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Spotted wing drosophila (SWD, Drosophila suzukii) has become a serious pest in Europe attacking many soft-skinned crops such as several berry species and grapevine since its spread in 2008 to Spain and Italy. An efficient and accurate monitoring system to identify the presence of SWD in crops and their surroundings is essential for the prevention of damage to economically valuable fruit crops. Existing methods for monitoring SWD are costly, time and labour-intensive, prone to errors, and typically conducted at a low spatial resolution. To overcome current monitoring limitations, we are developing a novel system consisting of photographable traps, which are monitored by means of unmanned aerial vehicles (UAVs) and an image processing pipeline that automatically identifies and counts the number of SWD per trap location. To this end, we are currently testing the approach using high-resolution RGB imagery of SWD traps taken from both a static position (tripod) and from a UAV. These are then used as input to train deep learning models. Preliminary results show that a large part of the SWD can be correctly identified using a ResNet-18-based model. An autonomous UAV platform will be programmed to capture imagery of the traps under field conditions. The collected imagery will be transferred directly to cloud-based storage for subsequent processing and analysis to identify the presence and count of SWD in near real time. This data will be used as input to a decision support system (DSS) to provide valuable information for farmers.

BACKGROUND The fruit fly Drosophila suzukii, or spotted wing drosophila (SWD), is a serious pest worldwide, attacking many soft‐skinned fruits. An efficient monitoring system that identifies and counts SWD in crops and their surroundings is therefore essential for integrated pest management (IPM) strategies. Existing methods, such as catching flies in liquid bait traps and counting them manually, are costly, time‐consuming and labour‐intensive. To overcome these limitations, we studied insect trap monitoring using image‐based object detection with deep learning. RESULTS Based on an image database with 4753 annotated SWD flies, we trained a ResNet‐18‐based deep convolutional neural network to detect and count SWD, including sex prediction and discrimination. The results show that SWD can be detected with an area under the precision recall curve (AUC) of 0.506 (female) and 0.603 (male) in digital images taken from a static position. For images collected using an unmanned aerial vehicle (UAV), the algorithm detected SWD individuals with an AUC of 0.086 (female) and 0.284 (male). The lower AUC for the aerial imagery was due to lower image quality caused by stabilisation manoeuvres of the UAV during image collection. CONCLUSION Our results indicate that it is possible to monitor SWD using deep learning and object detection. Moreover, the results demonstrate the potential of UAVs to monitor insect traps, which could be valuable in the development of autonomous insect monitoring systems and IPM. © 2020 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry., We studied the use of deep learning for unmanned aerial vehicle (UAV)‐based detection of Drosophila suzukii in sticky traps. Our results show that there is potential for UAVs to perform this task.

This qualitative and quantitative study describes the evolution of water–rock interaction processes in the groundwater–seawater mixing zone diagenetic environment associated with the development of sand injectite outcrops of the Bahrah coastal plain, northern Kuwait Bay. Fourteen rock samples were collected from the field area for petrographic analyses, X-ray diffractometry (XRD), transmitted-light microscopy (TLM), tungsten scanning electron microscopy (SEM), and cold cathodoluminescence (CL). Two groundwater samples were used for geochemical studies of bulk water chemistry properties (12 ions and salinities) and water isotope data (δ34S, δ37Cl, δ81Br, and δ13C of dissolved inorganic carbon, DIC). We found that in the mixing zone, 70% groundwater mixes with 30% seawater at shallow depths, which controls the diagenetic processes highlighted by the variability of petrographic characteristics of sand injectites in the study area.

The Disasters program uses Earth-observing data and applied research to improve the prediction of, preparation for, response to and recovery from hazards and disasters around the world. Before, during and after disasters strike, our team coordinates with decision-makers and local governments, providing actionable data to recover from disaster impacts and build resilient communities. This paper will highlight recent progress and tools.

Aberdeen University has a long history of using aerial photography, photogrammetry, cartography, remote sensing and surveying in Geography teaching and research. The development of an MSc in Enviro...

The Department of Geography and Environment at the University of Aberdeen has a long history of coastal and marine teaching and research from the 1960s to the present day. Beginning with the work o...

