La combinación de fármacos en la artrosis: una realidad terapéutica. EDITORIAL LITERATURA INTERNACIONAL Ctra. Nacional II. km 680,608389 Palafolls (Barcelona) – EspañaTel. 93 490 49 08 Fax 93 490 97 11 • Eficacia de la combinación de hidrocloruro de glucosamina, condroitín sulfato sódico de bajo peso molecular y ascorbato de manganeso en el tratamiento de la artrosis de rodilla
The Royal Parks
Design guide, technical speciﬁ cations D e s i g n g u i D e
Maintaining the historic landscape
the royal parks Context the eight royal parks comprise Bushy nash and Charles Bridgeman. park, the green park, greenwich the quality of the landscape design is park, hyde park, kensington gardens, not only reflected in the overall layout the regent's park with primrose and topography but also in the detail hill, richmond park and st James's and craftmanship employed. this guide park. the royal parks is responsible aims to ensure these quality standards for managing all these spaces and are secured for future generations.
conserving them for the future generations to enjoy. Brompton Cemetery, the gardens of 10, 11 and this summary document has been 12 Downing street, Victoria tower prepared by ruth holmes (landscape gardens and grosvenor square gardens Development and Design Manager) are also cared for by the royal parks. and emily alleway (landscape Development assistant) with the help the royal parks are important urban of the park Management teams greenspaces in london for their history, and park services team. facilities and access to high quality recreational open space. the parks have the authors would also like to thank characters that have developed over the stakeholders – the neighbours and many years, often with origins as royal interest groups – who have informed hunting grounds. all are listed and contributed to the development of landscapes on the english heritage register of parks and gardens (grade i with the exception of the green park O'Brien Thomas replica bench, which is grade ii). Many great Greenwich Park designers have had a part moulding the parks, including andré le nôtre, John ThE RoyAL PARkS DESIGn GuIDE 2009 Chestnut Sunday, Bushy Park the royal parks Context the eight royal parks comprise Bushy nash and Charles Bridgeman. park, the green park, greenwich the quality of the landscape design is park, hyde park, kensington gar not only reflected in the overall layout Isabella bench, Richmond Park Solid backless bench, Pembrooke Lodge, this section sets out principles of design the regent's park with primrose and topography but also in the detail Richmond Park Contents The Royal Parks Landscape Design Guide 2009-2010for gr hill, richmond park and st James's and craftmanship employed. this guide park. the royal parks is responsible eleMents oF Design oups of design elements. aims to ensure these quality standards Policies Tulip bin, Hyde Park
TRAFFIC SIGnS AnD RoAD MARkInGS Timber bin, for managing all these spaces and ar Design elements have been categorised e secured for future generations.
appreciate views or to allow visitors to Primrose Hill settings will be upgraded to impr raffic signs and eliminate visual clutter and minimise conserving them for the future use appropriate materials for their use only items that make a positive generations to enjoy impact on landscape character and park ACknoWLEDGEMEnTS Visual to make it easy to find the relevant this summary document has been rest. For this reason, benches are an surface quality and drainage and to setting and intensity of use.
contribution to the park.
specification in the data sheet section. important feature for making parks reduce areas of conflict. Where painted Cemetery, the gar dens of 10, 11 and • invest in quality, both in materials and • Choose park furniture that is well designed and Acknowledgements 3 P eet, V • keep signs and r ictoria tower oad markings to a minimum olicies and Principles ed by ruth holmes (landscape appropriate for the locality Development and Design Manager) and use only when they convey essential examples of elements have been park activities include: welcoming and accessible.
benches are being r eplaced, exposed collected from research undertaken by timber benches should be selected raffic signs and road markings • align and join materials in a harmonious way • Coordinate design and colours and position gardens and grosvenor square gardens land use Consultants for the parks and are also cared for by the royal parks. • Minimize the number of dif alleway (landscape each of the eight royal parks has its • necessary activities (rather than leisure all the elements of design covered in own character and sense of place. each ferent materials used activities e.g. travelling fr Bench styles fall into two main catego- them thoughtfully because they requir the landscape Design guide contribute e less maintenance.
