Public Spaces of European Cities

Public spaces of the city have moved up to the top of the agendasof city authorities, private sector developers, and built environmentprofessionals. Once they were merely considered as spaces leftoverafter development, while now public spaces have climbed the ladderof significance to become a key focus in the transformation of cities.This paper aims to explore the reasons behind this rising significance,and to develop a platform for debate and research into public spacesof cities. It starts by a discussion of the theoretical frameworks that needto be taken into account in analysing the urban space, before addressingsome of the main themes and issues about the subject, including threatsto and challenges facing urban public spaces in Europe

Building localised interactions between universities and cities through university spatial development

Universities are important players in the global development of the knowledge economy, alongside being significant contributors to the economic development of their host cities. They are both significant knowledge enterprises, as well as the suppliers of the human and intellectual capital on which the knowledge-based economy depends. What seems under-explored is how deliberative partnerships between universities and city authorities can develop around projects of mutual benefit, especially based on campus development. In this paper, with the help of five case studies (QUT, MIT, Harvard, Twente and Newcastle universities), we investigate how the spatial development of universities can be one of the main meeting points between the city and university, and how it can be used for stimulating economic development and managing growth. These cases show that university-city collaborative initiatives focused on university properties represent a desire to produce creative and competitive new urban spaces which reinforce the position of the university and the city in global economy. They also show that these developments need to be jointly managed to avoid undesirable impacts on either side

Políticas para el espacio público en las ciudades europeas.

Las ciudades europeas están cambiando rápidamente en respuesta parcial a los procesos de integración europea, la migración internacional, la globalización económica y el cambio climático. Los espacios públicos de estas ciudades, como ingredientes esenciales de la imagen urbana y la experiencia, juegan un papel cada vez más importante en esta transición. Una cuestión clave se refiere al papel que los espacios públicos deben desempeñar en la transformación política, económica y cultural de las ciudades, y el impacto de estas transformaciones en la naturaleza del espacio público como un recurso compartido. ¿Cómo hacen las autoridades públicas para abordar al espacio público como un catalizador para el cambio y como un bien común? Vamos a esbozar los desafíos que enfrentan las ciudades europeas y la importancia del espacio público para hacer frente a estos desafíos. Sobre la base de estudios de casos de todo Europa (Amberes, Belfast, Berlín, Budapest, Dresde, Estambul, Londres, Milán, Nápoles, París, Viena, Varsovia, y seis ciudades de Suiza), diversos autores han analizado las formas en que los espacios públicos han sido abordados por los poderes públicos en su interacción con las sociedades urbanas. Exploramos la política del espacio público en tres partes: las estrategias, planes y políticas; múltiples funciones del espacio público, y la vida cotidiana en la ciudad. Vamos a describir los principales desafíos y examinar las respuestas de estas ciudades europeas, en busca de tendencias y patrones identificables

Identity and public realm

In a very general sense, Identities materialise space to create significance, meaning and spatial relations. In urban design terms, identity is considered to be a fixed point of thought and being or ground of actions. However, as Hall (1989) describes, identity is, in fact, a development or a progression towards creation of inter-relationships between oneself and other and vice versa. Consequently, this paper explores the term ‘identity’ and its implication in an urban context, and also focuses upon the meaning of identity in a public realm to identify how it influences the meaning that people attach to their environments

Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy

Background A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets. Methods Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall’s tau for dichotomous variables, or Jonckheere–Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis. Results A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p < 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 0.822, respectively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all p < 0.001). Conclusion We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty

Schools and skills of critical thinking for urban design

© 2017, © 2017 Informa UK Limited, trading as Taylor & Francis Group. This paper explores possible ways in which urban design can engage with critical thinking and critical theory. After a brief explanation of the terms, with particular attention to the Frankfurt School of thought, it provides various answers to the question as to whether urban design is critical or not. One categorization applied to planning critical theory is then used to explain the potential for employing critical theories in urban design. Critical thinking skills are then argued to be helpful for enriching the literature of urban design in order to achieve better practice. The conclusion is that urban design can benefit from critical creativity, which is an embodiment of critical thinking within the limits imposed onto creativity. In this paper, the ways in which urban design can engage with both critical theory and with critical thinking are explored in order to achieve better critical creativity in the field

