Contractors & Builders Association v. City of Dunedin, 329 So. 2d 314 (Fla. 1976)

Local Government - CONCEPT OF IMPACT FEES UPHELD BUT RESTRICTIONS IMPOSED ON SCOPE OF THE FEE AND USE OF FUNDS

Naturunderstödda arbetsmiljöer : samverkan, kreativitet & återhämtning

This study investigates what collaborative, creative and restorative areas look like in a work environment and if workplace greenery and/or access to nature like environments have an impact on these areas. Semi-structured interviews were carried out with representatives from three different companies to understand the strategic incentives for their workplace design and development and a more in-depth work place study of one company interviewing four employees about their preferences and habits for collaborative, creative and restorative places in the office environment. The results from the interviews were analysed, using a summary of multiple studies of the perceived sensory dimensions framework, to understand how the framework formulated for an outdoor nature environment, could be used in an indoor workplace environment. Collaboration and collective creativity require open, inviting and flexible spaces, these are also the areas getting most attention at the workplaces studied. Individual creativity and restoration demand quiet and calm places away from distractions and seem to be somewhat neglected in the workplace development efforts. The spaces identified by the interviewees were made attractive by their proximity to greenery, window views and daylight. Although more research is required, establishing a framework based on the perceived sensory dimensions could be a pathway for workplace development to not only include collaboration and creativity but also restoration.Denna studie undersöker hur samverkande, kreativa och återhämtande arbetsmiljöer kan se ut och om grönska på arbetsplatsen och/eller tillgång till naturlika omgivningar har en inverkan på dessa områden. Semi-strukturerade intervjuer genomfördes med representanter från tre olika företag för att förstå deras strategiska incitament för arbetsmiljöutveckling och design. Dessutom gjordes en mer djupgående arbetsplatsstudie av ett företag där fyra anställda intervjuades om deras preferenser och vanor vad gäller samverkande, kreativa och återhämtande platser i kontorsmiljön. Resultaten från intervjuerna analyserades med hjälp av en sammanfattning av ett flertal studier av de åtta parkkaraktärerna för att förstå hur detta ramverk, formulerat för en naturlig utomhusmiljö, skulle kunna användas i en inomhusmiljö. Samverkan och kollektiv kreativitet kräver öppna, inbjudande och flexibla utrymmen, det är också de platser som får mest fokus på de undersökta arbetsplatserna. Individuell kreativitet och återhämtning kräver tysta och lugna miljöer utan distraktioner, denna typer av platser verkar vara något eftersatta i utvecklingen av nya arbetsmiljöer. Platserna som de intervjuade identifierar verkar vara attraktiva på grund av sin närhet till grönska, utsikt och dagsljus. Även om mer forskning krävs, skulle upprättande av ett ramverk, med utgångspunkt i de åtta parkkaraktärerna kunna vara en väg för arbetsmiljöutveckling att omfatta inte bara samarbete och kreativitet utan även återhämtning

Adding 6 months of androgen deprivation therapy to postoperative radiotherapy for prostate cancer: a comparison of short-course versus no androgen deprivation therapy in the RADICALS-HD randomised controlled trial

Background Previous evidence indicates that adjuvant, short-course androgen deprivation therapy (ADT) improves metastasis-free survival when given with primary radiotherapy for intermediate-risk and high-risk localised prostate cancer. However, the value of ADT with postoperative radiotherapy after radical prostatectomy is unclear. Methods RADICALS-HD was an international randomised controlled trial to test the efficacy of ADT used in combination with postoperative radiotherapy for prostate cancer. Key eligibility criteria were indication for radiotherapy after radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to radiotherapy alone (no ADT) or radiotherapy with 6 months of ADT (short-course ADT), using monthly subcutaneous gonadotropin-releasing hormone analogue injections, daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as distant metastasis arising from prostate cancer or death from any cause. Standard survival analysis methods were used, accounting for randomisation stratification factors. The trial had 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 80% to 86% (hazard ratio [HR] 0·67). Analyses followed the intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov, NCT00541047. Findings Between Nov 22, 2007, and June 29, 2015, 1480 patients (median age 66 years [IQR 61–69]) were randomly assigned to receive no ADT (n=737) or short-course ADT (n=743) in addition to postoperative radiotherapy at 121 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 9·0 years (IQR 7·1–10·1), metastasis-free survival events were reported for 268 participants (142 in the no ADT group and 126 in the short-course ADT group; HR 0·886 [95% CI 0·688–1·140], p=0·35). 10-year metastasis-free survival was 79·2% (95% CI 75·4–82·5) in the no ADT group and 80·4% (76·6–83·6) in the short-course ADT group. Toxicity of grade 3 or higher was reported for 121 (17%) of 737 participants in the no ADT group and 100 (14%) of 743 in the short-course ADT group (p=0·15), with no treatment-related deaths. Interpretation Metastatic disease is uncommon following postoperative bed radiotherapy after radical prostatectomy. Adding 6 months of ADT to this radiotherapy did not improve metastasis-free survival compared with no ADT. These findings do not support the use of short-course ADT with postoperative radiotherapy in this patient population

Duration of androgen deprivation therapy with postoperative radiotherapy for prostate cancer: a comparison of long-course versus short-course androgen deprivation therapy in the RADICALS-HD randomised trial

Background Previous evidence supports androgen deprivation therapy (ADT) with primary radiotherapy as initial treatment for intermediate-risk and high-risk localised prostate cancer. However, the use and optimal duration of ADT with postoperative radiotherapy after radical prostatectomy remains uncertain. Methods RADICALS-HD was a randomised controlled trial of ADT duration within the RADICALS protocol. Here, we report on the comparison of short-course versus long-course ADT. Key eligibility criteria were indication for radiotherapy after previous radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to add 6 months of ADT (short-course ADT) or 24 months of ADT (long-course ADT) to radiotherapy, using subcutaneous gonadotrophin-releasing hormone analogue (monthly in the short-course ADT group and 3-monthly in the long-course ADT group), daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as metastasis arising from prostate cancer or death from any cause. The comparison had more than 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 75% to 81% (hazard ratio [HR] 0·72). Standard time-to-event analyses were used. Analyses followed intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov , NCT00541047 . Findings Between Jan 30, 2008, and July 7, 2015, 1523 patients (median age 65 years, IQR 60–69) were randomly assigned to receive short-course ADT (n=761) or long-course ADT (n=762) in addition to postoperative radiotherapy at 138 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 8·9 years (7·0–10·0), 313 metastasis-free survival events were reported overall (174 in the short-course ADT group and 139 in the long-course ADT group; HR 0·773 [95% CI 0·612–0·975]; p=0·029). 10-year metastasis-free survival was 71·9% (95% CI 67·6–75·7) in the short-course ADT group and 78·1% (74·2–81·5) in the long-course ADT group. Toxicity of grade 3 or higher was reported for 105 (14%) of 753 participants in the short-course ADT group and 142 (19%) of 757 participants in the long-course ADT group (p=0·025), with no treatment-related deaths. Interpretation Compared with adding 6 months of ADT, adding 24 months of ADT improved metastasis-free survival in people receiving postoperative radiotherapy. For individuals who can accept the additional duration of adverse effects, long-course ADT should be offered with postoperative radiotherapy. Funding Cancer Research UK, UK Research and Innovation (formerly Medical Research Council), and Canadian Cancer Society