Timber bin, • use the least numberr of signs/road markings park is also sub-divided into character artefact surveys in the early 1980s. assistant) with the help ries: timber or cast iron with timber.
• Maintain and restore historic paving • use historically accurate furniture and materials • passive recreation to the visual appearance of the parks Pembroke Lodge, PRojECTS AnD MAnAGEMEnT BEnCh PALETTE AnD there are very few benches that cannot Richmond Park of the park Management t eas, based on an assessment of the the elements have also been categorised the royal parks are important urban • specify materials that ar e robust and restored in preference to heritage style and the sense of quality. elements are Planting Schemes 8 based on materials and character be categorised in this way. Most of the the bench palette has been condensed • the smallest variant and simplest format of each and park services team. visual envir greenspaces in london for their history, onment. the opportunities the royal parks continues to make improvements to and replace elements • remove or relocate superfluous or redundant not considered in isolation but on how elate back to historical to the types below Stone paving at Pembr this design guide also catalogues , though in particular oke Lodge, Richmond Park pe Design oad marking used8 locations. ideally and problems related to each ar , each element existing facilities and access to high quality they work and complement one another. within the landscape. this design guide designs, such as the o'Brien thomas cirsome of the elements of historical planned activities (picnics, parties etc.) cumstances bespoke benches may be • locate signs on railings, walls, within the park should be mapped. recreational open space. the parks have the authors would also like to thank • the royal parks is keen to ensur e best practice within the physical activity eplicas. Many of the designs can be • keep park furnitur est to others, with r any collection of elements will Benches are an important element, eate a sense of place. existing posts and lamp columns, rather characters that have developed over the stakeholders – the neighbours and organisation, impr landscape Management plans and found in the artefact schedules pr ce materials, such as timber elements, from than additional posts particularly as many have been For general use in the parks the many years, often with origins as royal interest groups – who have informed duced by land use Consultants in the ces with the appr • that the quality of the materials and ove efficiency and back to the artefact schedules. contribute to the sense of place. the operations plans. ensure best value thr• park furnitur events ocur e is kept to the high ement. it also demonstrates the approach guide sets out the palette that carries dinate designs and colours ed. the royal parks Bench Quality Control 25 and contributed to the development of early 1980s. some of the styles have the royal parks quality brand with hunting grounds. all are listed Elements of Design standard expected by visitors and to features in the landscape as part activities may occupy the same space • ensure backs of signs ar audit (2006) contains detailed e painted black or been phased out and replaced to create elements that can be subtly selected to • the o'Brien thomas replica bench landscapes on the english heritage een so that they are less intr the range of park activities also have an stakeholders. this design guide aims but at different times of the year or day. • the hyde park bench Traditional timber signage, Hyde Park of the management and maintenance the royal parks works closely with a standardised approach. create a unique or particular setting register of parks and gar impact on the variety of materials or to ensure that ther • the Br ocess for of the parks. other or ovide excellent facilities location, dedications and style.
other organisations on projects and with the exception of the green park park furniture used. O'Brien Thomas replica bench, procurement and that design standar without creating clutter or spoiling the ds such as english heritage, Friends management of the parks and aim • the rustic slat bench (3, 4 or 5 slats) which is grade ii). Many great eenwich Park are met. an integral part of this is ovide a pallet of benches appearance of the parks. oups and natural england, can to share best practice where possible. Landscape Character designers have had a part moulding the the styles of benches vary fr a review of the guide and pr opriate for most park be advised in the restoration of this guide enables the royal parks • the solid backless bench parks, including andré le nôtre, John Road and Path Surfaces to park. generally styles ar settings. For specific pr key elements that need to be heritage or horticultural features to set out the standards and principles within distinct areas of each park om this palette using ed at each review are: based on the principles and policies which can be shared with others, and thus they contribute to the alternative benches would be contained in the guide.
including local authorities and ThE RoyAL PARkS DESIGn GuIDE 2009 landscape setting, as well as providing considered if a good reason can be • procurement guidelines Raised Planters and Containers organisations such as transport for Projects and Management important resting points to enjoy demonstrated. this could be, for • sustainability london, the gla and international the parks. Benches ar e often located in example, historical precedence or to Stakeholders and Interest Groups Tree Support, Guar 17 egational areas, to create a specific sense of place.
