Advance transit oriented development typology : case study in Brisbane, Australia

Internationally, transit oriented development (TOD) is characterised by moderate to high density development with diverse land use patterns and well connected street networks centred around high frequency transit stops (bus and rail). Although different TOD typologies have been developed in different contexts, they are based on subjective evaluation criteria derived from the context in which they are built and typically lack a validation measure. Arguably there exist sets of TOD characteristics that perform better in certain contexts, and being able to optimise TOD effectiveness would facilitate planning and supporting policy development. This research utilises data from census collection districts (CCDs) in Brisbane with different sets of TOD attributes measured across six objectively quantified built environmental indicators: net employment density, net residential density, land use diversity, intersection density, cul-de-sac density, and public transport accessibility. Using these measures, a Two Step Cluster Analysis was conducted to identify natural groupings of the CCDs with similar profiles, resulting in four unique TOD clusters: (a) residential TODs, (b) activity centre TODs, (c) potential TODs, and; (d) TOD non-suitability. The typologies are validated by estimating a multinomial logistic regression model in order to understand the mode choice behaviour of 10,013 individuals living in these areas. Results indicate that in comparison to people living in areas classified as residential TODs, people who reside in non-TOD clusters were significantly less likely to use public transport (PT) (1.4 times), and active transport (4 times) compared to the car. People living in areas classified as potential TODs were 1.3 times less likely to use PT, and 2.5 times less likely to use active transport compared to using the car. Only a little difference in mode choice behaviour was evident between people living in areas classified as residential TODs and activity centre TODs. The results suggest that: (a) two types of TODs may be suitable for classification and effect mode choice in Brisbane; (b) TOD typology should be developed based on their TOD profile and performance matrices; (c) both bus stop and train station based TODs are suitable for development in Brisbane.

Advance care planning in stroke: Influence of time on engagement in the process

Purpose Individuals who experience stroke have a higher likelihood of subsequent stroke events, making it imperative to plan for future medical care. In the event of a further serious health event, engaging in the process of advanced care planning (ACP) can help family members and health care professionals (HCPs) make medical decisions for individuals who have lost the capacity to do so. Few studies have explored the views and experiences of patients with stroke about discussing their wishes and preferences for future medical events, and the extent to which stroke HCPs engage in conversations around planning for such events. In this study, we sought to understand how the process of ACP unfolded between HCPs and patients post-stroke. Patients and methods Using grounded theory (GT) methodology, we engaged in direct observation of HCP and patient interactions on an acute stroke unit and two stroke rehabilitation units. Using semi-structured interviews, 14 patients and four HCPs were interviewed directly about the ACP process. Results We found that open and continual ACP conversations were not taking place, patients experienced an apparent lack of urgency to engage in ACP, and HCPs were uncomfortable initiating ACP conversations due to the sensitive nature of the topic. Conclusion In this study, we identified lack of engagement in ACP post-stroke, attributable to patient and HCP factors. This encourages us to look further into the process of ACP in order to develop open communication between the patient with stroke, their families, and stroke HCPs.

A novel treatment planning methodology for high dose 166Ho-DOTMP therapy in patients with multiple myeloma

Bone marrow ablation, i.e., the complete sterilization of the active bone marrow, followed by bone marrow transplantation (BMT) is a comment treatment of hematological malignancies. The use of targeted bone-seeking radiopharmaceuticals to selectively deliver radiation to the adjacent bone marrow cavities while sparing normal tissues is a promising technique. Current radiopharmaceutical treatment planning methods do not properly compensate for the patient-specific variable distribution of radioactive material within the skeleton. To improve the current method of internal dosimetry, novel methods for measuring the radiopharmaceutical distribution within the skeleton were developed. 99mTc-MDP was proven as an adequate surrogate for measuring 166Ho-DOTMP skeletal uptake and biodistribution, allowing these measures to be obtained faster, safer, and with higher spatial resolution. This translates directly into better measurements of the radiation dose distribution within the bone marrow. The resulting bone marrow dose-volume histograms allow prediction of the patient disease response where conventional organ scale dosimetry failed. They indicate that complete remission is only achieved when greater than 90% of the bone marrow receives at least 30 Gy. ^ Comprehensive treatment planning requires combining target and non-target organ dosimetry. Organs in the urinary tract were of special concern. The kidney dose is primarily dependent upon the mean transit time of 166 Ho-DOTMP through the kidney. Deconvolution analysis of renograms predicted a mean transit time of 2.6 minutes for 166Ho-DOTMP. The radiation dose to the urinary bladder wall is dependent upon numerous factors including patient hydration and void schedule. For beta-emitting isotopes such as 166Ho, reduction of the bladder wall dose is best accomplished through good patient hydration and ensuring a partially full bladder at the time of injection. Encouraging the patient to void frequently, or catheterizing the patient without irrigation, will not significantly reduce the bladder wall dose. ^ The results from this work will produce the most advanced treatment planning methodology for bone marrow ablation therapy using radioisotopes currently available. Treatments can be tailored specifically for each patient, including the addition of concomitant total body irradiation for patients with unfavorable dose distributions, to deliver a desired patient disease response, while minimizing the dose or toxicity to non-target organs. ^

