Design Margins: Impact on Building Energy Performance

This paper examines the addition of design margins for building services energy infrastructure during the design process. It argues that care must be taken when applying margins; ensuring cumulative effects do not undermine the ability of systems to be energy efficient. An example of a hospital Trust is provided showing the addition of design margins impacting the energy efficiency of services provided. Tensions are found between delivery of flexibility, adaptability and other change parameters and the need for the system to be bounded, so as to encourage effectiveness

“Black, White and Grey”: Wartime Arguments for and against the Strategic Bomber Offensive

The strategic bomber offensive against Nazi Germany has attracted more than its fair share of attention, most of which has been highly critical, both on moral as well as pragmatic grounds. Scholarly articles and books, in addition to a much larger number of sensationalized popular accounts, have appeared at a steady rate since the end of the war.1 More recently, journalists and television producers—capitalising on the fiftieth anniversary commemorations of the Second World War—have taken an interest in this controversial yet highly marketable and therefore profitable subject. Partly revisionist, and deliberately emotive, their “factions” (part fact and part dramatic recreation or fiction) all too often have focused narrowly on a single, spurious theme; the Anglo-American bomber offensive was orchestrated and conducted by a group of “bloodthirsty bone-heads and blimps,” whose policy of saturation bombing was a grievous crime against humanity.

Medical Command and Control in Sea-Based Operations

During World War II it took the Navy and Marine Corps years to confirm and refine their prewar doctrine for amphibious attack. The labor began with the first U.S. landings at Guadalcanal in August 1942; the resulting doc- trine, organization, tactics, and techniques were subsequently used by the Army in Europe. Early operations in both theaters highlighted the enormous difficul- ties associated with essential medical elements, and it was not until late 1944, perhaps 1945, that these problems were adequately solved

Medicine Infected by Politics: The American Occupation of Haiti, 1915-1934

This article discusses the impact that politics and social beliefs have on the humanitarian goals of medicine, using the American occupation of Haiti (1915-1934) as a backdrop. First, the article explains how the United States intervened in Haiti in order to maintain its political hegemony in the Caribbean, develop Haiti as a new market for American investors, and civilize the supposedly backwards Haiti. Previously, historians have recognized the important role that medicine played during the occupation, but this article highlights how U.S. political, economic, and cultural motives distorted the practice of medicine in Haiti. For instance, from 1915-1922, the Americans established martial law and sought to eliminate resistance against the U.S. presence in Haiti. American brutality in these early years led to the selective practice of medicine, as the Americans only treated Haitian patients when it served to protect the health of U.S. Marines or pacify the Haitian populace. Thus, under the military, medicine\u27s goals morphed from patient health and well-being to order and control via health. Following the reorganization of the occupation, medicine sought to justify the continuation of U.S. control over Haiti. The widespread treatment of Haitian diseases served as wonderful propaganda for the Americans, but in reality, the aims of medicine were to confer the benefits of civilization upon Haiti and revitalize the nation\u27s economy via a healthy workforce. Thus, this article demonstrates the susceptibility of medicine to political and social aims

Arts, Health and Well-Being across the Military Continuum

Is there an active, meaningful role for the arts and creative arts therapies in addressing this vast array of critical human readiness issues across the military continuum? In general, "readiness" is the #1 issue for the military at all times. The connection of the arts to the human dimension of readiness is key. Military leaders say we need every weapon in our arsenal to meet the many challenges we face today. However, one of the most powerful tools we have in our arsenal -- the arts -- is often under-utilized and not well understood within the military and the healthcare system. The arts and creative arts therapists are -- and have been -- a part of military tradition and missions across all branches, supporting military health services, wellness, and mission readiness, including family support. For example, the War Department ordered the use of music in rehabilitation for the war wounded in World War II. In June 1945, the Department of War issued "Technical Bulletin 187: Music in Reconditioning in American Service Convalescent and General Hospitals." This bulletin was a catalyst for the growth and development of music therapy being used as a rehabilitative service for active duty service members and veterans alike during and after WWII. Although many gaps exist in our knowledge regarding the arts in military settings, what we do know to date holds great promise for powerful outcomes for our service members, veterans, their families, and the individuals who care for them. Today, a growing number of members of the public and private sectors are eager to collaborate with military leaders to help make these outcomes a reality.Nowhere was the momentum for greater collaboration more evident than in October 2011, when the first National Summit: Arts in Healing for Warriors was held at Walter Reed National Military Medical Center (now referred to as Walter Reed Bethesda) and the National Intrepid Center of Excellence (NICoE). Rear Admiral Alton L. Stocks, Commander of Walter Reed Bethesda, hosted the National Summit, in partnership with a national planning group of military, government, and nonprofit leaders. The 2011 Summit marked the first time various branches of the military collaborated with civilian agencies to discuss how engaging with the arts provides opportunities to meet the key health issues our military faces -- from pre-deployment to deployment to homecoming.Building upon its success, a multi-year National Initiative for Arts & Health in the Military was established in 2012, with the advice and guidance of federal agency, military, nonprofit, and private sector partners (see Figure 2). The National Initiative for Arts & Health in the Military (National Initiative) represents an unprecedented military/civilian collaborative effort whose mission is to "advance the arts in health, healing, and healthcare for military service members, veterans, their families, and caregivers."Members of the National Initiative share a commitment to optimize health and wellness, with a deep understanding and awareness that the arts offer a unique and powerful doorway into healing in ways that many conventional medical approaches do not. The Initiative's goals include working across military, government, private, and nonprofit sectors to: 1. Advance the policy, practice, and quality use of arts and creativity as tools for health in the military; 2. Raise visibility, understanding, and support of arts and health in the military; and 3. Make the arts as tools for health available to all active duty military, medical staff, family members, and veterans