1. How do people want to live? : Residential preferences and values in Gdynia, Poland

The importance of inhabitants attitude to the area they live in is drastically illustrated when detested settlements sooner or later are degraded, abandoned and destroyed. On the contrary, liked areas are often well maintained and have a low recirculation rate. In this paper a questionnaire study of values individuals express in their choice of settlements are reported, asking the inhabitants in Suchy Dwór, near Gdynia in Poland.Sustainable Urban Patterns around the Baltic Se

3. Building a sustainable neighbourhood : Kronsberg

Eleven recently built neighbourhoods applying principles of sustainability in all its aspects – environmental, economic and social – are described with a more detailed description of Kronsberg outside Hannover, Germany. Kronsberg with 15,000 inhabitants and working places for 2,000, consists of 10% single-family homes and 90% multi-storey buildings. Considerable obligations were made in all phases of the project to secure a high quality of life and to use natural resources sparingly.Sustainable Urban Patterns around the Baltic Se

Decision Tree Analyses for Prediction of QoL over a One-Year Period in Breast Cancer Patients: An Added Value of Patient-Reported Outcomes

Despite the current shift in medicine towards patient-centered care, clinicians rarely utilize patient-reported outcomes (PROs) in everyday practice. We examined the predictors of quality- of-life (QoL) trajectories in breast cancer (BC) patients during the first year after primary treatment. A total of 185 BC patients referred for postoperative radiotherapy (RT) filled in the EORTC QLQ-C30 Questionnaire assessing global QoL, functioning and cancer-related symptoms before starting RT; directly after RT; and 3, 6 and 12 months after RT. We used decision tree analyses to examine which baseline factors best allowed for predicting the one-year trajectory of the global QoL after BC treatment. We tested two models: ‘basic’, including medical and sociodemographic characteristics, and ‘enriched’, additionally including PROs. We recognized three distinct trajectories of global QoL: ‘high’, ‘U-shape’ and ‘low’. Of the two compared models, the ‘enriched’ model allowed for a more accurate prediction of a given QoL trajectory, with all indicators of model validation being better. In this model, baseline global QoL and functioning measures were the key discriminators of QoL trajectory. Taking PROs into account increases the accuracy of the prediction model. Collecting this information in the clinical interview is recommended, especially for patients with lower QoL

Diversity in changes of HRQoL over a one-year period after radiotherapy in Norwegian breast cancer survivors – results of cluster analyses

Purpose The diversity in long-term changes in health-related quality of life (HRQoL) among breast cancer (BC) survivors is poorly understood. The aim of this study was to identify clusters of trajectories (subgroups of patients with similar patterns of changes) of selected HRQoL domains over a 1-year period after radiotherapy (RT) in BC patients. Methods The group consisted of 250 BC patients referred for postoperative RT. Global quality of life (QoL), functions, and cancer-specific symptoms were assessed using the European Organisation for Research and Treatment of Cancer (EORTC) core Quality of Life Questionnaire (QLQ-C30) before starting RT, at completion of RT and 3, 6, and 12 months after RT. A hierarchical cluster analysis was used to identify possible trajectories of HRQoL domains. Results Three distinct types of clusters of trajectories were identified for all outcome variables: Type 1 clusters encompassing the rather time-stable high-global QoL cluster, high-functioning clusters, and low-symptom clusters (44–98% of patients), Type 2 clusters with medium levels of HRQoL domains (8–49%), Type 3 clusters encompassing low-global QoL, low-functioning, and high-symptoms clusters (2–51%). Conclusions Our results demonstrated a noticeable heterogeneity of changes in HRQoL domains after BC treatment. The findings support the importance of an accurate patient-reported HRQoL assessment as a routine element of BC survivors’ care. The pre-RT assessment of HRQoL alone allows to predict the course of HRQoL changes over the 1-year period after RT and the risk of “falling into” low functioning clusters

Enhancing GPs’ competencies in communication and activation of the elderly: results from the PRACTA computer-based intervention study

Background: Demographic changes over the past decades call for the promotion of health and disease prevention for older patients, as well as strategies to enhance their independence, productivity, and quality of life. Objective: Our objective was to examine the effects of a computer-based educational intervention designed for general practitioners (GPs) to promote active aging. Methods: The Promoting Active Aging (PRACTA) study consisted of a baseline questionnaire, implementation of an intervention, and a follow-up questionnaire that was administered 1 month after the intervention. A total of 151 primary care facilities (response rate 151/767, 19.7%) and 503 GPs (response rate 503/996, 50.5%) agreed to participate in the baseline assessment. At the follow-up, 393 GPs filled in the questionnaires (response rate, 393/503, 78.1%), but not all of them took part in the intervention. The final study group of 225 GPs participated in 3 study conditions: e-learning (knowledge plus skills modelling, n=42), a pdf article (knowledge only, n=89), and control (no intervention, n=94). We measured the outcome as scores on the Patients Expectations Scale, Communication Scale, Attitude Toward Treatment and Health Scale, and Self-Efficacy Scale. Results: GPs participating in e-learning demonstrated a significant rise in their perception of older patients’ expectations for disease explanation (Wald χ2=19.7, P<.001) and in perception of motivational aspect of older patients’ attitude toward treatment and health (Wald χ2=8.9, P=.03) in comparison with both the control and pdf article groups. We observed additional between-group differences at the level of statistical trend. GPs participating in the pdf article intervention demonstrated a decline in self-assessed communication, both at the level of global scoring (Wald χ2=34.5, P<.001) and at the level of 20 of 26 specific behaviors (all P<.05). Factors moderating the effects of the intervention were the number of patients per GP and the facility’s organizational structure. Conclusions: Both methods were suitable, but in different areas and under different conditions. The key benefit of the pdf article intervention was raising doctors’ reflection on limitations in their communication skills, whereas e-learning was more effective in changing their perception of older patients’ proactive attitude, especially among GPs working in privately owned facilities and having a greater number of assigned patients. Although we did not achieve all expected effects of the PRACTA intervention, both its forms seem promising in terms of enhancing the competencies of doctors in communication with and activation of older patients

Schematic structure of the REP modules analyzed in this study.

<p>The color-coded keys show the species and strain of origin of each plasmid (circles) and identified direct repeats (DRs), inverted repeats (IRs) as well as predicted DnaA and IHF binding sites (mixed shapes). The sequences of the iteron-like DRs are presented next to the relevant diagrams with a consensus sequence shown for DRs of plasmids with related REP modules. Blue arrows indicate the <i>rep</i> genes and their transcriptional orientation. Specific motifs identified within the aa sequences of the Rep proteins are indicated by colored rounded bars. A+T and G+C indicate DNA regions of lower or higher than average G+C content, respectively. The components of the REP modules are not shown to scale.</p