The Scored Patient-Generated Subjective Global Assessment (PG-SGA) and its Association with Quality of Life in Ambulatory Patients Receiving Radiotherapy

OBJECTIVE: To evaluate the scored Patient-generated Subjective Global Assessment (PG-SGA) tool as an outcome measure in clinical nutrition practice and determine its association with quality of life (QoL). DESIGN: A prospective 4 week study assessing the nutritional status and QoL of ambulatory patients receiving radiation therapy to the head, neck, rectal or abdominal area. SETTING: Australian radiation oncology facilities. SUBJECTS: Sixty cancer patients aged 24-85 y. INTERVENTION: Scored PG-SGA questionnaire, subjective global assessment (SGA), QoL (EORTC QLQ-C30 version 3). RESULTS: According to SGA, 65.0% (39) of subjects were well-nourished, 28.3% (17) moderately or suspected of being malnourished and 6.7% (4) severely malnourished. PG-SGA score and global QoL were correlated (r=-0.66, P<0.001) at baseline. There was a decrease in nutritional status according to PG-SGA score (P<0.001) and SGA (P<0.001); and a decrease in global QoL (P<0.001) after 4 weeks of radiotherapy. There was a linear trend for change in PG-SGA score (P<0.001) and change in global QoL (P=0.003) between those patients who improved (5%) maintained (56.7%) or deteriorated (33.3%) in nutritional status according to SGA. There was a correlation between change in PG-SGA score and change in QoL after 4 weeks of radiotherapy (r=-0.55, P<0.001). Regression analysis determined that 26% of the variation of change in QoL was explained by change in PG-SGA (P=0.001). CONCLUSION: The scored PG-SGA is a nutrition assessment tool that identifies malnutrition in ambulatory oncology patients receiving radiotherapy and can be used to predict the magnitude of change in QoL.

Integrating health and sustainability in life cycle assessment

Until now health impact assessment and environmental impact assessment are two different issues, often not addressed together. Both issues have to be dealt with for sustainable building. The aim of this paper is to link healthy and sustainable housing in life cycle assessment. Two strategies are studied: clean air as a functional unity and health as a quality indicator. The strategies are illustrated with an example on the basis of Eco-Quantum, which is a Dutch whole-building assessment tool. It turns out that both strategies do not conflict with the LCA methodology. The LCA methodology has to be refined for this purpose.

Developing a vision for an nD modelling tool

The design of a building is a complicated process, having to formulate diverse components through unique tasks involving different personalities and organisations in order to satisfy multi-faceted client requirements. To do this successfully, the project team must encapsulate an integrated design that accommodates various social, economic and legislative factors. Therefore, in this era of increasing global competition integrated design has been increasingly recognised as a solution to deliver value to clients.----- The ‘From 3D to nD modelling’ project at the University of Salford aims to support integrated design; to enable and equip the design and construction industry with a tool that allows users to create, share, contemplate and apply knowledge from multiple perspectives of user requirements (accessibility, maintainability, sustainability, acoustics, crime, energy simulation, scheduling, costing etc.). Thus taking the concept of 3-dimensional computer modelling of the built environment to an almost infinite number of dimensions, to cope with whole-life construction and asset management issues in the design of modern buildings. This paper reports on the development of a vision for how integrated environments that will allow nD-enabled construction and asset management to be undertaken. The project is funded by a four-year platform grant from the Engineering and Physical Sciences Research Council (EPSRC) in the UK; thus awarded to a multi-disciplinary research team, to enable flexibility in the research strategy and to produce leading innovation. This paper reports on the development of a business process and IT vision for how integrated environments will allow nD-enabled construction and asset management to be undertaken. It further develops many of the key issues of a future vision arising from previous CIB W78 conferences.

