sharp stack of razor shells. Photograph: Alamy

He blames the way the competition was organised, both as an open call – with the five-strong shortlist subject to public vote, taken account of in the judging – and the limited scope of the brief. Rather than considering the entire structure, and addressing the wider problems the building has with its context, the RIBA-led competition focused only on strapping a new youth zone to the side and allowing minor interventions to the ground floor of the building – which will continue to serve as a bus station.

The five floors of car-parking, each the size of two football pitches, as well as the expansive (and unused) rooftop, and the central retail spine of the building were all off limits, as was theEnvironmental management of asthma at Massachusetts managed care organizations.
Asthma management staff at eight Massachusetts managed care organizations (MCOs) were interviewed to learn the extent of inclusion of environmental prevention strategies in their asthma disease management policies. Six of the plans had formal asthma disease management programs, all reported to be based on the National Heart Lung and Blood Institute guidelines, but none followed these guidelines in their entirety. Three MCOs provided for home visits that included addressing environmental factors for severe asthmatics. Despite the limited role that MCOs appear to play in environmental prevention of asthma, the authors identify opportunities and encourage efforts to expand these programs.