The Post Office was an extremely important institution and London was the focal point of its operations. Throughout the nineteenth century London was the main sorting centre and accounted for a third of the mail delivered in Britain. However, London postal workers were relatively unhealthy and the majority retired before they reached sixty, mainly because of ill health. Using new evidence drawn from pension records, this article explores the extent of ill health in the London workforce, comparing it to that in the Metropolitan Police. For postmen, orthopaedic conditions were the main problem, relating to the ability to walk long distances. This was similar to the problems encountered in the police. For other postal workers, notably letter sorters, mental illness and poor vision were the main problems, relating to the pressure of having to work irregular hours, often at night-time and in poorly designed and overcrowded workspaces. These problems were exacerbated by the increasing frequency of mail deliveries and the constant shortage of space in the main headquarters building. In response to these issues and workers’ concerns, the Post Office introduced a range of measures including a medical service and generous sickness pay, more offices, new technologies to speed the flow of mail, better lighting, and changed working practices to ease pressures on the workforce.

Civic improvement in Georgian Britain required significant amounts of capital. Tontines were an important means of financing projects. This article provides new evidence based largely on local newspapers that demonstrates their local and national importance for mutual assurance and building. Shifts in profitability depended on the price of Consols and this explains why building tontines increased in importance. Tontines were used to fund new leisure spaces, workhouses, prisons, bridges, streets and other improvements. Their popularity waned in the later nineteenth century but until then they were an important means of funding civic improvements.

Summary This article explores the creation of the Post Office medical service. Working for the Post Office was relatively well-paid and an increasing number of doctors were employed. Medical provision expanded with the introduction of non-contributory pensions from mid-century and developed into a comprehensive and nationwide service that was involved at all stages of employment, from initial recruitment through to receiving a pension. Post Office doctors assessed candidates’ fitness for work, checked on sick absences, provided free medicine and advice and visited workers’ homes. Doctors were responsible for determining whether or not a worker should be pensioned off on grounds of ill health. The career of the first Chief Medical Officer, Dr Waller Lewis, also illustrates the range of other areas in which the Post Office medical service became involved, including the clinical assessment and relief of sickness as well as identifying preventative measures to improve health outcomes.

This chapter presents an overview of the potential role of UAVs for monitoring, mapping, surveying, modelling, and visualising the ‘built environment' and their role in sustainable urbanisation. The ‘built environment' includes rural, urban, and underwater environments. Together with low-cost image processing and softcopy photogrammetry, fixed-wing and multi-rotor UAVs can collect a wide range of imagery for generating 3D models of individual buildings, and record and analyse architecture and infrastructure and terrain models. Consideration is given to non-imaging sensors carried on UAVs. Input to GIS provides a basis to create visually realistic models of the ‘built-environment' for urban and rural planning and decision-making for sustainable urbanisation. 3D visualisation software, virtual, and augmented reality will allow public engagement with the spatial planning process. Safety and operational considerations are needed for UAV flights. The chapter concludes by examining how this technology will develop in the future to play a role in sustainable urbanisation.

Drosophila suzukii Matsumura, the spotted wing drosophila (SWD), has become a serious pest in Europe attacking many soft-skinned crops such as several berry species and grapevines since its spread in 2008 to Spain and Italy. An efficient and accurate monitoring system to identify the presence of D. suzukii in crops and their surroundings is essential for the prevention of damage to economically valuable fruit crops. Existing methods for monitoring D. suzukii are costly, time and labour intensive, prone to errors, and typically conducted at a low spatial resolution. To overcome current monitoring limitations, we are investigating and developing a novel system consisting of traps that are monitored by means of cameras from Unmanned Aerial Vehicles (UAVs) and an image processing pipeline that automatically identifies and counts the number of D. suzukii per trap location. To this end, we are currently collecting high-resolution RGB imagery of D. suzukii flies in sticky traps taken from both a static position (tripod) and a UAV, which are then used as input to train deep learning object detection models. Preliminary results show that a large part of the D. suzukii flies that are caught in the sticky traps can be correctly identified by the trained deep learning models. In the future, an autonomously flying UAV platform will be programmed to capture imagery of the traps under field conditions. The collected imagery will be transferred directly to cloud-based storage for subsequent processing and analysis to identify the presence and count of D. suzukii in near real time. This data will subsequently be used as input to a decision support system (DSS) to provide valuable information for farmers.

Unmanned aerial vehicles (UAVs) are now evolving as highly effective tools for tackling the requirements of oil and gas pipeline monitoring, a specific environmental application of the UAV technology. This chapter describes the current use of UAV platforms and sensors, as well as the foreseen potential of small UAV systems for monitoring oil and gas pipelines. This chapter will include sections covering the following: (i) an overview of the characteristics of UAVs; (ii) the use of UAVs for oil and gas pipeline monitoring to date with particular attention paid to the strengths and successes, as well as the weaknesses; (iii) considerations and developments in the technology of small-scale aerial platforms and sensors specifically tailored to oil and gas pipeline monitoring applications, including battery, sensor, navigation, software, and platform; and (iv) future prospects for UAV development and application.