ThE RoyAL PARkS DESIGn GuIDE 2009 Interpretation panel on the Mall, Visual Environment park authorities.the guide sets out • Visual impact the approach and the robust processes Where possible, benches and their St James's Park Landscape Character Areas 21 that have been adopted for many years and helps ensur • usability ThE RoyAL PARkS DESIGn GuIDE 2009 Signage and Markings • Maintenance liability d is maintained for Projects and Management Socialising on a bench, • Disability discrimination Greenwich Park • other legislation ThE RoyAL PARkS DESIGn GuIDE 2009 21 Stakeholders and ThE RoyAL PARkS DESIGn GuIDE 2009 23 Carpenter-made planter, Holly Lodge, Richmond Park ThE RoyAL PARkS DESIGn GuIDE 2009 25 J2 Design 3 De Beauvoir Court, London SW18 3SL T 020 8 874 5790 M 07985 751 264 E firstname.lastname@example.org W jonmorgan.co.uk
WIG 25 Anniversary Report
Cover, layout, production 9 What are the challenges for communication going forward? 29
9 What are the challenges for
9.1 Better use of an evidence based approach
communication going forward?
"Government is big and complex, so there's Interviewees noted that much of business had become sharper in its use of evidence in discussions with government. Individual companies always a sense that some • Recommendation 5: Business needs to do more to improve use economic consultancies and public affairs consultants to help focus stakeholders will feel the the quality and clarity of its evidence to support its views, and their arguments. The more adept business organisations deliver up-to- to show the consequences of a particular policy option. left hand of government date information from their memberships and often decide that the best won't always know what • Recommendation 6: While dialogue has generally improved, approach is to share the raw data with government.
allowing more business input at a formative stage in the policy- the right hand is doing." making process, both sides still need to make a greater effort to However, some businesses and trade associations need to continue (public sector perspective) muster resources early. Better mutual understanding of policy to improve the quality and clarity of their evidence. They need to objectives at an early stage is seen as key. More businesses need appreciate that government does not always have the same level of to dedicate resources to position themselves as worth talking to.
technical expertise and understanding. Interviewees pointed out that business must understand that civil servants have to balance different Closing the Gap
• Recommendation 7: Both business and government need a policy positions in advising ministers; business needs to present greater appreciation of the different timescales under which the evidence expertly to show the consequence of a particular policy option. other operates. Business needs to understand the complexity It was pointed out that those who ‘just turn up to whinge' will generally of government and that it takes time to secure a policy change. find it hard to get a second meeting.
Government needs to appreciate that, on urgent issues, business 9.2 Greater appreciation of the timescales under
• Recommendation 8: Policy announcements should be backed which business and government operate
up by detailed plans of how they will be delivered. It was suggested that departments should conduct and publish robust three year Interviewees agreed on the importance of ‘getting in early' and reviews of policy to assess what has been implemented, what is acknowledged that, while dialogue had generally improved allowing pending and what has been superseded. more business input at a formative stage in the policy-making process, both sides still needed to make a greater effort to muster resources • There is still frustration from business that government is not early. Better mutual understanding of policy objectives at an early stage ‘joined-up' and that they have to deal with different government was seen as crucial.
departments on a single issue.
From within business, there was recognition that they needed to • Recommendation 9: Departments with regulatory responsibilities dedicate increasing resources to positioning themselves as worth Improving communication between
have a diffi cult task balancing the needs of multiple stakeholders, talking to, be it in areas of technical expertise or, more generally, including those of business. It is important that they understand on issues such as employment. It was acknowledged that there was the impact of their regulations and to achieve this they need to often an internal challenge in getting busy executives to commit time build stronger relationships with business. In areas of technical to policy issues which, at the time, appeared remote. The net result expertise and innovation in particular, civil servants should be was the disproportionate visibility of those that do commit the time – encouraged to ‘get out' and understand up to date developments. business and government
the ‘usual suspects'.
