Design Dilemmas in Mental Hospital Architecture

Objective – The paper identifies dilemmas facing architects, planners and medical professionals in the process of designing a new psychiatric facility. Background – Rarely any other type of public building has had such a turbulent and complicated history of experimentation, and of design innovations being widely implemented all over the world during one decade and completely discarded in the following one. Everyone involved in the planning process has to make moral choices every step of the way, and those choices impacted design and subsequently the provision of care. Research question – The paper seeks to condense and formulate the dilemmas architects face in design process. Should psychiatric hospitals be dense to ensure short routes, easy observation and fast reaction in crisis? Or alternatively, should the wards be spacious, giving patients enough room to walk around freely? Should the hospital look like a medical facility, transmitting the image of competence and temporality, or should it be more ‘normal’, home-like and non-institutional? How do we combine domestic character of the ward environment with necessary safety features? Should spaces be designed according to hospital hierarchy and provide the patients with a clear structure that is easy to comprehend, or should social interactions in the hospitals be more fluid, emphasising an equally important part patients play in the treatment process? Those and other dilemmas are presented and discussed in the paper. Methods – The dilemmas were synthesized through historical analysis of both architecture and policy related to psychiatric facilities, literature, including the studies of mental hospital environment as well as accounts of staff and former patients, modern examples of behavioural facilities and personal professional experience of being involved in the design of several psychiatric hospitals. Results – As a result, 8 pairs of contradicting environmental characteristics were identified: privacy/isolation, efficiency/spaciousness, structure/fluidity, medical/normal, domesticity/safety, stimulating/calming, communication/ distraction, care/disability. These dilemmas are discussed in detail, with reference to existing studies. Also, the possible ways to study design dilemmas further are described. Conclusion – The paper calls for the discussion and additional studies to help solve those dilemmas and equip planners with concrete evidence. Hopefully, further research will help us to design mental hospitals that will be able not only to provide excellent care, but also be flexible enough to adapt to future change.publishedVersio

An investigation of the rate of biogenic volatile organic carbon emissions from commercial crop and plantation species in the Mpumalanga Province

Volatile Organic Carbons (VOCs) are extremely reactive compounds and play an important role in the ozone chemistry of the atmosphere. Biogenic Volatile Organic Compounds (BVOCs) are estimated to contribute ~1015 g C y-1 per year to the atmosphere which constitutes ~80 % of the chemically reactive VOCs added to the atmosphere each year. In the last decade considerable scientific effort has focused on quantifying biogenic emission rates in South Africa, mainly from indigenous savanna species. The Mpumalanga province occupies 6.7 % of the land area of South Africa. There is a high species diversity and variable land use which includes forestry, cropping agriculture, grazing and nature conservation. The aim of this study was to measure the emission rates of isoprene, β-pinene, α-pinene, limonene and linalool from five selected plant species. These plant species were Mangoes, Avocados and Bananas (subtropical crops) and Pines and Eucalyptus (exotic forestry species). The experimental work, which was all conducted in the field, was designed to demonstrate the effect of environmental conditions on emission rates, especially temperature and water availability. A rapid screening technique was carried out in the initial phase of the study and a more detailed leaf level study was carried out over the 2007-2008 growing season. Plantation species, emitted higher levels of BVOCs than crop species. Isoprene emission rates were similar for two functional groups of plants, however, selected monoterpene (β-pinene, α-pinene, limonene and linalool) emission rates were higher in the plantation. Isoprene emissions represented 41.6 % of the total emissions measured followed by monoterpenes: β-pinene 31.5 % and limonene, α-pinene and linalool the remaining 26.8 % of total emissions. Emissions increased immediately after the onset of the spring rains and responded to the annual cycle with increasing values in the summer months and rapid decreases in winter. The measured emission rates were higher from the selected species than those published from temperate regions of the world. The data from this study can be used in the future to develop a regional emission budget

Home green home; a case study of inducing energy-efficient innovations in the Dutch building sector