Advance care planning in nephrology care

On completion of this continuing professional development (CPD) activity, participants will be able to:
• describe advanced care planning and its relationship to person-centred care
• identify who is responsible for initiating advance care planning discussions in their nephrology department
• identify the benefits of advanced care planning• recall conversation triggers for raising the topic of advanced care planning.

A review of the guidelines for ABC stock control

The paper summarises the methods promulgated in the literature for the design and maintenance of an effective inventory control system. Surprisingly, when it comes to putting theory into practice, the directives are often contradictory or opaque and their logic is inconsistent. Several published cases are dissected to try and rectify this parlous situation. In fact, the exercise soon reveals the heart of the problem. The classic EOQ model ignores the part played at the supplier’s end by efficient and responsive warehouse and transport operations. These activities depend greatly upon good advanced resource planning, which in turn is able to benefit from regular, cyclic, stock replenishment procedures.

The role of the medical emergency team in end-of-life care : a multicenter, prospective, observational study

Objective: To investigate the role of medical emergency teams in end-of-life care planning.

Design: One month prospective audit of medical emergency team calls.

Setting: Seven university-affiliated hospitals in Australia, Canada, and Sweden.

Patients: Five hundred eighteen patients who received a medical emergency team call over 1 month.

Interventions: None.

Measurements and Main Results: There were 652 medical emergency team calls in 518 patients, with multiple calls in 99 (19.1%) patients. There were 161 (31.1%) patients with limitations of medical therapy during the study period. The limitation of medical therapy was instituted in 105 (20.3%) and 56 (10.8%) patients before and after the medical emergency team call, respectively. In 78 patients who died with a limitation of medical therapy in place, the last medical emergency team review was on the day of death in 29.5% of patients, and within 2 days in another 28.2%. Compared with patients who did not have a limitation of medical therapy, those with a limitation of medical therapy were older (80 vs. 66 yrs; p < .001), less likely to be male (44.1% vs. 55.7%; p .014), more likely to be medical admissions (70.8% vs. 51.3%; p < .001), and less likely to be admitted from home (74.5% vs. 92.2%, p < .001). In addition, those with a limitation of medical therapy were less likely to be discharged home (22.4% vs. 63.6%; p < .001) and more likely to die in hospital (48.4% vs. 12.3%; p < .001). There was a trend for increased likelihood of calls associated with limitations of medical therapy to occur out of hours (51.0% vs. 43.8%, p .089).

Conclusions: Issues around end-of-life care and limitations of medical therapy arose in approximately one-third of calls, suggesting a mismatch between patient needs for end-of-life care and resources at participating hospitals. These calls frequently occur in elderly medical patients and out of hours. Many such patients do not return home, and half die in hospital. There is a need for improved advanced care planning in our hospitals, and to confirm our findings in other organizations.

Terrestrial Radar Interferometric Measurement of Hillslope Deformation and Atmospheric Disturbances in the Illgraben Debris-Flow Catchment, Switzerland

We describe a method for rapid identification and precise quantification of slope deformation using a portable radar interferometer. A rockslide with creep-like behavior was identified in the rugged and inaccessible headwaters of the Illgraben debris-flow catchment, located in the Central Swiss Alps. The estimated volume of the moving rock mass was approximately 0.5 x 10(6) m(3) with a maximum daily (3-D) displacement rate of 3 mm. Fast scene acquisition in the order of 6 s/scene led to uniquely precise mapping of spatial and temporal variability of atmospheric phase delay. Observations led to a simple qualitative model for prediction of atmospheric disturbances using a simple model for solar radiation, which can be used for advanced campaign planning for short observation periods (hours to days).

Iowa Physician Orders for Scope of Treatment (IPOST) Work Plan, April 21, 2014

To promote community care coordination and advanced care planning. Seamless communication and execution of individual patient care choices across the healthcare continuum.

