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Food waste is a major source of avoidable greenhouse gas emissions. Responsible research and innovation (RRI) should contribute to meeting urgent challenges like climate change. This paper discusses collaborative innovations to reduce food waste and analyses this from the perspective of RRI, understood as purpose and process requirements. We study to what extent the focus on a responsible innovation outcome in Norwegian food supply chain collaboration corresponds with respecting the process dimensions of RRI, based on interviews and a consensus conference process. This contributes to understanding whether an urgent purpose can facilitate or is a barrier to the process dimensions of RRI. We find that besides aiming for a good outcome, the food companies intend to innovate in an inclusive and reflective way. The sustainability agenda as an important purpose for innovation, and the urgency of the goal of reducing food waste, is in our study well aligned with RRI.

Il presente commento ha l’obiettivo di evidenziare vantaggi e limiti dell’approccio scientifico basato sulle evidenze nel campo del trattamento psicoterapeutico. Pur riconoscendo l’importanza che le linee-guida ai trattamenti psicologici siano basate su solide evidenze scientifiche, permane la difficoltà relativa alla loro applicazione nei contesti di cura. Tali limiti sono ascrivibili soprattutto all’utilizzo dei disegni di ricerca sperimentali controllati (Randomized Controlled Trials, RCT), che si adattano parzialmente a trattamenti terapeutici non manualizzati rivolti a pazienti con condizioni psicopatologiche complesse. Gli studi metanalitici sul trattamento dell’ansia e della depressione inoltre sottolineano come la qualità metodologica degli studi di efficacia con RCT abbiano un livello di evidenza limitato. La ricerca in psicoterapia e le linee-guida ai trattamenti per ansia e depressione deve muoversi maggiormente verso la prospettiva della personalizzazione dell’intervento clinico.

Il documento in discussione interroga tutta la comunità scientifica e in particolare quella dedicata alla tutela della salute fisica e mentale. Quale il metodo scelto che risponde a criteri realmente scientifici? Quali le implicazioni etiche e deontologiche? Quanta l’attenzione all’età evolutiva indispensabile per una corretta prevenzione e tutela dei futuri cittadini? Quale la comprensione raggiunta circa i processi patologici indagati? Quale l’efficacia dello strumento definito ‘Consensus Conference’ per informare e raggiungere i Cittadini? L’autrice processa con attenzione questi aspetti presenti nel testo e restituisce alla comunità scientifica coinvolta nuovi quesiti indispensabili per un approccio laico (privo di connotazioni e di pregiudizi di scuola psicologica specifica), ma coerente con il metodo scientifico, indispensabile alla crescita collettiva della conoscenza. Il suo sforzo nel commentarlo mira non tanto a segnalare cosa condivide o meno o entrare nel merito di contenuti specifici, ma a segnalare passaggi cruciali in cui confusione tra livello epistemologico, teorico e tecnico generano slittamenti, e intrecci di livelli rischiando di allontanare anziché avvicinare la meta che si propone.

In questo contributo mi propongo di riassumere i miei commenti al dibattito in corso sulla Consensus Conference sulle Terapie Psicologiche per Ansia e Depressione. Nell’ottica scientifica di implementazione delle linee guida avviate dall’Istituto Superiore di Sanità, ho scelto di impostare le mie riflessioni nel formato di una peer-review, andando dunque ad individuare cinque aree che potrebbero beneficiare di una revisione. Ovviamente quelle che qui esprimo sono opinioni fallibili che cerco di motivare a partire dalla letteratura scientifica esistente.

Psoriasis is a complex disease often needing a multidisciplinary approach. In particular, the collaboration between dermatologist and rheumatologist is crucial for the management of patients suffering from both psoriasis (PSO) and psoriatic arthritis (PsA). Here we report a series of recommendations from a group of experts, as a result of a Consensus Conference, defining the circumstances in which it is preferable or even mandatory, depending on the available settings, to rely on the opinion of the two specialists, jointly or in a deferred manner. Indications are given on how to organize a 3rd level joint Dermatology- Rheumatology care unit, in connection with 1st and 2nd level clinicians of both specialties, GPs, and other specialists involved in the management of psoriasis. A potential patient journey is suggested, that can be used as a basis for future design and validation of national and/or local diagnostic therapeutic and assistance pathways.