Life cycle modelling and design knowledge development in 3D virtual environments : final report

Experience plays an important role in building management. “How often will this asset need repair?” or “How much time is this repair going to take?” are types of questions that project and facility managers face daily in planning activities. Failure or success in developing good schedules, budgets and other project management tasks depend on the project manager's ability to obtain reliable information to be able to answer these types of questions. Young practitioners tend to rely on information that is based on regional averages and provided by publishing companies. This is in contrast to experienced project managers who tend to rely heavily on personal experience. Another aspect of building management is that many practitioners are seeking to improve available scheduling algorithms, estimating spreadsheets and other project management tools. Such “micro-scale” levels of research are important in providing the required tools for the project manager's tasks. However, even with such tools, low quality input information will produce inaccurate schedules and budgets as output. Thus, it is also important to have a broad approach to research at a more “macro-scale.” Recent trends show that the Architectural, Engineering, Construction (AEC) industry is experiencing explosive growth in its capabilities to generate and collect data. There is a great deal of valuable knowledge that can be obtained from the appropriate use of this data and therefore the need has arisen to analyse this increasing amount of available data. Data Mining can be applied as a powerful tool to extract relevant and useful information from this sea of data. Knowledge Discovery in Databases (KDD) and Data Mining (DM) are tools that allow identification of valid, useful, and previously unknown patterns so large amounts of project data may be analysed. These technologies combine techniques from machine learning, artificial intelligence, pattern recognition, statistics, databases, and visualization to automatically extract concepts, interrelationships, and patterns of interest from large databases. The project involves the development of a prototype tool to support facility managers, building owners and designers. This final report presents the AIMMTM prototype system and documents how and what data mining techniques can be applied, the results of their application and the benefits gained from the system. The AIMMTM system is capable of searching for useful patterns of knowledge and correlations within the existing building maintenance data to support decision making about future maintenance operations. The application of the AIMMTM prototype system on building models and their maintenance data (supplied by industry partners) utilises various data mining algorithms and the maintenance data is analysed using interactive visual tools. The application of the AIMMTM prototype system to help in improving maintenance management and building life cycle includes: (i) data preparation and cleaning, (ii) integrating meaningful domain attributes, (iii) performing extensive data mining experiments in which visual analysis (using stacked histograms), classification and clustering techniques, associative rule mining algorithm such as “Apriori” and (iv) filtering and refining data mining results, including the potential implications of these results for improving maintenance management. Maintenance data of a variety of asset types were selected for demonstration with the aim of discovering meaningful patterns to assist facility managers in strategic planning and provide a knowledge base to help shape future requirements and design briefing. Utilising the prototype system developed here, positive and interesting results regarding patterns and structures of data have been obtained.

Life Cycle Modelling and Design Knowledge Development in 3D Virtual Environments

Experience plays an important role in building management. “How often will this asset need repair?” or “How much time is this repair going to take?” are types of questions that project and facility managers face daily in planning activities. Failure or success in developing good schedules, budgets and other project management tasks depend on the project manager's ability to obtain reliable information to be able to answer these types of questions. Young practitioners tend to rely on information that is based on regional averages and provided by publishing companies. This is in contrast to experienced project managers who tend to rely heavily on personal experience. Another aspect of building management is that many practitioners are seeking to improve available scheduling algorithms, estimating spreadsheets and other project management tools. Such “micro-scale” levels of research are important in providing the required tools for the project manager's tasks. However, even with such tools, low quality input information will produce inaccurate schedules and budgets as output. Thus, it is also important to have a broad approach to research at a more “macro-scale.” Recent trends show that the Architectural, Engineering, Construction (AEC) industry is experiencing explosive growth in its capabilities to generate and collect data. There is a great deal of valuable knowledge that can be obtained from the appropriate use of this data and therefore the need has arisen to analyse this increasing amount of available data. Data Mining can be applied as a powerful tool to extract relevant and useful information from this sea of data. Knowledge Discovery in Databases (KDD) and Data Mining (DM) are tools that allow identification of valid, useful, and previously unknown patterns so large amounts of project data may be analysed. These technologies combine techniques from machine learning, artificial intelligence, pattern recognition, statistics, databases, and visualization to automatically extract concepts, interrelationships, and patterns of interest from large databases. The project involves the development of a prototype tool to support facility managers, building owners and designers. This Industry focused report presents the AIMMTM prototype system and documents how and what data mining techniques can be applied, the results of their application and the benefits gained from the system. The AIMMTM system is capable of searching for useful patterns of knowledge and correlations within the existing building maintenance data to support decision making about future maintenance operations. The application of the AIMMTM prototype system on building models and their maintenance data (supplied by industry partners) utilises various data mining algorithms and the maintenance data is analysed using interactive visual tools. The application of the AIMMTM prototype system to help in improving maintenance management and building life cycle includes: (i) data preparation and cleaning, (ii) integrating meaningful domain attributes, (iii) performing extensive data mining experiments in which visual analysis (using stacked histograms), classification and clustering techniques, associative rule mining algorithm such as “Apriori” and (iv) filtering and refining data mining results, including the potential implications of these results for improving maintenance management. Maintenance data of a variety of asset types were selected for demonstration with the aim of discovering meaningful patterns to assist facility managers in strategic planning and provide a knowledge base to help shape future requirements and design briefing. Utilising the prototype system developed here, positive and interesting results regarding patterns and structures of data have been obtained.