This document provides a case study of policies aiming to foster technological innovations for ‘green’ buildings in the Netherlands. The study aims to provide 1) a detailed overview of the policy framework over the last thirty years, and 2) a picture of the level of innovations related to energy efficiency in buildings in the Netherlands. �The analysis shows an intensification of environmental policy in the Dutch building sector in the mid-1990s, followed by a slight decline after 2001. A striking feature of environmental policy in this sector is the large number of policy programs implemented successively for short periods of time. This might affect the stability and continuity of the policy framework and be damaging for innovation. Faced with high levels of uncertainty about future policies, firms may prefer to postpone risky investments in innovative activities. Finally, governmental R&D support for green innovations in general remains very low in the Netherlands. Descriptive data on patenting activities show that Dutch firms file nowadays about 150 patents annually in the field of energy efficiency in buildings. The Netherlands have a clear comparative advantage in the field of energy-saving lighting technologies, mainly due to intensive patenting activities by Philips. High-efficiency boilers also represent a substantial share of Dutch innovation activities in this domain over the last decades. In many other fields (such as insulation, heat-pumps and co-generation, solar boilers, etc), however, Germany, Austria and Scandinavian countries rank much higher than the Netherlands.

Pluronic® block-copolymers in medicine: from chemical and biological versatility to rationalisation and clinical advances

YesThis mini-review highlights the latest advances in the chemistry and biology of Pluronic® triblock copolymers. We focus on their applications in medicine, as drug delivery carriers, biological response modifiers, and pharmaceutical ingredients. Examples of drug delivery systems and formulations currently in clinical use, clinical trials or preclinical development are highlighted. We also discuss the role that Pluronic® copolymers may play in the innovative design of new nanomedicines in the near future.We thank the Leverhulme Trust (Early Career Fellowship no. ECF-2013-414 to NPEB), the University of Warwick (Grant no. RDF 2013-14 to NPEB) and EPSRC (EP/G004897/1 to APB) for support

Is there an environmental benefit to being an exporter? Evidence from firm level data

One of the greatest concerns over globalisation is its impact on the environment. This paper contributes to this debate by analysing the consequences of becoming an exporter on a firm's energy consumption. We show both theoretically and empirically that for low fuel intensity firms exporting status is associated with higher fuel consumption while for high fuel intensity firms exporting is results in decreased fuel consumption. Further analysis reveals that higher fuel consumption of low fuel intensity firms occurs after exporting, perhaps as a response to increased production. In contrast, firms using relatively large quantities of fuel decrease their energy use after exporting, perhaps by adopting more fuel-efficient technology. These results indicate that the use of aggregate data, as is the case in almost all studies of trade and the environment, is likely to conceal important connections between the two.Exporting, Energy, Heterogeneity, Quantiles, Matching

New technologies for drug delivery across the blood brain barrier

The blood-brain barrier (BBB) efficiently restricts penetration of therapeutic agents to the brain from the periphery. Therefore, discovery of new modalities allowing for effective delivery of drugs and biomacromolecules to the central nervous system (CNS) is of great need and importance for treatment of neurodegenerative disorders. This manuscript focuses on three relatively new strategies. The first strategy involves inhibition of the drug efflux transporters expressed in BBB by Pluronic® block copolymers, which allows for the increased transport of the substrates of these transporters to the brain. The second strategy involves the design of nanoparticles conjugated with specific ligands that can target receptors in the brain microvasculature and carry the drugs to the brain through the receptor mediated transcytosis. The third strategy involves artificial hydrophobization of peptides and proteins that facilitates the delivery of these peptides and proteins across BBB. This review discusses the current state, advantages and limitations of each of the three technologies and outlines their future prospects

Role of MRP transporters in regulating antimicrobial drug inefficacy and oxidative stress-induced pathogenesis during HIV-1 and TB infections.