As part of the formulation of the first National Water Plan (NWP) in Uruguay, a mini-public process called ‘Citizen Deliberation on Water (Deci Agua)’ was developed in 2016. While the draft of the plan was being discussed in the formal arenas of water governance (Basin Commissions and Regional Water Resources Councils), a University research team (led by the authors), in coordination with the national water authority, adapted the mechanism of consensus conferences in order to incorporate the citizens’ visions and to contribute to public understanding of the NWP challenges. This article analyses the main aspects of the developed participation strategy and discusses them regarding a set of quality criteria used to evaluate deliberative processes. Although the final version of the NWP (passed by decree in 2017) incorporated some of the contributions of the Citizen Panel, an in-depth analysis of the scope of the deliberative process of Deci Agua allows us to delve into some key aspects related to the quality of participation processes and the challenges. A mixed approach that combines stakeholder participation and lay citizens is novel and desirable in water governance since it increases the scope of participation, deepens the legitimacy of decision-making and improves the public debate. Highlights Deci Agua was a citizen deliberation process based on consensus conferences.; A Citizen Panel contributed to the formulation of Uruguay's first National Water Plan.; The inclusion of the ethical dimension of water management was the main contribution.; Mini-publics like Deci Agua collaborate with the public debate.; Processes of citizen participation can complement stakeholder participation forums.;

Abstract Background With the use of electronic health records (EHRs) increasing and causing unintended negative consequences, the medical scribe profession has burgeoned, but it has yet to be regulated. The purpose of this study was to describe scribe workflow as well as identify the threats and opportunities for the future of the scribe industry. Methods The first phase of the study used ethnographic methods consisting of interviews and observations by a multi-disciplinary team of researchers at five United States sites. In April 2019, a two-day conference of experts representing different stakeholder perspectives was held to discuss the results from site visits and to predict the future of medical scribing. An interpretive content analysis approach was used to discover threats and opportunities for the future of medical scribes. Results Threats facing the medical scribe industry were related to changes in the documentation model, EHR usability, different payment structures, the need to acquire disparate data during clinical encounters, and workforce-related changes relevant to the scribing model. Simultaneously, opportunities for medical scribing in the future included extension of their role to include workflow analysis, acting as EHR-related subject-matter-experts, and becoming integrated more effectively into the clinical care delivery team. Experts thought that if EHR usability increases, the need for medical scribes might decrease. Additionally, the scribe role could be expanded to allow scribes to document more or take on more informatics-related tasks. The experts also anticipated an increased use of alternative models of scribing, like tele-scribing. Conclusion Threats and opportunities for medical scribing were identified. Many experts thought that if the scribe role could be expanded to allow scribes to document more or take on more informatics activities, it would be beneficial. With COVID-19 continuing to change workflows, it is critical that medical scribes receive standardized training as tele-scribing continues to grow in popularity and new roles for scribes as medical team members are identified.

Scientification and technification of later life have pushed the very notion of ageing, embracing materiality as one of the co-producers of a continuous process of becoming. In this paper, we want to explore the role of materiality in a mechanism designed to allow older people to develop arguments regarding digitalization to inform public policies. To achieve this aim, we will employ a concept that will unfold the layers with which theories of ageing are configured in practice: infrastructuring. In our particular case study, this will highlight the coordinated effort among different agents needed to identify, negotiate and prove who can be considered a legitimate older citizen. Along this path, we will face three instances where the theory is challenged by practice: 1) the very sense of what an infrastructure is; 2) the theory about what a consensus conference is; and 3) what the definition of older person is. To conclude, we suggest the necessity to switch the very question about who can be considered an older person to how in a certain context a heterogeneous assemblage of (human and non-human) actors defines what an older person is.

This text is based on the recommendations accepted by the 4th Hungarian Consensus Conference on Breast Cancer, modified on the basis of the international consultation and conference within the frames of the Central-Eastern European Academy of Oncology. The recommendations cover non-operative, intraoperative and postoperative diagnostics, determination of prognostic and predictive markers and the content of cytology and histology reports. Furthermore, they address some specific issues such as the current status of multigene molecular markers, the role of pathologists in clinical trials and prerequisites for their involvement, and some remarks about the future.

