Background and purpose: Automatic approaches are widely implemented to automate dose optimization in radiotherapy treatment planning. This study systematically investigates how to configure automatic planning in order to create the best possible plans. Materials and methods: Automatic plans were generated using protocol based automatic iterative optimization. Starting from a simple automation protocol which consisted of the constraints for targets and organs at risk (OAR), the performance of the automatic approach was evaluated in terms of target coverage, OAR sparing, conformity, beam complexity, and plan quality. More complex protocols were systematically explored to improve the quality of the automatic plans. The protocols could be improved by adding a dose goal on the outer 2 mm of the PTV, by setting goals on strategically chosen subparts of OARs, by adding goals for conformity, and by limiting the leaf motion. For prostate plans, development of an automated post-optimization procedure was required to achieve precise control over the dose distribution. Automatic and manually optimized plans were compared for 20 head and neck (H&N), 20 prostate, and 20 rectum cancer patients. Results: Based on simple automation protocols, the automatic optimizer was not always able to generate adequate treatment plans. For the improved final configurations for the three sites, the dose was lower in automatic plans compared to the manual plans in 12 out of 13 considered OARs. In blind tests, the automatic plans were preferred in 80% of cases. Conclusions: With adequate, advanced, protocols the automatic planning approach is able to create high-quality treatment plans.
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The inherent complexity of planning at sea, called maritime spatial planning (MSP), requires a planning approach where science (data and evidence) and stakeholders (their engagement and involvement) are integrated throughout the planning process. An increasing number of innovative planning support systems (PSS) in terrestrial planning incorporate scientific models and data into multi-player digital game platforms with an element of role-play. However, maritime PSS are still early in their innovation curve, and the use and usefulness of existing tools still needs to be demonstrated. Therefore, the authors investigate the serious game, MSP Challenge 2050, for its potential use as an innovative maritime PSS and present the results of three case studies on participant learning in sessions of game events held in Newfoundland, Venice, and Copenhagen. This paper focusses on the added values of MSP Challenge 2050, specifically at the individual, group, and outcome levels, through the promotion of the knowledge co-creation cycle. During the three game events, data was collected through participant surveys. Additionally, participants of the Newfoundland event were audiovisually recorded to perform an interaction analysis. Results from survey answers and the interaction analysis provide evidence that MSP Challenge 2050 succeeds at the promotion of group and individual learning by translating complex information to players and creating a forum wherein participants can share their thoughts and perspectives all the while (co-) creating new types of knowledge. Overall, MSP Challenge and serious games in general represent promising tools that can be used to facilitate the MSP process.
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This paper examines how a serious game approach could support a participatory planning process by bringing stakeholders together to discuss interventions that assist the development of sustainable urban tourism. A serious policy game was designed and played in six European cities by a total of 73 participants, reflecting a diverse array of tourism stakeholders. By observing in-game experiences, a pre- and post -game survey and short interviews six months after playing the game, the process and impact of the game was investigated. While it proved difficult to evaluate the value of a serious game approach, results demonstrate that enacting real-life policymaking in a serious game setting can enable stakeholders to come together, and become more aware of the issues and complexities involved with urban tourism planning. This suggests a serious game can be used to stimulate the uptake of academic insights in a playful manner. However, it should be remembered that a game is a tool and does not, in itself, lead to inclusive participatory policymaking and more sustainable urban tourism planning. Consequently, care needs to be taken to ensure inclusiveness and prevent marginalization or disempowerment both within game-design and the political formation of a wider participatory planning approach.
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In this study, Dutch and Australian planning regimes are examined to determine whether they are ready to face climate extremes. Five different “cultural” facets of spatial planning determine the differences between the two regimes. These planning characteristics are first confronted with current climate change. The Dutch planning regime performs better under these conditions than the Australian. Secondly, a suite of spatial scenarios is confronted with both current change and a changed risk landscape, in which climate extremes are introduced. Again, the performance of planning characteristics to deal with these new vulnerabilities is tested. For type-1 impacts, exaggerating current change, a limited number of Dutch planning characteristics still hold, where the majority of Australian planning properties is likely to lose functionality. Under type-2 impacts, surprising climate events, the Dutch approach is no longer sufficient, while some Australian characteristics suddenly imply opportunities. The sectored planning approach, together with culturally determined individual responses, might prove to offer solace, under the condition that dealing with extreme events is made priority. Overall, current regimes face difficulties in dealing with surprising climate events and a fundamentally different planning approach is required. Swarm Planning, which dynamically deals with uncertainty, is proposed as a beneficial new planning method.
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Deze handreiking ‘Triage, Advance Care Planning en symptomatische behandeling bij een ernstig verloop van corona binnen de GGZ-instelling of thuis’ hoort bij de Richtlijn GGZ en corona. Bji het maken van de afweging om een patiënt wel/niet in het ziekenhuis te laten opnemen, dan wel of de patiënt wel/niet naar IC kan gaan gelden deze overwegingen: zie bestand.
