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Airport environments must be adaptable to change. Their ability to do so is dependent on embedding flexibility at four key stages of development or refurbishment: master planning, building design, space planning and components. This paper investigates and offers solutions for optimising airport design. Master planning is where it all begins, providing the first opportunity to build in flexibility. Critical to an airport's ability to sustain operational efficiency, withstand predictable changes and mitigate the effects of the unforeseen, it warrants careful consideration and investment. The paper highlights Dublin Airport as an example of how it is done. When addressing the building's form, functionality, efficiency, sustainability and adaptability are critical to the design. The airport must meet the operator's objectives, and only by taking a holistic view can space be optimised and barriers to growth avoided. Process and space must come together seamlessly. The selection of components must give due consideration to standardisation, delivery, installation and cost. It must also explore, based on construction sequence and maintenance, their interdependence or independence, allowing for demounting and repair. In the design process itself, there is room for flexibility. This paper outlines those cases where detailed upfront design can make way for a more flexible, beneficial approach, which ultimately ensures the building is fit for purpose on the day it opens.

BACKGROUND: Despite the significant public health burden of lower-extremity amputations in diabetes mellitus, few data are available on the epidemiology of lower-extremity amputations in diabetes mellitus in the community setting. METHODS: A retrospective incidence cohort study based in Rochester, Minn, was conducted. RESULTS: Among the 2015 diabetic individuals free of lower-extremity amputation at the diagnosis of diabetes mellitus, 57 individuals underwent 79 lower-extremity amputations (incidence, 375 per 100 000 person-years; 95% confidence interval, 297 to 467). Among the 1826 patients with non—insulin-dependent diabetes mellitus, 52 underwent 73 lower-extremity amputations, and the subsequent incidence of lower-extremity amputation among these residents was 388 per 100 000 person-years (95% confidence interval, 304 to 487). Of the 137 insulin-dependent diabetic patients, four subsequently underwent five lower-extremity amputations (incidence, 283 per 100 000 person-years; 95% confidence interval, 92 to 659). Twenty-five years after the diagnosis of diabetes mellitus, the cumulative risk of one lower-extremity amputation was 11.2% in insulin-dependent diabetes mellitus and 11.0% in non— insulin-dependent diabetes mellitus. When compared with lower-extremity amputation rates for Rochester residents without diabetes, patients with non—insulin-dependent diabetes mellitus were nearly 400 times more likely to undergo an initial transphalangeal amputation (rate ratio, 378.8) and had almost a 12-fold increased risk of a below-knee amputation (rate ratio, 11.8). In this community, more than 60% of lower-extremity amputations were attributable to non—insulin-dependent diabetes mellitus. CONCLUSIONS: These population-based data document the magnitude of the elevated risk of lower-extremity amputation among diabetic individuals. Efforts should be made to identify more precisely risk factors for amputation in diabetes and to intervene in the processes leading to amputation.(Arch Intern Med. 1994;154:885-892)