Both fixed-wing and multi-rotor platforms are increasingly being identified as potentially useful airborne platforms for a range of professional environmental remote sensing applications, including both expensive high-end specialist solutions and lower-cost, off-the-shelf commercial options. Small unmanned aerial vehicles (UAVs) are ideal for applications where aerial coverage requirements are small, flying experience and expertise is limited, and the operating budget is usually relatively small. With advances in battery technology, navigational controls, and payload capacities, many of the smaller UAVs are now capable of utilising several different sensors to collect photographic data; video footage; multispectral, thermal, and hyperspectral imagery; as well as light detection and ranging (LiDAR). With the aid of specialist digital image processing and soft-copy photogrammetry software, aerial data and imagery can be processed into a number of different products including ortho-photos, mosaics, and Digital Elevation Models (DEMs) and analysed to generate useful information for input to a Geographic Information System (GIS). Aerial photography and video imagery have been acquired using small aerial platforms for over 30 years. Small-scale radio-controlled (RC) model aircraft and helicopters, using small 35 mm single-lens reflex (SLR) and video cameras, have all been used to acquire panchromatic, colour, colour infrared (CIR), and multispectral aerial photography for a wide range of environmental applications. This chapter begins by examining the history of small-scale aerial (SSA) platforms for aerial image acquisition as the context for the current growth in popularity of UAVs, the associated technologies, and the range of small-scale sensors (e.g. GoPro Hero cameras) currently available for environmental monitoring, mapping, and modelling applications, together with image processing, analysis, and information extraction and soft-copy photogrammetry software such as Pix4D, Agisoft, and AirPhotoSE. The past and present advantages and disadvantages of small aerial platforms are also considered, together with some of the emerging technologies and recent developments.

In the later decades of the nineteenth century, the United Kingdom experienced a shift in the causes of mortality, from infectious diseases to those more associated with ageing. This epidemiological transition from acute to chronic conditions was accompanied by an increase in longevity and a corresponding increase in morbidity, measured by rising rates of sickness absence. As longevity improved, the period between the onset of ill health and death lengthened. If we are to understand the daily lived experiences of health in different places during the epidemiological transition, it is necessary to explore the complex causes of morbidity rather than just focus on mortality. We argue that other reasons need to be considered alongside age as important influences on the incidence and duration of ill health, including urbanisation, occupational risks and cultural and institutional factors. Using evidence drawn from a sample of pension records of postal workers, we examine a variety of different factors that could have accounted for the changing pattern of morbidity observed in other studies. We conclude that age alone cannot account for the greater incidence of sickness absence and ill health and that other factors relating to the residential and working environment, as well as institutional arrangements for sick pay, need to be taken into account.

Background There is increasing evidence that access to critical care services is not equitable. We aimed to investigate whether location of residence in Scotland impacts on the risk of admission to an Intensive Care Unit and on outcomes. Methods This was a population-based Bayesian spatial analysis of adult patients admitted to Intensive Care Units in Scotland between January 2011 and December 2015. We used a Besag–York–Mollié model that allows us to make direct probabilistic comparisons between areas regarding risk of admission to Intensive Care Units and on outcomes. Results A total of 17,596 patients were included. The five-year age- and sex-standardised admission rate was 352 per 100,000 residents. There was a cluster of Council Areas in the North-East of the country which had lower adjusted admission rates than the Scottish average. Midlothian, in South East Scotland had higher spatially adjusted admission rates than the Scottish average. There was no evidence of geographical variation in mortality. Conclusion Access to critical care services in Scotland varies with location of residence. Possible reasons include differential co-morbidity burden, service provision and access to critical care services. In contrast, the probability of surviving an Intensive Care Unit admission, if admitted, does not show geographical variation.