DesignWorld : a tool for team collaboration in high band virtual environments

Current software tools for documenting and developing models of buildings focus on supporting a single user who is a specialist in the specific software used within their own discipline. Extensions to these tools for use by teams maintain the single discipline view and focus on version and file management. There is a perceived need in industry to have tools that specifically support collaboration among individuals from multiple disciplines with both a graphical representation of the design and a persistent data model. This project involves the development of a prototype of such a software tool. We have identified multi-user 3D virtual worlds as an appropriate software base for the development of a collaborative design tool. These worlds are inherently multi-user and therefore directly support collaboration through a sense of awareness of others in the virtual world, their location within the world, and provide various channels for direct and indirect communication. Such software platforms also provide a 3D building and modelling environment that can be adapted to the needs of the building and construction industry. DesignWorld is a prototype system for collaborative design developed by augmenting the Second Life (SL) commercial software platform1 with a collection web-based tools for communication and design. Agents manage communication between the 3D virtual world and the web-based tools. In addition, agents maintain a persistent external model of designs in the 3D world which can be augmented with data such as relationships, disciplines and versions not usually associated with 3D virtual worlds but required in design scenarios.

Final report : a software diagnostic tool for evaluating distress mechanisms in bridges exposed to aggressive environments

Durability issues of reinforced concrete construction cost millions of dollars in repair or demolition. Identification of the causes of degradation and a prediction of service life based on experience, judgement and local knowledge has limitations in addressing all the associated issues. The objective of this CRC CI research project is to develop a tool that will assist in the interpretation of the symptoms of degradation of concrete structures, estimate residual capacity and recommend cost effective solutions. This report is a documentation of the research undertaken in connection with this project. The primary focus of this research is centred on the case studies provided by Queensland Department of Main Roads (QDMR) and Brisbane City Council (BCC). These organisations are endowed with the responsibility of managing a huge volume of bridge infrastructure in the state of Queensland, Australia. The main issue to be addressed in managing these structures is the deterioration of bridge stock leading to a reduction in service life. Other issues such as political backlash, public inconvenience, approach land acquisitions are crucial but are not within the scope of this project. It is to be noted that deterioration is accentuated by aggressive environments such as salt water, acidic or sodic soils. Carse, 2005, has noted that the road authorities need to invest their first dollars in understanding their local concretes and optimising the durability performance of structures and then look at potential remedial strategies.

Re-life of buildings - decision support tools for maximising project efficiency

This paper describes the process adopted in developing an integrated decision support framework for planning of office building refurbishment projects, with specific emphasize on optimising rentable floor space, structural strengthening, residual life and sustainability. Expert opinion on the issues to be considered in a tool is being captured through the DELPHI process, which is currently ongoing. The methodology for development of the integrated tool will be validated through decisions taken during a case study project: refurbishment of CH1 building of Melbourne City Council, which will be followed through to completion by the research team. Current status of the CH1 planning will be presented in the context of the research project.

