automatically generated plans was performed. Results: For all automatically generated plans, voxel-wise minimum D98% values for the CTVs were within clinical constraints and similar to manual plans. All investigated OAR parameters were favorable in the automatically generated plans (all P &lt; .001). Median reductions in mean dose to OARs went up to 667 cGy for the inferior pharyngeal constrictor muscle, and median reductions in D0.03cm3 in serial OARs ranged up to 1795 cGy for the spinal cord surface. The observed lower mean dose in parallel OARs resulted in statistically significant lower NTCP for xerostomia (grade ≥2: 34.4% vs 38.0%; grade ≥3: 9.0% vs 10.2%) and dysphagia (grade ≥2: 11.8% vs 15.0%; grade ≥3: 1.8% vs 2.8%). Conclusions: Erasmus-iCycle was able to produce IMPT dose distributions fully automatically with similar (robust) target coverage and improved OAR doses and NTCPs compared with clinical manual planning, with negligible hands-on planning workload.</p