Ecuador, as a signatory to the United Nations Framework Convention on Climate Change, in its Nationally Determined Contribution, has expressed its intention to reduce greenhouse gas emissions (GHG), with a focus on the energy and forest sectors. Despite the socio-economic importance and the growing pressure of agricultural and livestock activities on land use change, this sector is not explicitly considered in the national mitigation goals. Currently, grasslands occupy 57% of agricultural land in Ecuador and cattle, being the main livestock activity, is responsible for at least 46% of agricultural emissions, the third largest source of GHG emissions, after land use change and energy. The foot and mouth disease national eradication campaign carried out in 2016, shows that the cattle population is distributed over approximately 275000 farms, where 80% of these farms can be considered as subsistence systems (2, with two plots per farm. A UAV survey was performed using a DJI Mavic Pro quadcopter, equipped with an RGB camera, over plots off 125m2, and at a flying altitude of 70m. For this work, 37 farms were selected (13 in the Amazon region and 24 in the Coastal region) and GHG emissions calculated from cattle livestock activities using IPCC Tier 1 equations. The aboveground biomass for pasture areas was estimated using the Jucker et al., 2017 equation, with tree characteristics derived from the UAV survey. Average results were extrapolated to the total pasture area reported by farmers in the survey. Primary and secondary forest areas were identified from satellite images. Forest state (degradation level) was estimated using NIR data from SENTINEL-2/LANDSAT 8/PlanetScope. Aboveground biomass estimates for forests were obtained from published data using similar site conditions. Emissions from cattle activities are expressed as carbon equivalent. Biomass carbon was estimated as 0.47 of total biomass.

Aquatic macrophytes are a key component of river systems around the world. Surveys of macrophyte surface cover, cross-sectional blockage and plant/patch sizes provide data for river manager...

The aim of this study was to improve our understanding of what controls the isotope composition of Cu, Zn and Pb in particulate matter (PM) in the urban environment and to develop these isotope systems as possible source tracers. To this end, isotope ratios (Cu, Zn and Pb) and trace element concentrations (Fe, Al, Cu, Zn, Sb, Ba, Pb, Cr, Ni and V) were determined in PM 10 collected at two road sites with contrasting traffic densities in central London, UK, during two weeks in summer 2010, and in potential sources, including non-combustion traffic emissions (tires and brakes), road furniture (road paint, manhole cover and road tarmac surface) and road dust. Iron, Ba and Sb were used as proxies for emissions derived from brake pads, and Ni, and V for emissions derived from fossil fuel oil. The isotopic composition of Pb (expressed using 206 Pb/ 207 Pb) ranged between 1.1137 and 1.1364. The isotope ratios of Cu and Zn expressed as δ 65 Cu NIST976 and δ 66 Zn Lyon ranged between −0.01‰ and +0.51‰ and between −0.21‰ and +0.33‰, respectively. We did not find significant differences in the isotope signatures in PM 10 over the two weeks sampling period and between the two sites, suggesting similar sources for each metal at both sites despite their different traffic densities. The stable isotope composition of Pb suggests significant contribution from road dust resuspension and from recycled leaded gasoline. The Cu and Zn isotope signatures of tires, brakes and road dust overlap with those of PM 10 . The correlation between the enrichments of Sb, Cu, Ba and Fe in PM 10 support the previously established hypothesis that Cu isotope ratios are controlled by non-exhaust traffic emission sources in urban environments (Ochoa Gonzalez et al., 2016). Analysis of the Zn isotope signatures in PM 10 and possible sources at the two sites suggests significant contribution from tire wear. However, temporary additional sources, likely high temperature industrial emissions, need to be invoked to explain the isotopically light Zn found in 3 out of 18 samples of PM 10 .

This research is funded by the Environment Agency and United Utilities whose support is gratefully acknowledged. Some of the methods employed in this work have been tested on the background of the results obtained in MorphSed (www.morphsed.es), a research project funded by the Spanish Ministry of Economy and Competiveness and the European Regional Development Fund Scheme (FEDER; CGL2012-36394). The second author is funded by a Ramon y Cajal Fellowship (RYC-2010-06264). Authors acknowledge the support from the Economy and Knowledge Department of the Catalan Government through the Consolidated Research Group ‘Fluvial Dynamics Research Group’ (2014 SGR 645). The authors thank Manel Llena from the University of Lleida for his help and contribution to the camera calibration experiments. We are also grateful to the three anonymous reviewers and the editors for their comments that greatly improved the manuscript.

