983 resultados para Radiotherapy planning


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Although widely debated, some of the defining professional characteristics of planners appear to be competencies in co-ordination, mediation and multidisciplinary working. Despite this, there is little pedagogical reflection on how interprofessional skills are promoted in planning programmes. This paper reflects on the experience of bringing together undergraduate students from medicine and planning to explore the concept of Healthy Urban Planning in a real life context of an urban motorway extension. This reveals a number of unexpected outcomes of such collaboration and points to the value of promoting interprofessional education, both as a way of increasing interest in some of the key challenges now facing society and in order to induce greater professional reflection amongst students.

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This article examines the interaction between development control and economic development in the countryside within the context of contemporary debates on shifts in the agricultural sector from productivism to multi-functionality. Using planning application decisions from the case of Northern Ireland for the period 1994–95 to 2005–06, together with insights from high-level key informants with planning, economic development and environmental management expertise, the article critiques a perception that regulatory planning is in line with rural development ambitions to foster a multi-functional countryside. While the quantitative data indicate a high approval rate for economic development projects, the qualitative evidence points to limitations within the policy content and operational practices of the planning system. The article argues that regulatory planning must engage more deeply with rural development objectives.

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Purpose: Positron emission tomography (PET), in addition to computed tomography (CT), has an effect in target volume definition for radical radiotherapy (RT) for non–small-cell lung cancer (NSCLC). In previously PET-CT staged patients with NSCLC, we assessed the effect of using an additional planning PET-CT scan for gross tumor volume (GTV) definition. Methods and Materials: A total of 28 patients with Stage IA-IIIB NSCLC were enrolled. All patients had undergone staging PET-CT to ensure suitability for radical RT. Of the 28 patients, 14 received induction chemotherapy. In place of a RT planning CT scan, patients underwent scanning on a PET-CT scanner. In a virtual planning study, four oncologists independently delineated the GTVon the CT scan alone and then on the PET-CTscan. Intraobserver and interobserver variability were assessed using the concordance index (CI), and the results were compared using the Wilcoxon signed ranks test. Results: PET-CT improved the CI between observers when defining the GTVusing the PET-CT images compared with using CTalone for matched cases (median CI, 0.57 for CTand 0.64 for PET-CT, p = .032). The median of the mean percentage of volume change from GTVCT to GTVFUSED was 5.21% for the induction chemotherapy group and 18.88% for the RT-alone group. Using the Mann-Whitney U test, this was significantly different (p = .001). Conclusion: PET-CT RT planning scan, in addition to a staging PET-CT scan, reduces interobserver variability in GTV definition for NSCLC. The GTV size with PET-CT compared with CT in the RT-alone group increased and was reduced in the induction chemotherapy group.

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This study describes a study of 14 software companies, on how they initiate and pre-plan software projects. The aim was to obtain an indication of the range of planning activities carried out. The study, using a convenience sample, was carried out using structured interviews, with questions about early software project planning activities. The study offers evidence that an iterative and incremental development process presents extra difficulties in the case of fixed-contract projects. The authors also found evidence that feasibility studies were common, but generally informal in nature. Documentation of the planning process, especially for project scoping, was variable. For incremental and iterative development projects, an upfront decision on software architecture was shown to be preferred over allowing the architecture to just ‘emerge’. There is also evidence that risk management is recognised but often performed incompletely. Finally appropriate future research arising from the study is described.

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Delivering sufficient dose to tumours while sparing surrounding tissue is one of the primary challenges of radiotherapy, and in common practice this is typically achieved by using highly penetrating MV photon beams and spatially shaping dose. However, there has been a recent increase in interest in the possibility of using contrast agents with high atomic number to enhance the dose deposited in tumours when used in conjunction with kV x-rays, which see a significant increase in absorption due to the heavy element's high-photoelectric cross-section at such energies. Unfortunately, the introduction of such contrast agents significantly complicates the comparison of different source types for treatment efficacy, as the dose deposited now depends very strongly on the exact composition of the spectrum, making traditional metrics such as beam quality less valuable. To address this, a 'figure of merit' is proposed, which yields a value which enables the direct comparison of different source types for tumours at different depths inside a patient. This figure of merit is evaluated for a 15 MV LINAC source and two 150 kVp sources (both of which make use of a tungsten target, one with conventional aluminium filtration, while the other uses a more aggressive thorium filter) through analytical methods as well as numerical models, considering tissue treated with a realistic concentration and uptake ratio of gold nanoparticle contrast agents (10 mg ml(-1) concentration in 'tumour' volume, 10: 1 uptake ratio). Finally, a test case of human neck phantom is considered with a similar contrast agent to compare the abstract figure to a more realistic treatment situation. Good agreement was found both between the different approaches to calculate the figure of merit, and between the figure of merit and the effectiveness in a more realistic patient scenario. Together, these observations suggest that there is the potential for contrast-enhanced kilovoltage radiation to be a useful therapeutic tool for a number of classes of tumour on dosimetric considerations alone, and they point to the need for further research in this area.