Improved VMAT planning for head and neck tumors with an advanced optimization algorithm

OBJECTIVE In this study, the "Progressive Resolution Optimizer PRO3" (Varian Medical Systems) is compared to the previous version "PRO2" with respect to its potential to improve dose sparing to the organs at risk (OAR) and dose coverage of the PTV for head and neck cancer patients. MATERIALS AND METHODS For eight head and neck cancer patients, volumetric modulated arc therapy (VMAT) treatment plans were generated in this study. All cases have 2-3 phases and the total prescribed dose (PD) was 60-72Gy in the PTV. The study is mainly focused on the phase 1 plans, which all have an identical PD of 54Gy, and complex PTV structures with an overlap to the parotids. Optimization was performed based on planning objectives for the PTV according to ICRU83, and with minimal dose to spinal cord, and parotids outside PTV. In order to assess the quality of the optimization algorithms, an identical set of constraints was used for both, PRO2 and PRO3. The resulting treatment plans were investigated with respect to dose distribution based on the analysis of the dose volume histograms. RESULTS For the phase 1 plans (PD=54Gy) the near maximum dose D2% of the spinal cord, could be minimized to 22±5 Gy with PRO3, as compared to 32±12Gy with PRO2, averaged for all patients. The mean dose to the parotids was also lower in PRO3 plans compared to PRO2, but the differences were less pronounced. A PTV coverage of V95%=97±1% could be reached with PRO3, as compared to 86±5% with PRO2. In clinical routine, these PRO2 plans would require modifications to obtain better PTV coverage at the cost of higher OAR doses. CONCLUSION A comparison between PRO3 and PRO2 optimization algorithms was performed for eight head and neck cancer patients. In general, the quality of VMAT plans for head and neck patients are improved with PRO3 as compared to PRO2. The dose to OARs can be reduced significantly, especially for the spinal cord. These reductions are achieved with better PTV coverage as compared to PRO2. The improved spinal cord sparing offers new opportunities for all types of paraspinal tumors and for re-irradiation of recurrent tumors or second malignancies.