Drosophila suzukii has become a major threat for soft fruit production of berries, plums, peach, and grapevine in Europe and other regions worldwide. D. suzukii uses a wide range of different coloured fruits for reproduction. Currently, monitoring is conducted with baited cup-style traps. This is a laborious task and consequently is not widely deployed. Therefore, photographable and toxin baited sticky traps were suggested as an alternative trapping system. The color preferences were evaluated across nine sites on eight crop varieties before, during and after harvest time. This study identifies red as a significantly more attractive colour for sticky card traps under natural field conditions in various fruit crops during harvest time. The results demonstrate that crop and the harvest-state are factors influencing the color choice of the insect. Before and after harvest no color preference could be identified. The field-derived data suggest various reasons for colour preferences such as trap colour (1) contrast with the environment, (2) association with fruit colour and (3) ripening state. The multitude of influencing aspects shaping the interpretations are discussed. Author Approvals All authors approved the manuscript. The manuscript is not accepted or published elsewhere

Objective To examine trends of spontaneous very preterm birth (vPTB) and its relationship with maternal socioeconomic status and smoking. Methods This was a population-based cohort study in Aberdeen Maternity Hospital, UK. The cohort was restricted to spontaneous singleton deliveries occurring in Aberdeen from 1985 to 2010. The primary outcome was very preterm birth which was defined as Results There was an increased likelihood of vPTB in those with unskilled-occupations compared to professional-occupations [aOR:2.77 (95%CI:1.54–4.99)], in those who lived in the most deprived areas compared to those in the most affluent [aOR: 2.16 (95% CI: 1.27–3.67)] and in women who smoked compared to those who did not [aOR: 1.74 (95% CI: 1.36-2.21)]. The association with Carstairs index was no longer statistically significant when restricted to smokers but remained significant when restricted to non-smokers. Conclusion The strongest risk factor for vPTB was maternal smoking while socioeconomic deprivation showed a strong association in non-smokers. Smoking cessation interventions may reduce vPTB. Modifiable risk factors should be explored in deprived areas.

Both fixed-wing and multirotor platforms are increasingly being identified as potentially useful airborne platforms for a range of professional environmental remote-sensing applications, including both expensive high-end specialist solutions and lower-cost, off-the-shelf commercial options. Small UAVs are ideal for applications where aerial coverage requirements are small, flying experience and expertise are limited, and the operating budget is usually relatively small. With advances in battery technology, navigational controls, and payload capacities, many of the smaller UAVs are now capable of utilizing a number of different sensors to collect photographic data, video footage, and multispectral, thermal, and hyperspectral imagery as well as LiDAR. With the aid of specialist digital image processing and soft-copy photogrammetry software, aerial data and imagery can be processed into a number of different products including ortho-photos, mosaics, and digital elevation models (DEM), then analyzed to generate useful information for input to a GIS. This chapter begins by examining the history of small-scale aerial (SSA) platforms for aerial image acquisition as the context for the current growth in the popularity of UAVs, the associated technologies, and the range of small-scale sensors (e.g., GoPro Hero cameras) currently available for environmental monitoring, mapping, and modeling applications. This is taken together with image processing, analysis, and information extraction as well as soft-copy photogrammetry software such as Pix4D, AgiSoft, and AirPhotoSE. The past and present advantages and disadvantages of small aerial platforms are also considered, together with some of the emerging technologies and recent developments. Examples of monitoring and mapping macro-algal weedmats and coastal shorelines are used to illustrate the potential of today's small UAV platforms and the accompanying sensors to acquire low-cost airborne data and imagery.

Environmental land degradation is a major impediment to the utilization of land in many arid and semi-arid regions of the World and is a major issue in the East Nile Delta (END), Egypt. Waterlogging and salt-affected soil problems have serious implications for irrigated areas leading to socio-economic and agricultural development problems. In the present study, timely and accurate detection of land degradation through remote sensing and hydrosalinity indicators, along with their characteristics and severity classification in a GIS environment, has been undertaken to provide, determine, assess and map reliable geo-information of environmental land degradation. This research deals with an assessment of hydrosalinity and environmental land degradation based on some new, but simple and practical, approaches for assessing salinity and spread of land degradation through digital image processing, geo-statistics and geochemistry. This analysis utilises Landsat 8, ASTER GDEM data, hydrochemical and statistical analyses using a GIS, together with other field collected data sets for the same date of May 2014. The hydrosalinity mapping and the statistical data analysis of TDS, major ions, groundwater grouping and hydrochemical facies and also water table maps between 1994 and 2014 reveals that the main sources of groundwater recharge and water bodies are mostly attributed to the continuous seepage from newly cultivated lands. The new flow regime is the main contributing factor to the rising water level, water salinity and waterlogging problems. Moreover, the spatial distribution of major ion content could be attributed to the leaching of aquifer materials along the flow path (Na, Ca, and Cl), the study area affected by agricultural pollution (Mg and SO4) and the leaching process which acts on the easily soluble evaporate-rich fluvio-marine sediments of a shallow aquifer (NO3 and PO4). The spatial distribution maps of the physico-chemical properties of soil such as EC, pH, SAR, Na, Cl, SO4 and Ca are compared with remote sensing salinity indices and then integrated to classify and map the salinity and salt-affected soil by using GIS tools. These indicate that increases in soil salinity levels pose a serious threat to sustainable agricultural developments that requires special attention to maintain an appropriate soil–water plant relationship by providing an adequate drainage system. The identification of land degradation mitigation measures requires thorough knowledge of the ground and surface water, human activities, and the salinity dynamics of the study area.

