Suchergebnisse

AbstractThe paper addresses the question of what is a 'healthy'building, and whether the definition normally expressed in terms of occupant well‐being has changed over a period of time. This definition is considered in relation to the relevant physical correlates, and suggested that they support the idea of the light, airy building. Air quality is then investigated to see how it can be, and perhaps more importantly how it is, incorporated into current solutions. Two design approaches are suggested from which a decision can be made as to use and profit from the shape of buildings; these are climatically rejecting and climatically interactive, and the use of either can result in solutions of differing orders of technical complexity. Finally it is suggested that some of these orders of complexity of solution are more difficult to operate healthily than others, and indications are given of possible ways ahead.

SINCE 1945 GUERRILLA WARFARE HAS BEEN THE PRINCIPAL FORM OF VIOLENT CONFLICT. ITS SUCCESSFUL PRACTITIONERS APPLY A HIGHLY DEVELOPED SENCE OF GEOGRAPHY TO EXPLOIT THE ADVANTAGES OF TERRAIN TO DISCOMFORT THE ESTABLISHED ORDER. TO OVERCOME SUCH ATTACKS. COUNTER-INSURGENTS NEED AN EQUAL OR SUPERIOR UNDERSTANDING OF THE LANDSCAPE. THE TACTICS EMPLOYED BY GUERRILLAS AND THEIR OPPOSITION ARE SUGGESTIVE OF GENERAL SETS OF GEORGAPHICAL CONDITIONS FAVOURING ONE SIDE OR THE OTHER. IT IS POSTULATED THAT THE PRINCIPAL FACTORS DETERMINING THE RELATIVE ADVANTAGE OF THE LANDSCAPE FOR GUERRILLA OR REGULAR FORCES ARE POPULATION DENSITY AND THE COVER AFFORDED BY THE TERRAIN. EMPIRICAL DATA FROM A SELECTION OF CONFLICTS ARE PRESENTED. THESE SUGGEST THAT GUERRILLAS ARE AT A COMPARATIVE ADVANTAGE IN CONDITIONS OF HIGH POPULATION DENSITY AND GREATER COVER. THE DENSITY AND MAN-MADE BROKEN TERRAIN OF CITY AND SUBURB OFFER A READY EXPLANATION FOR THE EMERGENCE OF URBAN GUE RRILLAS IN RECENT YEARS. THESE ADVANTAGES ARE ENCHANCED BY THE DETERRENT THE URBAN SETTING OFFERS TO QUANTITATIVE MILITARY OPERATIONS. IN CITIES THERE IS THE MAXIMUMI PROSPECT OF OFFENDING THE CIVILIAN POPULATION IN SEEKING TO ROOT OUT GUERRILLAS.

AbstractAlthough no legislation in England and Wales directly addresses the causes and effects of eutrophication of surface freshwaters, a wide range of laws may be applied to the reduction of nutrient inputs. Nature conservation laws are applicable, in that rivers, lakes, reservoirs and canals designated as 'sites of special scientific interest'(SSSIs) are theoretically safeguarded from degradation. However, the SSSI system is not designed to protect water quality at the catchment level. Since intensive agricultural practices are responsible for significant nutrient losses, legislation aimed at extensification is also relevant. Increasingly, laws related to extensification of agriculture include environmental imperatives ‐ a trend which will inevitably extend to nutrient conservation. Basically, enrichment is a water‐quality issue, but policy and legislation in this area are not yet sufficiently developed to address the problem comprehensively. Existing regulatory systems for water quality carry the potential to work comparatively well for point sources, but appear ineffective in dealing with diffuse losses.

Objectives: The INCAPS COVID Oceania study aimed to assess the impact caused by the COVID-19 pandemic on cardiac procedure volume provided in the Oceania region. Methods: A retrospective survey was performed comparing procedure volumes within March 2019 (pre-COVID-19) with April 2020 (during first wave of COVID-19 pandemic). Sixty-three (63) health care facilities within Oceania that perform cardiac diagnostic procedures were surveyed, including a mixture of metropolitan and regional, hospital and outpatient, public and private sites, and 846 facilities outside of Oceania. The percentage change in procedure volume was measured between March 2019 and April 2020, compared by test type and by facility. Results: In Oceania, the total cardiac diagnostic procedure volume was reduced by 52.2% from March 2019 to April 2020, compared to a reduction of 75.9% seen in the rest of the world (p<0.001). Within Oceania sites, this reduction varied significantly between procedure types, but not between types of health care facility. All procedure types (other than stress cardiac magnetic resonance [CMR] and positron emission tomography [PET]) saw significant reductions in volume over this time period (p<0.001). In Oceania, transthoracic echocardiography (TTE) decreased by 51.6%, transoesophageal echocardiography (TOE) by 74.0%, and stress tests by 65% overall, which was more pronounced for stress electrocardiograph (ECG) (81.8%) and stress echocardiography (76.7%) compared to stress single-photon emission computerised tomography (SPECT) (44.3%). Invasive coronary angiography decreased by 36.7% in Oceania. Conclusion: A significant reduction in cardiac diagnostic procedure volume was seen across all facility types in Oceania and was likely a function of recommendations from cardiac societies and directives from government to minimise spread of COVID-19 amongst patients and staff. Longer term evaluation is important to assess for negative patient outcomes which may relate to deferral of usual models of care within cardiology.