Decision - Support Software Tool Handbook

The road and transport industry in Australia and overseas has come a long way to understanding the impact of road traffic noise on the urban environment. Most road authorities now have guidelines to help assess and manage the impact of road traffic noise on noise-sensitive areas and development. While several economic studies across Australia and overseas have tried to value the impact of noise on property prices, decision-makers investing in road traffic noise management strategies have relatively limited historic data and case studies to go on. The perceived success of a noise management strategy currently relies largely on community expectations at a given time, and is not necessarily based on the analysis of the costs and benefits, or the long-term viability and value to the community of the proposed treatment options. With changing trends in urban design, it is essential that the 'whole-of-life' costs and benefits of noise ameliorative treatment options and strategies be identified and made available for decisionmakers in future investment considerations. For this reason, CRC for Construction Innovation Australia funded a research project, Noise Management in Urban Environments to help decision-makers with future road traffic noise management investment decisions. RMIT University and the Queensland Department of Main Roads (QDMR) have conducted the research work, in collaboration with the Queensland Department of Public Works, ARUP Pty Ltd, and the Queensland University of Technology. The research has formed the basis for the development of a decision-support software tool, and helped collate technical and costing data for known noise amelioration treatment options. We intend that the decision support software tool (DST) should help an investment decision-maker to be better informed of suitable noise ameliorative treatment options on a project-by-project basis and identify likely costs and benefits associated with each of those options. This handbook has been prepared as a procedural guide for conducting a comparative assessment of noise ameliorative options. The handbook outlines the methodology and assumptions adopted in the decision-support framework for the investment decision-maker and user of the DST. The DST has been developed to provide an integrated user-friendly interface between road traffic noise modelling software, the relevant assessment criteria and the options analysis process. A user guide for the DST is incorporated in this handbook.

Life cycle inventory for Australian building materials

This paper discusses challenges to developers of a national Life Cycle Inventory (LCI) database on which to base assessment of building environmental impacts and a key to development of a fully integrated eco-design tool created for automated eco-efficiency assessment of commercial building design direct from 3D CAD. The scope of this database includes Australian and overseas processing burdens involved in acquiring, processing, transporting, fabricating, finishing and using metals, masonry, timber, glazing, ceramics, plastics, fittings, composites and coatings. Burdens are classified, calculated and reported for all flows of raw materials, fuels, energy and emissions to and from the air, soil and water associated with typical products and services in building construction, fitout and operation. The aggregated life cycle inventory data provides the capacity to generate environmental impact assessment reports based on accepted performance indicators. Practitioners can identify hot spots showing high environmental burdens of a proposed design and drill down to report on specific building components. They can compare assessments with case studies and operational estimates to assist in eco-efficient design of a building, fitout and operation.

Redefining life cycle for a building sustainability assessment framework

Understanding the differences between the temporal and physical aspects of the building life cycle is an essential ingredient in the development of Building Environmental Assessment (BEA) tools. This paper illustrates a theoretical Life Cycle Assessment (LCA) framework aligning temporal decision-making with that of material flows over building development phases. It was derived during development of a prototype commercial building design tool that was based on a 3-D CAD information and communications technology (ICT) platform and LCA software. The framework aligns stakeholder BEA needs and the decision-making process against characteristics of leading green building tools. The paper explores related integration of BEA tool development applications on such ICT platforms. Key framework modules are depicted and practical examples for BEA are provided for: • Definition of investment and service goals at project initiation; • Design integrated to avoid overlaps/confusion over the project life cycle; • Detailing the supply chain considering building life cycle impacts; • Delivery of quality metrics for occupancy post-construction/handover; • Deconstruction profiling at end of life to facilitate recovery.