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Universities planning the provision of space for their teaching requirements need to do so in a fashion that reduces capital and maintenance costs whilst still providing a high-quality level of service. Space plans should aim to provide sufficient capacity without incurring excessive costs due to over-capacity. A simple measure used to estimate over-provision is utilisation. Essentially, the utilisation is the fraction of seats that are used in practice, or the ratio of demand to supply. However, studies usually find that utilisation is low, often only 20–40%, and this is suggestive of significant over-capacity.

Our previous work has provided methods to improve such space planning. They identify a critical level of utilisation as the highest level that can be achieved whilst still reliably satisfying the demand for places to allocate teaching events. In this paper, we extend this body of work to incorporate the notions of event-types and space-types. Teaching events have multiple ‘event-types’, such as lecture, tutorial, workshop, etc., and there are generally corresponding space-types. Matching the type of an event to a room of a corresponding space-type is generally desirable. However, realistically, allocation happens in a mixed space-type environment where teaching events of a given type are allocated to rooms of another space-type; e.g., tutorials will borrow lecture theatres or workshop rooms.

We propose a model and methodology to quantify the effects of space-type mixing and establish methods to search for better space-type profiles; where the term “space-type profile” refers to the relative numbers of each type of space. We give evidence that these methods have the potential to improve utilisation levels. Hence, the contribution of this paper is twofold. Firstly, we present informative studies of the effects of space-type mixing on utilisation, and critical utilisations. Secondly, we present straightforward though novel methods to determine better space-type profiles, and give an example in which the resulting profiles are indeed significantly improved.

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Upland Scotland contains some of Britain’s most prized areas of natural heritage value. However, although such areas may appear both ‘wild’ and ‘remote’, these are typically working landscapes which symbolise the interdependence of nature and society. The complexity of this relationship means that management responses will need to address a multitude of potentially conflicting priorities whilst at the same time ensuring that sufficient social and institutional capital exists to allow for the promotion of landscape integrity. The introduction of national parks to Scotland in the form of the National Parks (Scotland) Act 2000 allows for a high-level of protection for designated areas in upland Scotland. Yet, whilst the recent Act outlines the statutory purpose and direction national parks should take, it allows a significant degree of flexibility in theway in which the Actmay be implemented. This level of discretion allows for significant local distinctiveness within the model but also raises questions about the potential effectiveness of chosen responses. In order to assess the potential implications of a model rooted in self-determination,we provide a case study review of the institutional basis of the Cairngorms National Park along with an assessment of the strategic character of the first National Park Plan. It is argued that whilst the Cairngorms National Park Authority has developed a significant level of stakeholder engagement, the authority may struggle to bridge the policy-implementation gap. Although a number of shortcomings are identified, particular concerns relate to the potential mismatch between strategic ambition and local level capacity.

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This paper aims to contribute to the current debate on Marine Spatial Planning (MSP) by exploring the issue of stakeholder engagement. MSP is an emergent policy field that is subject to an increasing body of research, yet the role, scope and nature of participatory engagement within the process remains a neglected topic. This paper briefly reviews the nature of the ‘marine problem’, to which MSP is seen to be the response and describes the emergence of MSP policy in the UK with specific emphasis on participatory aspects. Drawing on the experience of terrestrial planning it discusses the potential benefits of stakeholder engagement in MSP and highlights some of the key issues that need to be taken into account when shaping stakeholder input into the process. It then goes on to describe the findings from a series of interviews with key stakeholders in the Irish Sea Region, which suggest that we need to develop a more critical and deeper understanding of how various interests frame the ‘marine problem’, and how they see their role in shaping the form of the MSP process. This highlights the importance of encouraging stakeholder involvement in MSP, the need to develop a shared vision of a ‘sea interest’. Priorities are then set for research to support this important policy agenda.