Improving shared decision-making about cancer treatment through design-based data-driven decision-support tools and redesigning care paths: an overview of the 4D PICTURE project.

Background: Patients with cancer often have to make complex decisions about treatment, with the options varying in risk profiles and effects on survival and quality of life. Moreover, inefficient care paths make it hard for patients to participate in shared decision-making. Data-driven decision-support tools have the potential to empower patients, support personalized care, improve health outcomes and promote health equity. However, decision-support tools currently seldom consider quality of life or individual preferences, and their use in clinical practice remains limited, partly because they are not well integrated in patients' care paths. Aim and objectives: The central aim of the 4D PICTURE project is to redesign patients' care paths and develop and integrate evidence-based decision-support tools to improve decision-making processes in cancer care delivery. This article presents an overview of this international, interdisciplinary project. Design methods and analysis: In co-creation with patients and other stakeholders, we will develop data-driven decision-support tools for patients with breast cancer, prostate cancer and melanoma. We will support treatment decisions by using large, high-quality datasets with state-of-the-art prognostic algorithms. We will further develop a conversation tool, the Metaphor Menu, using text mining combined with citizen science techniques and linguistics, incorporating large datasets of patient experiences, values and preferences. We will further develop a promising methodology, MetroMapping, to redesign care paths. We will evaluate MetroMapping and these integrated decision-support tools, and ensure their sustainability using the Nonadoption, Abandonment, Scale-Up, Spread, and Sustainability (NASSS) framework. We will explore the generalizability of MetroMapping and the decision-support tools for other types of cancer and across other EU member states. Ethics: Through an embedded ethics approach, we will address social and ethical issues. Discussion: Improved care paths integrating comprehensive decision-support tools have the potential to empower patients, their significant others and healthcare providers in decision-making and improve outcomes. This project will strengthen health care at the system level by improving its resilience and efficiency.

Improving the cancer patient journey and respecting personal preferences: an overview of the 4D PICTURE project The 4D PICTURE project aims to help cancer patients, their families and healthcare providers better undertstand their options. It supports their treatment and care choices, at each stage of disease, by drawing on large amounts of evidence from different types of European data. The project involves experts from many different specialist areas who are based in nine European countries. The overall aim is to improve the cancer patient journey and ensure personal preferences are respected.

Analysis of urban agriculture solid waste in the frame of circular economy: Case study of tomato crop in integrated rooftop greenhouse.

Within urban agriculture (UA), integrated rooftop greenhouses (i-RTG) have great growth potential as they offer multiple benefits. Currently it is intended to improve environmental benefits by taking advantage of the water, nutrients and gases flows. On the other hand, solid waste (SW) generated by the UA is a new type of waste within cities that has not well been classified or quantified for its use. This could become a new problem for the waste management system within cities in the future, mainly the organic fraction. The objective of this research is to identify what type of i-RTG SW has the potential to be used from a circular economy (CE) perspective and propose a type of management for its material valorization. The results of the case study show that, of the SW generated in i-RTG, the biomass has the greatest potential to be used locally as an eco-material, particularly the tomato stems. Its use is proposed as a substrate for two experimental lettuce crops in i-RTG. The results show that tomato stems have a better yield as a substrate after a prewash treatment, since at first the values of electrical conductivity (EC) are very high with respect to the control substrate, which is expanded perlite. In conclusion, we can say that it is possible to increase the environmental benefits of i-RTG by taking advantage of its biomass locally, helping to foresee a possible future problem regarding the management of the residual biomass of i-RTG within cities. In this way, the paradigm about the perception of the SW of the UA could be changed to give them a by-product treatment from the beginning.

Introducing ergonomics requirements in the eco-design of energy-related products from users' behaviour approach.

Ergonomics has been a very important activity in the design process. However, ergonomics rarely includes the environmental requirements into the design of products. The article proposes and presents the Eco-Ergo model through its application to a real-world product, a washing machine, to allow designers and ergonomists to establish product design requirements in order to minimise environmental impacts related to user-product interaction during the use stage. This model uses a visual language of representation, Blueprinting-based, that helps designers explore problems they have not previously considered during the market research when a wide variety of products with different interaction elements is analysed. The application of this model allows direct efforts and attention on the user analysis phase in the most influential user's actions on the environmental performance of energy-related products during use, establishing ergonomics requirements related to users behaviour at the initial design phase. Practitioner summary: This study provides a proposal to incorporate ergonomics into the practice of eco-design through the use of human factors in the establishment of initial eco-design requirements. This blueprint-based model combines an empirical and theoretical approach, based on the product test developed by designers, ergonomists and environmentalists. Abbreviations: CO2: carbon dioxide; DBIM: design behaviour intervention model; DfSB: design for sustainable behaviour; DwI Method: design with intent method; LCA: life cycle assessment; LCD: liquid cristal display; MJ: megajoule; MTM: methods-time measurement; PSS: product-service system; RPM: revolutions per minute.