Multi-Drug Resistance Proteins (MRPs) are members of the ATP binding cassette (ABC) drug-efflux transporter superfamily. MRPs are known to regulate the efficacy of a broad range of anti-retroviral drugs (ARV) used in highly active antiretroviral therapy (HAART) and antibacterial agents used in Tuberculus Bacilli (TB) therapy. Due to their role in efflux of glutathione (GSH) conjugated drugs, MRPs can also regulate cellular oxidative stress, which may contribute to both HIV and/or TB pathogenesis. This review focuses on the characteristics, functional expression, and modulation of known members of the MRP family in HIV infected cells exposed to ARV drugs and discusses their known role in drug-inefficacy in HIV/TB-induced dysfunctions. Currently, nine members of the MRP family (MRP1-MRP9) have been identified, with MRP1 and MRP2 being the most extensively studied. Details of the other members of this family have not been known until recently, but differential expression has been documented in inflammatory tissues. Researchers have found that the distribution, function, and reactivity of members of MRP family vary in different types of lymphocytes and macrophages, and are differentially expressed at the basal and apical surfaces of both endothelial and epithelial cells. Therefore, the prime objective of this review is to delineate the role of MRP transporters in HAART and TB therapy and their potential in precipitating cellular dysfunctions manifested in these chronic infectious diseases. We also provide an overview of different available options and novel experimental strategies that are being utilized to overcome the drug resistance and disease pathogenesis mediated by these membrane transporters

Role of MRP transporters in regulating antimicrobial drug inefficacy and oxidative stress-induced pathogenesis during HIV-1 and TB infections

Multi-Drug Resistance Proteins (MRPs) are members of the ATP binding cassette (ABC) drug-efflux transporter superfamily. MRPs are known to regulate the efficacy of a broad range of anti-retroviral drugs (ARV) used in highly active antiretroviral therapy (HAART) and antibacterial agents used in Tuberculus Bacilli (TB) therapy. Due to their role in efflux of glutathione (GSH) conjugated drugs, MRPs can also regulate cellular oxidative stress, which may contribute to both HIV and/or TB pathogenesis. This review focuses on the characteristics, functional expression, and modulation of known members of the MRP family in HIV infected cells exposed to ARV drugs and discusses their known role in drug-inefficacy in HIV/TB-induced dysfunctions. Currently, nine members of the MRP family (MRP1-MRP9) have been identified, with MRP1 and MRP2 being the most extensively studied. Details of the other members of this family have not been known until recently, but differential expression has been documented in inflammatory tissues. Researchers have found that the distribution, function, and reactivity of members of MRP family vary in different types of lymphocytes and macrophages, and are differentially expressed at the basal and apical surfaces of both endothelial and epithelial cells. Therefore, the prime objective of this review is to delineate the role of MRP transporters in HAART and TB therapy and their potential in precipitating cellular dysfunctions manifested in these chronic infectious diseases. We also provide an overview of different available options and novel experimental strategies that are being utilized to overcome the drug resistance and disease pathogenesis mediated by these membrane transporters

Cell-mediated drug delivery

Introduction: Drug targeting to sites of tissue injury, tumor or infection with limited toxicity is the goal for successful pharmaceutics. Immunocytes (including mononuclear phagocytes (dendritic cells, monocytes and macrophages), neutrophils and lymphocytes) are highly mobile; they can migrate across impermeable barriers and release their drug cargo at sites of infection or tissue injury. Thus, immune cells can be exploited as Trojan horses for drug delivery. Areas covered: This paper reviews how immunocytes laden with drugs can cross the blood-brain or blood-tumor barriers to facilitate treatments for infectious diseases, injury, cancer, or inflammatory diseases. The promises and perils of cell-mediated drug delivery are reviewed, with examples of how immunocytes can be harnessed to improve therapeutic end points. Expert opinion: Using cells as delivery vehicles enables targeted drug transport and prolonged circulation times, along with reductions in cell and tissue toxicities. Such systems for drug carriage and targeted release represent a new disease-combating strategy being applied to a spectrum of human disorders. The design of nanocarriers for cell-mediated drug delivery may differ from those used for conventional drug delivery systems; nevertheless, engaging different defense mechanisms in drug delivery may open new perspectives for the active delivery of drugs