Advanced system of planning and organization of classes at the university

This document is the result of a process of web development to create a tool that will allow to Cracow University of Technology consult, create and manage timetables. The technologies chosen for this purpose are Apache Tomcat Server, My SQL Community Server, JDBC driver, Java Servlets and JSPs for the server side. The client part counts on Javascript, jQuery, AJAX and CSS technologies to perform the dynamism. The document will justify the choice of these technologies and will explain some development tools that help in the integration and development of all this elements: specifically, NetBeans IDE and MySQL workbench have been used as helpful tools. After explaining all the elements involved in the development of the web application, the architecture and the code developed are explained through UML diagrams. Some implementation details related to security are also deeper explained through sequence diagrams. As the source code of the application is provided, an installation manual has been developed to run the project. In addition, as the platform is intended to be a beta that will be grown, some unimplemented ideas for future development are also exposed. Finally, some annexes with important files and scripts related to the initiation of the platform are attached. This project started through an existing tool that needed to be expanded. The main purpose of the project along its development has focused on setting the roots for a whole new platform that will replace the existing one. For this goal, it has been needed to make a deep inspection on the existing web technologies: a web server and a SQL database had to be chosen. Although the alternatives were a lot, Java technology for the server was finally selected because of the big community backwards, the easiness of modelling the language through UML diagrams and the fact of being free license software. Apache Tomcat is the open source server that can use Java Servlet and JSP technology. Related to the SQL database, MySQL Community Server is the most popular open-source SQL Server, with a big community after and quite a lot of tools to manage the server. JDBC is the driver needed to put in contact Java and MySQL. Once we chose the technologies that would be part of the platform, the development process started. After a detailed explanation of the development environment installation, we used UML use case diagrams to set the main tasks of the platform; UML class diagrams served to establish the existing relations between the classes generated; the architecture of the platform was represented through UML deployment diagrams; and Enhanced entity–relationship (EER) model were used to define the tables of the database and their relationships. Apart from the previous diagrams, some implementation issues were explained to make a better understanding of the developed code - UML sequence diagrams helped to explain this. Once the whole platform was properly defined and developed, the performance of the application has been shown: it has been proved that with the current state of the code, the platform covers the use cases that were set as the main target. Nevertheless, some requisites needed for the proper working of the platform have been specified. As the project is aimed to be grown, some ideas that could not be added to this beta have been explained in order not to be missed for future development. Finally, some annexes containing important configuration issues for the platform have been added after proper explanation, as well as an installation guide that will let a new developer get the project ready. In addition to this document some other files related to the project are provided: - Javadoc. The Javadoc containing the information of every Java class created is necessary for a better understanding of the source code. - database_model.mwb. This file contains the model of the database for MySQL Workbench. This model allows, among other things, generate the MySQL script for the creation of the tables. - ScheduleManager.war. The WAR file that will allow loading the developed application into Tomcat Server without using NetBeans. - ScheduleManager.zip. The source code exported from NetBeans project containing all Java packages, JSPs, Javascript files and CSS files that are part of the platform. - config.properties. The configuration file to properly get the names and credentials to use the database, also explained in Annex II. Example of config.properties file. - db_init_script.sql. The SQL query to initiate the database explained in Annex III. SQL statements for MySQL initialization. RESUMEN. Este proyecto tiene como punto de partida la necesidad de evolución de una herramienta web existente. El propósito principal del proyecto durante su desarrollo se ha centrado en establecer las bases de una completamente nueva plataforma que reemplazará a la existente. Para lograr esto, ha sido necesario realizar una profunda inspección en las tecnologías web existentes: un servidor web y una base de datos SQL debían ser elegidos. Aunque existen muchas alternativas, la tecnología Java ha resultado ser elegida debido a la gran comunidad de desarrolladores que tiene detrás, además de la facilidad que proporciona este lenguaje a la hora de modelarlo usando diagramas UML. Tampoco hay que olvidar que es una tecnología de uso libre de licencia. Apache Tomcat es el servidor de código libre que permite emplear Java Servlets y JSPs para hacer uso de la tecnología de Java. Respecto a la base de datos SQL, el servidor más popular de código libre es MySQL, y cuenta también con una gran comunidad detrás y buenas herramientas de modelado, creación y gestión de la bases de datos. JDBC es el driver que va a permitir comunicar las aplicaciones Java con MySQL. Tras elegir las tecnologías que formarían parte de esta nueva plataforma, el proceso de desarrollo tiene comienzo. Tras una extensa explicación de la instalación del entorno de desarrollo, se han usado diagramas de caso de UML para establecer cuáles son los objetivos principales de la plataforma; los diagramas de clases nos permiten realizar una organización del código java desarrollado de modo que sean fácilmente entendibles las relaciones entre las diferentes clases. La arquitectura de la plataforma queda definida a través de diagramas de despliegue. Por último, diagramas EER van a definir las relaciones entre las tablas creadas en la base de datos. Aparte de estos diagramas, algunos detalles de implementación se van a justificar para tener una mejor comprensión del código desarrollado. Diagramas de secuencia ayudarán en estas explicaciones. Una vez que toda la plataforma haya quedad debidamente definida y desarrollada, se va a realizar una demostración de la misma: se demostrará cómo los objetivos generales han sido alcanzados con el desarrollo actual del proyecto. No obstante, algunos requisitos han sido aclarados para que la plataforma trabaje adecuadamente. Como la intención del proyecto es crecer (no es una versión final), algunas ideas que se han podido llevar acabo han quedado descritas de manera que no se pierdan. Por último, algunos anexos que contienen información importante acerca de la plataforma se han añadido tras la correspondiente explicación de su utilidad, así como una guía de instalación que va a permitir a un nuevo desarrollador tener el proyecto preparado. Junto a este documento, ficheros conteniendo el proyecto desarrollado quedan adjuntos. Estos ficheros son: - Documentación Javadoc. Contiene la información de las clases Java que han sido creadas. - database_model.mwb. Este fichero contiene el modelo de la base de datos para MySQL Workbench. Esto permite, entre otras cosas, generar el script de iniciación de la base de datos para la creación de las tablas. - ScheduleManager.war. El fichero WAR que permite desplegar la plataforma en un servidor Apache Tomcat. - ScheduleManager.zip. El código fuente exportado directamente del proyecto de Netbeans. Contiene todos los paquetes de Java generados, ficheros JSPs, Javascript y CSS que forman parte de la plataforma. - config.properties. Ejemplo del fichero de configuración que permite obtener los nombres de la base de datos - db_init_script.sql. Las consultas SQL necesarias para la creación de la base de datos.

Aplicação da metodologia Advanced Product Quality Planning no desenvolvimento de um novo produto no setor automóvel

Este projeto surgiu com a necessidade da constituição de uma equipa multidisciplinar, incluindo uma pessoa responsável pela qualidade no desenvolvimento de um novo produto da fábrica. O produto é a estrutura metálica de um encosto de trás de um automóvel. Para o desenvolvimento do produto foi usado o método Advanced Product Quality Planning, vastamente utilizado no setor automóvel. Com o intuito de melhor perceber os problemas que podem surgir no novo produto foi estudado um produto fabricado no local de estágio e outro produzido numa outra fábrica do mesmo grupo, que têm algumas semelhanças a nível de processo e de design, respetivamente. Foram utilizadas algumas ferramentas da qualidade para explorar os problemas existentes na fábrica a nível do produto já existente e comprovado se algumas ações de melhoria propostas foram, ou não, bem-sucedidas. Com os outputs retirados da análise dos defeitos internos e externos foi elaborado o Plano de Controlo, que inclui a listagem de controlos necessários para se conseguir prever a qualidade do novo produto.