Population‐based cohort study of outcomes following cholecystectomy for benign gallbladder diseases

Background The aim was to describe the management of benign gallbladder disease and identify characteristics associated with all‐cause 30‐day readmissions and complications in a prospective population‐based cohort. Methods Data were collected on consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing all‐cause 30‐day readmissions and complications were analysed by means of multilevel, multivariable logistic regression modelling using a two‐level hierarchical structure with patients (level 1) nested within hospitals (level 2). Results Data were collected on 8909 patients undergoing cholecystectomy from 167 hospitals. Some 1451 cholecystectomies (16·3 per cent) were performed as an emergency, 4165 (46·8 per cent) as elective operations, and 3293 patients (37·0 per cent) had had at least one previous emergency admission, but had surgery on a delayed basis. The readmission and complication rates at 30 days were 7·1 per cent (633 of 8909) and 10·8 per cent (962 of 8909) respectively. Both readmissions and complications were independently associated with increasing ASA fitness grade, duration of surgery, and increasing numbers of emergency admissions with gallbladder disease before cholecystectomy. No identifiable hospital characteristics were linked to readmissions and complications. Conclusion Readmissions and complications following cholecystectomy are common and associated with patient and disease characteristics

The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy

Background: The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations. Methods: Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration. A multivariable binary logistic regression model was produced in order to identify significant independent predictors of long (> 90 min) operations. The resulting model was converted to a risk score, which was subsequently validated on second cohort of patients using ROC curves. Results: After exclusions, data were available for 7227 patients in the derivation (CholeS) cohort. The median operative duration was 60 min (interquartile range 45–85), with 17.7% of operations lasting longer than 90 min. Ten factors were found to be significant independent predictors of operative durations > 90 min, including ASA, age, previous surgical admissions, BMI, gallbladder wall thickness and CBD diameter. A risk score was then produced from these factors, and applied to a cohort of 2405 patients from a tertiary centre for external validation. This returned an area under the ROC curve of 0.708 (SE = 0.013, p  90 min increasing more than eightfold from 5.1 to 41.8% in the extremes of the score. Conclusion: The scoring tool produced in this study was found to be significantly predictive of long operative durations on validation in an external cohort. As such, the tool may have the potential to enable organisations to better organise theatre lists and deliver greater efficiencies in care

The Cholecystectomy As A Day Case (CAAD) Score: A Validated Score of Preoperative Predictors of Successful Day-Case Cholecystectomy Using the CholeS Data Set

Background Day-case surgery is associated with significant patient and cost benefits. However, only 43% of cholecystectomy patients are discharged home the same day. One hypothesis is day-case cholecystectomy rates, defined as patients discharged the same day as their operation, may be improved by better assessment of patients using standard preoperative variables. Methods Data were extracted from a prospectively collected data set of cholecystectomy patients from 166 UK and Irish hospitals (CholeS). Cholecystectomies performed as elective procedures were divided into main (75%) and validation (25%) data sets. Preoperative predictors were identified, and a risk score of failed day case was devised using multivariate logistic regression. Receiver operating curve analysis was used to validate the score in the validation data set. Results Of the 7426 elective cholecystectomies performed, 49% of these were discharged home the same day. Same-day discharge following cholecystectomy was less likely with older patients (OR 0.18, 95% CI 0.15–0.23), higher ASA scores (OR 0.19, 95% CI 0.15–0.23), complicated cholelithiasis (OR 0.38, 95% CI 0.31 to 0.48), male gender (OR 0.66, 95% CI 0.58–0.74), previous acute gallstone-related admissions (OR 0.54, 95% CI 0.48–0.60) and preoperative endoscopic intervention (OR 0.40, 95% CI 0.34–0.47). The CAAD score was developed using these variables. When applied to the validation subgroup, a CAAD score of ≤5 was associated with 80.8% successful day-case cholecystectomy compared with 19.2% associated with a CAAD score >5 (p < 0.001). Conclusions The CAAD score which utilises data readily available from clinic letters and electronic sources can predict same-day discharges following cholecystectomy

Cities in time : temporary urbanism and the future of the city

xi, 198 p. : ill. ; 24 cm