Abstract Background and aims Acute appendicitis (AA) is among the most common causes of acute abdominal pain. Diagnosis of AA is still challenging and some controversies on its management are still present among different settings and practice patterns worldwide. In July 2015, the World Society of Emergency Surgery (WSES) organized in Jerusalem the first consensus conference on the diagnosis and treatment of AA in adult patients with the intention of producing evidence-based guidelines. An updated consensus conference took place in Nijemegen in June 2019 and the guidelines have now been updated in order to provide evidence-based statements and recommendations in keeping with varying clinical practice: use of clinical scores and imaging in diagnosing AA, indications and timing for surgery, use of non-operative management and antibiotics, laparoscopy and surgical techniques, intra-operative scoring, and peri-operative antibiotic therapy. Methods This executive manuscript summarizes the WSES guidelines for the diagnosis and treatment of AA. Literature search has been updated up to 2019 and statements and recommendations have been developed according to the GRADE methodology. The statements were voted, eventually modified, and finally approved by the participants to the consensus conference and by the board of co-authors, using a Delphi methodology for voting whenever there was controversy on a statement or a recommendation. Several tables highlighting the research topics and questions, search syntaxes, and the statements and the WSES evidence-based recommendations are provided. Finally, two different practical clinical algorithms are provided in the form of a flow chart for both adults and pediatric (< 16 years old) patients. Conclusions The 2020 WSES guidelines on AA aim to provide updated evidence-based statements and recommendations on each of the following topics: (1) diagnosis, (2) non-operative management for uncomplicated AA, (3) timing of appendectomy and in-hospital delay, (4) surgical treatment, (5) intra-operative grading of AA, (6) ,management of perforated AA with phlegmon or abscess, and (7) peri-operative antibiotic therapy.

Introduction: Lumbar spinal stenosis (LSS) is a common degenerative disease that every spine surgeon will come across in daily practice. Despite this, the natural history and treatment have not been well established and standardized as yet, and there have been few guidelines published on this topic to date. The aim of the World Federation of Neurosurgical Society Spine Committee Consensus Conference is to define evidence-based and expert-based recommendations for the diagnosis and treatment of LSS, considering the different possibilities and facilities in countries worldwide. Methods: An international committee of spinal surgeons reunited to perform the Consensus Conference on the topic of LSS. The Delphi method was applied to administer a questionnaire and obtain a consensus on various topics. A multidisciplinary committee defined 6 panels: 1) natural course and diagnosis of LSS; 2) conservative treatment and follow-up; 3) percutaneous techniques; 4) decompressive surgery; 5) fusion surgery; 6) mobility preserving surgery. The statements and the literature review were presented and voted. Results: A total of 44 statements were stated and then voted by 16 experienced spine surgeons to obtain the final results. A total of 36 statements reached a consensus, of which 34 reached a positive consensus and 2 a negative consensus, whereas no consensus was reached in 8 cases. Conclusions: In the absence of evidence-based medicine, these recommendations offer support for all practitioners, independent from economic resources and personal experience. Obviously, further studies are needed and will be well accepted to support or modify these recommendations.

In this paper, we offer a novel conceptual framework of some of the most important aims for science communication efforts found in the contemporary literature on science communication. We identify several distinct aims present in the literature such as generating public epistemic and moral trust, generating social acceptance, and enhancing democratic legitimacy, and we discuss some of the relations between the different aims. Finally, we examine whether and, if so, to what extent these different aims can be said to have been successfully reached in practice and find that the empirical literature regarding the evaluation of science communications efforts is scarce. We conclude by suggesting that science communicators be attentive to formulating their communicative aim(s) in more precise terms, as well as conduct systematic studies of the effectiveness of their communicative efforts.