Measuring and supporting quality of life

It is widely acknowledged that “quality of life” (QoL) is an imprecise concept, which is difficult to define (Arnold, 1991; Ball et al., 2000; Bury & Holme, 1993; Byrne & MacLean, 1997; Guse & Masesar, 1999; McDowell & Newell, 1996). McDowell and Newell (1996) described the term as “intuitively familiar” (p.382), suggesting that everyone believes that they know what it means; while, in reality its meaning differs from person to person. Recent years, have seen steadily increasing interest in the study and measurement of QoL related to human services, which reflects greater importance being attached to accountability in its widest sense. Anecdotally, many care staff will indicate that ensuring good QoL for their clients is important to them, but how can we ascertain whether we are achieving positive QoL outcomes, and given the complexities of the concept and its measurement, how can we best incorporate QoL assessment into everyday practice? This chapter will explore the issues of QoL definition and measurement, particularly as they pertain to aged care. It will consider many measurement tool options, and provide advice on how to choose an appropriate instrument for your circumstances. Issues of quality of care and their relationship to QoL will also be considered, and the chapter will conclude with a discussion on the integration of QoL assessment into practice. Because residential aged care constitutes a living environment as well as a care environment, QoL is considered particularly pertinent in this context, and as such, it will provide much of the focus for the chapter

The relationship between clinical outcomes and quality of life for residents of aged care facilities

Objectives It is widely assumed improving care in residential facilities will improve quality of life (QoL), but little research has explored this relationship. The Clinical Care Indicators (CCI) Tool was developed to fill an existing gap in quality assessment within Australian residential aged care facilities and it was used to explore potential links between clinical outcomes and QoL. Design and Setting Clinical outcome and QoL data were collected within four residential facilities from the same aged care provider. Subjects Subjects were 82 residents of four facilities. Outcome Measures Clinical outcomes were measured using the CCI Tool and QoL data was obtained using the Australian WHOQOL‑100. Results Independent t‑test analyses were calculated to compare individual CCIs with each domain of the WHOQOL‑100, while Pearson’s product moment coefficients (r) were calculated between the total number of problem indicators and QoL scores. Significant results suggested poorer clinical outcomes adversely affected QoL. Social and spiritual QoL were particularly affected by clinical outcomes and poorer status in hydration, falls and depression were most strongly associated with lower QoL scores. Poorer clinical status as a whole was also significantly correlated with poorer QoL. Conclusions Hydration, falls and depression were most often associated with poorer resident QoL and as such appear to be key areas for clinical management in residential aged care. However, poor clinical outcomes overall also adversely affected QoL, which suggests maintaining optimum clinical status through high quality nursing care, would not only be important for resident health but also for enhancing general life quality.

The interaction order of Second Life : how micro sociology can contribute to online games innovation

This paper uses the virtual world Second Life (as Web 2.0 environment) to discuss how sociological theory is a relevant tool for innovation in the area of games design as a methodological strategy. Via the theories of Erving Goffman’s interaction order the paper illustrates how micro studies of online interaction demonstrate active accounts of membership and complex interactivity. In order to achieve this, the paper outlines a methodological tool to assist in the application of micro sociology to Web 2.0 environments that accounts for the multiple dimensions of participation within the digital field.

Real Design of a Virtual Landscape : Designing and building a landscape in Second Life

3D Virtual Environments (VE) are real; they exist as digital worlds with the advantage of having none of the constraints of the real world. As such they are the perfect training ground for design students who can create, build and experiment with design solutions without the constraint of real world projects. This paper reports on an educational setting used to explore a model for using VE such as Second Life (SL) developed by Linden Labs in California, as a collaborative environment for design education. A postgraduate landscape architecture learning environment within a collaborative design unit was developed to integrate this model where the primary focus was the application of three-dimensional tools within design, not as a presentation tool, but rather as a design tool. The focus of the unit and its aims and objectives will be outlined before describing the use of SL in the unit. Attention is focused on the collaboration and learning experience before discussing the outcomes, student feedback, future projects using this model and potential for further research. The outcome of this study aims to contribute to current research on teaching and learning design in interactive VE’s. We present a case study of our first application of this model.