Waterlogged and salt-affected soils are serious environmental hazard indicators for wasteland problems in arid and semi-arid regions of the World. Similarly human activities in agricultural and urban sustainable developments have also led to the development of waterlogging and subsequent salinization of soils leading to many geo-environmental problems. Thus, it is important to be able to monitor, assess and map waterlogged and salt-affected areas at an early stage to develop an effective soil reclamation programme that helps to reduce and prevent a future increase in areas of wasteland. Remote sensing and GIS tools and techniques have been found to outperform more traditional methods for assessing the impact of soil salinity and waterlogging, thereby providing extremely useful, informative, and professional rapid assessment techniques for monitoring and accurate mapping and the quantification of waterlogged areas and salt-affected soils. This study applies digital image processing and GIS tools to monitor, assess, and map the waterlogged and salt-affected areas, to establish the main causes that lead to widespread wastelands, and to suggest approaches to mitigation in the eastern Nile Delta region in Egypt. Multi-temporal Landsat 5, 7 and 8 data for 1984, 2000, 2006 and 2013 and ASTER GDEM were selected to monitor, assess and map the waterlogged and salt-affected areas, and to determine and map the rate of change of land-use/land-cover, the status of wasteland, and the use of geomorphological terrain analyses based on enhanced digital images processing and field verification. Image band combinations, PCA, change detection, and image classification techniques, together with many indices such as NDVI, NDSI, NDWI and NDBI were applied, together with statistical analysis, to construct various thematic and spatial distribution change maps of the wasteland hazard indicators. Spatial distribution maps of waterlogging, salt-affected areas, permanent and temporarily waterlogged areas, surface changes, and their rate of change in addition to integrated relationships between terrain analyses, water table, depth to water and landform maps over a timespan of 29 years based on the analysis and interpretation results of image processing, field investigation and ancillary geological and hydrogeological data. The results reveal that changes to land-cover caused by human activities - particularly irrigated agriculture and land reclamation as well as urban expansion - will lead to a serious deterioration in the environment through waterlogging and salinization presenting future difficulties for any sustainable development of the study area. In addition; the existence of natural factors such as areas of low-lying land, topographic depressions, and rising water tables will increase the threat of waterlogging and salinization. It is concluded that it is essential for planners and decision makers to seriously consider taking appropriate action now concerning the recommended mitigation measurements from this study to avoid serious future problems in these areas.

Background Critical illness requires specialist and timely management. The aim of this study was to create a geographic accessibility profile of the Scottish population to emergency departments and intensive care units. Methods This was a descriptive, geographical analysis of population access to ‘intermediate’ and ‘definitive’ critical care services in Scotland. Access was defined by the number of people able to reach services within 45 to 60 min, by road and by helicopter. Access was analysed by health board, rurality and as a country using freely available geographically referenced population data. Results Ninety-six percent of the population reside within a 45-min drive of the nearest intermediate critical care facility, and 94% of the population live within a 45-min ambulance drive time to the nearest intensive care unit. By helicopter, these figures were 95% and 91%, respectively. Some health boards had no access to definitive critical care services within 45 min via helicopter or road. Very remote small towns and very remote rural areas had poorer access than less remote and rural regions.

The New Poor Law established a central poor law authority, at first known as the Poor Law Commission, later the Poor Law Board and finally the Local Government Board, whose task it was to outline relief policy and monitor implementation. Commending the principle of deterrence enshrined in the New Poor Law of 1834, Charles Mott, Assistant Commissioner for London, remarked that 'The Poor Law Amendment Act may indeed be called an Act of renovation for it causes lame to walk, the blind to see, and dumb to speak'. In relation to that group of paupers, poor law authorities faced a dilemma: by associating medical relief with pauperism, the Poor Law positively discouraged those in genuine need of treatment and, in so doing, may have added to their misery and indirectly encouraged spread of disease. The issues surrounding medical treatment and poor relief were especially problematic in London. The capital provided unique challenge to centralising efforts of the 19th-century Poor Law.