Robert Reich School of Landscape Architecture

Military installations and cities in the twenty-first century share many of the same dynamics and face many of the same challenges – i.e. the same environmental, climatic, and anthropogenic pressures. The military response to these challenges is, however, constrained by hierarchy and the culture of command and control. In a city, informal adaptations, experiments and solutions can arise to pressing urban issues that were unanticipated or unanswered by the formal city. By contrast, decisions and solutions in military installations have traditionally come down the chain of command. In an ever more complex world in which the future is ambiguous and change is a certainty, top-down decision making and the predictive sciences, alone, will not be enough to ensure a sustainable future. Cities and military installations will need to be adaptable and resilient to survive the complex, ever changing, and uncertain threats of the future.

The Isthmus of Panama comprises a lithologically diverse andesitic oceanic arc of Late Cretaceous to Holocene age; it has large spatial variation in rainfall, displays a large range of physical erosion rates, and, therefore, is an ideal location to examine silicate weathering in the tropics. We use a multiyear data set of river chemistry for a 450 km transect across the Cordillera Central of west-central Panama to investigate controls on chemical weathering in tropical small mountainous rivers. Sea-salt corrected cation weathering yields (Casil + Mgsil + Na + K) range over more than an order in magnitude from 3.1 to 31.7 t/km2/yr, while silicate weathering yields (Casil + Mgsil + Na + K + Si) range from 6.9 to 69.5 t/km2/yr. Watershed lithology is the primary control on riverine chemistry, but landscape topographic character and land cover and/or land use also influence solute delivery potential. Strong statistical links of small mountainous river chemical weathering fluxes with rainfall and physical weathering rates attest to the importance of runoff and erosion in maintaining elevated bedrock weathering rates. CO2 consumption ranges from 155 × 103 mol/km2/yr to 1566 × 103 mol/km2/yr, in the upper range of global rates, leading us to suggest that andesite terrains should be considered separately when calculating removal of CO2 from the atmosphere via silicate weathering.

Parental satisfaction with the process of disclosure of disability was investigated in interviews with 103 parents of children with severe physical disability. Only 37 per cent of parents were satisfied with disclosure. Parents were more likely to be satisfied if they felt that the professional carrying out the disclosure had a sympathetic, understanding and approachable manner, and was direct and communicated well; if they had been given sufficient information and opportunities to ask questions; and if they were from a manual social-class background. Factors in the procedure of the disclosure, such as the timing, were not significantly related to satisfaction. These results demonstrate the importance of the parent-professional interaction and point towards an increased emphasis on communication skills in medical training.

Hypertension and tachycardia are well known features of acute porphyria and have been shown to be related to increased circulating catecholamines. The mechanism by which circulating catecholamines are increased was studied using the isolated perfused rat heart and human platelets as a model of adrenergic neuronal function. It was found that neither delta-aminolevulinate (ALA) nor porphobilinogen (PBG) blocked uptake or caused release in the isolated perfused rat heart. Platelets from six patients with acute prophyria, three in remission and three latent, with matching normal controls were studied with regard to their uptake of [(3)H]norepinephrine in the presence of ALA or PBG. It was found that ALA and PBG significantly reduced uptake and accumulation of [(3)H]-norepinephrine in patients with acute porphyria; however, no similar reduction in uptake and accumulation was observed in the platelets of normal controls. Therefore, it appears that there is a latent defect in the catecholamine uptake and (or) accumulation of platelets of patients with acute prophyria which only manifests itself in the presence of ALA or PBG. If platelet uptake serves as a model of adrenergic neuron uptake, this suggests that elevated circulating catecholamine levels during acute attacks of acute porphyria are caused at least partially by blockade of re-uptake into the sympathetic neurons.

Shock and the generalized Shwartzman reaction are well known features of endotoxin which have been shown to involve the sympathetic nervous system. The mechanism of sympathetic nervous system involvement with endotoxin injection was studied in rabbits chemically sympathectomized with 6-hydroxydopamine. Endotoxin, in doses producing a spectrum of morbidity and mortality in normal rabbits, was administered i.v. to chemically sympathectomized, normal, and unilateral renal surgically sympathectomized animals. Chemical sympathectomy produced a significant depletion of tissue norepinephrine which, in endotoxin recipient animals, was associated with a significantly lower mortality rate and greatly decreased fibrin deposition in the lungs and kidneys, despite intravascular coagulation. Unilateral renal sympathectomy afforded protection to the ipsilateral kidney, but data on mortality and systemic fibrin deposition were similar to those reported for normal rabbits given endotoxin. Six-hydroxydopamine prevents significant tissue injury secondary to endotoxin in this experimental model. In addition, the data provide direct evidence that an intact reactive sympathetic nervous system is essential for development of lethal toxicity and generalized Shwartzman reaction due to endotoxin.

Long-term epidemiological and laboratory studies were carried out in a kindred with familial pheochromocytoma associated with von Hippel-Lindau disease. Thirteen members were affected by the syndrome and the trait appears to be transmitted in an autosomal dominant fashion. Of 13 patients, 7 had pheochromocytoma alone. Of the remaining six patients, one had pheochromocytoma combined with von Hippel-Lindau disease, four had pheochromocytoma with retinal disease only, and a single patient had a retinal lesion without pheochromocytoma. In four patients, pheochromocytoma antedated the development of retinal lesions. Ten members also had mild hypercalcemia without accompanying elevations of PTH in the 4 patients in whom this was determined. In all, hypercalcemia was corrected with removal of tumors, and no patient had a return of hypercalcemia in the absence of recurrent increases in urinary catecholamines. The clinical presentations in 12 patients varied markedly, as did their urinary excretion rates of norepinephrine, epinephrine and their metabolites. However, an analysis of the data revealed significant correlations not previously described between the urinary excretion of free catecholamines (norepinephrine plus epinephrine), blood pressure, the free catecholamine content of the tumor and the age of the patient. Urinary excretion of free norepinephrine plus epinephrine appear to be decreased with advancing age (p less than 0.001). Both systolic and diastolic blood pressures and the age of the patient were inversely correlated (p less than 0.01). A significant inverse relationship between the tumor content of free catecholamines and the age of the patients was, although to a lesser degree, also present (p less than 0.05). As a whole, the size of the tumors and their norepinephrine content were not correlated. We present a concept that, in familial pheochromocytoma, the metabolism of catecholamines is altered by the process of aging, and that this change modifies the clinical presentations of the disease.