• Better communication is needed on regulation. It was suggested that departments should be encouraged to pick one of their A greater appreciation is needed by both government and business regulations and to ask business if there was some way they could of the different timescales under which each operates. Business needs achieve the same outcomes by more business friendly means.
to understand the complexity of government and that it takes time to secure a policy change. Ministers make decisions based on advice • Recommendation 10: Government should be more ‘joined-up' from civil servants – advice that can take a long time to prepare. in consulting with business on the development of tax policy to The Parliamentary process and other democratic constraints mean ensure there are no surprises. decisions can seldom be implemented as quickly as they are "We need more early in business.
discussions at industry Equally civil servants need to appreciate that business operates in level before policy is rolled In spite of the considerable improvements in communication
real time – "If there is an urgent problem, it can't wait for a few drafts out, rather than between business and government, there are still some
of a memo before being escalated to the Secretary of State". announcement after signifi cant challenges to making dialogue more effective. Those
announcement, most of raised in the interviews are outlined in this section.
which we'll ignore." connecting the sectors 4 Why do business and government talk to each other? 4 Why do business and government talk
to each other?
The research for this project took in a range of views on the
"You need to be very well government make the best merits of ‘big' government versus ‘small' government and
informed in government. decisions from the business intervention versus laissez faire, but interviewees were
You need to have very unanimous that government and business need to talk.
perspective, to be as There are four main imperatives:
bright people combing the helpful as possible to world for trends. You the economy. Sometimes 4.1 Reputation management
need to make sure UK you disagree about the companies understand the principle, but you enter Within government as much as in business, reputational risk trends and that you have is increasingly seen as a crucial part of risk management.
the debate to get a a dialogue about them. pragmatic outcome." In the last 10 to 15 years business has become more concerned with You don't seek to tell protecting its operating environment and reputation, committing more (private sector perspective) resource to communications in general, including with government.
companies what to do." 4.3 Commercial relationship
(public sector perspective) Companies want to ensure that those involved in policy-making and delivery are aware of the ethos and objectives of their business, of how 25 years ago most public services were provided directly by government these may be aligned with the objectives of government, and of how employees. Today business and the third sector employ 1.2m people they can help contribute to the success of the UK. in delivering £79bn of public sector business.3 Business needs to keep abreast of policy-making and thinking and work out how its know-how Whitehall has a similar need to promote and defend ‘corporate and capabilities can help support policy objectives. It also needs to reputation'. It needs to make sure that it gets its understanding right ensure that government is aware of what is technologically possible, be about the conditions for business success at home and abroad. it the use of IT in health services or defence procurement. The dialogue It also needs to take the best soundings about the economy, business within this relationship was summarised as being "not so much about and social trends to ensure the ‘corner flags' of policy are put in the lobbying as about positioning and demonstrating capability". right position.
In order to focus the scope of the research, this aspect of 4.2 Informing policy
communication was not explored in great depth. However, it is clearly a subject of enormous relevance to the future of efficient outsourcing This is where conversations go beyond ‘the general narrative' to specific and procurement, and well worth further investigation. proposals; alongside reputation management, this was the relationship that dominated most interviews. It is where government and business 4.4 Sharing best practice and ‘public good'
engage in a mix of informal dialogue and formal consultation to ensure that government policy touches on the right issues and that detailed A number of interviewees (from both the public and the private sectors) regulations are framed and implemented in the ‘right' way. It is where were vehement that business and government needed to talk for business feeds in, generally in a politically neutral way, to help set the ‘public good'. Part of the imperative is to share best practice and learn right policy framework. from each other so both sectors can improve, and part is the more immeasurable but indispensable building of longer term understanding and trust. Seen by some as ‘enlightened self-interest', it is a conversation where the value of the dialogue is not just seen in terms of immediate outcomes. As mentioned by one: "Having people who have spent some time talking and thinking together about issues doesn't half help, particularly when it comes to a crisis".