Baltic Ossoeintegration Academy (BOA) together with the Lithuanian University of Health Sciences (LSMU) and Universities from Europe and USA organized their second Consensus Conference (CC) devoted to the topic of "Post-Extraction Bone Remodelling and Alveolar Ridge Preservation". BOA - LSMU consensus development group (CDG) was seeking to review the dental literature on a topical area in dental implantology and to produce high-quality, unbiased evidence-based guidelines and consensus statement (CS). CDG as the responsible body formulated the task of developing CS devoted to the topic of "Post-Extraction Bone Remodelling and Alveolar Ridge Preservation" to Gintaras Juodzbalys (Lithuania). CS Panel members were invited by the chairman. They are representatives of Universities, experts in a field and made every effort to produce nonbiased, independent, evidence-based clinical practice guidelines. Panel members had no conflicts of interest and signed a Panel Member Agreement (PMA). Working groups were established and following clinically relevant topics suitable for consensus discussion were identified: 1. Biological aspects of tooth extraction, socket healing and indications for socket preservation (group leader: Gintaras Juodzbalys) [1]. 2. Extraction socket preservation methods and dental implant placement outcomes within grafted sockets (group leader: Pablo Galindo-Moreno) [2].

Stefano Tamburin,1 Stefano Paolucci,2 Francesca Magrinelli,1 Massimo Musicco,2,3 Giorgio Sandrini4,5 On behalf of the Italian Consensus Conference on Pain in Neurorehabilitation (ICCPN) 1Department of Neurological, Biomedical and Movement Sciences, University of Verona, Verona, 2Santa Lucia Foundation, IRCCS, Rome, 3Institute of Biomedical Technologies (IBT) National Research Council of Italy (CNR), Segrate, Milan, 4C. Mondino National Institute of Neurology Foundation, IRCCS, 5Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy Abstract: Pain is very common in the neurorehabilitation setting, where it may not only represent a target for treatment but can also negatively influence rehabilitation procedures directly or through the side effects of painkillers. To date, there are neither guidelines nor consensus on how to assess and treat pain in neurorehabilitation. Because of the very scanty pieces of evidence on this topic, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCPN) was promoted under the auspices of different scientific societies. This article illustrates the rationale, methodology, and topics of the ICCPN. The recommendations of the ICCPN will offer some information on how to deal with pain in neurorehabilitation and may represent the starting point for further studies.Keywords: assessment, consensus conference, neurology, pain, rehabilitation, treatment

Currently we observe a gap between theory and practices of patient engagement. If both scholars and health practitioners do agree on the urgency to realize patient engagement, no shared guidelines exist so far to orient clinical practice. Despite a supportive policy context, progress to achieve greater patient engagement is patchy and slow and often concentrated at the level of policy regulation without dialoguing with practitioners from the clinical field as well as patients and families. Though individual clinicians, care teams and health organizations may be interested and deeply committed to engage patients and family members in the medical course, they may lack clarity about how to achieve this goal. This contributes to a wide “system” inertia—really difficult to be overcome—and put at risk any form of innovation in this filed. As a result, patient engagement risk today to be a buzz words, rather than a real guidance for practice. To make the field clearer, we promoted an Italian Consensus Conference on Patient Engagement (ICCPE) in order to set the ground for drafting recommendations for the provision of effective patient engagement interventions. The ICCPE will conclude in June 2017. This document reports on the preliminary phases of this process. In the paper, we advise the importance of “fertilizing a patient engagement ecosystem”: an oversimplifying approach to patient engagement promotion appears the result of a common illusion. Patient “disengagement” is a symptom that needs a more holistic and complex approach to solve its underlined causes. Preliminary principles to promote a patient engagement ecosystem are provided in the paper.

A Consensus Conference on Specific Learning Disorders has been promoted by the Italian National Institute of Health (Istituto Superiore di Sanità, ISS). The Consensus Conference consisted in a systematic review of the international literature addressing the issues of diagnosis, risk factors and prognosis, treatment, service delivery and organizational models for Specific Learning Disorders (reading, spelling/writing, calculation). Selected papers were examined by a group of Evaluators and then discussed by a Scientific and Technical Committee, whose conclusions were examined and approved by a Jury Panel. The part on diagnostic issues is presented here, encompassing a systematic discussion of the use and appropriateness of diagnostic criteria, parameters, tasks and psychometric indexes as illustrated in the literature, and providing recommendations for clinical practice. Special attention has been devoted to the collection, analysis and discussion of published data concerning languages with transparent orthography. Controversial issues such as discrepancy criteria, role of reading comprehension and importance of accuracy and fluency are discussed.

