Suchergebnisse

Change is inevitable in all communities: they both grow and decline. Planning is a means by which we have sought to manage this change. It has not always succeeded in providing the types of settlements and environments which many residents and others want, either because it is operating with the wrong policies or because it is failing to ensure that the right policies are effectively implemented. These failings have opened planning to criticism by a dominant neoliberal orthodoxy which shapes an increasingly difficult environment in which planning has to operate. Planning for Small Town Change builds on an underexploited selection of international research and the authors' English case studies to consider the efficacy of planning for change. Drawing on insightful small town experiences, three themes emerge: understanding and conceptualising change; appreciating the potential within place; and the mechanisms for planning and delivery. The research draws on many examples of how key actors have made a significant difference to specific places and provides important insights into how the planning process can be better matched to the long-term and complex challenges faced. Whilst small town experiences are often neglected, they are found to be particularly insightful in understanding the potential roles of local communities and the importance of place quality when planning for change. Book jacket.

Introduction -- Need for public consultation and stated preference -- Stated preference : methods and challenges -- Qualitative methods -- Interpreting stated preference responses -- Investigating sensitivity to scope -- Constructing better preferences? -- Communal nature of stated preference -- Evaluating and redesigning stated preference.

The planning practice of focusing most rural development within larger settlements has failed to achieve goals of rural activity colocation. In a society where quality of opportunity has become dominant in location decisions, a broader imaginative perspective than the physical proximity of functions is required if meaningful activity colocation is to occur. The extent to which residents and employees can be encouraged to localise their activity is explored through case studies of three very different small towns within the English county of Norfolk. Although not of universal appeal, small towns provide an important niche for many rural actors. Rather than abandoning policy endeavours, there is potential to improve their effectiveness by ensuring that the possible benefits arising from the colocation of activity are realised. By adopting a more flexible approach to policy application, utilising complementary conceptions which are attentive to the specific characteristics of individual places, potential exceptions to policies of development concentration can be identified. However, in the UK context ongoing cutbacks in local authority budgets are likely to prejudice the conduct of the type of fine-grained local policy development required to achieve these objectives.

This study assesses the effect of light rail transit system (LRT) on residential property values in Greater Kuala Lumpur, Malaysia, where traffic congestion has been a major issue since the mid 1990s. A relatively new technique namely Geographically Weighted Regression (GWR) is employed to estimate the increased value of land in the form of residential property values as a result of improved accessibility owing to the construction of the LRT systems. Using the Kelana Jaya LRT Line, located in Greater Kuala Lumpur, Malaysia as a case study, this paper reveals that the improvement of accessibility to employment and other amenities provided by the LRT system added premiums on residential property values but with spatial variation over geographical area indicates that the existence of the LRT systems may have a positive effect on residential property values in some areas but negative in others. The use of the GWR in this study is identified as a better approach to investigate the effect of the LRT system on residential property values since it has the capability to produce meaningful results by revealing spatially varying relationship.

Purpose. To estimate the lifetime cost of three types of employer-sponsored breast cancer screening programs and to identify factors influencing cost. Design. A computerized decision analysis model was constructed to compare lifetime costs of providing breast cancer screening in each of three screening programs: on-site within an employer, mobile unit visiting the employer, and off-site. Subjects. Three hypothetical cohorts of 10,000 female employees 38 years of age at time of first screening. Intervention. A cohort was enrolled in each screening program and received screening from age 38 through age 64. Employees continued to receive benefits related to breast cancer until age 100 or death. Measures. Costs in the model included those for screening, workup for a suspicious mammogram, treatment for breast cancer, short-term losses in employee productivity, and disability due to breast cancer. Approach. The model was used to estimate the mean lifetime cost per employee, to the employer, of the On-Site program. This cost was compared to the cost of the other programs. Results. Mean lifetime cost per employee was $5,485 for the On-Site screening program. This cost was significantly (P<.0001) lower than in the Off-Site program (by $311) or the Mobile program (by $212). The baseline results for the On-Site program were quite sensitive to the cost of screening, the sensitivity and specificity of screening, age at initiation of screening, and the underlying incidence of breast cancer in the population. Conclusion. Employers and other entities should consider these factors such as location and content in selecting the most efficient and effective breast cancer screening program.

<p><strong>Objective</strong>: The aim of our study was to investigate whether current eGFR equations in clinical use might systematically overestimate the kidney function, and thus misclassify CKD status, of Black Americans with HIV. Specifically, we evaluated the impact of removing the race coefficient from the MDRD and CKD-EPI equations on comparisons between Black and White HIV-infected veterans related to: 1) the prevalence of reduced eGFR; 2) the distribution of eGFR values; and 3) the relationship between eGFR and all-cause mortality.</p><p><strong>Design:</strong> Retrospective cohort study.</p><p><strong>Setting:</strong> The Department of Veterans Affairs (VA) HIV Clinical Case Registry (CCR), which actively monitors all HIV-infected persons receiving care in the VA nationally.</p><p><strong>Patients/Participants:</strong> 21,905 treatmentnaïve HIV-infected veterans.</p><p><strong>Main Outcome Measures:</strong> Estimated glomerular filtration rate (eGFR) using the abbreviated Modification of Diet in Renal Disease (MDRD) formula with and without (MDRD-RCR) the race coefficient and allcause mortality.</p><p><strong>Results:</strong> Persons with eGFR &lt;45 mL/ min/1.73m2 had a higher risk of death compared with those with eGFR &gt;80 mL/ min/1.73m2 among both Blacks (HR=2.8, 95%CI: 2.4-3.3) and Whites (HR=1.9, 95%CI: 1.4-2.6), but the association appeared to be stronger in Blacks (P=.038, test for interaction). Blacks with eGFR 45- 60 mL/min/1.73m2 also had a higher risk of death (HR=1.7, 95%CI: 1.4-2.1) but Whites did not (HR=0.86, 95%CI: .67- 1.10; test for interaction: P&lt;.0001). Racial differences were substantially attenuated when eGFR was re-calculated without the race coefficient.</p><p><strong>Conclusions:</strong> Our findings suggest that clinicians may want to consider estimating glomerular filtration rate without the race coefficient in Blacks with HIV. <em>Ethn Dis.</em> 2016;26(2):213-220; doi:10.18865/ ed.26.2.213</p>