Development of an international Core Outcome Set (COS) for best care for the dying person: study protocol

Background: In contrast to typical measures employed to assess outcomes in healthcare such as mortality or recovery rates, it is difficult to define which specific outcomes of care are the most important in caring for dying individuals. Despite a variety of tools employed to assess different dimensions of palliative care, there is no consensus on a set of core outcomes to be measured in the last days of life. In order to optimise decision making in clinical practice and comparability of interventional studies, we aim to identify and propose a set of core outcomes for the care of the dying person. Methods: Following the COMET initiative approach, the proposed study will proceed through four stages to develop a set of core outcomes: In stage 1, a systematic review of the literature will identify outcomes measured in existing peer reviewed literature, as well as outcomes derived through qualitative studies. Grey literature, will also be included. Stage 2 will allow for the identification and determination of patient and proxy defined outcomes of care at the end of life via quantitative and qualitative methods at an international level. In stage 3, from a list of salient outcomes identified through stages 1 and 2, international experts, family members, patients, and patient advocates will be asked to score the importance of the preselected outcomes through a Delphi process. Stage 4 consists of a face-to-face consensus meeting of in

Generalization Of Dense Digital Terrain Models While Enhancing Important Objects

Laser altimetry is a leading technology for the extraction of information of physical surfaces, and hence it is the main source for generating a dense digital surface of the terrain. This results in data sets with a very high density and accuracy. This high quality data sets bring about a massive amount of data, which is hardly manageable or accessible. Particularly the efficient graphic representation of this data in real time appears to be difficult. To reduce the three dimensional information and make it manageable, methods of generalization and simplification are needed. During the process of generalization, important objects within the DTM have to be emphasized, to guarantee their perceptibility. The objects to be emphasized differ according to the intention of the generalization. In the context of a 3D-city modelling, especially buildings and their structures have to be generalized. Whereas for the purpose of terrain surface visualization, special attention has to be given to the enhancement and generalization of topographic objects like dams or streets. For the time being, the main focus of this work is laid on the enhancement and generalization of street objects. The streets in the DTM are enhanced by widening them to either side of the middle axis. Changing the height values within the broadened street brings about discontinuities in the adjacent regions. For this reason, also the height values in this regions have to be adapted, however the extent of the area to be modified has to be defined. In addition, a weighting function for the adaptation has to be chosen. Another option is the displacement and thus a compression of that parts of the surface, which lie between the broadened streets. The different options for the adjustment of the terrain model after t..