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Vlaanderen voert sinds meer dan vier decennia een autonoom sportbeleid. Dit heeft een impact op hoe het Vlaamse sportlandschap gestructureerd is. In het voorliggende werk staan de organisatie en de planning van de sport en het sportbeleid in Vlaanderen centraal. De krijtlijnen van het speelveld bestaat uit twee delen. In het eerste deel wordt een beeld gegeven van de beleidsruimte. Hier worden eerst ontwikkelingen geschetst inzake sportparticipatie, sportaanbod, sporttewerkstelling, alsook de economische betekenis van sport in Vlaanderen. Vervolgens wordt ingegaan op de organisatie van de sport, met name de omgeving van de sport en de sportsector zelf. Heel wat (sport)actoren en hun onderlinge relaties passeren daarbij de revue. Het tweede deel focust op de beleidsontwikkeling. We beschrijven de evolutie van het sportbeleid in Vlaanderen, het beleidsproces alsook het instrumentarium dat gehanteerd wordt om tot besluitvorming, en beleidsvoering in het algemeen, te komen. Dit boek richt zich tot studenten die inzicht wensen te verwerven in hoe sport(beleid) in Vlaanderen georganiseerd is. Ook beleidsmakers, sportmanagers en andere professionals die interesse hebben voor sport bieden we met dit werk een handig overzicht en interessant naslagwerk. Er wordt in dit boek dan ook de nodige zorg besteed aan figuren waarin concepten en modellen schematisch worden weergegeven.
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Vlaanderen voert sinds meer dan vier decennia een autonoom sportbeleid. Dit heeft een impact op hoe het Vlaamse sportlandschap gestructureerd is. In het voorliggende werk staan de organisatie en de planning van de sport en het sportbeleid in Vlaanderen centraal. De krijtlijnen van het speelveld bestaat uit twee delen. In het eerste deel wordt een beeld gegeven van de beleidsruimte. Hier worden eerst ontwikkelingen geschetst inzake sportparticipatie, sportaanbod, sporttewerkstelling, alsook de economische betekenis van sport in Vlaanderen. Vervolgens wordt ingegaan op de organisatie van de sport, met name de omgeving van de sport en de sportsector zelf. Heel wat (sport)actoren en hun onderlinge relaties passeren daarbij de revue. Het tweede deel focust op de beleidsontwikkeling. We beschrijven de evolutie van het sportbeleid in Vlaanderen, het beleidsproces alsook het instrumentarium dat gehanteerd wordt om tot besluitvorming, en beleidsvoering in het algemeen, te komen. Dit boek richt zich tot studenten die inzicht wensen te verwerven in hoe sport(beleid) in Vlaanderen georganiseerd is. Ook beleidsmakers, sportmanagers en andere professionals die interesse hebben voor sport bieden we met dit werk een handig overzicht en interessant naslagwerk. Er wordt in dit boek dan ook de nodige zorg besteed aan figuren waarin concepten en modellen schematisch worden weergegeven.
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Participatory energy planning at the local level engages citizens, builds legitimacy and trust, and increases successful implementation of renewable energies. In the context of heat planning, technology choices highly vary depending on the local context and social conditions and including social input therefore benefits the planning process. This research adds to the current literature, which lacks concrete examples and verified approaches that clarify what the guiding principles of participatory energy planning are and how the opportunities and challenges can be dealt with. This paper elaborates on these opportunities and challenges and proposes a process design, using multiple tools (a survey, an Information-choice Questionnaire, and workshops) to collect the social input that is necessary to make technology choices in a participatory manner. The process design is applied and tested in a case study of a Dutch neighbourhood and lessons learned are drafted as a basis for further research.
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In urban planning, 3D modeling and virtual reality (VR) provide new means for involving citizens in the planning process. For municipal government, it is essential to know how effective these means are, to justify investments. In this study, we present a case of using VR in a municipal process of civic participation concerning the redesign of a public park. The process included codesign activities and involved citizens in decision-making through a ballot, using 3D-rendered versions of competing designs. In codesign, 3D-modeling tools were instrumental in empowering citizens to negotiate design decisions, to discuss the quality of designs with experts, and to collectively take decisions. This paper demonstrates that, in a ballot on competing designs with 1302 citizens, VR headsets proved to be equally effective compared to other display technologies in informing citizens during decision making. The results of an additional, controlled experiment indicate that VR headsets provide higher engagement and more vivid memories than viewing the designs on non-immersive displays. By integrating research into a municipal process, we contribute evidence of cognitive and engagement effects of using 3D modeling and immersive VR technologies to empower citizens in participatory urban planning. The case described in the paper concerns a public park; a similar approach could be applied to the design of public installations including media architecture.
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Terwijl we inmiddels bij elektriciteit en gas met centrale planning werken, wil de minister de benodigde investeringen in de waterstofinfra juist aan de markt overlaten. Martien Visser waarschuwt voor onbalans in het energiesysteem.
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