3. Dr. DeAnne Julius CBE. Understanding the Public Services Industry: How big, how good, where next? (BERR: 2008). J2 Design 3 De Beauvoir Court, London SW18 3SL T 020 8 874 5790 M 07985 751 264 E email@example.com W jonmorgan.co.uk
COPD The impact of early intervention Boehringer Ingelheim The impact of early intervention Francisco Gebauer Judith von Gordon Corporate Media Relations Corporate Division Communications Phone: +1/212 733 5191 Phone: +49/61 32 77 35 82 The need for contr
New findings for telmisartan 24 hour blood pressure control and renoprotection potential The need for control
New findings for telmisartan 24 hour blood pressure control and renoprotection potential ONTARGET / TRANSCEND® Study Design Model ONTARGET was a randomised,
double-blind clinical trial which
evaluated over 25,600 high CV risk
Randomisation (n=5,926) patients tolerant to ACEi,
Randomisation (n=25,620) with normal or controlled blood
What is cardiovascular disease? Cardiovascular disease (CVD) is the term given to a wide range of diseases that aﬀ ect the heart and blood vessels. TRANSCEND® was a randomised,
Follow up at six weeks, double-blind clinical trial which ere
Follow up at six weeks, six months and then every W ved 5,926 patients who w
hat are the diﬀ erent forms six months and then every intolerant to ACEi2
of cardiovascular disease? 1. Micardis
Press Pack, Invitation
coronary heart disease (chd) is a disease
rheumatic heart disease (rhd) is
of the blood vessels supplying the heart. damage to the heart valves and heart (shown), Banner, Lectern panel, The implications of CHD include: muscle from the infl ammation and scarring • myocardial infarction (MI, more commonly caused by rheumatic fever. Rheumatic fever Clinical endpoints1,2 Powerpoint, Press paper referred to as heart attack) is caused by streptococcal bacteria, which usually • angina (chest pain) begins as a sore throat or tonsillitis in children.
ythmias (abnormal heart rhythms).
PRIMARy ENDPOINTS • The impact of MICARDIS® peripheral v
ascular disease (pVd) is a
cerebrovascular disease (cVbd) is a disease
• Whether MICARDIS® 80mg daily was at 80mg on the incidenc disease of the blood vessels supplying the of the blood vessels supplying the brain. Press Pack, Invitation, CD
arms and legs that can result in intermittent The implications of cerebrovascular disease least as effective as ramipril 10mg daily newly diagnosed heart failure, aching or cramping pain, particularly in the leg in reducing the combined risk of revascularisation procedures, muscles during exercise.
• stroke (damage to brain cells caused by insuffi cient (shown), Banner, Lectern panel,
myocardial infarction (MI), stroke, newly diagnosed diabetes hospitalisation for congestive heart mellitus, cognitive decline and • transient ischaemic attacks caused by insuffi cient Powerpoint, Press paper failure and CV death compared with dementia, and new onset of blood supply due to a blood clot (temporary ramipril 10mg alone atrial fibrillation impairment to vision, speech, sensation or movement).
• Whether the combination of MICARDIS® Cardiovascular disease - death and disability 3. Medical Backgrounders
80mg and ramipril 10mg daily was more effective in reducing the same composite endpoint • CVD is responsible for nearly a third of • The impact of MICARDIS® all deaths worldwide and is the number Illustrations, diagrams, charts • The impact of MICARDIS® 80mg on the 80mg on the incidenc one cause of death. composite of CV mortality, acute MI, newly diagnosed heart failure, tion for congestive By 2015, global CVD stroke or hospitalisa revascularisation procedures, deaths are predicted heart failure compared with best newly diagnosed diabetes to reach 20 million1 standard care in ACEi intolerant patients mellitus, cognitive decline and • Over 80% of CVD dementia and new onset of deaths take place atrial fibrillation All for Ogilvy Health PR in low- and middle- income countries and occur almost equally in men and women2 Annual regional CVD mortality statistics2 J2 Design 3 De Beauvoir Court, London SW18 3SL T 020 8 874 5790 M 07985 751 264 E firstname.lastname@example.org W jonmorgan.co.uk
September 2005Volume 23 Sunday Eucharist8am & 10amSaturday Vigil 5pmMonday 7.15am Cluny ConventTuesday 7amWednesday 9amThursday 7amFriday 12.05pmSaturday 8am Adoration ofBlessed SacramentFriday 11amBenedictionFriday 12 noonReconciliationFriday 11.30amSaturday 9.30am