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3Background 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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There is a lot of attention for the reduction of city logistics’ emissions. But also if city logistics’ vehicles are zero emission, the vehicles remain present in urban areas. Zero emission vehicles also occupy valuable urban space during unloading on the road and on sidewalks. Despite the spatial impact of city logistics, it is rarely considered in spatial planning. Based on four case studies, we explore possibilities to actively integrate city logistics in spatial planning policies and practices in order to reduce nuisance, but also to enhance efficiency of deliveries. In the end, spatial planning determines the physical urban conditions in which city logistics operations are taking place for many years. From the results we distil a research agenda to bridge the gap between city logistics as a traffic issue and its integration in spatial planning policies.
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De laatste maand van het jaar nodigt uit tot introspectie en reflectie. Het wordt tijd voor goede voornemens voor het volgende jaar. Daarmee lijkt het wel wat op een persoonlijke planning & control cyclus.
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Strategic foresight research often overlooks SMEs, leaving them vulnerable in a changing landscape. While scenario planning is valuable for SMEs, literature notes barriers. Three case studies examined these barriers, revealing challenges. Despite challenges, our workshop on structured scenario planning met enthusiasm, addressing outside-in thinking. The SMEs employed scenarios not just for adaptation but also as a narrative foundation for broader strategy development. Four preconditions for effective SME scenario planning were identified: (1) Diverse group composition to stimulate divergent views, (2) reflection on the business-as-usual narrative, (3) structured approach with steps over time, and (4) leadership to support implementation and follow-up actions.
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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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Of het nu gaat om de energietransitie, klimaatadaptatie of verdere verdichting in steden: in de ondergrond wordt naar oplossingen gezocht en vaak ook gevonden. Dat is mooi, maar zorg is op zijn plek. Op strategisch ruimtelijk planniveau spelen de potenties en beperkingen vanuit de ondergrond nog nauwelijks een rol in overwegingen. Daardoor kunnen beperkingen in de ondergrond op den duur het realiseren van maatschappelijke doelen belemmeren en worden potenties niet benut. Het pragmatisme op uitvoeringsniveau, waarmee alle wensen nu nog zo goed mogelijk bij elkaar gebracht worden, loopt voor de grote transitieopgaven tegen zijn grenzen aan.
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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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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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Cities all over the world are rethinking their mobility policies in light of environmental and quality of life objectives. As space is one of cities’ scarcest resources, mobility’s spatial footprint is increasingly scrutinized as externality to mitigate. Similar to passenger transport, goods transport is envisioned to shift towards efficient and zero emission mobilities. To achieve an urban logistics system that eliminates inefficiencies and fossil fuels, the logistics sector requires space to unload, cross-dock, consolidate and stock goods closer to their destinations. Such a ‘proximity logistics’ is however at odds with ‘logistics sprawl’, the historic outward migration pattern of logistics facilities. With policies and planning, cities can support the (re)integration of logistics facilities in urban areas to facilitate and enable the shift to an efficient urban logistics system. Logistics still being a largely neglected policy subject in many cities, knowledge on how to approach this (re)integration is hardly available. Therefore, we compare two pioneering cities: Rotterdam and Paris. Both cities have an established track record in advancing urban logistics policies and are spearheading the practice of planning for logistics. Based on interviews and policy analyses, we develop best practices on how to address the integration of urban logistics facilities for cities.
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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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