Monumental architecture : it\u27s role in the modern city : a theatrical center and tourist center in Rome Italy

This study is designed to reconsider the contemporary role of historical ruins within the urban context of the modern city. Today extant ancient architecture is often conflated with ruins and conceived of as works of art. This thesis contends that these monumental relics can still be utilized in a manner for which they were conceived

Cancer pain and the World Health Organization analgesic ladder

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Jamaican Universities Aiding the Design of an Urban Public Space

Many governments are actively seeking solutions to address the economic crises bedeviling their countries. University/college towns have proven to be successful models of opportunities for attracting investments for economic development while at the same time promoting optimal health outcomes. Harvard, MIT and Newcastle universities provide examples of successful models of universities aiding in spatial design and planning of towns or neighborhoods where they are located to yield sustainable development. The Government of Jamaica has supported the proposal from the University of Technology, Jamaica, (UTech, Jamaica Ja.) to redesign the Papine area in St. Andrew into a university town, given its proximity to the two largest universities in Jamaica, UTech, Ja. and the University of the West Indies (UWI). Both institutions collaborated by using cutting-edge scholarly research and design approaches to propose workable solutions that can promote economic development and healthy lifestyle in an area designated as a university town. The research found that SOPARC was a feasible and reliable instrument for assessing park user variables and associated contextual variables. However, for the proposed design to be executed and maintained, the study recommends establishing a body such as a University District/Town Council with oversight responsibility for planning and land use management of the area

Integration of palliative and supportive care in the management of advanced liver disease:development and evaluation of a prognostic screening tool and supportive care intervention

BACKGROUND AND OBJECTIVES: Patients with decompensated cirrhosis rarely receive palliative and supportive care interventions, which are routine in other life-limiting diseases. We aimed to design and evaluate a prognostic screening tool to routinely identify inpatients with decompensated cirrhosis at high risk of dying over the coming year, alongside the development of a supportive care intervention. DESIGN: Clinical notes from consecutive patients admitted as an emergency to University Hospitals Bristol with a diagnosis of cirrhosis over two distinct 90-day periods were scrutinised retrospectively for the presence or absence of five evidence-based factors associated with poor prognosis. These were analysed against their ability to predict mortality at 1 year. ‘Plan-Do-Study-Act’ (PDSA) methodology was used to incorporate poor-prognosis screening into the routine assessment of patients admitted with cirrhosis, and develop a supportive care intervention. RESULTS: 73 admissions were scrutinised (79.5% male, 63% alcohol-related liver disease, median age 54). The presence of three or more poor-prognosis criteria at admission predicted 1-year mortality with sensitivity, specificity and positive predictive value of 72.2%, 83.8% and 81.3%, respectively, and was used as a trigger for implementing the supportive care intervention. Following modification from six PDSA cycles, prognostic screening was integrated into the assessment of all patients admitted with decompensated cirrhosis, with the supportive care intervention (developed simultaneously) instigated for appropriate patients. CONCLUSIONS: We describe a model of care which identifies inpatients with cirrhosis at significant risk of dying over the coming year, and describe development of a supportive care intervention, which can be offered to suitable patients in parallel to ongoing active management