Baltic Ossoeintegration Academy (BOA) together with the Lithuanian University of Health Sciences (LSMU) and Universities from Europe and USA organized their first Consensus Conference (CC) devoted to the topic of peri-implantitis. BOA - LSMU consensus development group (CDG) was seeking to review the dental literature on a topical area in implantology and to produce high-quality, unbiased evidence-based guidelines and consensus statement (CS). CDG as the responsible body formulated the task of developing CS devoted to the topic of peri-implantitis to Gintaras Juodzbalys (Lithuania). CS Panel members were invited by the chairman. They are representatives of Universities, experts in a field and made every effort to produce nonbiased, independent, evidence-based clinical practice guidelines. Panel members had no conflicts of interest and signed a Panel Member Agreement (PMA). Working groups were established and following clinically relevant topics suitable for consensus discussion were identified: Peri-Implantitis Aetiology, Risk Factors and Pathology (group leader: Claudio Stacchi) [1]. Peri-Implantitis Diagnostics and Decision Tree (group leader: Tolga Fikret Tözüm) [2]. Peri-Implantitis Treatment (group leader: Fernando Suárez-López del Amo) [3].

Rationale: Disease-related malnutrition constitutes a highly prevalent healthcare problem with high costs associated. In Spain, the prevalence of malnutrition in hospitalized patients has been reported from 30% to 50%. Objectives: Main purposes of this consensus document were to establish recommendations that facilitate decision-making and action to prevent and early-diagnose disease-related hospital malnutrition, on the management of nutritional support methods and actions to evaluate nutritional treatment compliance and efficacy. Methods: A systematic bibliographical search of authors was performed, complemented by updated bibliography by author references up to 2010. From this review, some recommendations were defined, modified and critically evaluated by the representatives of scientific societies in a consensus conference (Dec 2010) following a structured brainstorming technique: the Metaplan® technique. A double validation process was undertaken until final recommendations were obtained. Results: 30 consensus recommendations for the prevention and management of hospital malnutrition are presented in this document. Recommendations cover all clinical care settings as well as prevention, screening, diagnosis, treatment and follow-up of disease-related malnutrition. Conclusions: Nutritional screening is strongly recommended at all clinical settings when nutritional risk factors are identified or there is clinical suspicion of malnutrition. Nutritional assessment should be designed and performed according to centers' resources, but clearly identified protocols should be available.La desnutrición relacionada con la enfermedad constituye un problema sanitario de elevada prevalencia y altos costes. En España, la prevalencia de desnutrición de los pacientes hospitalizados se ha estimado entre el 30% y el 50%. Objetivos: El objetivo principal de este consenso fue establecer recomendaciones para facilitar la toma de decisiones para la prevención y el diagnostico precoz de la desnutrición hospitalaria, el manejo del soporte nutricional, y las acciones para evaluar el cumplimiento de la intervención nutricional y su eficacia. Métodos: Se realizó una búsqueda sistemática de autor complementada por bibliografía actualizada por referencias de autor hasta el año 2010. A partir de esta revisión, se definieron algunas recomendaciones que fueron criticadas y modificadas por los representantes de las Sociedades Científicas participantes en una conferencia de consenso (Diciembre 2010) siguiendo una técnica de brainstorming estructurado: la técnica Metaplan". Se realizaron dos vueltas de validación de las recomendaciones hasta obtener las recomendaciones finales. Resultados: Este documento presenta 30 recomendaciones para la prevención y el manejo de la desnutrición hospitalaria. Las mismas cubren todas las áreas de actuación clínica así como la prevención, cribado, diagnóstico, tratamiento y seguimiento de la desnutrición hospitalaria relacionada con la enfermedad. Conclusiones: Se recomienda enérgicamente el cribado nutricional en todas las áreas de actuación clínica cuando se identifiquen factores de riesgo nutricional o sospecha clínica de desnutrición. La valoración del estado nutricional debe diseñarse y realizarse de acuerdo a los recursos disponibles en cada centro, disponiendo de claros protocolos de actuación.

Consistent with studies on inclusive management, this paper adopts the concept of “boundary object” and therefore an emergent approach to explain the collaboration of heterogeneous social actors in public deliberation. My long-term participant observation of the consensus conferences in Taiwan from 2002 through 2005 in general and the transcript of a national consensus conference on prenatal examination in 2005 in particular form the data sources. The identification of a series of boundary objects in the consensus conferences led me to conclude that, on the one hand, the consensus conference is a boundary infrastructure that fosters the establishment of a community of participation and thereby facilitates diverse parties’ deliberation on sensitive issues. On the other hand, whereas a newly formed collective identity is emerging in public deliberation, boundary tensions and the differences between diverse social actors are managed and halted temporarily instead of eliminated permanently by boundary objects. That is, collaboration in public deliberation is always an achievement “in the making” by all parties.

The purpose of this consensus conference was to have a lay panel of persons with type 2 diabetes (T2D) work in collaboration with an expert panel of diabetes professionals to develop strategies designed to improve dietary and physical activity adherence in persons with T2D. Lay panel participants were 15 people living with T2D. The seven experts had expertise in exercise management, cardiovascular risk factors, community-based lifestyle interventions, healthy weight strategies, the glycemic index, exercise motivation, and social, environmental and cultural interactions. All meetings were facilitated by a professional, neutral facilitator. During the conference each expert gave a 15-minute presentation answering questions developed by the lay panel and all panel members worked to generate suggestions for programs and ways in which the needs of persons with T2D may be better met. A subgroup of the lay panel used the suggestions created from the conference to generate a final list of recommendations. Recommendations were categorized into 1) diagnosis/awareness (e.g., increasing awareness about T2D in the general public, need for lifelong self-monitoring post-diagnosis); 2) education for the person with diabetes (e.g., periodic refresher courses), professionals (e.g., regular interactions between researchers and persons with T2D so researchers better understand the needs of the affected population), and the community (e.g., support for families and employers); and 3) ongoing support (e.g., peer support groups). The recommendations from the conference can be used by researchers to design and evaluate physical activity and nutrition programs. The results can also be of use to policy makers and health promoters interested in increasing adherence to physical activity and nutrition guidelines among persons with T2D.

Exercises intended to engage laypeople in deliberations about emerging scientific and technological issues have become very popular in recent decades. These exercises are typically organized by political or intellectual elites, and often assessed in a top-down fashion as well. This paper disrupts that pattern by using a mix of complementary qualitative approaches to explore the experiences of citizen participants in a large exercise on emerging technologies, the 2008 U.S. National Citizens Technology Forum (NCTF), which included both face-to-face and online deliberations. Research questions explore participants’ perspectives on 1) the quality of the deliberations, 2) the potential for the exercise to have impacts, and 3) the degree of empowerment they experienced. While most participants had positive experiences in the exercise, and did not feel that anyone dominated deliberations, at times tensions and conflicts simmered under the surface. Further, the majority of the participants were highly critical of what they felt were chaotic online interactions that failed to engage with some of their key questions. Though many mentioned gaining some personal efficacy, most categorized the exercise as a research project and therefore did not feel it would have many broader societal or political impacts. Finally, participants’ reflections on their experiences in the exercise revealed interesting insights that went beyond the focal research questions—such as their awareness of the top-down power dynamics in the exercise—and how they actively negotiated these dynamics in ways that shaped the quality of deliberation, their sense of empowerment, and assessments of the exercise’s potential impacts.

ABSTRACT Objective: to analyze the attributes, antecedents and consequents of the family conference concept. Method: Walker and Avante's method for concept analysis and the stages of the integrative review process, with a selection of publications in the PubMed, Cinahl and Lilacs databases focusing on the family conference theme in the context of palliative care. Results: the most cited antecedents were the presence of doubts and the need to define a care plan. Family reunion and working instrument were evidenced as attributes. With respect to consequents, to promote the effective communication and to establish a plan of consensual action were the most remarkable elements. Final considerations: the scarcity of publications on the subject was observed, as well as and the limitation of the empirical studies to the space of intensive therapy. Thus, by analyzing the attributes, antecedents and consequents of the concept it was possible to follow their evolution and to show their efficacy and effectiveness as a therapeutic intervention.